At the Heart of Health Care Reform: Leadership Lessons from President Obama

Health care encompasses a broad. complicated web of political. economic and cultural ideology. values and systems, which have haunted every U.S. president serving over the last century. While many presidents have tried, few have succeeded in making such sweeping change as President Barack Obama when, on March 23, 2010, historic reform was enacted, with the passing of the Patient Protection and Affodable Care Act. A history of broad reform efforts under each president\u27s leadership is reviewed. followed by an exploration into definitions and requirements of presidential leadership. Lessons for reform as developed by Blumenthal and Morone (2009) are outlined and President Obama\u27s efforts since taking office are applied within this framework. Evaluating President Obama within this lens offers an opportunity to explore this new framework, to show connections between presidential leadership and his role in reform efforts, and provides lessons for any leader striving to create change

Synthesis and Photophysics of the Optical Probe N1-Methyl-7-azatryptophan

The development of a new intrinsic optical probe of protein structure and dynamics, Nl-methyl-7- azatryptophan (1M7AT), is reported. The utility of this nonnatural amino acid derivative lies in its single-exponential, long-lived fluorescence decay (21.7 f 0.4 ns) and in its high fluorescence quantum yield (0.53 f 0.07). Its absorption and emission maxima are red-shifted 10 and 65 nm, respectively, from those of tryptophan. These characteristics permit its unambiguous detection with unprecedented discrimination against emission from multiply occurring native tryptophan residues. In a mixture of these two amino acids, no tryptophan signal is detected until the tryptophan: N1-methyl-7-azatryptopharna tio exceeds 75: 1. Consequently, NI-methyl-7-azatryptophains ideal for studying the interactions of small peptides containing it with large proteins

Using 7-Azatryptophan To Probe Small Molecule-Protein Interactions on the Picosecond Time Scale: The Complex of Avidin and Biotinylated 7-Azatryptophan

The utility of 7-azatryptophan as an alternative to tryptophan for optically probing protein structure and dynamics is demonstrated by investigating the complex of egg-white avidin and biotinylated 7-azatryptophan. We report the synthesis of biotinylated 7-azatryptophan and optical measurements of its complex with avidin. Although there are four biotin binding sites, the emission from the 7-azatryptophan tagged to biotin decays by a single exponential, whereas the tryptophyl emission from avidin requires two exponentials in order to be adequately fit. Fluorescence depolarization measurements of the complex probed by emission from 7-azatryptophan reveal both rapid (-80 ps) and much longer-lived decay. The former component is attributable to the local motion of the probe with respect to the protein; the latter component represents overall protein tumbling. In addition, energy transfer from tryptophan to 7-azatryptophan and a blue-shift in the spectrum of biotinylated 7-azatryptophan are observed upon formation of the complex. Modified strategies of effecting optical selectivity are also discussed

Ultrarelativistic Bondi--Hoyle Accretion I: Axisymmetry

An ultrarelativistic relativistic study of axisymmetric Bondi--Hoyle accretion onto a moving Kerr black hole is presented. The equations of general relativistic hydrodynamics are solved using high resolution shock capturing methods. In this treatment we consider the ultrarelativistic limit wherein one may neglect the baryon rest mass density. This approximation is valid in the regime where the internal energy of the system dominates over the rest mass energy contribution from the baryons. The parameters of interest in this study are the adiabatic constant $\Gamma$, and the asymptotic speed of the fluid, $v_\infty$. We perform our simulations in three different regimes, subsonic, marginally supersonic, and supersonic, but the primary focus of this study is the parameter regime in which the flow is supersonic, that is when $v_\infty \ge c_{s}^{\infty}$. As expected from previous studies the supersonic regimes reveal interesting dynamics, but even more interesting is the presence of a bow shock in marginally supersonic systems. A range of parameter values were investigated to attempt to capture possible deviations from steady state solutions, none were found. To show the steady state behaviour of each of the flows studied we calculate the energy accretion rates on the Schwarzschild radius. Additionally, we also find that the accretion flows are dependent on the location of the computational boundary, that if the computational boundary is located too close to the black hole the calculated flow profiles are marred with numerical artifacts. This is a problem not found in previous relativistic models for ultrarelativistic hydrodynamic systems.Comment: 16 pages, 15 figures, Typos correcte

Paradigms and Controversies in the Treatment of HIV-Related Burkitt Lymphoma

Burkitt lymphoma (BL) is a very aggressive subtype of non-Hodgkin's lymphoma that occurs with higher frequency in patients with HIV/AIDS. Patients with HIV-related BL (HIV-BL) are usually treated with high-intensity, multi-agent chemotherapy regimens. The addition of the monoclonal antibody Rituximab to chemotherapy has also been studied in this setting. The potential risks and benefits of commonly used regimens are reviewed herein, along with a discussion of controversial issues in the practical management of HIV-BL, including concurrent anti-retroviral therapy, treatment of relapsed and/or refractory disease, and the role of stem cell transplantation

Equilibrium solutions of the shallow water equations

A statistical method for calculating equilibrium solutions of the shallow water equations, a model of essentially 2-d fluid flow with a free surface, is described. The model contains a competing acoustic turbulent {\it direct} energy cascade, and a 2-d turbulent {\it inverse} energy cascade. It is shown, nonetheless that, just as in the corresponding theory of the inviscid Euler equation, the infinite number of conserved quantities constrain the flow sufficiently to produce nontrivial large-scale vortex structures which are solutions to a set of explicitly derived coupled nonlinear partial differential equations.Comment: 4 pages, no figures. Submitted to Physical Review Letter

Photophysics and Biological Applications of 7-Azaindole and Its Analogs

7-Azaindole is the chromophoric moiety of 7-azatryptophan, which is an alternative to tryptophan as an optical probe of protein structure and dynamics. The great power of the 7-azaindole chromophore is that it is red shifted both in absorption and emission from tryptophan, that its fluorescence decay is single exponential in water under appropriate conditions, and that its emission is sensitive to solvent. In addition, 7-azatryptophan can be incorporated into synthetic peptides and bacterial protein. In this article, the interactions of 7-azaindole with its environment are discussed. Special attention is directed to the difference in its fluorescence properties in water as opposed to nonaqueous solvents. The sensitivity of 7-azaindole to its environment is demonstrated and then exploited by studying it and its analogs in peptides and in complexes with larger proteins containing many tryptophan residues

Inverse monoids and immersions of 2-complexes

It is well known that under mild conditions on a connected topological space $\mathcal X$, connected covers of $\mathcal X$ may be classified via conjugacy classes of subgroups of the fundamental group of $\mathcal X$. In this paper, we extend these results to the study of immersions into 2-dimensional CW-complexes. An immersion $f : {\mathcal D} \rightarrow \mathcal C$ between CW-complexes is a cellular map such that each point $y \in {\mathcal D}$ has a neighborhood $U$ that is mapped homeomorphically onto $f(U)$ by $f$. In order to classify immersions into a 2-dimensional CW-complex $\mathcal C$, we need to replace the fundamental group of $\mathcal C$ by an appropriate inverse monoid. We show how conjugacy classes of the closed inverse submonoids of this inverse monoid may be used to classify connected immersions into the complex

General Relativistic Magnetohydrodynamic Bondi--Hoyle Accretion

In this paper we present a fully relativistic study of axisymmetric magnetohydrodynamic Bondi--Hoyle accretion onto a moving Kerr black hole. The equations of general relativistic magnetohydrodynamics are solved using high resolution shock capturing methods. In this treatment we consider the ideal MHD limit. The parameters of interest in this study are the adiabatic constant $\Gamma$, the asymptotic speed of sound $c_{s}^{\infty}$, and the plasma beta parameter $\beta_{P}$. We focus the investigation on the parameter regime in which the flow is supersonic, or when $v_\infty \ge c_{s}^{\infty}$. In some cases, subsonic asymptotic flows are considered for comparison purposes. We study the accretion rates of the total energy and momenta, as well as the hydrodynamic energy and momentum accretion rates. The models presented in this study exhibit a matter density depletion in the downstream region of the black hole which tends to vacuum $(\rho_0=0)$ in convergence tests. This feature is due to the presence of the magnetic field, more specifically the magnetic pressure, and is not seen in previous purely hydrodynamic studies.Comment: Version 2: The figures have been reformatted to fit the paper. All verbal content remains identical to version