Tests for Automobile Guest Statute Application

Automobile guest statutes, like so many other new things that are a part of our daily life, were first approached with caution akin to apprehension, by both courts and lawyers. They were not quickly assimilated into the law. But today most of the ramifications of these statutes have been explored. Definite rules and standards have begun to take definite shape. The chief tests and criteria enunciated by the Ohio cases are generally valid anywhere

Evaluating PRISM Precipitation Grid Data As Possible Surrogates For Station Data At Four Sites In Oklahoma

The development of climate-sensitive decision support for agriculture or water resource management requires long time series of monthly precipitation for specific locations. Archived station data for many locations is available, but time continuity, quality, and spatial coverage of station data remain significant issues. One possible alternative for station data are continuous, gridded monthly data produced by the PRISM Climate Group, with each grid cell roughly 4 km per side. The PRISM monthly precipitation data is evaluated against station data for four sites in Oklahoma, for possible use whenever station data is unavailable or insufficient. The station and PRISM data are found to be very similar in two key respects (specifically 30-year monthly means and certain characteristics of probability density functions), but significantly different in variance. The difference in variance is attributed to situations where precipitation varied by significant amounts over short distances, with the gridded PRISM data "smearing" the heavy rainfall over locations that received lower amounts. As a result, PRISM precipitation data would be suitable for downscaling seasonal climate forecasts or other analyses that require knowledge of the mean and central shape of the local probability density function, but not for specifying variance as input for weather generators

R.A.P.I.D. (Root Aggregated Prioritized Information Display): A single screen display for efficient digital triaging of medical reports

AbstractObjectiveThe timely acknowledgement of critical patient clinical reports is vital for the delivery of safe patient care. With current EHR systems, critical reports reside on different screens. This leads to treatment delays and inefficient work flows. As a remedy, the R.A.P.I.D. (Root Aggregated Prioritized Information Display) system represents all data on a single screen, and its simple and intuitive “button” array structure allows triaged sign-off/sign-out of critical and non-critical reports.Materials and methodsWith 100 hematology and chemistry reports from each of two EHR systems Meditech (Westwood, MA) and Orchard Labs, Inc. (Carmel, IN), we generated files of the reports in their individual standard display formats (enhanced Meditech-EM and enhanced Orchard-EO). We also displayed the same 200 reports in the R.A.P.I.D. format. We then conducted a randomized trial to compare the time and accuracy of acknowledgement of critical and non-critical results.ResultsThe sign-off times for reviewing the results for physician and non-physician providers, respectively, in seconds (with 95% confidence intervals) were for EM 1.78 (1.40–2.26) and 1.99 (1.72–2.30), for EO 2.69 (2.12–3.42) and 2.78 (2.40–3.21), and for R.A.P.I.D. 0.83 (0.70–0.98) and 1.58 (1.43–1.76). Non-physician providers reassigned system-defined non-critical results as critical with a frequency of 15.2% for EM, 18.4% for EO, and 7.83% for R.A.P.I.D., and critical results as non-critical with a frequency of 14.7%, 5.6%, and 5.8% respectively.DiscussionThe new display system was superior to two standard EHR systems that were significantly enhanced by first collecting the reports from their usual distributed locations and then by creating for each of the two standard EHRs a single file of reports for acknowledgement.ConclusionsFrom a single screen display of all reports, the new display system enables timely acknowledgement of critical reports for patient safety and non-critical report triage for improved provider work flows

Scavenger Receptor Class A Plays a Central Role in Mediating Mortality and the Development of the Pro-Inflammatory Phenotype in Polymicrobial Sepsis

Sepsis is a frequent complication in critical illness. The mechanisms that are involved in initiation and propagation of the disease are not well understood. Scavenger receptor A (SRA) is a membrane receptor that binds multiple polyanions such as oxidized LDL and endotoxin. Recent studies suggest that SRA acts as a pattern recognition receptor in the innate immune response. The goal of the present study was to determine the role of SRA in polymicrobial sepsis. SRA deficient (SRA-/-) and C57BL/6JB/6J (WT) male mice were subjected to cecal ligation and puncture (CLP) to induce polymicrobial sepsis. NFκB activity, myeloperoxidase activity, and co-association of SRA with toll like receptor (TLR) 4 and TLR2 was analyzed in the lungs. Spleens were analyzed for apoptosis. Serum cytokines and chemokines were assayed. Blood and peritoneal fluid were cultured for aerobic and anaerobic bacterial burdens. Long term survival was significantly increased in SRA-/- septic mice (53.6% vs. 3.6%, p\u3c0.05) when compared to WT mice. NFκB activity was 45.5% lower in the lungs of SRA-/- septic mice versus WT septic mice (p\u3c0.05). Serum levels of interleukin (IL)-5, IL-6, IL-10 and monocyte chemoattractant protein -1 were significantly lower in septic SRA-/- mice when compared to septic WT mice (p\u3c0.05). We found that SRA immuno-precipitated with TLR4, but not TLR2, in the lungs of WT septic mice. We also found that septic SRA-/- mice had lower bacterial burdens than WT septic mice. SRA deficiency had no effect on pulmonary neutrophil infiltration or splenocyte apoptosis during sepsis. We conclude that SRA plays a pivotal, and previously unknown, role in mediating the pathophysiology of sepsis/septic shock in a murine model of polymicrobial sepsis. Mechanistically, SRA interacts with TLR4 to enhance the development of the pro-inflammatory phenotype and mediate the morbidity and mortality of sepsis/septic shock

The X-ray Afterglows of GRB 020813 and GRB 021004 with Chandra HETGS: Possible Evidence for a Supernova Prior to GRB 020813

We report on the detection of an emission line near 1.3 keV, which we associate with blue-shifted hydrogen-like sulfur (S XVI), in a 76.8 ksec Chandra HETGS spectrum of the afterglow of GRB 020813. The line is detected at 3.3 sigma significance. We also find marginal evidence for a line possibly due to hydrogen-like silicon (Si XIV) with the same blue-shift. A line from Fe is not detected, though a very low significance Ni feature may be present. A thermal model fits the data adequately, but a reflection model may provide a better fit. There is marginal evidence that the equivalent width of the S XVI line decrease as the burst fades. We infer from these results that a supernova likely occurred >~ 2 months prior to the GRB. We find no discrete or variable spectral features in the Chandra HETGS spectrum of the GRB 021004 afterglow.Comment: 26 pages, 11 figures, submitted to Ap

Book reviews

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45789/1/11153_2005_Article_BF01313791.pd

The First Extrasolar Planet Discovered with a New Generation High Throughput Doppler Instrument

We report the detection of the first extrasolar planet, ET-1 (HD 102195b), using the Exoplanet Tracker (ET), a new generation Doppler instrument. The planet orbits HD 102195, a young star with solar metallicity that may be part of the local association. The planet imparts radial velocity variability to the star with a semiamplitude of $63.4\pm2.0$ m s$^{-1}$ and a period of 4.11 days. The planetary minimum mass ($m \sin i$) is $0.488\pm0.015$ $M_J$.Comment: 42 pages, 11 figures and 5 tables, Accepted for publication in Ap

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning

Exploring the mycobacteriophage metaproteome: Phage genomics as an educational platform

Bacteriophages are the most abundant forms of life in the biosphere and carry genomes characterized by high genetic diversity and mosaic architectures. The complete sequences of 30 mycobacteriophage genomes show them collectively to encode 101 tRNAs, three tmRNAs, and 3,357 proteins belonging to 1,536 "phamilies" of related sequences, and a statistical analysis predicts that these represent approximately 50% of the total number of phamilies in the mycobacteriophage population. These phamilies contain 2.19 proteins on average; more than half (774) of them contain just a single protein sequence. Only six phamilies have representatives in more than half of the 30 genomes, and only three - encoding tape-measure proteins, lysins, and minor tail proteins - are present in all 30 phages, although these phamilies are themselves highly modular, such that no single amino acid sequence element is present in all 30 mycobacteriophage genomes. Of the 1,536 phamilies, only 230 (15%) have amino acid sequence similarity to previously reported proteins, reflecting the enormous genetic diversity of the entire phage population. The abundance and diversity of phages, the simplicity of phage isolation, and the relatively small size of phage genomes support bacteriophage isolation and comparative genomic analysis as a highly suitable platform for discovery-based education. © 2006 Hatfull et al