156 research outputs found

    Comparison of Hospital Costs and Length of Stay for Community Internists, Hospitalists, and Academicians

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    BACKGROUND: The model of inpatient medical management has evolved toward Hospitalists because of greater cost efficiency compared to traditional practice. The optimal model of inpatient care is not known. OBJECTIVE: To compare three models of inpatient Internal Medicine (traditional private practice Internists, private Hospitalist Internists, and Academic Internists with resident teams) for cost efficiency and quality at a community teaching hospital. DESIGN: Single-institution retrospective cohort study. MEASUREMENTS AND MAIN RESULTS: Measurements were hospital cost, length of stay (LOS), mortality, and 30-day readmission rate adjusted for severity, demographics, and case mix. Academic Internist teams had 30% lower cost and 40% lower LOS compared to traditional private Internists and 24% lower cost and 30% lower LOS compared to private Hospitalists. Hospital mortality was equivalent for all groups. Academic teams had 2.3–2.6% more 30-day readmissions than the other groups. CONCLUSIONS: Academic teams compare favorably to private Hospitalists and traditional Internists for hospital cost efficiency and quality

    Development of Genomic Resources for Pacific Herring through Targeted Transcriptome Pyrosequencing

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    Pacific herring (Clupea pallasii) support commercially and culturally important fisheries but have experienced significant additional pressure from a variety of anthropogenic and environmental sources. In order to provide genomic resources to facilitate organismal and population level research, high-throughput pyrosequencing (Roche 454) was carried out on transcriptome libraries from liver and testes samples taken in Prince William Sound, the Bering Sea, and the Gulf of Alaska. Over 40,000 contigs were identified with an average length of 728 bp. We describe an annotated transcriptome as well as a workflow for single nucleotide polymorphism (SNP) discovery and validation. A subset of 96 candidate SNPs chosen from 10,933 potential SNPs, were tested using a combination of Sanger sequencing and high-resolution melt-curve analysis. Five SNPs supported between-ocean-basin differentiation, while one SNP associated with immune function provided high differentiation between Prince William Sound and Kodiak Island within the Gulf of Alaska. These genomic resources provide a basis for environmental physiology studies and opportunities for marker development and subsequent population structure analysis

    Planet Populations as a Function of Stellar Properties

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    Exoplanets around different types of stars provide a window into the diverse environments in which planets form. This chapter describes the observed relations between exoplanet populations and stellar properties and how they connect to planet formation in protoplanetary disks. Giant planets occur more frequently around more metal-rich and more massive stars. These findings support the core accretion theory of planet formation, in which the cores of giant planets form more rapidly in more metal-rich and more massive protoplanetary disks. Smaller planets, those with sizes roughly between Earth and Neptune, exhibit different scaling relations with stellar properties. These planets are found around stars with a wide range of metallicities and occur more frequently around lower mass stars. This indicates that planet formation takes place in a wide range of environments, yet it is not clear why planets form more efficiently around low mass stars. Going forward, exoplanet surveys targeting M dwarfs will characterize the exoplanet population around the lowest mass stars. In combination with ongoing stellar characterization, this will help us understand the formation of planets in a large range of environments.Comment: Accepted for Publication in the Handbook of Exoplanet

    The 12 Item Social and Economic Conservatism Scale (SECS)

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    Recent years have seen a surge in psychological research on the relationship between political ideology (particularly conservatism) and cognition, affect, behaviour, and even biology. Despite this flurry of investigation, however, there is as yet no accepted, validated, and widely used multi-item scale of conservatism that is concise, that is modern in its conceptualisation, and that includes both social and economic conservatism subscales. In this paper the 12-Item Social and Economic Conservatism Scale (SECS) is proposed and validated to help fill this gap. The SECS is suggested to be an important and useful tool for researchers working in political psychology

    Chitosan-coated mesoporous MIL-100(Fe) nanoparticles as improved bio-compatible oral nanocarriers

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    Nanometric biocompatible Metal-Organic Frameworks (nanoMOFs) are promising candidates for drug delivery. Up to now, most studies have targeted the intravenous route, related to pain and severe complications; whereas nanoMOFs for oral administration, a commonly used non-invasive and simpler route, remains however unexplored. We propose here the biofriendly preparation of a suitable oral nanocarrier based on the benchmarked biocompatible mesoporous iron(III) trimesate nanoparticles coated with the bioadhesive polysaccharide chitosan (CS). This method does not hamper the textural/ structural properties and the sorption/release abilities of the nanoMOFs upon surface engineering. The interaction between the CS and the nanoparticles has been characterized through a combination of high resolution soft X-ray absorption and computing simulation, while the positive impact of the coating on the colloidal and chemical stability under oral simulated conditions is here demonstrated. Finally, the intestinal barrier bypass capability and biocompatibility of CS-coated nanoMOF have been assessed in vitro, leading to an increased intestinal permeability with respect to the noncoated material, maintaining an optimal biocompatibility. In conclusion, the preservation of the interesting physicochemical features of the CS-coated nanoMOF and their adapted colloidal stability and progressive biodegradation, together with their improved intestinal barrier bypass, make these nanoparticles a promising oral nanocarrier

    Economic Impacts of Non-Native Forest Insects in the Continental United States

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    Reliable estimates of the impacts and costs of biological invasions are critical to developing credible management, trade and regulatory policies. Worldwide, forests and urban trees provide important ecosystem services as well as economic and social benefits, but are threatened by non-native insects. More than 450 non-native forest insects are established in the United States but estimates of broad-scale economic impacts associated with these species are largely unavailable. We developed a novel modeling approach that maximizes the use of available data, accounts for multiple sources of uncertainty, and provides cost estimates for three major feeding guilds of non-native forest insects. For each guild, we calculated the economic damages for five cost categories and we estimated the probability of future introductions of damaging pests. We found that costs are largely borne by homeowners and municipal governments. Wood- and phloem-boring insects are anticipated to cause the largest economic impacts by annually inducing nearly 1.7billioninlocalgovernmentexpendituresandapproximately1.7 billion in local government expenditures and approximately 830 million in lost residential property values. Given observations of new species, there is a 32% chance that another highly destructive borer species will invade the U.S. in the next 10 years. Our damage estimates provide a crucial but previously missing component of cost-benefit analyses to evaluate policies and management options intended to reduce species introductions. The modeling approach we developed is highly flexible and could be similarly employed to estimate damages in other countries or natural resource sectors

    Soy protein–gum karaya conjugate: emulsifying activity and rheological behavior in aqueous system and oil in water emulsion

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    The main objective of this study is to investigate the effects of mixing and conjugation of soy protein isolate (SPI) with gum karaya on the characteristics of the hybrid polymer (protein–gum) in both aqueous systems and oil-in-water (O/W) emulsions. It was hypothesized that the covalent linkage of gum karaya with SPI would improve the emulsifying activity and rheological properties of both polymers. Conjugation occurred under controlled conditions (i.e., 60 °C and 75 % relative humidity, 3 days). The conjugated hybrid polymer produced smaller droplet with better uniformity, higher viscosity and stronger emulsifying activity than native gum karaya, suggesting the conjugated polymer provided a bulkier secondary layer with more efficient coverage around oil droplets, thereby inducing stronger resistance against droplet aggregation and flocculation. Emulsions containing the native gum karaya produced the largest droplet size among all prepared emulsions (D 3,2 = 8.6 μm; D 4,3 = 22.4 μm); while the emulsion containing protein–gum conjugate (1:1 g/g) had the smallest droplet size (D 3,2 = 0.2 μm; D 4,3 = 0.7 μm) with lower polydispersity. The protein–gum conjugate (1:1 g/g) also showed the highest elastic and viscous modulus, the lowest polydispersity (span) and the highest emulsifying activity among all native, mixed and conjugated polymers. Therefore, the percentage of gum karaya used for production of O/W emulsion can be decreased by partially replacing it with the conjugated gum
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