Current Approaches to Improving the Value of Care: A Physician's Perspective

Evaluates the utility of judgment-based approaches to quality improvement -- pay-for-performance, public reporting, consumer-directed health plans, and tiering -- as ways to control costs. Recommends incentive- and accountability-based programs

Letter to the Editor: The Value of Value-Based Purchasing

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The Saccharomyces cerevisiae SEC14 Gene Encodes a Cytosolic Factor That Is Required for Transport of Secretory Proteins from the Yeast Golgi Complex

We have obtained and characterized a genomic clone of SEC14, a Saccharomyces cerevisiae gene whose product is required for export of yeast secretory proteins from the Golgi complex. Gene disruption experiments indicated that SEC14 is an essential gene for yeast vegetative growth. Nucleotide sequence analysis revealed the presence of an intron within the SEC14 structural gene, and predicted the synthesis of a hydrophilic polypeptide of 35 kD in molecular mass. In confirmation, immunoprecipitation experiments demonstrated SEC14p to be an unglycosylated polypeptide, with an apparent molecular mass of some 37 kD, that behaved predominantly as a cytosolic protein in subcellular fractionation experiments. These data were consistent with the notion that SEC14p is a cytosolic factor that promotes protein export from yeast Golgi. Additional radiolabeling experiments also revealed the presence of SEC14p-related polypeptides in extracts prepared from the yeasts Kluyveromyces lactis and Schizosaccharomyces pombe. Furthermore, the K. lactis SEC14p was able to functionally complement S. cerevisiae sec14ts defects. These data suggested a degree of conservation of SEC14p structure and function in these yeasts species

Numerical analysis and simulation of an assured crew return vehicle flow field

A lifting body was proposed as a candidate for the Assured Crew Return Vehicle (ACRV) which will serve as a crew rescue vehicle for the Space Station Freedom. The focus is on body surface definition, both surface and volume grid definition, and the computation of inviscid flow fields about the vehicle at wind tunnel conditions. Very good agreement is shown between the computed aerodynamic characteristics of the vehicle at M(sub infinity) = 10 and those measured in wind tunnel tests at high Reynolds numbers

Massive quenched galaxies at z~0.7 retain large molecular gas reservoirs

The physical mechanisms that quench star formation, turning blue star-forming galaxies into red quiescent galaxies, remain unclear. In this Letter, we investigate the role of gas supply in suppressing star formation by studying the molecular gas content of post-starburst galaxies. Leveraging the wide area of the SDSS, we identify a sample of massive intermediate-redshift galaxies that have just ended their primary epoch of star formation. We present ALMA CO(2-1) observations of two of these post-starburst galaxies at z~0.7 with M* ~ 2x10^11 Msun. Their molecular gas reservoirs of (6.4 +/- 0.8) x 10^9 Msun and (34.0 +/- 1.6) x 10^9 Msun are an order of magnitude larger than comparable-mass galaxies in the local universe. Our observations suggest that quenching does not require the total removal or depletion of molecular gas, as many quenching models suggest. However, further observations are required both to determine if these apparently quiescent objects host highly obscured star formation and to investigate the intrinsic variation in the molecular gas properties of post-starburst galaxies.Comment: Accepted for publication in ApJ Letters (6 pages, 5 figures

The Written Description Requirement

It is now well accepted that this provision of the 1952 Patent Act (Patent Act) includes a written description requirement that is separate and distinct from the enablement requirement. Thus, a specification may enable one of ordinary skill to make or use a claimed invention, but still not adequately describe the invention in a way that the public knows that the inventor was in possession of the claimed invention at the time of filing the application. For example, a patent specification that discloses various patterns of eight wooden shingles, does not necessarily provide written description for a claim amendment that recites “at least six shingles,” even though the specification would enable one so inclined to construct a panel of at least six wooden shingles. However, it was not entirely clear from the language of the Patent Act itself that there was a written description requirement separate and distinct from the enablement requirement. The well-accepted understanding that these are separate and distinct requirements flows from judicial decisions, and not the text of the Patent Act itself

Laser-induced fluorescence studies of HfF+ produced by autoionization

Autoionization of Rydberg states of HfF, prepared using the optical-optical double resonance (OODR) technique, holds promise to create HfF+ in a particular Zeeman level of a rovibronic state for an electron electric dipole moment (eEDM) search. We characterize a vibronic band of Rydberg HfF at 54 cm-1 above the lowest ionization threshold and directly probe the state of the ions formed from this vibronic band by performing laser-induced fluorescence (LIF) on the ions. The Rydberg HfF molecules show a propensity to decay into only a few ion rotational states of a given parity and are found to preserve their orientation qualitatively upon autoionization. We show empirically that we can create 30% of the total ion yield in a particular |J+,M+> state and present a simplified model describing autoionization from a given Rydberg state that assumes no angular dynamics.Comment: 8 pages, 5 figure

The effect of frequent hemodialysis on nutrition and body composition: frequent Hemodialysis Network Trial.

We investigated the effects of frequency of hemodialysis on nutritional status by analyzing the data in the Frequent Hemodialysis Network Trial. We compared changes in albumin, body weight, and composition among 245 patients randomized to six or three times per week in-center hemodialysis (Daily Trial) and 87 patients randomized to six times per week nocturnal or three times per week conventional hemodialysis, performed largely at home (Nocturnal Trial). In the Daily Trial, there were no significant differences between groups in changes in serum albumin or the equilibrated protein catabolic rate by 12 months. There was a significant relative decrease in predialysis body weight of 1.5 ± 0.2 kg in the six times per week group at 1 month, but this significantly rebounded by 1.3 ± 0.5 kg over the remaining 11 months. Extracellular water (ECW) decreased in the six times per week compared with the three per week hemodialysis group. There were no significant between-group differences in phase angle, intracellular water, or body cell mass (BCM). In the Nocturnal Trial, there were no significant between-group differences in any study parameter. Any gain in 'dry' body weight corresponded to increased adiposity rather than muscle mass but was not statistically significant. Thus, frequent in-center hemodialysis reduced ECW but did not increase serum albumin or BCM while frequent nocturnal hemodialysis yielded no net effect on parameters of nutritional status or body composition

Insights from the 2006 Disease Management Colloquium

This roundtable discussion emanates from the presentations given and issues raised at the 2006 Disease Management Colloquium, which was held May 10–12, 2006 in Philadelphia, Pennsylvania

The Host Galaxy and Central Engine of the Dwarf AGN POX 52

We present new multi-wavelength observations of the dwarf Seyfert 1 galaxy POX 52 in order to investigate the properties of the host galaxy and the active nucleus, and to examine the mass of its black hole, previously estimated to be ~ 10^5 M_sun. Hubble Space Telescope ACS/HRC images show that the host galaxy has a dwarf elliptical morphology (M_I = -18.4 mag, Sersic index n = 4.3) with no detected disk component or spiral structure, confirming previous results from ground-based imaging. X-ray observations from both Chandra and XMM show strong (factor of 2) variability over timescales as short as 500 s, as well as a dramatic decrease in the absorbing column density over a 9 month period. We attribute this change to a partial covering absorber, with a 94% covering fraction and N_H = 58^{+8.4}_{-9.2} * 10^21 cm^-2, that moved out of the line of sight in between the XMM and Chandra observations. Combining these data with observations from the VLA, Spitzer, and archival data from 2MASS and GALEX, we examine the spectral energy distribution (SED) of the active nucleus. Its shape is broadly similar to typical radio-quiet quasar SEDs, despite the very low bolometric luminosity of L_bol = 1.3 * 10^43 ergs/s. Finally, we compare black hole mass estimators including methods based on X-ray variability, and optical scaling relations using the broad H-beta line width and AGN continuum luminosity, finding a range of black hole mass from all methods to be M_bh = (2.2-4.2) * 10^5 M_sun, with an Eddington ratio of L_bol/L_edd = 0.2-0.5.Comment: 19 pages, 16 figures, accepted for publication in Ap