Beneficiaries are registered by an insurance provider for an insurance coverage policy for fertility diagnosis and treatable infertility conditions using either manual or online registration applications over a communications network. Using, knowledge base systems, prospective beneficiary personal descriptor information is matched with terms and conditions information preloaded into the insurance company computer system to generate a customized contract for delivery of infertility treatment services to different categories of beneficiaries. Beneficiaries may range in age from newborn infants up to adults. However, infertility treatment services are not provided either until the beneficiaries reach childbearing age or until the policies of adult beneficiaries vest over a designated time period. Adults can purchase infertility insurance naming their infant child as beneficiary and pay premiums over time until the child reaches childbearing age. Once the child reaches childbearing age, the insurance policy can be utilized by the beneficiary or can be transferred.

Infertility affects about 7.3 million people in the U.S. This amounts to between about 12% to 15% of persons in the reproductive age population. (Source: National Survey of Family Growth, CDC 2002). Requirements for the initiation of pregnancy include ovulation and the production of a competent oocyte (egg), production of competent sperm, proximity of the sperm and oocyte in the reproductive tract, fertilization, transport of the embryo into the uterine cavity and implantation of the embryo into the endometrium. Many disease processes contribute to infertility in humans. The World Health Organization task force on Diagnosis and Treatment of Infertility determined in developed countries, diseases that contributed to infertility were attributed to the female partner in 37% of couples, to the male partner in 8% of couples, and to both partners in 35% of couples. Five percent of the couples had no identifiable cause of infertility (i.e., unexplained infertility). Diseases in females most often identified included: ovulatory disorder (25%), pelvic adhesions (12%), tubal occlusion (11%) other tubal abnormalities (11%), hyperprolactinemia (7%), endometriosis (15%) and no identifiable diseases (20%). Decision by persons in the reproductive population to defer childbearing due to careers and other lifestyle factors are increasing the numbers of infertile couples. Over the past three decades, women have been choosing and will continue to choose to pursue higher education and careers and thus postpone marriage. Professional couples tend to get married at an older age and are continuing to delay having children, well into their late thirties up to their mid forties, because of changing life styles and career demands. These trends increase the need for fertility treatments. Also, alternative life styles, i.e., same sex couples, offer a major challenge to options in fertility treatments, which are not currently well recognized or addressed. Technology is continuing to advance in efforts to resolve infertility issues. Egg cryopreservation is becoming an option for women who may have medical conditions that will require treatments that may cause sterility. Also, egg cryopreservation may be beneficial to women who are delaying reproduction. Currently technology is being developed to give a female the opportunity to freeze oocytes (eggs) during the best time of her reproductive years; thus, providing the ability for these women to have children at a later time in life. Freezing of oocytes provides an opportunity not just for women who choose to delay having children but also for women who are diagnosed with cancer or other illness and who may require the use of radiation and/or chemotherapy which may leave the these women sterile. Currently there are gaps in services available, in regard to egg cryopreservation. However freezing of oocytes alone will not solve all of the potential future problems for these women. Assisted reproductive techniques and/or treatments with in vitro fertilization will be required for fertilization of frozen oocytes and the transfer of embryos into the uterus of these women to achieve a pregnancy.
The need for providing coverage for infertility treatment is huge and steadily increasing. As of 2002, infertility affected at least 7.3 million women and their partners in the United States. This is about 12% of the reproductive age population in the U.S. (Source: National Survey of Family Growth, CDC 2002). Of those affected, one third of infertility is due to male factors, one third is due to female factors and the other third is a combination of problems in both partners.
The most common causes of female infertility include fallopian tube damage or blockage, endometriosis, ovulation disorders, elevated prolactin, polycystic ovary syndrome (PCOS), early menopause, benign uterine fibroids and pelvic adhesions.
Fallopian tube damage usually results from inflammation of the fallopian tube (salpingitis). Chlamydia, a sexually transmitted disease, is the most frequent cause. Tubal inflammation may go unnoticed or cause pain and fever. Tubal damage is the major risk factor of a pregnancy in which the fertilized egg is unable to make its way through the fallopian tube to implant in the uterus (ectopic pregnancy). One episode of tubal infection may cause fertility difficulties. The risk of ectopic pregnancy increases with each occurrence of tubal infection.
Endometriosis occurs when the uterine tissue implants and grows outside of the uterus often affecting the function of the ovaries, uterus and fallopian tubes. These implants respond to the hormonal cycle and grow, shed and bleed in sync with the lining of the uterus each month, which can lead to scarring and inflammation. Pelvic pain and infertility are common in women with endometriosis.
Some cases of female infertility are caused by ovulation disorders. Hormonal disruptions in the part of the brain that regulates ovulation can cause low levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Even slight irregularities in the hormone system can affect ovulation. Specific causes of hypothalamic-pituitary disorders include injury, tumors, excessive exercise and starvation.
Elevated prolactin (hyperprolactinemia). The hormone prolactin stimulates breast milk production. High levels in women who aren't pregnant or nursing may affect ovulation. An elevation in prolactin levels may also indicate the presence of a pituitary tumor. In addition, some drugs can elevate levels of prolactin. Milk flow not related to pregnancy or nursing can be a sign of high prolactin.
Polycystic ovary syndrome (PCOS). In PCOS, the body produces too much androgen hormone, which affects ovulation. PCOS is associated with insulin resistance and obesity.
Early menopause (premature ovarian failure): Early menopause is the absence of menstruation and the early depletion of ovarian follicles before age 35. Although the cause is often unknown, certain conditions are associated with early menopause, including immune system diseases, radiation or chemotherapy treatment, and smoking.
Benign uterine fibroids. Fibroids are benign tumors in the wall of the uterus and are common in women in their 30s. Occasionally they may cause infertility by blocking the fallopian tubes.
Pelvic adhesions: Pelvic adhesions are bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery. This scar tissue formation may impair fertility.
OTHER CAUSES: A number of other causes can lead to infertility in women:
Medications: Temporary infertility may occur with the use of certain medications. In most cases, fertility is restored when the medication is stopped.
Thyroid problems: Disorders of the thyroid gland, either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism), can interrupt the menstrual cycle and cause infertility.
Cancer and its treatment. Certain cancers particularly female reproductive cancers often severely impair female fertility. Both radiation and chemotherapy may affect a woman's ability to reproduce. Chemotherapy may impair reproductive function and fertility in men and women.
Other medical conditions: Medical conditions associated with delayed puberty or amenorrhea, such as Cushing's disease, sickle cell disease, HIV/AIDS, kidney disease and diabetes, can affect a woman's fertility.
Caffeine intake. Excessive caffeine consumption reduces fertility in the female.
TABLE 1Female InfertilityAnovulation10 to 15%Pelvic factor30 to 40%Cervical factor10 to 15%
Percentage of women who are infertile, by age from three national U.S. surveys:
TABLE 2AgeUnder 3030-35 36-4041-45>45% with infertility after20%20%33%66%95%one year of tryingMiscarriage rate15%15%17%34%53%
CAUSES OF MALE INFERTILITY: A number of things can cause impaired sperm count or mobility, or impaired ability of the sperm to fertilize the egg. The most common causes of male infertility include abnormal sperm production or function, impaired delivery of sperm, general health and lifestyle issues, and overexposure to certain environmental elements.
IMPAIRED PRODUCTION OR FUNCTION OF SPERM: Most cases of male infertility are due to problems with the sperm, such as:
Impaired shape and movement of sperm. Sperm must be properly shaped and able to move rapidly and accurately toward the egg for fertilization to occur. If the shape and structure (morphology) of the sperm are abnormal or the movement (motility) is impaired, sperm may not be able to reach or penetrate the egg.
Low sperm concentration. A normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen. A count of 10 million or fewer sperm per milliliter of semen indicates low sperm concentration (subfertility). A count of 40 million sperm or higher per milliliter of semen indicates increased fertility. Complete failure of the testicles to produce sperm is rare, affecting very few infertile men.
Varicocele: A varicocele is a varicose vein in the scrotum that may prevent normal cooling of the testicle, leading to reduced sperm count and motility.
Undescended testicle. Undescended testicle occurs when one or both testicles fail to descend from the abdomen into the scrotum during fetal development. Because the testicles are exposed to the higher internal body temperature, compared with the temperature in the scrotum, sperm production may be affected.
Testosterone deficiency (male hypogonadism). Infertility can result from disorders of the testicles themselves, or an abnormality affecting the hypothalamus or pituitary gland in the brain that produces the hormones that control the testicles.
Genetic defects. In the genetic defect Klinefelter's syndrome, a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes abnormal development of the testicles, resulting in low or absent sperm production and possibly low testosterone.
Infections. Infection may temporarily affect sperm motility. Repeated bouts of sexually transmitted diseases (STDs), such as chlamydia and gonorrhea, are most often associated with male infertility. These infections can cause scarring and block sperm passage. If mumps, a viral infection usually affecting young children, occurs after puberty, inflammation of the testicles can impair sperm production. Inflammation of the prostate (prostatitis), urethra or epididymis also may alter sperm motility.
In many instances, no cause for reduced sperm production is found. When sperm concentration is less than 5 million per milliliter of semen, genetic causes could be involved. A blood test can reveal whether there are subtle changes in the Y chromosome.
IMPAIRED DELIVERY OF SPERM: Problems with the delivery of sperm from the penis into the vagina can result in infertility. These may include:
Sexual issues. Often treatable, problems with sexual intercourse or technique may affect fertility. Difficulties with erection of the penis (erectile dysfunction), premature ejaculation, painful intercourse (dyspareunia), or psychological or relationship problems can contribute to infertility. Use of lubricants such as oils or petroleum jelly can be toxic to sperm and impair fertility.
Retrograde ejaculation. This occurs when semen enters the bladder during orgasm rather than emerging out through the penis. Various conditions can cause retrograde ejaculation including diabetes, bladder, prostate or urethral surgery, and the use of certain medications.
Blockage of epididymis or ejaculatory ducts. Some men are born with blockage of the part of the testicle that contains sperm (epididymis) or ejaculatory ducts. Some men lack the tube that carries sperm (vas deferens) from the testicle out to the opening in the penis.
No semen (ejaculate). The absence of ejaculate may occur in men with spinal cord injuries or diseases. This fluid carries the sperm from the penis into the vagina.
Misplaced urinary opening (hypospadias). A birth defect can cause the urinary (urethral) opening to be abnormally located on the underside of the penis. If not surgically corrected, this condition can prevent sperm from reaching the woman's cervix.
Anti-sperm antibodies. Antibodies that target sperm and weaken or disable them usually occur after surgical blockage of part of the vas deferens for male sterilization (vasectomy). Presence of these antibodies may complicate the reversal of a vasectomy.
Cystic fibrosis. Men with cystic fibrosis often have missing or obstructed vas deferens.
GENERAL HEALTH AND LIFESTYLE: A man's general health and lifestyle may affect fertility. Some common causes of infertility related to health and lifestyle include:
Emotional stress: Stress may interfere with certain hormones needed to produce sperm. The sperm count may be affected by excessive or prolonged emotional stress. A problem with fertility itself can sometimes become long term and discouraging, producing more stress. Infertility can affect social relationships and sexual functioning.
Malnutrition: Deficiencies in nutrients such as vitamin C, selenium, zinc and folate may contribute to infertility.
Obesity: Increased body mass may be associated with fertility problems in men.
Cancer and its treatment: Both radiation and chemotherapy treatment for cancer can impair sperm production, sometimes severely. The closer radiation treatment is to the testicles, the higher the risk of infertility. Removal of one or both testicles due to cancer also may affect male fertility.
Alcohol and drugs: Alcohol or drug dependency can be associated with poor health and reduced fertility. The use of certain drugs also can contribute to infertility. Anabolic steroids, for example, which are taken to stimulate muscle strength and growth, can cause the testicles to shrink and sperm production to decrease.
Other medical conditions: A severe injury or major surgery can affect male fertility. Certain diseases or conditions, such as diabetes, thyroid disease, Cushing's syndrome, or anemia may be associated with infertility.
Age. A gradual decline in fertility is common in men older than 35.
ENVIRONMENTAL EXPOSURE: Overexposure to certain environmental elements such as heat, toxins and chemicals can reduce sperm count either directly by affecting testicular function or indirectly by altering the male hormonal system. Specific causes include:
Pesticides and other chemicals: Herbicides and insecticides may cause female hormone-like effects in the male body and may be associated with reduced sperm production and testicular cancer. Lead exposure may also cause infertility.
Overheating the testicles: Frequent use of saunas or hot tubs can elevate the core body temperature. This may impair sperm production and lower sperm count.
Substance abuse: Use of cocaine or marijuana may temporarily reduce the number and quality of sperm.
Tobacco smoking: Men who smoke may have a lower sperm count than those who don't smoke.
SOCIAL TRENDS AS CAUSES OF INFERTILITY: In addition, social trends of deferred childbearing have increased in the past three decades due to men and women pursuing higher education and careers and thus marriage has been postponed to a latter age. Professional couples tend to get married at an older age and are continuing to delay having children well into their late thirties to mid forties because of changing life styles and career demands. These drastically increase the need for infertility treatments due to advanced maternal age. Often times, these treatments call for the employment of cutting-edge techniques such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis (PGD), embryo and sperm cryopreservation and storage as well as alternative treatments such as egg, sperm, and embryo donations and surrogate carriers for those who lost the ability to successfully carry the pregnancy. Also, alternative life styles (same sex couples) offer a major challenge to options in infertility treatments that are currently not well recognized or addressed.
TABLE 3Male InfertilityMale30 to 40%
TABLE 4Male and Female InfertilityUnexplained infertility10%
TABLE 5Population of the United StatesAgeYear 2000Year 20100-419,175,79821,426,1635-920,549,90520,705,84510-1420,528,07219,767,29115-1920,219,89021,336,475State Infertility Insurance Benefits and Laws
Currently there are only fourteen states that require insurers to either cover or offer to cover some form of infertility diagnosis and treatment. Those states are Arkansas, California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia. Fertility insurance coverage in most if not all of these states is limited in scope and does not encompass the full range of options available for infertility treatments. In addition, the Employment Retirement Income and Security Act of 1974 exempts companies that self-insure from state regulation. These insurers are under heavy pressure to curtail and further reduce fertility coverage, treatments and benefits. These State mandated insurers are for the most part limited and deficient. Following is a description of the laws that govern how these states cover fertility insurance.
ARKANSAS: Arkansas law requires all health insurers that cover maternity benefits to cover the cost of IVF. Health maintenance organizations are exempt from the law. Patients need to meet the following conditions in order to get IVF coverage:
The patient must be the policyholder or the spouse of the policyholder and be covered by the policy;
The patient's eggs must be fertilized with her spouse's sperm;
The patient and her spouse must have at least a two-year history of unexplained infertility, OR the infertility must be associated with one or more of the following conditions:
Endometriosis: Fetal exposure to diethylstilbestrol, also known as DES;
Blocked or surgically removed fallopian tubes that are not a result of voluntary sterilization; or
Abnormal male factors contributing to the infertility. The patient has not been able to achieve a successful pregnancy through any other less costly infertility treatment for which coverage is available under the policy.
IVF procedure must be performed at a medical facility licensed or certified by the Arkansas Department of Health. Those facilities certified by the Department of Health must conform to the American College of Obstetricians and Gynecologists guidelines for in vitro fertilization clinics or meet the American Fertility Society's (sic) minimal standards for programs of in vitro fertilization.
The IVF benefits in Arkansas are subject to the same deductibles and co-insurance payments as maternity benefits. The law also permits insurers to limit coverage to a lifetime maximum of $15,000. (Arkansas Statutes Annotated, Sections 23-85-137 and 23-86-118).
CALIFORNIA: California law requires certain insurers to offer coverage for infertility diagnosis and treatment. That means group health insurers covering hospital, medical or surgical expenses must let employers know infertility coverage is available. However, the law does not require those insurers to provide the coverage; nor does it force employers to include it in their employee insurance plans.
California law defines infertility as: The presence of a demonstrated condition recognized by a licensed physician and surgeon as a cause of infertility; or the inability to conceive a pregnancy or carry a pregnancy to a live birth after a year or more of sexual relations without contraception.
California law defines treatment as including, but not limited to:
Diagnosis and diagnostic tests;
Medication;
Surgery; and Gamete Intrafallopian Transfer, also known as GIFT.
California law specifically exempts insurers from having to offer IVF coverage. Also, the law does not require employers that are religious organizations to offer coverage for treatment that conflict with the organization's religious and ethical purposes. (California Health and Safety Code, Section 1374.55).
CONNECTICUT: Individual and group health insurance policies are required to cover medically necessary expenses for infertility diagnosis and treatment. Infertility is defined as the inability to conceive or sustain a successful pregnancy during a one-year period.
Covered treatments include ovulation induction, interuterine insemination, IVF, uterine embryo lavage, embryo transfer, GIFT, ZIFT, and low tubal embryo transfer. Coverage is limited to individuals who have maintained coverage under the policy for at least a year.
Some additional limitations apply: The covered individual must be under 40 years of age;
There is a life-time coverage maximum of four cycles of ovulation induction, three cycles of IUI, and two cycles of IVF, GIFT, ZIFT, or low tubal embryo transfer (with not more than two embryo transfers per cycle);
Covered treatments must be performed at facilities that conform to standards and guidelines developed by ASRM or SREI.
Individuals seeking coverage must disclose to their insurance carrier any prior infertility treatments for which they received coverage under a different insurance policy. Religious employers are permitted to exclude coverage for treatments that are contrary to their bona fide religious tenets. (Public Act No. 05-196).
HAWAII: Hawaii law requires certain insurance plans to provide a one-time only benefit for outpatient costs resulting from in vitro fertilization. Those plans include individual and group health insurance plans, hospital contracts or medical service plan contracts that provide pregnancy-related benefits. Patients need to meet the following conditions in order to get their IVF covered:
The patient's eggs must be fertilized with her spouse's sperm;
The patient or the patient's spouse must have at least a five-year history of infertility;
The patient has been unable to get and stay pregnant through other infertility treatments covered by insurance;
The IVF is performed at medical facilities that conform to standards set by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists; and
The infertility must be associated with one or more of the following conditions:
Endometriosis;
Fetal exposure to diethylstilbestrol, also known as DES; Blocked or surgically removed fallopian tubes; or Abnormal male factors contributing to the infertility. (Hawaii Revised Statutes, Sections 431-1OA-116.5 and 432.1-604).
ILLINOIS: Illinois law requires insurance policies that cover more than 25 people and provide pregnancy-related benefits to cover costs of the diagnosis and treatment of infertility. The law defines infertility as the inability to get pregnant after one year of unprotected sex or the inability to carry a pregnancy to term.
Coverage includes, but is not limited to:
In vitro fertilization (IVF);
Uterine embry lavage;
Embryo transfer;
Artificial insemination;
Gamete intrafallopian transfer (GIFT);
Zygote intrafallopian transfer (ZIFT);
Intracytoplasmic Sperm Injection (ICSI);
Four completed egg retrievals per lifetime; and Low tubal egg transfer.
Coverage for IVF, GIFT and ZIFT is required only if:
The patient has used all reasonable, less expensive and medically appropriate treatments and is still unable to get pregnant or carry a pregnancy;
The patient has not reached the maximum number of allowed egg retrievals;
The procedures are performed at facilities that conform to standards set by the America Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists.
Illinois law exempts religious organizations which believe the covered procedures violate their teachings and beliefs. (Illinois Compiled Statutes Annotated, Chapter 215, Sections 5/356m and 125/5-3).
MARYLAND: Maryland law requires health and hospital insurance policies issued or delivered in Maryland that provide pregnancy-related benefits to also cover the outpatient costs of in-vitro fertilization. HMO's must provide IVF benefits to the same extent as the benefits provided for other infertility services.
Patients need to meet the following conditions in order to get their IVF covered:
The patient's eggs must be fertilized with her spouse's sperm;
The patient is unable to get pregnant through less expensive covered treatments;
The IVF is performed at facilities that conform to standards set by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists.
The patient and his or her spouse must have at least a two-year history of infertility; OR their infertility must be associated with one or more of the following conditions:
Endometriosis;
Fetal exposure to diethylstilbestrol, also known as DES;
Blocked or surgically removed fallopian tubes; or
Abnormal male factors, including oligozoospermia.
Coverage may be limited to three in vitro fertilization attempts per live birth and a maximum lifetime benefit of $100,000.
A religious organization may, by request have this coverage excluded from its policies and contracts if the required coverage conflicts with its bona fide religious beliefs and practices.
Regulations that took effect in 1994 exempt businesses with 50 or fewer employees from having to provide the IVF coverage. (Maryland Insurance Article §15-810, Health General Article §19-706).
MASSACHUSETTS: Massachussettes law requires health maintenance organizations and insurance companies that cover pregnancy-related benefits to cover medically necessary expenses of infertility diagnosis and treatment. The law defines infertility as "the condition of a presumably healthy individual who is unable to conceive or produce conception during a one-year period."
Benefits covered include:
Artificial insemination;
In vitro fertilization;
Gamete Intrafallopian Transfer;
Sperm, egg and/or inseminated egg retrieval, to the extent that those costs are not covered by the donor's insurer;
Intracytoplasmic Sperm Injection (ICSI) for the treatment of male infertility; and
Zygote Intrafallopian Transfer (ZIFT).
Insurers may, but are not required, to cover experimental procedures, surrogacy, reversal of voluntary sterilization or cryopreservation of eggs. (Annotated Laws of Massachusetts, Chapters 175, §47H; 176A, §8K; 176B, §4J; and 176G, §4, 211 CMR 37.00).
MONTANA: Montana law requires health maintenance organizations to cover infertility services as part of basic preventive health care services. The law does not define infertility or the scope of services covered; nor did the state ever draft regulations explaining what infertility services entail.
As for health insurers other than HMOs, the law specifically excludes infertility coverage from the required scope of health benefits those insurers must provide. (Montana Code Annotated, Sections 33-22-1521 and 33-31-102).
NEW JERSEY: New Jersey Family Building Act requires insurance policies that cover more than 50 people and provide pregnancy-related benefits to cover the cost of the diagnosis and treatment of infertility. The law defines infertility as the disease or condition that results in the inability to get pregnant after two years of unprotected sex (female partner under the age of 35) or one year of unprotected sex (female partner over the age of 35) or the inability to carry a pregnancy to term.
Coverage includes, but is not limited to:
Diagnosis & diagnostic tests
Medications
Surgery
In vitro fertilization (IVF)
Embryo transfer
Artificial insemination
Gamete intra fallopian transfer (GIFT)
Zygote intra fallopian transfer (ZIFT)
Intracytoplasmic Sperm Injection (ICSI)
Four completed egg retrievals per lifetime
Coverage for IVF, GIFT and ZIFT is required only if: The patient has used all reasonable, less expensive and medically appropriate treatments and is still unable to get pregnant or carry a pregnancy; The patient has not reached the maximum number of allowed egg retrievals and the patient is 45 years of age or younger.
The procedures are performed at facilities that conform to standards set by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists.
The law allows religious organizations to request an exclusion of this coverage if it is contrary to the religious employer's bona fide religious tenets. (New Jersey Permanent Statutes: 17B:27-46.1X Group Health Insurance Policies; 17:48A-7W Medical Service Corporations; 17:48-6X Hospital Service Corporations; 17:48 E-35.22 Health Service Corporations; 26:2 J-4.23 Health Maintenance Organizations)
NEW YORK: Insurers are required to cover the diagnosis and treatment of correctable medical conditions and shall not exclude coverage of a condition solely because the medical condition results in infertility. Private, group health insurance plans, issued or delivered in the state of New York providing coverage for hospital care or surgical and medical care are required to provide coverage for the diagnosis and treatment of infertility for patients between the ages of 21 and 44, who have been covered under the policy for at least 12 months. Certain procedures are excluded from this requirement, including IVF, GIFT, ZIFT, reversal of elective sterilization, sex change procedures, cloning, and experimental procedures. Plans that include coverage for prescription drugs must include coverage of drugs approved by FDA for use in diagnosis and treatment of infertility. (New York Consolidated Laws, Insurance, Section 3221(k)(6), Section 4303(s).)
OHIO: Ohio law requires health maintenance organizations to cover basic preventive health services, including infertility. The Ohio Insurance Department has no written definition of infertility services, but states that the procedure must be medically necessary. Experimental procedures are not covered. (Ohio Revised Code Annotated §1751) 1742 was repealed and replaced and the $2,000 General Interpretation no longer applies.
RHODE ISLAND: Rhode Island law requires insurers and HMO's that cover pregnancy services to cover the cost of medically necessary expenses of diagnosis and treatment of infertility. The law defines infertility as "the condition of an otherwise healthy married individual who is unable to conceive or produce conception during a period of one year. The patient's co-payment cannot exceed 20 percent. (Rhode Island General Laws (§27-18-30, 27-19-23, 27-20-20 and 27-41-33).
TEXAS: Texas law requires certain insurers that cover pregnancy services to offer coverage for in vitro fertilization. That means insurers must let employers know this coverage is available. However, the law does not require those insurers to provide the coverage; nor does it force employers to include it in their health plans. Patients need to meet the following conditions in order to get their IVF covered:
The patient must be the policyholder or the spouse of the policyholder and be covered by the policy;
The patient's eggs must be fertilized with her spouse's sperm;
The patient has been unable to get and stay pregnant through other infertility treatments covered by insurance;
The IVF is performed at medical facilities that conform to standards set by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists; and
The patient and her spouse must have at least a continuous five-year history of unexplained infertility, OR the infertility must be associated with one or more of the following conditions:
Endometriosis.
Fetal exposure to diethylstilbestrol (DES);
Blocked or surgical removal of one or both fallopian tubes; or Oligospermia.
Texas law does not require organizations that are affiliated with religious groups to cover treatment that conflicts with the organization's religious and ethical beliefs. (Texas Insurance Code, Article 3.51-6).
WEST VIRGINIA: West Virginia law requires health maintenance organizations to cover basic health care services, including infertility services, when medically necessary. The West Virginia Insurance Commissioner does not define infertility services. (West Virginia Code §33-25A-2).
TABLE 6STATE INFERTILITY COVERAGE AT A GLANCE(OCTOBER 2005)IncludesExcludesIVFMandateMandateIVFIVFcoverageStateDate enactedto coverto offercoveragecoverageONLYArkansas1987X1XCalifornia1989XX2Connecticut1989XXHawaii1987XX3Illinois1991XX4Maryland1985X5XMassachusetts1987XXMontana1987X6New Jersey2001XXNew York1990X7Ohio1991X8Rhode Island1989XXTexas1987XXWest Virginia1977X81Includes a lifetime maximum benefit of not less than $15,000.2Excludes IVF, but covers gamete intrafallopian transfer (GIFT).3Provides a one-time only benefit covering all outpatient expenses arising from IVF.4Limits first-time attempts to four oocyte retrievals. If a child is born, two complete oocyte retrievals for a second birth are covered. Businesses with 25 or fewer employees are exempt from having to provide the coverage specified by the law.5Businesses with 50 or fewer employees do not have to provide coverage specified by law.6Applies to HMOs only; other insurers specifically are exempt from having to provide the coverage.7Provides coverage for the diagnosis and treatment of correctable medical conditions. Does not consider IVF a corrective treatment.8Applies to HMOs only.
It is evident from the above that of the fourteen states which require insurers to either cover, or offer to cover some form of infertility diagnosis and treatment, provide, for the most part limited and deficient benefits that will be exhausted in a short time, often with many restrictions and conditions attached. At the national level, in states other than the fourteen states mentioned above, the majority of medical insurance plans don't cover infertility benefits at all. In today's difficult environment, where tough choices must be made by medical insurers to provide maximum health benefits at a minimum cost, it is expected that even the limited and deficient infertility benefits available today will be further reduced and curtailed.
In 2002, one percent of the babies born in the United States were conceived, based on assisted reproductive technology treatments. Some insurance companies currently assist in initial fertility evaluations of couples seeking to have children; these evaluations include: semen analysis, documentation of competent ovulation and documentation of tubal patency; however, such evaluations are costly. In addition, the costs associated with infertility treatments are very expensive. Few insurance companies provide insurance coverage and/or assistance for couples who contract with or who intend to contract with medical providers who perform the specialized medical procedures comprising infertility treatments either in the United States or outside of the jurisdiction of the United States. Currently, people who do not have coverage for infertility treatments will need to apply for loans with very high interest rates, or take out home equity loans to obtain funds to pay for infertility treatments. Not only is the high cost of treating infertility prohibitive, but also the prohibitive nature of the costs generate significant stress for couples seeking infertility treatments; and this stress can cause relationships of some frustrated couples to end in separation and/or divorce. There are no known comprehensive financial services and/or products that support or provide insurance coverage for all of the potentially required fertility diagnoses and infertility treatments and options.
Therefore, the need exists for the provision of comprehensive methods and systems for providing and paying for insurance coverage of treatable infertility conditions that affect at least 7.3 million women and their partners (12% of the reproductive age population) in the United States.
Furthermore, the need exists for the provision of affordable payment options and payment plans for insurance coverage of treatable infertility conditions. In addition, the need exists for computer implemented, automated business methods and systems of providing insurance coverage of treatable infertility conditions, so as to reduce emotional and financial stress for patients, health care providers and insurance providers, interested in the delivery of infertility treatments and services. Thus, the focus of this invention is to provide insurance coverage for infertility treatments for individuals in a disciplined manner, enabling individuals to set aside money to address future issues that may interfere with them or their children or grandchildren giving birth to offspring. An additional focus of this invention is to assure that the best available technology is employed to provide a wide comprehensive spectrum of innovative fertility treatments and options to those seeking childbirth. Ultimately, the invention provides leadership in the field of providing financial products for fertility treatments in reproductive medicine, including male and female infertility treatments and to advance knowledge and technology in the science and practice of reproductive medicine.
Additionally, there can be a plurality of income streams associated with various incentives, bonuses and options, in regard to insurance coverage for infertility treatment. This invention can be used by any number of insurance carries and underwriters on a for fee basis. The insurance carriers and/or underwriters can provide incentives to other insurers and underwriters, in order to promote the income generation capabilities of a comprehensive fertility insurance program in various jurisdictions throughout the United States. However, the main income associated with the fertility insurance program will be from the premiums paid by the purchasers of the comprehensive fertility insurance policies.

Methods and systems of insuring fertility care lifestyle affairs


In a production process of a cellulose acetate which comprises (a) a reduced pressure-acetylation step of acetylating a cellulose under a reduced pressure in the presence of sulfuric acid or other acidic catalyst, with distilling off a gaseous phase component of the reaction system out of the system, and (b) a post-acetylation step of allowing the acetylation to further proceed by increasing the pressure as compared with the pressure of the reduced pressure-acetylation step by means of release of the pressure reduction of the reaction system or the like, the shift operation from the reduced pressure-acetylation step to the post-acetylation step is conducted by taking a distilling rate of a distillate in the reduced pressure-acetylation step as an index to control the reaction temperature of the post-acetylation step. The shift operation from the reduced pressure-acetylation step to the post-acetylation step may also be conducted by taking a distilling rate after the distilling rate in the reduced pressure-acetylation step has reached a maximum value.

As a typical example of commercial production processes of a cellulose acetate, there has been known a process which comprises acetylating a cellulose by means of an acetylating agent such as acetic anhydride in the presence of an acidic catalyst such as sulfuric acid. The acetylation of the cellulose is a vigorously exothermic reaction, and when a reaction temperature, in particular a peak temperature (highest temperature) is high, depolymerization of a cellulose proceeds so that the polymerization degree of the cellulose acetate decreases and the quality of the product is deteriorated.
Therefore, it is significantly important to control or regulate the reaction temperature in the acetylation reaction with high accuracy for the purpose of sustaining qualities of the cellulose acetate.
Japanese Patent Publication No. 5761/1990 (JP-B-2-5761) discloses a production process of a cellulose acetate using a cellulose as a raw material, acetic anhydride as an acetylating agent, acetic acid as a solvent and sulfuric acid as a catalyst, which method is characterized by reducing a pressure in the reaction system over the whole period or in a partial period inclusive of the initial stage of an acetylation reaction, condensing a generated vapor and distilling a resultant product out of the reaction system to concentrate the reaction product. This literature mentions that, in the course of the reaction, when the pressure reduction is broken turning to an ambient pressure (atmospheric pressure) at the point that the vapor component is distilled off in a predetermined amount, the reaction temperature rises to reach a peak temperature due to a reaction heat in the acetylation of unreacted cellulose provided that the heat is radiated to some extent, and thereafter the temperature descends or decreases, and that the peak temperature can be controlled or regulated with a distilling amount of the vapor component taken as an index.
However, when an acetylation step under a reduced pressure (reduced pressure-acetylation step) and an acetylation step (post-acetylation step) which comprises increasing the reaction pressure and raising the reaction temperature due to a reaction heat of the rest of the cellulose to allow the acetylation reaction to further proceed are conducted continuously in a batch system, dispersion of the peak temperature in the postacetylation step in a process, as mentioned above, where pressure reduction control is ceased by taking the distilling amount of a vapor component as an index to raise the reaction temperature. Accordingly, the polymerization degree of a product cellulose acetate varies and stable qualities will not be expected.
This is probably because of the following reasons. That is, a cellulose used as a raw material generally contains moisture, so that hydrolysis of acetic anhydride due to the moisture proceeds in addition to the acetylation of the cellulose in the first half of the reduced pressure-acetylation step. Therefore, the producing amounts of the acetic acid and reaction heats in the reaction system vary or differ depending on the moisture contents of the material cellulose, and hence the amounts of distilled liquids (distillates) vary each other. Further, the reaction system in the first half of the reduced pressure-acetylation step is unstable because the reaction temperature rises violently and the amount of internal reflux is large, and distilled amount of the distilled liquid (a mixture of acetic acid and acetic anhydride) tends to vary or shift. Thus, according to the above mentioned process, the concentrations of unreacted cellulose in the reaction system practically differ even when the amounts of the distilled liquids are the same. It should be considered that the quantity of heat generated in the post-acetylation step varies with variation of the concentrations of unreacted cellulose, so that the peak temperature fluctuates or varies.
On the other hand, a peak temperature of a reaction can be stabilized, theoretically, by using an adiabatic reactor as an acetylation reactor, and strictly controlling the amounts of charged material, acetylating agent, reaction solvent and catalyst, and the reaction temperature. When the cellulose acetate is, however, produced commercially, a lot of instruments are required to take an enormous cost for the purpose of using a complete adiabatic system as the acetylation reactor, or precisely controlling the amounts or proportions of the acetylating agent or others and temperature.

Method and apparatus for acetylating cellulose


A method and apparatus for displaying a plurality of secondary images based on image data of a primary image include displaying a primary image and a plurality of secondary images based on the image data of the primary image. Each of the plurality of secondary images is displayed having a size based on a relevance of each respective one of the plurality of secondary images to the primary image. The primary image can be selected from a plurality of images or a frame of a video. Subsets of secondary images can be displayed in clusters including images having content similar to particular content of the primary image.

Image acquisition devices such as digital video and picture cameras allow users to record images of various people, settings, and events. After images have been captured, the images are often loaded onto a local or remote storage device, such as a hard drive for later review and/or retrieval. Since storage devices can contain a large number of images, it can be hard for users to find particular images. Typically, users must search manually through stored images to find particular images of interest. In addition, if a user would like to view images containing similar content depicted in a particular image, the user must additionally search through many images.


A method for displaying a distance to empty (DTE) of a vehicle include calculating an indicated distance to empty based on a learned fuel efficiency which is learned before starting. A target distance to empty is calculated based on an updated learned fuel efficiency which is updated until a present time. A driving mode is determined according to a difference between the indicated distance to empty and the target distance to empty. A final distance to empty is calculated according to the driving mode, and the final distance to empty is displayed.

Generally a distance to empty (DTE) is calculated by a residual fuel quantity and is displayed on a vehicle cluster.
A method for displaying the distance to empty according to a conventional art detects a residual fuel quantity, and calculates the distance to empty by multiplying the residual fuel quantity and default fuel efficiency.
However, the default fuel efficiency is changed in accordance with a driving condition such as a driving habit of a driver and a state of a road, and thus, the distance to empty calculated on the basis of the default fuel efficiency without considering a change of the driving condition has a great difference with an actual distance to empty.
Therefore, the method for displaying the distance to empty is calculated on the basis of a learned fuel efficiency which is accumulated by a past driving pattern of the driver and averaging the past fuel efficiency for considering the change of the driving condition.
However, in a case that the distance to empty is calculated only on the basis of the learned fuel efficiency, the distance to empty increases or decreases even though the driving pattern is maintained constantly because the learned fuel efficiency changes and an input value of the residual fuel quantity is not linear.
The above information disclosed in this Background section is only for enhancement of understanding of the background of the invention, and therefore, it may contain information that does not form the prior art that is already known in this country to a person of ordinary skill in the art.

Apparatus and method for displaying distance to empty of vehicle


A circuit for converting an A.C. power supply voltage into a D.C. voltage, including: a first branch capable of providing a first power level; and a second parallel branch capable of providing a second power level greater than the first one, the second branch including a bidirectional activation switch.

1. Technical Field
Embodiments generally relate to electronic circuits, and more specifically to power supply circuits intended for electronic devices (circuits or circuit assemblies) having at least two operating modes requiring different power supply voltages. Embodiments more specifically apply to a power supply circuit for an electronic device having a stand-by mode of lower power consumption than an active mode.
2. Discussion of the Related Art
In many electronic devices, unnecessary power consumption of the power supply circuit during periods when the powered device is not active is desired to be avoided. Several power supply circuits which are activated independently from one another according to needs are generally provided.
Such devices are relatively complex. In particular, they require selectors downstream of rectifying means.
Further, most often, a control signal is issued by the powered device to activate or deactivate the different power supply modes. Such control signals are generally logic signals originating from a microcontroller of the powered device. This requires interface circuits between the powered device and the power supply circuit. Further, this requires additional terminals on the power supply circuit side and on the powered device side.
It would be desirable to have a power supply circuit with a decreased loss, especially in stand-by mode.
It would further be desirable to have a self-contained power supply circuit capable of adapting to the power required by the load, without for a control signal to have to be issued by said load.

Power supply circuit with low stand-by losses


A system, method and apparatus for operating a laser at a downhole location is disclosed. A gas is configured to receive an output of a laser and to absorb a selected wavelength of the laser corresponding to a selected spectral line of the gas. A pressure device reduces broadening of the selected spectral line related to a temperature at the downhole location. A photodetector receives light from the gas chamber and provides a measurement related to the received light. A processor alters an operating parameter of the laser using the obtained measurement to operate the laser.

1. Field of the Disclosure
The present disclosure is related to performing an operation in a wellbore and, in particular, to operation of a laser at a downhole location.
2. Description of the Related Art
In various drilling operations, it is useful to dispose a laser at a downhole location in order to perform a measurement or a downhole operation. Often, the accuracy of a laser-based downhole measurement is dependent on the wavelength of the laser. However, the wavelength of the laser may drift with temperature and/or other downhole conditions. In order to maintain a laser operating at a selected frequency at a downhole location, it is necessary to lock the laser at a selected wavelength. One method of locking a laser includes the use of a Fabry-Perot etalon. The etalon needs to have a low coefficient of expansion and be transparent at laser wavelengths. Zerodur® is a material that meets these requirements but has bad temperature stability at downhole temperatures. However, in a downhole environment, the temperature can range between about 120° C. and 200° C. and the temperature of the Zerodur® needs to be controlled within a few millidegrees in order to achieve high locking precision. Additionally, downhole operations require that this etalon control be maintained for up to 12 hours or longer. Another method of laser locking uses a spectral line of a gas to provide a wavelength standard. This method can also be affected by downhole temperatures and other conditions encountered downhole. Therefore, there is a need to provide a method and apparatus for maintain operation of a laser downhole at a selected wavelength.

High precision locked laser operating at elevated temperatures


This invention presents a single-stage power converter for driving many number of Light-Emitting-Diode (LED). The power converter converts an AC input voltage into DC current source and regulates the current flowing into the LED. In addition, the AC input current is controlled to have a sinusoidal waveform synchronized with the AC input voltage so that AC input Power Factor is corrected. Hence, both of Power Factor Correction (PFC) and LED current regulation are obtained simultaneously by using a single power conversion stage. So higher efficiency with low cost can be obtained.

LEDs have become increasingly popular as a lighting choice and, for many applications, have begun to replace conventional lamps having filament. For example, LEDs are now widely used in traffic signal lights and for the back lighting of liquid crystal display (LCD) panels.
In many applications, it is it desirable to vary the lighting output (i.e., brightness) of an LED. Generally, it is difficult to use voltage control for controlling LED brightness. Instead, the brightness of an LED is proportional to its current. Therefore, LED current should be controlled to control LED brightness (e.g., for dimming an LED). With the increased popularity of LEDs in numerous applications which require varying degrees of brightness, there is an increasing need for a suitable power converter for controlling LED current.
In some applications, the power for driving LEDs is in the form of an alternating current (AC) input. In this case, the AC line current needs to be synchronized to the line voltage, thus minimizing line current distortion so that the transferred energy from the power source is maximized. If there is a phase delay between the incoming voltage and current, the transferred energy is circulated from source to load. This reduces the power transferred from the source to the load in relation to the cosine of its phase difference. If the voltage and line current are made to be in phase, the phase difference is zero and its cosine becomes unity. This technique is known as power factor correction (PFC). Sometimes, the line current may be distorted and harmonics are involved in the line current by power conversion processing.
According to some previous designs, power converters for LEDs require at least two power stages in order to provide both control of LED current as well as power factor correction (PFC). Each power stage performs some form of power conversion. Typically, the first stage is referred to as a pre-regulator and provides PFC control. The second stage is a DC-to-DC converter and provides LED current control. Because any given power stage is not 100% efficient, there is a loss of power across each stage for such power converters. This results in lower overall efficiency for the power converter. For example, assuming that the each of two power stages in a previous design power converter is 90% efficient, then the overall system efficiency will be 81% efficient (0.90×0.90=0.81).

Single-stage digital power converter for driving LEDs


The subject invention relates to a charge transport layer forming coating liquid containing a charge transport material, at least one selected from the group consisting of polycarbonate resins and polyester resins, at least one of xylene and toluene, and cyclopentanone. The proportion of cyclopentanone in the charge transport layer forming coating liquid is in the range of 50% by mass to 85% by mass relative to the total mass of at least one of xylene and toluene and cyclopentanone.

Field of the Invention
The present disclosure relates to an electrophotographic photosensitive member, a process cartridge, an electrophotographic apparatus, a charge transport layer forming coating liquid, and a method for manufacturing the electrophotographic photosensitive member.
Description of the Related Art
Electrophotographic apparatus users have recently been being diversified. It is desirable that the electrophotographic apparatus can output more high-quality images than ever without varying image quality over the period of use. Accordingly, it is also desirable that the electrophotographic photosensitive member incorporated in such an electrophotographic apparatus respond to these demands.
For forming high-quality images over a long time from the beginning, Japanese Patent Laid-Open No. 2013-142705 discloses an electrophotographic photosensitive member including a photosensitive layer having a surface layer containing 100 ppm by mass to 2500 ppm by mass of an aromatic hydrocarbon.
For suppressing the degradation of sensitivity, Japanese Patent Laid-Open No. 2004-4159 discloses an electrophotographic photosensitive member including a photosensitive layer containing a saturated alicyclic ketone with a content in the range of 3000 ppm to 50000 ppm relative to the solid content.
For suppressing fluctuations in potential, Japanese Patent Laid-Open No. 7-5703 discloses an electrophotographic photosensitive member including a photoconductive layer (photosensitive layer) containing 0.05% by weight to 10.0% by weight of cyclopentanone.
The applications of electrophotographic apparatuses are expanding. Some of the electrophotographic apparatuses come to be used for quick printing without being limited to use in offices. Accordingly, an electrophotographic photosensitive member suitable for highspeed processes is desired.
When the electrophotographic photosensitive member disclosed in Japanese Patent Laid-Open No. 2013-142705 was used in a high-speed process with substantially the same amount of light for image exposure as in a general process, however, the electrophotographic photosensitive member exhibited poor sensitivity, and a desired light portion potential was not obtained.
The electrophotographic photosensitive members disclosed in Japanese Patent Laid-Open Nos. 2004-4159 and 7-5703 also exhibited the same disadvantage in some cases.
For coating liquids for forming the layers of an electrophotographic photosensitive member, it is desirable that the solute be fully dissolved in the coating liquid, and that the coating liquid do not deteriorate during storage and have good coatability.
Japanese Patent Laid-Open No. 2001-343762 discloses a coating liquid for forming a charge transport layer (hereinafter referred to as charge transport layer forming coating liquid). In this coating liquid, a solvent made up of dimethoxymethane, ethylene glycol dimethyl ether, and an aromatic hydrocarbon (other than benzene) is used from the viewpoint of preventing the coating liquid from whitening.
Japanese Patent Laid-Open No. 2014-160238 discloses a charge transport layer forming coating liquid from the viewpoint of achieving both a high potential stability and a high abrasion resistance when the photosensitive member is repeatedly used. The coating liquid contains an aromatic hydrocarbon solvent and a compound having a higher boiling point than the aromatic hydrocarbon solvent at 1 atmosphere. Japanese Patent Laid-Open No. 6-308744 discloses a charge transport layer forming coating liquid containing a cyclic ketone as the solvent.
For the technique of Japanese Patent Laid-Open No. 2001-343762, it has been found that the charge transport layer forming coating liquid may gel when stored for a long time. It has also been found that the charge transport layer forming coating liquids disclosed in Japanese Patent Laid-Open Nos. 2014-160238 and 6-308744 may gel when stored under severer conditions for a long time.

Electrophotographic photosensitive member, process cartridge, electrophotographic apparatus, charge transport layer forming coating liquid, and method for manufacturing electrophotographic photosensitive member


Disclosed is a controlled release pharmaceutical dosage form, including: (a) microgranules of a pharmaceutical and an excipient; (b) a plurality of polymeric lipidic and wax-like coatings applied to the microgranules, the coated microgranules having dimensions which allow suspension of the coated microgranules in a liquid administration vehicle; and (c) a liquid administration vehicle for the coated microgranules, the vehicle including an effective amount of the pharmaceutical in a form immediately available upon ingestion. A process for the preparation of the controlled release therapeutic system is also described.

An important aspect of the administration of drugs in conventional forms is the fluctuation between high and low plasma concentration of the drug in the period between the administration of two successive doses. In fact, if the drug is too rapidly absorbed, excessive plasma levels may be attained, leading to undesirable and even toxic side effects. On the other hand, drugs possessing a short half-life are eliminated too rapidly and require therefore frequent administrations. In both cases the patient must be careful because particular attention and constancy in the administration is required during therapy and such conditions can not always be easily obtained. Many efforts have been made to formulate pharmaceutical preparations able to protract in time the activity of the drug in the body at optimum plasma levels, reducing the number of administrations and thus improving the response of the patient to the treatment.
The preparation of pharmaceutical compositions intended to supply a gradual and controlled release in time of the active ingredient is well known in the pharmaceutical technology field. Systems are known comprising tablets, capsules, microcapsules, microspheres and formulations in general in which the active ingredient is released gradually by various means.
It is also known that oral administration is by far the most frequently employed in therapy and the most appreciated by the patient, particularly when repeated administrations are otherwise necessary. Among formulations for oral administration, the liquid ones present the advantage of being easily adaptable to the patient in dosage and better accepted by the patient, particularly by children and the elderly. For this reason a liquid controlled release formulation is more advantageous compared to a corresponding controlled release solid formulation.
In the preparation of controlled release liquid pharmaceutical compositions several problems may be encountered. One problem is that the actual controlled release forms must be of such a size to be easily suspended and kept in suspension in the liquid vehicle. Furthermore, poor or non-homogeneous distribution in the vehicle is to be avoided as far as possible, and it is also preferable to avoid the unpleasant sensation which may be present upon ingestion of a suspension containing coarse particles (sand effect). This problem may be avoided by suitably reducing the size of the particles to be suspended. On the other hand, the use of reduced size particles, increasing the surface area available for diffusion, makes it difficult to obtain a constant and protracted control of release, as is possible with particles having larger dimensions.
A further problem is the difficulty of obtaining controlled release liquid preparations able to maintain for a long period the release characteristics of the pharmaceutical compound contained. The solution of these problems is commercially and therapeutically important both for the necessity of having ready-to-use liquid dosage formulations as far as possible stable in time, and for having liquid formulations which, prepared at the moment of use, will remain stable for a long time once the dispersion of the therapeutic agent in the dosage liquid has taken place.
All the above mentioned difficulties may explain why only a few controlled release liquid systems are known, and among them only one is actually available commercially. Examples of known controlled release liquid formulations are found in the following patents: BE903540, W085/03000, WO 87/07833, U.S. Pat. Nos. 4,221,778 and 4,717,713.
The necessity is felt therefore, for a system which allows the administration of substances in a liquid oral dosage form in such a way that the release in time of the substances may be effected in the best possible way according to pre-established schedules. Such a system should be adjustable according to the particular therapeutic characteristics of the active ingredient to be administered; should possess homogeneity characteristic such as to allow a correct dosage; and should maintain its characteristics in the selected vehicle for a long period of time even after the beginning of the treatment.

Controlled release therapeutic system for a liquid pharmaceutical formulations

Recordati S.A., Chemical and Pharmaceutical Company


In some aspects, a method of displaying wireless-spectrum usage information is described. In some examples, a surface plot of a measure of wireless-spectrum usage for a geographic region is generated. The surface plot is based on analysis of physical layer signals detected at wireless-spectrum monitoring locations distributed over the geographic region. The surface plot is superimposed onto a view of the geographic region by operation of a display device. The superimposed surface plot visually indicates values for the measure of wireless-spectrum usage over the view of the geographic region.

This specification relates to presenting wireless-spectrum usage information.
Radio frequency (RF) spectrum is a limited and valuable resource. Governmental agencies and regulatory authorities typically control allocation and use of the spectrum, and the rights to use portions of the spectrum are sold or licensed to wireless service providers and other types of public and private entities. The wireless service providers use the spectrum allocated to them to provide wireless services to end users, for example, in the frequency bands for wireless communication standards.

Presenting wireless-spectrum usage information


In a heat exchanger in which the number of parts is small, assembling is easy, bonded portions of each part are fewer and reliability of brazing is improved, a core body is constituted by turning up and bending a strip-shaped metal plate in a fanfold manner, and first flow passages and second flow passages are formed alternately in the thickness direction. Both ends of each of the first flow passages are blocked by each come tooth of a pair of comb-state members, and a fin is set within the second flow passages so as to constitute a core. And in the heat exchanger in which a cylindrical casing is fitted with the outer periphery of the core body, the comb-state member has its tooth base crossing perpendicularly with each of the comb tooth and a root of each comb tooth bent in the L-shape along the tooth base, the plane of the tooth base is brought into contact with a turned-up end edge, and each connection portion between the comb-state member and the core body is integrally brazed/fixed.

The present invention relates to a heat exchanger in a simple structure which can be applied to a heat exchanger (EGR cooler) used in an exhaust gas recirculation apparatus in an automobile and other heat exchangers, in which a core body formed by bending a strip-shaped metal plate in a fanfold manner, and having flat first flow passages and second flow passages alternately in the thickness direction of the metal plate, each of the first flow passages of the core body being blocked by each tooth of a pair of comb-state members at both end positions.
A conventional EGR cooler is made of an assembly of a large number of flat tubes or a large number of plates, a large number of fins, a casing and a header, in which cooling water is made to communicate through the casing side and an exhaust gas is made to communicate inside each of the flat tubes or the like as proposed in the invention described in Japanese Patent Application Laid-Open No. 5-18634.
Another heat exchanger is proposed in which a core of the heat exchanger is formed by a strip-shaped metal plate bent in a fanfold manner and a pair of comb-state members, the outer periphery being fitted with a cylindrical casing, and a pair of headers are provided at openings on both ends in the longitudinal direction and ports for cooling water at both ends of the casing in the longitudinal direction as in the invention described in WO 2004/065876 A1.
In the former heat exchanger such as the EGR cooler, the number of parts is large, which makes assembling cumbersome and increases the number of brazing portions on the parts, and there is a problem that a leakage tends to occur at the brazing portion.
In the latter heat exchanger, comb teeth of the comb-state member are arranged at every other of the large number of flat groove-state portions in a core body formed in the fanfold state, and the groove bottom and the tip end of the comb tooth are bonded. And the casing is fitted with the outer periphery of the core. In this type of heat exchanger, there is a problem that a gap tends to occur at a brazed portion between the root of each comb tooth and the side face of the core body as well as between the tip end of each comb tooth and each groove bottom, from which leakage of a fluid easily occurs. Along with that, a crack is easily generated at a brazed portion particularly at the root portion of each comb tooth by a heat stress or the like due to use of the heat exchanger.
The present invention has an object to provide a heat exchanger in which the number of parts is small, assembling is easy, leakage does not occur, and reliability in a brazed portion is high.


The invention is directed to a method and to an apparatus for the correction of the positioning errors of a light ray deflected across a surface by a deflection system comprising at least one mirror face, said light ray moving transversely vis-a-vis the line direction relative to the deflection system. The light ray is generated with a laser diode that is displaceable transversely relative to the direction of the emerging light ray dependent on correction values. Before the actual operation, a plurality of positioning errors of the light ray are measured for every mirror face of the deflection system in the line direction (X-positioning error) and perpendicularly thereto (Y-positioning errors), measurements are made at measuring points orientated in the line direction on the surface. At least one X-correction value and one Y-correction value is generated for every mirror face. The laser diode is displaced such dependent on the X-correction values and on the Y-correction values such that the light ray incident onto the surface experiences correction displacements in and perpendicularly vis-a-vis the line direction for the elimination of the X-positioning errors and of the Y-positioning errors. Given simultaneous checking of the positioning errors, the correction values are varied until the positioning errors are compensated. The correction values calculated in this way are stored and are output during actual operation for continuous error compensations synchronized with the motion of the deflection system.

The invention relates to the field of electronic reproduction technology and is directed to a method and to an apparatus for the correction of positioning errors of a light ray in a flying spot laser scanner deflected Point-by-point and line-by-line by a deflection system comprising at least one mirror surface, particularly by a multi-face rotating mirror.
Flying spot laser scanners are employed in electronic reproduction technology as input scanners for point-by-point and line-by-line scanning of originals or as an output scanner for recording information. In an input scanner, a light ray is conducted over an original point-by-point and line-by-line with a deflection system and the scan light allowed to pass by or reflected from the original is converted into an image signal in an opto-electronic transducer. In an output scanner (recorder), a light ray that is intensity-modulated by an image signal is conducted across a recording medium point-by-point and line-by-line with a deflection system. The original or recording medium, referred to below as a surface, thereby move continuously or in steps perpendicularly to the line direction of the deflected light ray.
In order to achieve a high reproduction quality, a high deflection precision of the light ray must be maintained during original scanning and recording. Among those things required are that the spacings of the lines are identical and that the line starts and line ends on the surface lie on lines proceeding exactly perpendicularly to the line direction.
As a result of optical-geometrical aberrations of a deflection system, positioning errors of the deflected light ray arise on the surface, the precision being deteriorated as a result thereof.
The cause of such optical-geometrical errors, for example, are tolerances in the manufacture of the deflection system and deficiencies in the mechanical structure.
Mirror faces that are not arranged parallel to the rotational axis of the deflection system and an unstable position of the rotational axis cause positioning errors of the light ray perpendicularly vis-a-vis the line direction and, thus, cause unequal line spacings on the surface. Different angles between abutting mirror faces cause positioning errors in line direction and, thus, unequal line starts and line ends on the surface. Further positioning errors can arise due to uneven mirror faces. These positioning errors that are expressed by a non-uniform angular speed of the deflection system and, thus, by distortions within the lines are especially disturbing when a high precision or, respectively, reproduction quality is demanded.
EP-B-0054170 already discloses a means for the correction of a light ray in a flying spot laser scanner deflected by a deflection system in the form of a multi-face rotating mirror. In the known means, correction deflectors for the light ray are arranged between the laser generator for generating the light ray and the deflection system in order to compensate the positioning errors of the light ray caused by the deflection system. The positioning errors of the light ray are measured in a measurement phase preceding the actual operation. Correction values for driving the correction deflectors are then generated and the correction values are modified while constantly checking the positioning errors until the positioning errors are compensated by the correction deflectors. The correction values required for compensating the positioning errors are stored and are output for ongoing compensation of positioning errors during the actual operation synchronized with the rotational movement of the deflection system. The correction deflectors are piezoelectrically driven tilting mirrors or acousto-optical deflectors.
The known apparatus has the disadvantage that additional correction deflectors are required therein for compensating the positional errors and that the piezoelectrically driven tilting mirrors or acousto-optical deflectors have intrinsic errors that do not allow an optimum correction. For example, a piezoelectrically driven tilting mirror has a nonlinear characteristic affected with hysteresis and, due to its relatively great mass, only achieves a limited deflection speed. Added thereto is that the temperature dependency and the aging of the piezoceramic require a more frequent balancing of the apparatus.
Given an acousto-optical deflector, the optical efficiency unfavorably varies with the deflection angle and an acousto-optical deflector only allows a small ray diameter, as a result whereof its area of utilization is restricted. Moreover, a relatively involved frequency control is required for the operation of such an acousto-optical deflector.

Method and apparatus for the correction of positioning errors of a deflected light ray


Circuitry is described for compensating leakage currents in capacitive sensing circuits. A single active leakage compensation circuit may sense a representative leakage current and drive a plurality of output transistors, each of which provides a compensating current to a respective capacitive sensing circuit. The leakage compensation circuit may sense current flow through a device substantially equivalent to a device exhibiting leakage current in a capacitive sensing circuit, and in response, provide a signal to drive one or more output transistors to supply approximately equivalent currents to a plurality of circuit nodes. For embodiments having multiple similar capacitive sensors and capacitive sensing circuits, only one transistor need be added to each capacitive sensing circuit to compensate for leakage current.

1. Technical Field
The invention relates to apparatus and methods for detecting and compensating leakage currents in capacitive sensing circuits.
2. Discussion of the Related Art
Capacitive sensing elements have found wide use present day consumer electronics. For example, capacitive sensing elements may be incorporated in touch-sensitive user interfaces for various electronic devices such as computers, tablets, personal digital assistants, video gaming devices, and cellular phones. Capacitive sensing circuits may be used to sense changes in capacitance of a capacitive sensing element due to some type of perturbation, e.g., when an object such as a human finger is brought near the capacitive element. Some capacitive sensing circuits are used in commercial devices to enable device control or device operation via a touch-sensitive user interface. Capacitive sensing circuits may find applications in simple on/off touch pads, touch-sensitive operation panels, touch-sensitive track pads for computer operation, and touch-sensitive screens. Touch-sensitive components can provide a convenient user interface for microprocessor-based devices and may obviate the need for more cumbersome buttons or keyboards in some applications.
One example of a capacitive sensing circuit is shown in FIG. 1. The circuit shown is configured to sense or detect a change in a current Iin that flows to or from the capacitive sensing element 110 as a result of a change in capacitance C1 of the capacitive element. There may be a small potential applied to one node of capacitive element 110. Capacitive element 110 may be two plates of a capacitive sensor that is configured to be touched, or nearly touched, by a human finger or some device. Unperturbed, the two plates may exhibit a capacitance C1. As a finger or some other conductive object approaches the capacitive element 110, its capacitance C1 changes. The change in capacitance can lead to production of a current Iin associated with the change in capacitance. This can be understood from the following basic relation.C=g/V  (1)
where q represents the charge stored by the capacitor and V represents a voltage applied across the capacitor. If C varies with time and V is held constant, then the charge q varies with time causing current flow to or from the capacitive element 110.
In FIG. 1, a change in current Iin may be sensed by current sensing circuitry 150, which may comprise an operational amplifier 120 and a capacitor C2 coupled between the op-amp's output and inverting input. The non-inverting input may be connected to a reference potential. The current sensing circuit 150 may provide a voltage output Vout that is proportional to changes in capacitance of the capacitive element 110. Accordingly, the current sensing circuit 150 may also be referred to as a capacitive sensing circuit herein.
In an ideal capacitive sensing device, all the change in current Iin attributable to changes in capacitance of the capacitive element 110 would be received by the current sensing circuit 150. That is, ideally IA would be the same as Iin. However, in practice the current sensing circuit 150 is protected from potential damage that may be caused by electrostatic discharge (ESD). In order to protect the circuit, an ESD diode D1 130 is connected between a node common to the capacitive element 110 and the current sensing circuit 150 and a ground (GND) node or reference voltage node as shown in FIG. 1. The ESD diode may or may not be considered to be part of current sensing circuit 150. Unfortunately, the introduction of the ESD diode 130 results in a leakage current ID1. Current IA now becomes Iin−ID1. Additionally, the leakage current through diode 130 changes with temperature. At room temperature, it may be negligibly small. However, the leakage current ID1 can increase to be almost equal to Iin at temperatures of around 50 degrees Celcius, leaving only a very small current IA to be sensed by the current sensing circuit 150. Reduction in the magnitude of current IA can lead to noise-related errors and poor user-interaction with devices that use such capacitive-sensing elements and circuitry.


A rack for a control cabinet comprising a front and rear frame with vertical and horizontal frame pieces connected to each other by upper and lower depth braces, where the vertical and horizontal frame pieces, as well as the depth braces each form, with two sides disposed perpendicular to each other, an inner edge, and where identical rows of identical fastening receptacles and/or fastening bores are formed in these sides at the same distance from the inner edge. A selective installation of components with metric or inch division is achieved by means of a new profile for the frame pieces of the rack and by additional installation frames which can be connected to the rack.

1. Field of the Invention
This invention relates to a rack for a control cabinet comprising a front and rear frame with vertical and horizontal frame pieces which can be connected to each other by upper and lower depth braces, where the vertical and horizontal frame pieces, which are welded together in the corner areas and welded to corner connectors, as well as the depth braces each form, with two sides located perpendicularly to each other, an inner edge, and where identical rows of identical fastening receptacles and/or fastening bores are provided in these sides at the same distance from the inner edge, where the vertical and horizontal frame pieces have identical cross sections and identical rows of fastening receptacles and/or fastening bores.
2. Description of Prior Art
A rack of this type is taught by German Patent Publication DE 33 44 598 C1 where the frame pieces are cut to length from a uniform hollow profile section. In this rack, the rows of fastening receptacles and/or fastening bores offer universal installation possibilities in both directions of the cabinet interior as well as beyond the cabinet interior to adjoining, lined-up control cabinets. The division of the fastening receptacles and/or fastening bores in the row is metric, so that component supports or the like for components divided by inches cannot be easily installed in the rack.
German Patent Publication DE 39 20 353 A1 teaches a rack where two frames are made from C-profile sections, which are welded together in the corner areas. The C-profile sections have a base leg, two lateral legs and, at their ends, end sections bent at right angles and oriented towards each other. One profile side of an end section forms an inner edge with another profile side. These profile sides are provided with identical rows of identical fastening receptacles or fastening bores. In this known rack, the C-profile sections are mitered and welded together to form two frames. The two frames are connected to each other in the corner areas by four horizontal braces. In this case, the ends of the horizontal braces are welded to the frame. The fastening receptacles or fastening bores in this embodiment of the frame pieces are not suitable for the selective installation of components with metric division or inch division.
German Patent Publication DE 34 23 721 A1 teaches a rack where rails extending perpendicular to two vertical frame pieces can be installed between these, but which does not offer any additional fastening opportunities.
German Patent Publication DE 88 14 472 U1 discloses a rack which is also constructed of horizontal and vertical frame pieces and only permits the installation of components with a single pre-determined division. The same holds true for the mounting rails which can be installed in a rack in accordance with French Patent Publication FR 24 20 233.


System, computer-implemented method, and computer program product to receive a case by a deep question answering system, identify a policy relevant in generating a response to the case, the policy containing a set of criteria used in generating the response to the case, produce, by a first annotator, of a set of annotators, one or more relevant passages of the case, compute a criteria score for a first criterion, of the set of criteria, based on the one or more relevant passages of the case, an determine that the first criterion is met by the case when the criteria score for the first criterion exceeds a predefined threshold.

Embodiments disclosed herein relate to deep question answering systems. More specifically, embodiments disclosed herein relate to an inner passage relevancy layer for large intake cases in a deep question answering system.
In some use cases of a deep question answering (deep QA) systems, like IBM's Watson®, cases (or questions) and the passages being compared are often of dramatically different sizes. For example, in an insurance provider implementation, a corpus consisting of various medical insurance policies and guidelines may exist, which in turn consists of specific criteria corresponding to a given procedure. In order for a requested procedure to be approved by the insurance provider, the specific criteria must be met in accordance with the patient's clinical information (CI). The patient's CI often contains detailed history and description of present illness which can span several pages of text. The CI is essentially the question (also referred to as an intake case) sent to the deep QA system. To counteract the large intake case, the deep QA pipeline may turn the policy and guideline criteria into the "question," and the intake case into the supporting/refuting "passage." This allows the relatively short criteria to be the subject of deep analysis by the deep QA system. However, despite this switch, many scoring algorithms of the deep QA system still perform poorly (in terms of accuracy and computational performance). For example, a passage term match scorer attempts to match each term in the question by comparing it to each term in the passage. It then produces an overall score by totaling all the individual question term scores. If the intake case (i.e., the passage) is substantially larger than the criteria (i.e., the question), then the chances of every term in the criteria matching something in the intake case abnormally increases. The problem is exacerbated by a lack of focus in the question. In the insurance context, there are only three possible answers to an intake case—approve, deny, or refer to physician. It never makes sense to replace part of a criterion with any of these answers to form a hypothesis in the traditional sense. Embodiments disclosed herein propose a novel solution to this problem.

This patent is subject to a terminal disclaimer.

Inner passage relevancy layer for large intake cases in a deep question answering system

International Business Machines Corporation


A contactless power supplying device is provided. A primary coil and a basic power supplying unit circuit are arranged in a power supplying area. The primary coil supplies secondary power through electromagnetic induction to a secondary coil of a power receiving device in the power supplying area. The basic power supplying unit circuit excites the primary coil in the power supplying area. The basic power supplying unit circuit transmits an oscillation signal from the power supplying area to the power receiving device, receives a modulated wave signal from the power receiving device that detects a modulation wave that is in accordance with a magnetic flux change, and detects the modulated wave signal to demodulate the modulation wave. A system control unit determines whether or not a metal foreign object is present in the power supplying area corresponding to the basic power supplying unit circuit based on the modulation wave.

In a contactless power supplying system that performs electromagnetic induction method, an electric appliance including a power receiving device is set on a setting surface of a contactless power supplying device. In this state, the contactless power supplying device excites its primary coil thereby exciting a secondary coil arranged in the power receiving device of the electric appliance through electromagnetic induction. Secondary power is generated by the secondary coil and converted into direct current power in the power receiving device. The DC power is supplied to a load of the electric appliance as driving power.
The contactless power supplying device may include a metal detector that detects metal foreign objects and stops supplying power when the metal detector detects a metal foreign object. This prevents heating of a metal foreign object. When a metal foreign object is arranged between the contactless power supplying device and the electric appliance (power receiving device), the metal foreign object may be inductively heated when power is being supplied.
Japanese Laid-Open Patent Publication No. 2000-295796 describes an example of a metal detector arranged in a contactless power supplying device. The metal detector described in the publication excites the primary coil of the contactless power supplying device at a predetermined frequency (210 kHz), which differs from an excitation frequency (180 kHz) when supplied with power. The metal detector detects the presence of a metal foreign object when a change occurs in the inductance of the primary coil excited at the predetermined frequency and stops supplying power when a metal foreign object is present.

Panasonic Intellectual Property Management Co., Ltd.


Tread for heavy vehicles with radial carcass comprising a plurality of cimferential rows of blocks (13) having incisions (15), defined by circumferential (10) and transverse (12) grooves, said blocks being connected to each other in circumferential direction by platforms 14) which are arranged in the transverse grooves (12) and the height of which increases from the center towards the edges of the tread, the depth of the incisions (15) decreasing from the center towards the edge of the tread and the density of the incisions being maximum in the central zone (Z) of the tread.

The present invention relates to treads for radial carcass tires intended for heavy vehicles, more particularly buses.
Due to the very draconian conditions caused by the use of studded tires, it has appeared necessary, in order to avoid damage to the roads or even a total prohibition against the use of studded tires, to provide tires intended for heavy vehicles, and in particular buses, which are excellent in all weather, in all positions of the vehicle and, in particular, on the driving axles. It is well known that the tread of all-weather radial tires for heavy vehicles is generally formed of individual blocks arranged in several circumferential rows so as to provide excellent traction. However, such a tread rapidly leads to abnormal wear which may result in premature retirement of the tires due to the noise produced upon travel.
In order to overcome this drawback, U.S. Pat. No. 4,676,290 has proposed a tread formed of individual blocks with recesses on each of their circumferential edges, which are separated in circumferential direction by narrow grooves of generally transverse orientation which are of reduced depth as compared with those of the circumferential grooves and form platforms between the blocks in the circumferential direction. These identical platforms are present in all the rows of blocks with the exception of the side blocks of the tread. Such a solution has the drawback of offering only small driving traction on snow-covered ground.
It is furthermore known from British Patent 2 120 183 to improve the adherence of heavy vehicles on wet ground when they are under low load by using a tread formed of several rows of individual blocks present in the median zone and separated from each other in the circumferential direction by platforms arranged in narrow transverse grooves, the platforms in the vicinity of the median axis of the tread having, at least in the part close to the median axis, the smallest height and a greater height in the part directed towards the edges of the tread. This solution is no more satisfactory than the preceding one from the standpoint of adherence to snow-covered ground.
European Patent Application 355 636 describes a heavy- vehicle tire tread which retains its initial braking properties even after half-wear, which has, in the median zone of the said tread, fine incisions of a depth greater than those present in the side zones and a density less than the density of incisions present in the side zones.

Compagnie Generale des Etablissements Michelin - Michelin & Cie


The present invention relates to a recording liquid comprising at least:                a pigment (a); and        a polymer (b) having one or more types of bond selected from the group consisting of amide bond, urethane bond and urea bond in the molecule, having a weight-average molecular weight of 5000 to 300000 and having an acid value of free acid of not less than 55 mgKOH/g and less than 150 mgKOH/g,        the surface tension of said recording liquid being 25 to 54 dyne/cm.

The present invention relates to a recording liquid. More particularly, it relates to a recording liquid for ink jet recording or one suited for recording with hand writing instruments, and an ink jet recording method.
Hitherto, aqueous recording liquids (inks) prepared by dissolving an acid dye or direct dye in an aqueous medium or solvent type recording liquids produced by dissolving an oil-soluble dye in an organic solvent have been used as recording liquid for ink jet recording (hereinafter referred to as ink jet recording liquid). Solvent type recording liquids have the problems relating to environmental safety because of use of solvents, and their field of application is limited for inadequacy for office or home use. On the other hand, aqueous recording liquids which are most popularly used for business or domestic ink jet printers involve the problem of unsatisfactory water fastness and light fastness of the prints because of use of water-soluble pigments (dyes). The same holds true with the recording liquids for hand writing instruments.
In order to solve the above problems, there has been proposed and used in some quarters a recording liquid in which a pigment such as carbon black with excellent water fastness and light fastness is dispersed as colorant. However, the conventional recording liquids are unsatisfactory especially in respect of rubbing resistance of the prints and have the problem that the prints may be fouled when they are traced with a marker.
To overcome these problems, studies have been made on the recording liquids in which various types of polymeric material are added as binder. These recording liquids, however, have the disadvantage of being impaired in discharging stability in use because of rise of viscosity or for other reasons, and thus there has yet been available no recording liquid which can satisfy all of the essential requirements, i.e. stability of jetting performance, print density, rubbing resistance and tolerance to marker. Especially when a printing is to be used for a specific purpose such as presentation as a bulletin, the recording method is used primarily in which recording is made on a special recording sheet having an ink receiving layer on the support such as paper or resin film by an ink jet printing system. In this case, when it is tried to obtain good ink jettability and storage stability, there tend to arise the problem that rubbing resistance and gloss of the prints become unsatisfactory in the case of glossy paper having a smooth surface, whilst the print density lowers in the case of matte paper with high surface roughness.
As a result of the present inventors' earnest study to solve the above problems, it has been found that the above problems can be easily attained by containing a specific polymeric material in a pigment-dispersed recording liquid and determining the optimal range of surface tension of the said recording liquid.
The present invention has been attained on the basis of the above finding.

Recording liquid and ink jet recording method