Time-Utilization of a Population of General Practitioners in a Prepaid Group Practice

A population of seven general surgeons in a prepaid group practice previously shown to have a mean operative work load of 9.2 HE per week were found to have a mean standardized seven day working week of 56.2 hours exclusive of evening activities. The surgeons also devoted a mean of 6.7 evening hours to professional activities for a total working week of 62.9 hours. Comparisons of the time utilization of this population of general surgeons with a population of previously studied community surgeons revealed that the prepaid group surgeons were able to maintain a surgical output more than double that of the community surgeons without having to devote twice as much time to professional activities. Economies in the utilization of surgical manpower in the prepaid group appear to stem from geographic and specialty restrictions on the scope of work of the surgeons, from a reduction of waiting time in the office, and from the utilization of paraprofessional personnel for operative assisting.

Religious Technology Center v. Netcom On-Line Communications Services, Inc.: The Knowledge Standard for Contributory Copyright Infringement and the Fair Use Doctrine

With 30 million people connected worldwide and the ability to rapidly transfer large amounts of data, the Internet poses a great threat to owners of intellectual property. The Internet\u27s rapid growth has led to substantial speculation about how courts will apply intellectual property law concepts to conduct in cyberspace. On November 21, 1995, U.S. District Judge Ronald Whyte ruled that an Internet Service Provider (ISP) could be liable for contributory copyright infringement when a subscribing member directly infringes a copyright

Products and Ratios of Characteristic Polynomials of Random Hermitian Matrices

We present new and streamlined proofs of various formulae for products and ratios of characteristic polynomials of random Hermitian matrices that have appeared recently in the literature.Comment: 18 pages, LaTe

Resolved Millimeter-wavelength Observations of Debris Disks around Solar-type Stars

The presence of debris disks around young main-sequence stars hints at the existence and structure of planetary systems. Millimeter-wavelength observations probe large grains that trace the location of planetesimal belts. The Formation and Evolution of Planetary Systems Spitzer Legacy survey of nearby young solar analogues yielded a sample of five debris disk-hosting stars with millimeter flux suitable for interferometric follow-up. We present observations with the Submillimeter Array (SMA) and the Combined Array for Research in Millimeter-wave Astronomy at ~2'' resolution that spatially resolve the debris disks around these nearby (d ~ 50 pc) stars. Two of the five disks (HD 377, HD 8907) are spatially resolved for the first time and one (HD 104860) is resolved at millimeter wavelengths for the first time. We combine our new observations with archival SMA and Atacama Large Millimeter/Submillimeter Array data to enable a uniform analysis of the full five-object sample. We simultaneously model the broadband photometric data and resolved millimeter visibilities to constrain the dust temperatures and disk morphologies, and perform a Markov Chain Monte Carlo analysis to fit for basic structural parameters. We find that the radii and widths of the cold outer belts exhibit properties consistent with scaled-up versions of the Solar System's Kuiper Belt. All the disks exhibit characteristic grain sizes comparable to the blowout size, and all the resolved observations of emission from large dust grains are consistent with an axisymmetric dust distribution to within the uncertainties. These results are consistent with comparable studies carried out at infrared wavelengths

Safety of trastuzumab (Herceptin®) during pregnancy: two case reports

We report on two cases of women on trastuzumab therapy for breast cancer who became pregnant and delivered healthy live infants. At the time of reporting the children are growing and developing normally (ages 3 and 2)

Confirming the Primarily Smooth Structure of the Vega Debris Disk at Millimeter Wavelengths

Clumpy structure in the debris disk around Vega has been previously reported at millimeter wavelengths and attributed to concentrations of dust grains trapped in resonances with an unseen planet. However, recent imaging at similar wavelengths with higher sensitivity has disputed the observed structure. We present three new millimeter wavelength observations that help to resolve the puzzling and contradictory observations. We have observed the Vega system with the Submillimeter Array (SMA) at a wavelength of 880 μm and an angular resolution of 5"; with the Combined Array for Research in Millimeter-wave Astronomy (CARMA) at a wavelength of 1.3 mm and an angular resolution of 5"; and with the Green Bank Telescope (GBT) at a wavelength of 3.3 mm and angular resolution of 10". Despite high sensitivity and short baselines, we do not detect the Vega debris disk in either of the interferometric data sets (SMA and CARMA), which should be sensitive at high significance to clumpy structure based on previously reported observations. We obtain a marginal (3σ) detection of disk emission in the GBT data; the spatial distribution of the emission is not well constrained.We analyze the observations in the context of several different models, demonstrating that the observations are consistent with a smooth, broad, axisymmetric disk with inner radius 20–100 AU and width ≾50 AU. The interferometric data require that at least half of the 860 μm emission detected by previous single-dish observations with the James Clerk Maxwell Telescope be distributed axisymmetrically, ruling out strong contributions from flux concentrations on spatial scales of ≾100 AU. These observations support recent results from the Plateau de Bure Interferometer indicating that previous detections of clumpy structure in the Vega debris disk were spurious

Methodology for Development of a 600-Year Tree-Ring Multi-Element Record for Larch from the Taymir Peninsula, Russia

We developed a long (600-year) dataset for the concentrations of 26 elements in tree rings of larch from the Taymir Peninsula, the northernmost region in the world (ca. 72°N) where trees grow. Tree rings corresponding to the time period from 1300 to 1900 A.D. were studied. Eleven wood strips, each from a different larch tree, were cut into ca. 100 mg samples usually consisting of ten consecutive tree rings (but occasionally five). Between 19 and 40 consecutive samples resulted from each tree, yielding a total of 277 samples. The replication of each time interval ranged from three (for periods 1300-1400 A.D. and 1600-1700 A.D.) to six (for 1450-1600 A.D.). Wood samples were digested with concentrated HNO 3 for measurement of Li, B, Na, Mg, Al, Si, P, Cl, K, Ca, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Rb, Sr, Y, Zr, Nb, Mo, Ag, Cd, Sn, Sb, I, Ba, La, Ce, Nd, W, Au, Pb, Bi, Th, and U using solution Inductively Coupled Plasma Mass Spectrometry (ICPMS). Fourteen elements (V, Co, As, Y, Nb, Mo, Sb, La, Ce, Nd, W, Au, Th, and U) with extremely low concentrations were eliminated from consideration as unreliable. Here we report our sample preparation and measurement procedure, as well as the observed concentrations in tree rings, emphasizing considerations for developing representative and reliable denrodochemical datasets.Нами был получен длительный массив данных (600 лет) концентраций 26 элементов в годичных кольцах лиственницы с полуострова Таймыр, самого северного региона в мире (около 72° с.ш.), где возможен рост деревьев. Изучались годичные кольца, соответствующие промежутку времени с 1300 по 1900 год н.э. Одиннадцать древесных выпилов, по одному для каждой лиственницы, нарезались на образцы массой около 100 мг, которые, как правило, состояли из десяти годичных колец (но в некоторых случаях из пяти). Из каждого дерева было получено от 19 до 40 последовательных образцов, что дало в общей сложности 277 образцов. Повторность для каждого временного интервала варьировала от трех (для периодов 1300-1400 г.н.э. и 1600-1700 г.н.э.) до шести (для периода 1450-1600 г.н.э.). Древесные образцы растворяли в концентрированной HNO 3 для последующего измерения Li, B, Na, Mg, Al, Si, P, Cl, K, Ca, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Rb, Sr, Y, Zr, Nb, Mo, Ag, Cd, Sn, Sb, I, Ba, La, Ce, Nd, W, Au, Pb, Bi, Th и U при помощи масс-спектрометрии с индуктивно связанной плазмой (ICP-MS) для растворов. Четырнадцать элементов (V, Co, As, Y, Nb, Mo, Sb, La, Ce, Nd, W, Au, Th и U) с очень низкими концентрациями были исключены из рассмотрения как недостоверные. В данной статье, основной целью которой являлась отработка методики получения репрезентативных и достоверных дендрохимических данных, приводится использованная нами процедура пробоподготовки и измерений, а также полученные концентрации в годичных кольцах

Successful treatment of Mycobacterium ulcerans osteomyelitis with minor surgical debridement and prolonged rifampicin and ciprofloxacin therapy: a case report

ABSTRACT: INTRODUCTION: Treatment for osteomyelitis-complicating Mycobacterium ulcerans infection typically requires extensive surgery and even amputation, with no reported benefit from adjunctive antibiotics. CASE PRESENTATION: We report a case of an 87-year-old woman with M. ulcerans osteomyelitis that resolved following limited surgical debridement and 6 months of therapy with rifampicin and ciprofloxacin. CONCLUSION: M. ulcerans osteomyelitis can be successfully treated with limited surgical debridement and adjunctive oral antibiotics