Key Findings From HSC's 2010 Site Visits: Health Care Markets Weather Economic Downturn, Brace for Health Reform

Presents findings about hospital payment rate increases, hospital-physician alignment, and insurance premiums, funding for safety-net providers, and their implications from HSC's site visits to twelve nationally representative metropolitan communities

Endogenous growth and property rights over renewable resources

We study how different regimes of access rights to renewable natural resources - namely, open access versus full property rights – affect sustainability, growth and welfare in the context of modern endogenous growth theory. Resource exhaustion may occur under both regimes but is more likely to arise under open access. Moreover, under full property rights, positive resource rents increase expenditures on manufacturing goods and temporarily accelerate productivity growth, but also yield a higher resource price at least in the short-to-medium run. We characterize analytically and quantitatively the model’s dynamics to assess the welfare implications of differences in property rights enforcement

Factors Associated With the Appropriate Use of Ultra-Broad Spectrum Antibiotics, Meropenem, for Suspected Healthcare-Associated Pneumonia

ABSTRACT: Pneumonia is a common disease-causing hospitalization. When a healthcare-associated infection is suspected, antibiotics that provide coverage for multi-drug resistant (MDR) or extended-spectrum beta-lactamase (ESBL) bacteria are frequently prescribed. Limited data is available for guidance on using meropenem as a first-line empiric antimicrobial in hospitalized patients with risk factors for MDR/ESBL bacterial infections. This was a single-center, retrospective study designed and conducted to identify factors associated with positive cultures for MDR/ESBL pathogens in hospitalized patients with suspected healthcare-associated pneumonia.Of the 246 patients, 103 patients (41%) received meropenem. Among patients prescribed meropenem, MDR/ESBL pathogens were detected in only 20 patients (13%). Patients admitted from a skilled nursing facility/long-term acute care (SNF/LTAC) or with a history of a positive culture for MDR/ESBL pathogens were significantly associated with positive cultures of MDR/ESBL pathogens during the hospitalization (odds ratio [95% confidence intervals], 31.40 [5.20-189.6] in SNF/LTAC and 18.50 [2.98-115.1] in history of culture-positive MDR/ESBL pathogen). There was no significant difference in mortality between the 3 antibiotic groups.Admission from a SNF/LTAC or having a history of cultures positive for MDR/ESBL pathogens were significantly associated with a positive culture for MDR/ESBL pathogens during the subsequent admission. We did not detect significant association between meropenem use as a first-line drug and morbidity and mortality for patients admitted to the hospital with suspected healthcare-associated pneumonia, and further prospective studies with larger sample size are needed to confirm our findings

GSTM1 Tissue Genotype as a Recurrence Predictor in Non-muscle Invasive Bladder Cancer

Tissue genotyping is more useful approach than using blood genomic DNA, which can reflect the effects of the somatic mutations in cancer. Although polymorphisms in glutathione S-transferase (GST) have been associated with the risk of bladder cancer (BC) development, few reports provide information about the prognosis of BC. We investigated glutathione S-transferase mu (GSTM1) and glutathione S-transferase theta (GSTT1) genotypes using genomic DNA from primary 165 BC tissue samples to assess the association with disease prognosis. DNA samples from tumor were analyzed by multiplex polymerase chain reaction (PCR). The results were compared with clinicopathological parameters. The prognostic significance of the GSTs was evaluated by Kaplan-Meier and multivariate Cox regression model. Kaplan-Meier estimates revealed significant differences in time to tumor recurrence according to the GSTM1 tissue genotype (P = 0.038) in non-muscle invasive bladder cancer (NMIBC). Multivariate Cox regression analysis also revealed that the tissue GSTM1 genotype (hazards ratio [HR]: 0.377, P = 0.031) was an independent predictor of bladder tumor recurrence in NMIBC. This identification of GSTM1 tissue genotype as a prognosticator for determining recurrence in NMIBC should prove highly useful in a clinical setting

Should the existing science of teams be applied to fluid teams? An exploration of fluid team effectiveness within the context of healthcare simulation

IntroductionFluid teams have become increasingly prevalent and necessary for modern-day issues, yet they differ from more traditional teams, on which much of the current teams literature is based. For example, fluid teams are often comprised of members from different disciplines or organizational divisions who do not have a shared history or future, as they come together to perform a critical, time-sensitive task, and then disband. For these reasons, the mechanisms through which they function and perform may differ from those of more traditional teams, and research is needed to better understand these differences.MethodsTo this end, this study utilized critical incident techniques and thematic analysis to examine fluid teams within healthcare, one of the primary contexts in which they are prevalent. Interdisciplinary faculty and students in the medical field who encounter fluid teams within simulation-based education were prompted to reflect on key factors that facilitate or hinder fluid team effectiveness.ResultsPrimary themes extracted pertained to the conditions fluid teams operate within (e.g., high-stress), the behaviors and emergent states that contribute to their success (e.g., communication), and the KSAO’s of value for members of fluid teams to possess (e.g., readiness). These themes were then compared to existing literature, yielding the identification of some similarities but also many important differences between fluid and traditional teams.DiscussionA series of practical recommendations for how to promote fluid team effectiveness is then presented

A cloud platform for automating and sharing analysis of raw simulation data from high throughput polymer molecular dynamics simulations

Open material databases storing hundreds of thousands of material structures and their corresponding properties have become the cornerstone of modern computational materials science. Yet, the raw outputs of the simulations, such as the trajectories from molecular dynamics simulations and charge densities from density functional theory calculations, are generally not shared due to their huge size. In this work, we describe a cloud-based platform to facilitate the sharing of raw data and enable the fast post-processing in the cloud to extract new properties defined by the user. As an initial demonstration, our database currently includes 6286 molecular dynamics trajectories for amorphous polymer electrolytes and 5.7 terabytes of data. We create a public analysis library at https://github.com/TRI-AMDD/htp_md to extract multiple properties from the raw data, using both expert designed functions and machine learning models. The analysis is run automatically with computation in the cloud, and results then populate a database that can be accessed publicly. Our platform encourages users to contribute both new trajectory data and analysis functions via public interfaces. Newly analyzed properties will be incorporated into the database. Finally, we create a front-end user interface at https://www.htpmd.matr.io for browsing and visualization of our data. We envision the platform to be a new way of sharing raw data and new insights for the computational materials science community.Comment: 21 pages, 7 figure

Mathematical programming modelling tools for resource-poor countries and organisations

In recent years, powerful mathematical modelling languages have enabled Operational Research practitioners to rapidly develop prototype tools capable of modelling complex managerial decisions such as staff shift scheduling, or production and supply chain planning. However, such tools have often required expensive commercial optimisation solvers that are sometimes beyond the financial reach of small companies and organisations, particularly in the low-income and emerging economies. Fortunately, the worldwide scope of the internet has put powerful free optimisation tools within the reach of anyone with a modest PC and even a slow internet connection. This article will present examples showing just how beneficial such an approach can be for resource-poor organisations

Entangled Stories: The Red Jews in Premodern Yiddish and German Apocalyptic Lore

“Far, far away from our areas, somewhere beyond the Mountains of Darkness, on the other side of the Sambatyon River…there lives a nation known as the Red Jews.” The Red Jews are best known from classic Yiddish writing, most notably from Mendele's Kitser masoes Binyomin hashlishi (The Brief Travels of Benjamin the Third). This novel, first published in 1878, represents the initial appearance of the Red Jews in modern Yiddish literature. This comical travelogue describes the adventures of Benjamin, who sets off in search of the legendary Red Jews. But who are these Red Jews or, in Yiddish, di royte yidelekh? The term denotes the Ten Lost Tribes of Israel, the ten tribes that in biblical times had composed the Northern Kingdom of Israel until they were exiled by the Assyrians in the eighth century BCE. Over time, the myth of their return emerged, and they were said to live in an uncharted location beyond the mysterious Sambatyon River, where they would remain until the Messiah's arrival at the end of time, when they would rejoin the rest of the Jewish people. This article is part of a broader study of the Red Jews in Jewish popular culture from the Middle Ages through modernity. It is partially based on a chapter from my book, Umstrittene Erlöser: Politik, Ideologie und jüdisch-christlicher Messianismus in Deutschland, 1500–1600 (Göttingen: Vandenhoeck & Ruprecht, 2011). Several postdoctoral fellowships have generously supported my research on the Red Jews: a Dr. Meyer-Struckmann-Fellowship of the German Academic Foundation, a Harry Starr Fellowship in Judaica/Alan M. Stroock Fellowship for Advanced Research in Judaica at Harvard University, a research fellowship from the Heinrich Hertz-Foundation, and a YIVO Dina Abramowicz Emerging Scholar Fellowship. I thank the organizers of and participants in the colloquia and conferences where I have presented this material in various forms as well as the editors and anonymous reviewers of AJS Review for their valuable comments and suggestions. I am especially grateful to Jeremy Dauber and Elisheva Carlebach of the Institute for Israel and Jewish Studies at Columbia University, where I was a Visiting Scholar in the fall of 2009, for their generous encouragement to write this article. Sue Oren considerably improved my English. The style employed for Romanization of Yiddish follows YIVO's transliteration standards. Unless otherwise noted, translations from the Yiddish, Hebrew, German, and Latin are my own. Quotations from the Bible follow the JPS translation, and those from the Babylonian Talmud are according to the Hebrew-English edition of the Soncino Talmud by Isidore Epstein

Measurement of the ratio B(D0->pi+pi-pi0)/B(D0->K-pi+pi0) and the time-integrated CP asymmetry in D0->pi+pi-pi0

We report a high-statistics measurement of the relative branching fraction B(D0->pi+pi-pi0)/B(D0->K-pi+pi0) using a 532 fb^{-1} data sample collected with the Belle detector at the KEKB asymmetric-energy e+e- collider. The measured value of the relative branching fraction is B(D0->pi+pi-pi0)/B(D0->K-pi+pi0) = (10.12 +/- 0.04(stat) +/- 0.18(syst))x10^{-2} which has an accuracy comparable to the world average. We also present a measurement of the time-integrated CP asymmetry in D0->pi+pi-pi0 decay. The result, A_{CP} = (0.43 +/- 1.30)%, shows no significant CP violation.Comment: 15 pages, 11 figures, submitted to Physics Letters