Hospital Community Benefits After the ACA: Building on State Experience

Analyzes hospitals' requirements to conduct community health needs assessments, financial assistance and billing and collection policies, and community benefit reporting and oversight strategies. Notes implications for federal and state law and practice

The Value of a virtual Kitchen to assess the activities of Daily life in Alzheimer Disease

Patients with Alzheimer\u27s disease (AD patients) experience difficulties in everyday life activities that effect independence. These difficulties can be tested using virtual reality (VR) environments that simulate real life situations. The purpose of this study was to examine the value of a virtual kitchen as an assessment tool of everyday life activities in AD patients. We focus on the assessment results obtained in a group of AD patients on a virtual kitchen designed to assess their ability to prepare a virtual cup of coffee using a virtual coffee machine. An identical real daily living task was tested. Twenty-four AD patients were matched to 32 healthy elderly controls. Significant differences in performance between research and control groups were detected on the virtual and the real tasks, with the research group performing worse. In addition, regression analyses revealed that the number of errors in the virtual test was the best predictor for the real assessment and the Instrumental Activities of Daily Living score. This provides initial support for the sensitivity and the ecological validity of the virtual kitchen as an assessment tool of everyday life activities in AD patient

Bond percolation on isoradial graphs: criticality and universality

In an investigation of percolation on isoradial graphs, we prove the criticality of canonical bond percolation on isoradial embeddings of planar graphs, thus extending celebrated earlier results for homogeneous and inhomogeneous square, triangular, and other lattices. This is achieved via the star-triangle transformation, by transporting the box-crossing property across the family of isoradial graphs. As a consequence, we obtain the universality of these models at the critical point, in the sense that the one-arm and 2j-alternating-arm critical exponents (and therefore also the connectivity and volume exponents) are constant across the family of such percolation processes. The isoradial graphs in question are those that satisfy certain weak conditions on their embedding and on their track system. This class of graphs includes, for example, isoradial embeddings of periodic graphs, and graphs derived from rhombic Penrose tilings.Comment: In v2: extended title, and small changes in the tex

Novel Glial Cells Missing-2 (GCM2) variants in parathyroid disorders

Objective: The aim of this study was to analyze variants of the gene glial cells missing-2 (GCM2), encoding a parathyroid cell-specific transcription factor, in familial hypoparathyroidism and in familial isolated hyperparathyroidism (FIHP) without and with parathyroid carcinoma. Design: We characterized 2 families with hypoparathyroidism and 19 with FIHP in which we examined the mechanism of action of GCM2 variants. Methods: Leukocyte DNA of hypoparathyroid individuals was Sanger sequenced for CASR, PTH, GNA11 and GCM2 mutations. DNA of hyperparathyroid individuals underwent MEN1, CDKN1B, CDC73, CASR, RET and GCM2 sequencing. The actions of identified GCM2 variants were evaluated by in vitro functional analyses. Results: A novel homozygous p.R67C GCM2 mutation which failed to stimulate transcriptional activity in a luciferase assay was identified in affected members of two hypoparathyroid families. Oligonucleotide pull-down assay and in silico structural modeling indicated that this mutant had lost the ability to bind the consensus GCM recognition sequence of DNA. Two novel (p.I383M and p.T386S) and one previously reported (p.Y394S) heterozygous GCM2 variants that lie within a C-terminal conserved inhibitory domain were identified in three affected individuals of the hyperparathyroid families. One family member, heterozygous for p.I138M, had parathyroid carcinoma (PC), and a heterozygous p.V382M variant was found in another patient affected by sporadic PC. These variants exerted significantly enhanced in vitro transcriptional activity, including increased stimulation of the PTH promoter. Conclusions: We provide evidence that two novel GCM2 R67C inactivating mutations with an inability to bind DNA are causative of hypoparathyroidism. Additionally, we provide evidence that two novel GCM2 variants increased transactivation of the PTH promoter in vitro and are associated with FIHP. Furthermore, our studies suggest that activating GCM2 variants may contribute to facilitating more aggressive parathyroid disease

The near-critical planar FK-Ising model

We study the near-critical FK-Ising model. First, a determination of the correlation length defined via crossing probabilities is provided. Second, a phenomenon about the near-critical behavior of FK-Ising is highlighted, which is completely missing from the case of standard percolation: in any monotone coupling of FK configurations $\omega_p$ (e.g., in the one introduced in [Gri95]), as one raises $p$ near $p_c$, the new edges arrive in a self-organized way, so that the correlation length is not governed anymore by the number of pivotal edges at criticality.Comment: 34 pages, 8 figures. This is a streamlined version; the previous one contains more explanations and additional material on exceptional times in FK models with general $q$. Furthermore, the statement and proof of Theorem 1.2 have slightly change

Finding Water Scarcity Amid Abundance Using Human–Natural System Models

Water scarcity afflicts societies worldwide. Anticipating water shortages is vital because of water’s indispensable role in social-ecological systems. But the challenge is daunting due to heterogeneity, feedbacks, and water’s spatial-temporal sequencing throughout such systems. Regional system models with sufficient detail can help address this challenge. In our study, a detailed coupled human–natural system model of one such region identifies how climate change and socioeconomic growth will alter the availability and use of water in coming decades. Results demonstrate how water scarcity varies greatly across small distances and brief time periods, even in basins where water may be relatively abundant overall. Some of these results were unexpected and may appear counterintuitive to some observers. Key determinants of water scarcity are found to be the cost of transporting and storing water, society’s institutions that circumscribe human choices, and the opportunity cost of water when alternative uses compete