Sharing Resources: Opportunities for Smaller Primary Care Practices to Increase Their Capacity for Patient Care

Outlines findings linking shared resources with use of health information technology, care coordination, self-management, and quality monitoring, and strategies to increase resources among small and midsize practices by expanding shared resource models

Bacterial fitness shapes the population dynamics of antibiotic-resistant and -susceptible bacteria in a model of combined antibiotic and anti-virulence treatment

Bacterial resistance to antibiotic treatment is a huge concern: introduction of any new antibiotic is shortly followed by the emergence of resistant bacterial isolates in the clinic. This issue is compounded by a severe lack of new antibiotics reaching the market. The significant rise in clinical resistance to antibiotics is especially problematic in nosocomial infections, where already vulnerable patients may fail to respond to treatment, causing even greater health concern. A recent focus has been on the development of anti-virulence drugs as a second line of defence in the treatment of antibiotic-resistant infections. This treatment, which weakens bacteria by reducing their virulence rather than killing them, should allow infections to be cleared through the body's natural defence mechanisms. In this way there should be little to no selective pressure exerted on the organism and, as such, a predominantly resistant population would be unlikely to emerge. However, much controversy surrounds this approach with many believing it would not be powerful enough to clear existing infections, restricting its potential application to prophylaxis. We have developed a mathematical model that provides a theoretical framework to reveal the circumstances under which anti-virulence drugs may or may not be successful. We demonstrate that by harnessing and combining the advantages of antibiotics with those provided by anti-virulence drugs, given infection-specific parameters, it is possible to identify treatment strategies that would efficiently clear bacterial infections, while preventing the emergence of resistant subpopulations. Our findings strongly support the continuation of research into anti-virulence drugs and demonstrate that their applicability may reach beyond infection prevention.Comment: Pre-review manuscript. Submitted to Journal of Theoretical Biology, July 21st 201

Thinning of the Sun's magnetic layer: the peculiar solar minimum could have been predicted

The solar magnetic activity cycle causes changes in the Sun on timescales that are relevant to human lifetimes. The minimum in solar activity that preceded the current solar cycle (cycle 24) was deeper and quieter than any other recent minimum. Using data from the Birmingham Solar-Oscillations Network (BiSON), we show that the structure of the solar sub-surface layers during the descending phase of the preceding cycle (cycle 23) was very different from that during cycle 22. This leads us to believe that a detailed examination of the data would have led to the prediction that the cycle-24 minimum would be out of the ordinary. The behavior of the oscillation frequencies allows us to infer that changes in the Sun that affected the oscillation frequencies in cycle 23 were localized mainly to layers above about 0.996Rsun, depths shallower than about 3000 km. In cycle 22, on the other hand, the changes must have also occurred in the deeper-lying layers.Comment: To appear in Ap

The neural basis of unwanted thoughts during resting state.

Human beings are constantly engaged in thought. Sometimes thoughts occur repetitively and can become distressing. Up to now the neural bases of these intrusive or unwanted thoughts is largely unexplored. To study the neural correlates of unwanted thoughts, we acquired resting-state fMRI data of 41 female healthy subjects and assessed the self-reported amount of unwanted thoughts during measurement. We analyzed local connectivity by means of regional homogeneity (ReHo) and functional connectivity of a seed region. More unwanted thoughts (state) were associated with lower ReHo in right dorsolateral prefrontal cortex (DLPFC) and higher ReHo in left striatum (putamen). Additional seed-based analysis revealed higher functional connectivity of the left striatum with left inferior frontal gyrus (IFG) in participants reporting more unwanted thoughts. The state-dependent higher connectivty in left striatum was positively correlated with rumination assessed with a dedicated questionnaire focussing on trait aspects. Unwanted thoughts are associated with activity in the fronto-striatal brain circuitry. The reduction of local connectivity in DLPFC could reflect deficiencies in thought suppression processes, whereas the hightened activity in left striatum could imply an imbalance of gating mechanisms housed in basal ganglia. Its functional connectivity to left IFG is discussed as the result of thought-related speech processes

Folding of a single domain protein entering the endoplasmic reticulum precedes disulfide formation

The relationship between protein synthesis, folding and disulfide formation within the endoplasmic reticulum (ER) is poorly understood. Previous studies have suggested pre-existing disulfide links are absolutely required to allow protein folding and, conversely, that protein folding occurs prior to disulfide formation. To address the question of what happens first within the ER; that is, protein folding or disulfide formation, we studied folding events at the early stages of polypeptide chain translocation into the mammalian ER using stalled translation intermediates. Our results demonstrate that polypeptide folding can occur without complete domain translocation. Protein disulfide isomerase (PDI) interacts with these early intermediates, but disulfide formation does not occur unless the entire sequence of the protein domain is translocated. This is the first evidence that folding of the polypeptide chain precedes disulfide formation within a cellular context and highlights key differences between protein folding in the ER and refolding of purified proteins

Delivery System Reform Tracking: A Framework for Understanding Change

Proposes a framework for tracking progress on delivery system reforms such as patient-centered medical homes and accountable care organizations by assessing structures, capabilities, incentives, and outcomes. Outlines challenges for data collection

Measuring Person–Job Fit and Career Paths of Distance Learning Librarians

While person–job fit has been used to determine satisfaction in many professions, no research has been done among distance learning librarians. This study investigates person–job fit among librarians with primary distance learning responsibility compared to librarians with some distance learning responsibility and examines whether a common career path exists among the two groups. Responses indicate that librarians who work primarily in distance learning perceive a slightly better fit with their positions and the work itself while those with some distance learning responsibility experience a slightly better fit within their library organizations. Career advancement is a common motivator for both groups

Visions, Missions, and Strategic Plans 101

This presentation outlines a basic method to identify the tasks, functions and outcomes of a department or division in order to craft meaningful vision and mission statements, and suggest questions to ask and methods to use in designing a strategic plan