A Health Plan Work in Progress: Hospital-Physician Price and Quality Transparency

Assesses health plans' efforts to provide consumers with price and quality comparisons on hospitals and doctors in twelve metropolitan areas. Looks at the plans' motives and strategies, as well as the limitations, risks, and challenges of transparency

Health and Wellness: The Shift From Managing Illness to Promoting Health

Examines the rise in health plan initiatives to promote wellness as a way for employers to manage costs and to engage employees in their own healthcare decisions through wellness activities, behavior modification programs, and health risk assessments

Drifter studies in warm core rings

The results of multiple deployments of surface drifters in warm core rings of the Gulf Stream are presented. Four satellite drifters (tracked by the Argos system) were deployed on nine separate occasions and two LORAN-C drifters (operated by the University of Miami) were deployed three times. Drifter studies were conducted during four cruises aboard the R/V Endeavor in 1982 in conjunction with the Warm Core Rings Experiment and one cruise of the USNS Bartlett in January 1983 which was sponsored by the Office of Naval Research. Translational velocities and periods of rotation are provided for two rings: 82B and 82H.National Science Foundation under grant OCE80-1698

A comparison of the in vitro and in planta responses of Phytophthora cinnamomi isolates to phosphite

Research in plant pathology often relies on testing interactions between a fungicide and a pathogen in vitro and extrapolating from these results what may happen in planta. Likewise, results from glasshouse experiments are used to estimate what will happen if the fungicide is applied in the field. However, it is difficult to obtain conditions in vitro and in the glasshouse which reflect the conditions where the fungicide may eventually be used, in the field. The aim of this paper is to compare results of the effect of phosphite on P. cinnamomi isolates in vitro and in planta

Edge Shear Flows and Particle Transport near the Density Limit in the HL-2A Tokamak

Edge shear flow and its effect on regulating turbulent transport have long been suspected to play an important role in plasmas operating near the Greenwald density limit $n_G$. In this study, equilibrium profiles as well as the turbulent particle flux and Reynolds stress across the separatrix in the HL-2A tokamak are examined as $n_G$ is approached in ohmic L-mode discharges. As the normalized line-averaged density $\bar{n}_e/n_G$ is raised, the shearing rate of the mean poloidal flow $\omega_{\rm sh}$ drops, and the turbulent drive for the low-frequency zonal flow (the Reynolds power $\mathcal{P}_{Re}$) collapses. Correspondingly, the turbulent particle transport increases drastically with increasing collision rates. The geodesic acoustic modes (GAMs) gain more energy from the ambient turbulence at higher densities, but have smaller shearing rate than low-frequency zonal flows. The increased density also introduces decreased adiabaticity which not only enhances the particle transport but is also related to a reduction in the eddy-tilting and the Reynolds power. Both effects may lead to the cooling of edge plasmas and therefore the onset of MHD instabilities that limit the plasma density

Rational Witt Classes of 4-Stranded Pretzel Knots

The rational Witt classes of knots are invariants related to knot concordance. Although they are somewhat weaker than other concordance invariants, for example, the algebraic concordance classes, they are much easier to compute. The goal of this thesis is to obstruct sliceness of 4-stranded pretzel knots by obtaining specific numerical restrictions on the parameters of the knot. We begin by building the theory of bilinear forms over arbitrary fields and construct our main tool, the rational Witt ring. Some examples are presented and we address the specific case of 4-stranded pretzel knots, which exhibit interesting phenomena in the restrictions of the parameters to ensure triviality of their Witt class

Genomic Organization, Splice Variants and Expression of CGMl, a CD66-related Member of the Carcinoembryonic Antigen Gene Family

The tumor marker carcinoembryonic antigen (CEA) belongs to a family of proteins which are composed of one immunogiobulin variable domain and a varying number of immunoglobulin constant-like domains. Most of the membrane-bound members, which are anchored either by a glycosylphosphatidylinositol moiety or a transmembrane domain, have been shown to convey cell adhesion in vitro. Here we describe two splice variants of CGMI. a transmembrane member of the CEA family without immunoglobulin constant.like domains. CGM1a and CGM1c contain cytopiasmic domains of 71 and 31 amino acids, respectively, The cytoplasmic region of CGM1a is encoded by four exons (Cyt1-Cyt4). Differential splicing of the Cyt1 exon (53 bp)..

Recent progress towards a physics-based understanding of the H-mode transition

Results from recent experiment and numerical simulation point towards a picture of the L-H transition in which edge shear flows interacting with edge turbulence create the conditions needed to produce a non-zero turbulent Reynolds stress at and just inside the LCFS during L-mode discharges. This stress acts to reinforce the shear flow at this location and the flow drive gets stronger as heating is increased. The L-H transition ensues when the rate of work done by this stress is strong enough to drive the shear flow to large values, which then grows at the expense of the turbulence intensity. The drop in turbulence intensity momentarily reduces the heat flux across the magnetic flux surface, which then allows the edge plasma pressure gradient to build. A sufficiently strong ion pressure gradient then locks in the H-mode state. These results are in general agreement with previously published reduced 0D and 1D predator prey models. An extended predator-prey model including separate ion and electron heat channels yields a non-monotonic power threshold dependence on plasma density provided that the fraction of heat deposited on the ions increases with plasma density. Possible mechanisms to explain other macroscopic transition threshold criteria are identified. A number of open questions and unexplained observations are identified, and must be addressed and resolved in order to build a physics-based model that can yield predictions of the macroscopic conditions needed for accessing H-mode

Driving calmodulin protein towards conformational shift by changing ionization states of select residues

Proteins are complex systems made up of many conformational sub-states which are mainly determined by the folded structure. External factors such as solvent type, temperature, pH and ionic strength play a very important role in the conformations sampled by proteins. Here we study the conformational multiplicity of calmodulin (CaM) which is a protein that plays an important role in calcium signaling pathways in the eukaryotic cells. CaM can bind to a variety of other proteins or small organic compounds, and mediates different physiological processes by activating various enzymes. Binding of calcium ions and proteins or small organic molecules to CaM induces large conformational changes that are distinct to each interacting partner. In particular, we discuss the effect of pH variation on the conformations of CaM. By using the pKa values of the charged residues as a basis to assign protonation states, the conformational changes induced in CaM by reducing the pH are studied by molecular dynamics simulations. Our current view suggests that at high pH, barrier crossing to the compact form is prevented by repulsive electrostatic interactions between the two lobes. At reduced pH, not only is barrier crossing facilitated by protonation of residues, but also conformations which are on average more compact are attained. The latter are in accordance with the fluorescence resonance energy transfer experiment results of other workers. The key events leading to the conformational change from the open to the compact conformation are (i) formation of a salt bridge between the N-lobe and the linker, stabilizing their relative motions, (ii) bending of the C-lobe towards the N-lobe, leading to a lowering of the interaction energy between the two-lobes, (iii) formation of a hydrophobic patch between the two lobes, further stabilizing the bent conformation by reducing the entropic cost of the compact form, (iv) sharing of a Ca+2 ion between the two lobes