Spectroscopy of D-type asteroids

We have performed a spectroscopic survey of 19 D-type asteroids. Comparison with previous photometry shows excellent agreement. Although the majority have similar colors to cometary nuclei, no cometary emission bands were present in any of the spectra. Absorption bands sporadically appearing were apparently due to stellar objects, and no features inherent to the asteroids were observed

Philosophy and updating of the asteroid photometric catalogue

The Asteroid Photometric Catalogue now contains photometric lightcurves for 584 asteroids. We discuss some of the guiding principles behind it. This concerns both observers who offer input to it and users of the product

Hyperestrogenism Affects Adult Height Outcome in Growth Hormone Treated Boys With Silver-Russell Syndrome

Background: Intrauterine growth retardation and short stature are common features in Silver-Russell syndrome (SRS). Despite recombinant growth hormone (rGH) treatment, poor pubertal height gain, affecting adult height (AH), is common. This study investigated whether growth patterns and estrogen concentrations are associated with AH outcome in rGH treated SRS males.Methods: In this retrospective longitudinal single-center study, 11 males with SRS were classified as non-responders (NR = 6) or responders (R = 5), depending on AH adjusted for midparental height. Epigenetic analysis and longitudinal growth measures, including bone age, rGH related parameters, pubertal development, gonadotropins and estrogen concentrations, were analyzed until AH.Results: Pubarche before 9 years was only observed in one NR. At 10 years of age, there was no difference in gonadotropins between NR and R. However, estradiol (E2) concentrations at 10 years of age showed a strong association to AH adjusted for MPH (r = −0.78, p < 0.001). Serum E2 (pmol/L) was significantly higher in NR at ages 10 years [median (range) 2 (<2–5) vs. <2 (<2)], 12 years [23 (10–57) vs. 2 (<2–2)] and 14 years [77 (54–87) vs. 24 (<2–38)] but not at 16 years. Birth weight standard deviation score (SDS) was lower in NR [−4.1 (−4.7 to −2.1) vs. −2.7 (−3.3 to −1.7)]. Weight gain (SDS) until pubertal onset was greater in NR [2.4 (1.4–3.5) vs. 0.8 (−0.4 to 1.7)] and pubertal height gain (SDS) was lower in NR [−1.0 (−2.7–0.4) vs. 0.1 (−0.1 to 1.1)]. At AH, a number of NR and R had high E2 concentrations and small testes.Conclusion: Increased E2 concentrations at age 10, 12, and 14 years were associated to less pubertal height gain, thus affecting AH. Due to the small number of patients, the results need to be confirmed in larger cohorts. The finding of impaired testicular development stresses the need of hormonal evaluation as a complement to clinical and radiological assessment when predicting AH in males with SRS

Understanding the context of balanced scorecard implementation: a hospital-based case study in pakistan

Background: As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods: Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp\u27s context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation.Results: Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing infrastructures and data networks. Conclusion: Variable levels of the BSC implementation were observed in this study. Those intending to apply the BSC in other hospital settings need to ensure a participatory culture, clear institutional mandate, appropriate leadership support, proper reward and recognition system, and sensitization to BSC benefits

Patient-centred attitudes among medical students: gender and work experience in health care make a difference

Background: Previous studies of medical students' patient-centred attitudes show a decline across undergraduate education and overall higher scores for female students. Aim: To assess undergraduate students' patient-centred attitudes at various stages of education and to explore possible associations between attitudes and age, gender and work experience in health care. Methods: In autumn 2005, medical students in Gothenburg (n = 797) were asked to answer Patient-Practitioner Orientation Scale (PPOS), a validated instrument exploring attitudes towards the doctor-patient relationship. Data including gender, age, current term and students' work experience in health care were collected. Results: Of 797 students 600 (75%) answered the questionnaire. No decrease of students' PPOS score across the curriculum was observed. PPOS scores from female students were higher compared to males (p < 0.0001) and female scores were significantly higher in the later terms compared with earlier (p = 0.0011). Female students had more experience from working in health care (p = 0.0023). Extended work experience was associated with higher PPOS only among females (p = 0.0031). Conclusion: No decline of students' patient-centred attitudes may indicate an ongoing shift. Gender differences in patient-centred attitudes were reproduced. Work experience in health care presents a new gender difference. These gender differences should be considered when training patient-centred attitudes and skills

Boosting the Performance of Shared Memory Multiprocessors

Shared memory multiprocessors make it practical to convert sequential programs to parallel ones in a variety of applications. An emerging class of shared memory multiprocessors are nonuniform memory access machines with private caches and a cache coherence protocol. Proposed hardware optimizations to CC-NUMA machines can shorten the time processors lose because of cache misses and invalidations. The authors look at cost-performance trade-offs for each of four proposed optimizations: release consistency, adaptive sequential prefetching, migratory sharing detection, and hybrid update/invalidate with a write cache. The four optimizations differ with respect to which application features they attack, what hardware resources they require, and what constraints they impose on the application software. The authors measured the degree of performance improvement using the four optimizations in isolation and in combination, looking at the trade-offs in hardware and programming complexities. Although one combination of the proposed optimizations (prefetching and migratory sharing detection) can boost a sequentially consistent machine to perform as well as a machine with release consistency, release consistency models offer significant performance improvements across a broad application domain at little extra complexity in the machine design. Moreover, a combination of sequential prefetching and hybrid update/invalidate with a write cache cuts the execution time of a sequentially consistent machine by half with fairly modest changes to the second-level cache and the cache protocol. The authors expect that designers will begin to turn more to the release consistency model