Financial advantages of hospitals’ relationships with accountable care organizations

Accountable care organizations are groups of providers who agree to accept the responsibility for elevating the health status of a defined group of patients, with the goal of enabling people to take charge of their health and enroll in shared decision-making with providers. The large initial investment required (estimated at $1.8 million) to develop an ACO implies that the participation of large health care organizations, especially hospitals and health systems, is required for success. Findings of the study suggest that ACOs based in a larger hospital organizations are more likely to meet CMS criteria for formation because of financial and structural assets of those entities

Multispecies event experiences : Introducing more-than-human perspectives to event studies

Events are all about experiences, and event managers and designers are encouraged to explore innovative and creative ways to engage and excite customers, creating satisfaction and loyalty. These experiences are not always solely human phenomena, although event studies as an academic field has yet to acknowledge this multispecies aspect and remains firmly anthropocentric. In this paper we introduce more-than-human perspectives to event studies to illustrate how moving beyond humanist paradigms can open up alternative insights and add to the richness of understanding about event experiences. Drawing on ethnographic fieldwork conducted at equestrian ‘endurance riding’ events both in the UK and Australia, we apply a multispecies lens to the investigation of event experiences. In equestrian events, the experiences of human participants are profoundly shaped by those of the equine participants, and the interactions between the two. Endurance riding offers an interesting example of one ‘contact zone’ between human and nonhuman, as horse and human work together to create sporting performance, travelling through varied landscapes and environments. In such ways, horses are co-creaters of event experiences, actively shaping and helping create those encounters, whether they be memorable or mundane. By decentring human experience, more-than-human perspectives open up possibilities for exploring and understanding the richness of event experiences that involve multiple actors and species

Metalloprotease Meprinβ in Rat Kidney: Glomerular Localization and Differential Expression in Glomerulonephritis

Meprin (EC 3.4.24.18) is an oligomeric metalloendopeptidase found in microvillar membranes of kidney proximal tubular epithelial cells. Here, we present the first report on the expression of meprinβ in rat glomerular epithelial cells and suggest a potential involvement in experimental glomerular disease. We detected meprinβ in glomeruli of immunostained rat kidney sections on the protein level and by quantitative RT-PCR of laser-capture microdissected glomeruli on the mRNA level. Using immuno-gold staining we identified the membrane of podocyte foot processes as the main site of meprinβ expression. The glomerular meprinβ expression pattern was altered in anti-Thy 1.1 and passive Heymann nephritis (PHN). In addition, the meprinβ staining pattern in the latter was reminiscent of immunostaining with the sheep anti-Fx1A antiserum, commonly used in PHN induction. Using Western blot and immunoprecipitation assays we demonstrated that meprinβ is recognized by Fx1A antiserum and may therefore represent an auto-antigen in PHN. In anti-Thy 1.1 glomerulonephritis we observed a striking redistribution of meprinβ in tubular epithelial cells from the apical to the basolateral side and the cytosol. This might point to an involvement of meprinβ in this form of glomerulonephritis

The July 31, 2007 Stellar Occultation by Pluto

International audienc

The July 31, 2007 Stellar Occultation by Pluto

International audienc

Role of Integrin αvβ6 in Acute Lung Injury Induced by Pseudomonas aeruginosa▿

Deletion of integrin αvβ6 has been associated with significant protection in experiments where lung injury was induced by bleomycin, lipophilic polysaccharides, and high tidal volume ventilation. This has led to the suggestion that antibody blockade of this integrin is a novel therapy for acute lung injury. We questioned whether β6 gene deletion would also protect against Pseudomonas aeruginosa-induced acute lung injury. Wild-type and littermate β6-null mice, as well as recombinant soluble TGF-β receptor type II-Fc (rsTGF-βRII-Fc) and anti-αvβ6 treated wild-type mice, were instilled with live P. aeruginosa. Four or 8 h after bacterial instillation, the mice were euthanized, and either bronchoalveolar lavage fluid or lung homogenates were obtained. Deletion of the β6 gene resulted in an overall increase in inflammatory cells in the lungs. Bacterial numbers from the lung homogenates of infected β6-null mice were significantly decreased compared to the numbers in the wild-type mice (1.6 × 106 CFU versus 4.2 × 106 CFU [P < 0.01]). There were no significant differences in P. aeruginosa-mediated increases in lung endothelial permeability between wild-type and β6-null mice. Similarly, pretreatment with the αvβ6 antibody or with rsTGF-βRII-Fc did not significantly affect the P. aeruginosa-induced lung injury or rate of survival compared to pretreatment with control immunoglobulin G. We conclude that deletion or inhibition of the integrin αvβ6 did not protect animals from P. aeruginosa-induced lung injury. However, these therapies also did not increase the lung injury, suggesting that host defense was not compromised by this promising new therapy