Geographic Variation in Informed Consent Law: Two Standards for Disclosure of Treatment Risks

We analyzed 714 jury verdicts in informed consent cases tried in 25 states in 1985–2002 to determine whether the applicable standard of care (“patient” vs. “professional” standard) affected the outcome. Verdicts for plaintiffs were significantly more frequent in states with a patient standard than in states with a professional standard (27 percent vs. 17 percent, P = 0.02). This difference in outcomes did not hold for other types of medical malpractice litigation (36 percent vs. 37 percent, P = 0.8). The multivariate odds of a plaintiff’s verdict were more than twice as high in states with a patient standard than in states with a professional standard (odds ratio = 2.15, 95% confidence interval = 1.32–3.50). The law’s expectations of clinicians with respect to risk disclosure appear to vary geographically

Carbon Free Boston: Technical Summary

Part of a series of reports that includes: Carbon Free Boston: Summary Report; Carbon Free Boston: Social Equity Report; Carbon Free Boston: Buildings Technical Report; Carbon Free Boston: Transportation Technical Report; Carbon Free Boston: Waste Technical Report; Carbon Free Boston: Energy Technical Report; Carbon Free Boston: Offsets Technical Report; Available at http://sites.bu.edu/cfb/OVERVIEW: This technical summary is intended to argument the rest of the Carbon Free Boston technical reports that seek to achieve this goal of deep mitigation. This document provides below: a rationale for carbon neutrality, a high level description of Carbon Free Boston’s analytical approach; a summary of crosssector strategies; a high level analysis of air quality impacts; and, a brief analysis of off-road and street light emissions.Published versio

Sensitivity of the NOy budget over the United States to anthropogenic and lightning NOx in summer

We examine the implications of new estimates of the anthropogenic and lightning nitrogen oxide (NOx) source for the budget of oxidized nitrogen (NOy) over the United States in summer using a 3-D global chemical transport model (Model of Ozone and Related Tracers-4). As a result of the Environmental Protection Agency (EPA) State Implementation call, power plant NOx emissions over the eastern United States decreased significantly, as reflected by a 23% decrease in summer surface emissions from the 1999 U.S. EPA National Emissions Inventory to our 2004 inventory. We increase the model lightning NOx source over northern midlatitude continents (by a factor of 10) and the fraction emitted into the free troposphere (FT, from 80% to 98%) to better match the recent observation-based estimates. While these NOx source updates improve the simulation of NOx and O3 compared to the Intercontinental Chemical Transport Experiment-North America aircraft observations, a bias in the partitioning between nitric acid (HNO3) and peroxyacetylnitrate (PAN) remains especially above 8 km, suggesting gaps in the current understanding of upper tropospheric processes. We estimate a model NOy export efficiency of 4%−14% to the North Atlantic in the FT, within the range of previous plume-based estimates (3%−20%) and lower than the 30% exported directly from the continental boundary layer. Lightning NOx contributes 24%−43% of the FT NOy export from the U.S. to the North Atlantic and 28%−34% to the NOy wet deposition over the United States, with the ranges reflecting different assumptions. Increasing lightning NOx decreases the fractional contribution of PAN to total NOy export, increases the O3 production in the northern extratropical FT by 33%, and decreases the regional mean ozone production efficiency per unit NOx (OPE) by 30%. If models underestimate the lightning NOx source, they would overestimate the background OPE in the FT and the fractional contribution of PAN to NOy export. Therefore, a model underestimate of lightning NOx would likely lead to an overestimate of the downwind O3 production due to anthropogenic NOx export. Better constraints on the lightning NOx source are required to more confidently assess the impacts of anthropogenic emissions and their changes on air quality over downwind regions

Sensitivity of the NOy budget over the United States to anthropogenic and lightning NOx in summer

We examine the implications of new estimates of the anthropogenic and lightning nitrogen oxide (NOx) source for the budget of oxidized nitrogen (NOy) over the United States in summer using a 3-D global chemical transport model (Model of Ozone and Related Tracers-4). As a result of the Environmental Protection Agency (EPA) State Implementation call, power plant NOx emissions over the eastern United States decreased significantly, as reflected by a 23% decrease in summer surface emissions from the 1999 U.S. EPA National Emissions Inventory to our 2004 inventory. We increase the model lightning NOx source over northern midlatitude continents (by a factor of 10) and the fraction emitted into the free troposphere (FT, from 80% to 98%) to better match the recent observation-based estimates. While these NOx source updates improve the simulation of NOx and O3 compared to the Intercontinental Chemical Transport Experiment-North America aircraft observations, a bias in the partitioning between nitric acid (HNO3) and peroxyacetylnitrate (PAN) remains especially above 8 km, suggesting gaps in the current understanding of upper tropospheric processes. We estimate a model NOy export efficiency of 4%−14% to the North Atlantic in the FT, within the range of previous plume-based estimates (3%−20%) and lower than the 30% exported directly from the continental boundary layer. Lightning NOx contributes 24%−43% of the FT NOy export from the U.S. to the North Atlantic and 28%−34% to the NOy wet deposition over the United States, with the ranges reflecting different assumptions. Increasing lightning NOx decreases the fractional contribution of PAN to total NOy export, increases the O3 production in the northern extratropical FT by 33%, and decreases the regional mean ozone production efficiency per unit NOx (OPE) by 30%. If models underestimate the lightning NOx source, they would overestimate the background OPE in the FT and the fractional contribution of PAN to NOy export. Therefore, a model underestimate of lightning NOx would likely lead to an overestimate of the downwind O3 production due to anthropogenic NOx export. Better constraints on the lightning NOx source are required to more confidently assess the impacts of anthropogenic emissions and their changes on air quality over downwind regions

Trajectories of university adjustment in the United Kingdom: Emotion management and emotional self-efficacy protect against initial poor adjustment

Little is known about individual differences in the pattern of university adjustment. This study explored longitudinal associations between emotional self-efficacy, emotion management, university adjustment, and academic achievement in a sample of first year undergraduates in the United Kingdom (N=331). Students completed measures of adjustment to university at three points during their first year at university. Latent Growth Mixture Modeling identified four trajectories of adjustment: (1) low, stable adjustment, (2) medium, stable adjustment, (3) high, stable adjustment, and (4) low, increasing adjustment. Membership of the low, stable adjustment group was predicted by low emotional self-efficacy and low emotion management scores, measured at entry into university. This group also had increased odds of poor academic achievement, even when grade at entry to university was controlled. Students who increased in adjustment had high levels of emotion management and emotional self-efficacy, which helped adaptation. These findings have implications for intervention

Could Public Restrooms Be an Environment for Bacterial Resistomes?

PMCID: PMC3547874This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Ten Misconceptions from the History of Analysis and Their Debunking

The widespread idea that infinitesimals were "eliminated" by the "great triumvirate" of Cantor, Dedekind, and Weierstrass is refuted by an uninterrupted chain of work on infinitesimal-enriched number systems. The elimination claim is an oversimplification created by triumvirate followers, who tend to view the history of analysis as a pre-ordained march toward the radiant future of Weierstrassian epsilontics. In the present text, we document distortions of the history of analysis stemming from the triumvirate ideology of ontological minimalism, which identified the continuum with a single number system. Such anachronistic distortions characterize the received interpretation of Stevin, Leibniz, d'Alembert, Cauchy, and others.Comment: 46 pages, 4 figures; Foundations of Science (2012). arXiv admin note: text overlap with arXiv:1108.2885 and arXiv:1110.545

The ADAMTS (A Disintegrin and Metalloproteinase with Thrombospondin motifs) family

The ADAMTS (A Disintegrin and Metalloproteinase with Thrombospondin motifs) enzymes are secreted, multi-domain matrix-associated zinc metalloendopeptidases that have diverse roles in tissue morphogenesis and patho-physiological remodeling, in inflammation and in vascular biology. The human family includes 19 members that can be sub-grouped on the basis of their known substrates, namely the aggrecanases or proteoglycanases (ADAMTS1, 4, 5, 8, 9, 15 and 20), the procollagen N-propeptidases (ADAMTS2, 3 and 14), the cartilage oligomeric matrix protein-cleaving enzymes (ADAMTS7 and 12), the von-Willebrand Factor proteinase (ADAMTS13) and a group of orphan enzymes (ADAMTS6, 10, 16, 17, 18 and 19). Control of the structure and function of the extracellular matrix (ECM) is a central theme of the biology of the ADAMTS, as exemplified by the actions of the procollagen-N-propeptidases in collagen fibril assembly and of the aggrecanases in the cleavage or modification of ECM proteoglycans. Defects in certain family members give rise to inherited genetic disorders, while the aberrant expression or function of others is associated with arthritis, cancer and cardiovascular disease. In particular, ADAMTS4 and 5 have emerged as therapeutic targets in arthritis. Multiple ADAMTSs from different sub-groupings exert either positive or negative effects on tumorigenesis and metastasis, with both metalloproteinase-dependent and -independent actions known to occur. The basic ADAMTS structure comprises a metalloproteinase catalytic domain and a carboxy-terminal ancillary domain, the latter determining substrate specificity and the localization of the protease and its interaction partners; ancillary domains probably also have independent biological functions. Focusing primarily on the aggrecanases and proteoglycanases, this review provides a perspective on the evolution of the ADAMTS family, their links with developmental and disease mechanisms, and key questions for the future