Setting New Jersey Hospital Rates: A Regulatory System Under Stress

This Article reviews the history of hospital rate setting in New Jersey, emphasizing the system\u27s evolution in response to newly perceived problems and changing political forces. The system experienced some early success in controlling cost growth and demonstrating new techniques of hospital rate setting. In later years, rate setting in New Jersey has been less successful at confronting a new federal role and the growing problem of health care access. The problems faced by New Jersey hold lessons for both the federal government as it pursues cost containment and the other states who either operate rate regulation systems or contemplate them for the future

Guidance for Restarting Inflammatory Bowel Disease Therapy in Patients Who Withheld Immunosuppressant Medications During COVID-19

Patients with inflammatory bowel diseases [IBD] are frequently treated with immunosuppressant medications. During the coronavirus disease 2019 [COVID-19] pandemic, recommendations for IBD management have included that patients should stay on their immunosuppressant medications if they are not infected with the severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], but to temporarily hold these medications if symptomatic with COVID-19 or asymptomatic but have tested positive for SARS-CoV-2. As more IBD patients are infected globally, it is important to also understand how to manage IBD medications during convalescence while an individual with IBD is recovering from COVID-19. In this review, we address the differences between a test-based versus a symptoms-based strategy as related to COVID-19, and offer recommendations on when it is appropriate to consider restarting IBD therapy in patients testing positive for SARS-CoV-2 or with clinical symptoms consistent with COVID-19. In general, we recommend a symptoms-based approach, due to the current lack of confidence in the accuracy of available testing and the clinical significance of prolonged detection of virus via molecular testing

Quantitative analysis of soft-bottom molluscs in the Bellingshausen Sea and around Peter I Island

Macrobenthic soft-bottom molluscs were sampled in 30 stations located in the Bellingshausen Sea at depths ranging from 90 to 3304 m. The samples were collected using a quantitative grab box-corer during the cruises BENTART 03, from 24 January to 3 March 2003, and BENTART 06, from 2 January to 16 February 2006. Molluscs represent 1074 specimens belonging to 62 species of Polyplacophora, Gastropoda, Bivalvia and Scaphopoda. The bivalve Cyamiocardium denticulatum was the most abundant species (448 specimens). The abundance per station varied between 1 and 446 specimens. The Shannon–Wiener diversity index ranged between one specimen and 2.36, the Pielou evenness index ranged between 0.00 and 1 and species richness ranged from 1 to 14 species. Diversity showed great variations at different stations. After multivariate analysis (cluster analysis and nonmetrical multidimensional scaling) based on Bray–Curtis similarities, we were able to separate two principal clusters. The first cluster groups together species from shallower bottoms near Peter I Island and the Antarctic Peninsula, and the second cluster groups together species from deeper bottoms in the Bellingshausen Sea. The combination of environmental variables with the highest correlations with faunistic data was that of depth and coarse sand at the surface.Publicado

Effect of CNFs content on the tribological behaviour of spark plasma sintering ceramic-CNFs composites

Alumina-carbon nanofibres (CNFs) and silicon carbide-CNFs nanocomposites with different volume fraction of CNFs (0-100vol.%) were obtained by spark plasma sintering. The effect of CNFs content on the tribological behaviour in dry sliding conditions on the ceramic-carbon nanocomposites has been investigated using the ball-on-disk technique against alumina balls. The wear rate of ceramic-CNFs nanocomposites decreases with CNFs increasing content. The friction coefficient of the Al 2O 3/CNFs and SiC/CNFs nanocomposites with high CNFs content was found to be significantly lower compared to monolithic Al 2O 3 and SiC due to the effect of CNFs and unexpectedly slightly lower than CNFs material. The main wear mechanism in the nanocomposite was abrasion of the ceramic and carbon components which act in the interface as a sort of lubricating media. The experimental results demonstrate that the addition of CNFs to the ceramic composites significantly reduces friction coefficient and wear rate, resulting in suitable materials for unlubricated tribological applications. © 2011.This work has been carried out with financial support of National Plan Projects MAT2006-01783 and MAT2007-30989-E and the Regional Project FICYT PC07-021. A. Borrell acknowledges the Spanish Ministry of Science and Innovation for her FPI Ph.D. grant. We would like to thank the people from Institute Technological of Materials (ITM) of the Polytechnic University of Valencia for helping us with the tribology experiments during A. Borrell's short stay in 2009.Borrell Tomás, MA.; Torrecillas, R.; Rocha, VG.; Fernandez, A.; Bonache Bezares, V.; Salvador Moya, MD. (2012). Effect of CNFs content on the tribological behaviour of spark plasma sintering ceramic-CNFs composites. Wear. 274:94-99. https://doi.org/10.1016/j.wear.2011.08.013S949927

Horizontal Branch Stars: The Interplay between Observations and Theory, and Insights into the Formation of the Galaxy

We review HB stars in a broad astrophysical context, including both variable and non-variable stars. A reassessment of the Oosterhoff dichotomy is presented, which provides unprecedented detail regarding its origin and systematics. We show that the Oosterhoff dichotomy and the distribution of globular clusters (GCs) in the HB morphology-metallicity plane both exclude, with high statistical significance, the possibility that the Galactic halo may have formed from the accretion of dwarf galaxies resembling present-day Milky Way satellites such as Fornax, Sagittarius, and the LMC. A rediscussion of the second-parameter problem is presented. A technique is proposed to estimate the HB types of extragalactic GCs on the basis of integrated far-UV photometry. The relationship between the absolute V magnitude of the HB at the RR Lyrae level and metallicity, as obtained on the basis of trigonometric parallax measurements for the star RR Lyrae, is also revisited, giving a distance modulus to the LMC of (m-M)_0 = 18.44+/-0.11. RR Lyrae period change rates are studied. Finally, the conductive opacities used in evolutionary calculations of low-mass stars are investigated. [ABRIDGED]Comment: 56 pages, 22 figures. Invited review, to appear in Astrophysics and Space Scienc

A precise measurement of the magnetic field in the corona of the black hole binary V404 Cygni

Observations of binary stars containing an accreting black hole or neutron star often show x-ray emission extending to high energies (>10 kilo­–electron volts), which is ascribed to an accretion disk corona of energetic particles akin to those seen in the solar corona. Despite their ubiquity, the physical conditions in accretion disk coronae remain poorly constrained. Using simultaneous infrared, optical, x-ray, and radio observations of the Galactic black hole system V404 Cygni, showing a rapid synchrotron cooling event in its 2015 outburst, we present a precise 461 ± 12 gauss magnetic field measurement in the corona. This measurement is substantially lower than previous estimates for such systems, providing constraints on physical models of accretion physics in black hole and neutron star binary systems. This article has a correction. Please see: http://science.sciencemag.org/content/360/6386/eaat927

A historical perspective on the discovery of statins

Cholesterol is essential for the functioning of all human organs, but it is nevertheless the cause of coronary heart disease. Over the course of nearly a century of investigation, scientists have developed several lines of evidence that establish the causal connection between blood cholesterol, atherosclerosis, and coronary heart disease. Building on that knowledge, scientists and the pharmaceutical industry have successfully developed a remarkably effective class of drugs—the statins—that lower cholesterol levels in blood and reduce the frequency of heart attacks

Aligning simulation models: A case study and results

This paper develops the concepts and methods of a process we will call “alignment of computational models” or “docking” for short. Alignment is needed to determine whether two models can produce the same results, which in turn is the basis for critical experiments and for tests of whether one model can subsume another. We illustrate our concepts and methods using as a target a model of cultural transmission built by Axelrod. For comparison we use the Sugarscape model developed by Epstein and Axtell.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44707/1/10588_2005_Article_BF01299065.pd

Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies

Objectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease. Background: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of ∼10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and the interest in using this technology is growing. Incorporation of IVOCT in research and daily clinical practice can be facilitated by the development of uniform terminology and consensus-based standards on use of the technology, interpretation of the images, and reporting of IVOCT results. Methods: The IWG-IVOCT, comprising more than 260 academic and industry members from Asia, Europe, and the United States, formed in 2008 and convened on the topic of IVOCT standardization through a series of 9 national and international meetings. Results: Knowledge and recommendations from this group on key areas within the IVOCT field were assembled to generate this consensus document, authored by the Writing Committee, composed of academicians who have participated in meetings and/or writing of the text. Conclusions: This document may be broadly used as a standard reference regarding the current state of the IVOCT imaging modality, intended for researchers and clinicians who use IVOCT and analyze IVOCT data