Increasing EHR Use for Quality Improvement in Community Health Centers: The Role of Networks

Describes how five community health center networks helped implement electronic health records to improve chronic and preventive care, as well as the obstacles they faced, including limited software capabilities, funding, and ability to share resources

The In Vivo and In Vitro Metabolism of S-Adenosyl-L-Homocysteine by the Rat

Radioactively labeled S-adenosyl-L-homocysteine was administered intravenously to rats to determine the fate of the homocysteine moiety and to isolate and identify any excretory products that arose from the metabolism of this compound in vivo. After intravenous injection of S-adenosyl-L-homocysteine-3H (homocysteine labeled) into rats, less than 15% of the radioisotope was incorporated into protein methionine or excreted as α-ketobutyrate. The remaining tritium was associated with a previously unidentified keto acid which was excreted in the urine. Intravenous injections of S-adenosyl-3H-L-homocysteine (adenosine labeled) or S-adenosyl-L-homocysteine-35S revealed that both the purine moiety and the sulfur atom remained associated with the keto acid excretory product. The compound was isolated from the urine by ion-exchange chromatography, purified and crystallized. Based on chemical, elemental, and ultraviolet and infrared spectral analyses as well as the information obtained from the radioisotope tracer studies, the chemical structure of the compound was proposed as S-adenosyl-γ-thio-α-ketobutyrate. To determine the type of reaction responsible for the formation of S-adenosyl-γ-thio-α-ketobutyrate, S-adenosyl-3H-L-homocysteine was incubated with various rat tissue extracts under conditions which would favor oxidative deamination or transamination. Radioactive S-adenosyl-γ-thio-α-ketobutyrate was isolated by chromatography from reaction mixtures in which kidney and liver extracts were used. The reaction was found to be catalyzed by the general L-amino acid oxidase, EC 1.4.3.2. Incubation of the partially purified oxidase with S-adenosyl-L-homocysteine resulted in the oxidative deamination of the substrate to S-adenosyl-γ-thio-α-ketobutyrate with the utilization f 0.48 μmoles of oxygen per μmole of ammonia and keto acid formed in the presence of catalase. Without catalase oxygen consumption was doubled. The pH optimum for S-adenosyl-γ-thio-α-ketobutyrate formation ranged from 8.8 to 9.2 and the Km value for S-adenosyl-L-homocysteine was 2.5 x 10-2 M as compared to those of 1.3 x 10-2 M and 1.9 x 10-2 M for L-leucine and L-methionine, respectively. Cell-free extracts of the major rat tissues were surveyed for the presence of S-adenosyl-L-homocysteine hydrolase, and only liver extracts exhibited activity. When isolated livers were perfused with buffer containing erythrocytes, serum albumin and tritiated S-adenosyl-L-homocysteine, neither hydrolysis to adenosine and L-homocysteine not deamination to of S-adenosyl-γ-thio-α-ketobutyrate occurred. The apparent impermeability of the live cells to S-adenosyl-L-homocysteine would explain why this compound was not readily hydrolyzed during the in vivo experiments. However, formation of S-adenosyl-L-homocysteine intracellularly in the liver as a result of transmethylation reactions, could be subsequently followed by hydrolysis to adenosine and L-homocysteine. S-adenosyl-L-homocysteine formed in other organs would not be hydrolytically cleaved but could be oxidatively deaminated by the kidney L-amino acid oxidase and eliminated in the urine as of S-adenosyl-γ-thio-α-ketobutyrate

International student recruitment to universities in England: discourse, rationales and globalisation

2E4 (dounclaintieo)n The recruitment of international students to universities in England has become a central issue in an era of globalisation for university administrators, senior managers, international offices and heads of schools and faculties. We examine the policy rationales for the recruitment of international students to England. Through the use of in-depth interviews with key role players at four English universities, we compare the rhetoric, rationales and reasons for the recruitment of international students. A range of discourses can be identified in the recruitment of international students and an economic competition rationale is dominant. This is expressed within the discourse of globalisation

Students interviewing students: the Aston-Hong Kong Project

This article provides an account of undergraduate sociology students conducting indepth interviews with international students from Hong Kong. The research is locating in a broader project of identifying rationales for the recruitment of international students. One of the shortcomings of previous research was that the student voice and rationale were missing. We have addressed this by involving undergraduate researchers in the collection and analysis of data. This project report draws on one of the reflections of the student researcher

Three-dimensional propagation effects near the mid-Atlantic Bight shelf break (L)

Significant three-dimensional (3-D) environmental variability exists in the vicinity of the shelf break along the mid-Atlantic Bight. This study examines the influence of azimuthal coupling due to this variability on acoustic propagation in this region. Numerical studies employing a 3-D ray code, a hybrid ray-mode code, and a 3-D parabolic equation model are used to study the significance of azimuthal coupling on various propagation paths. These paths include up-slope, slant-slope, and cross-slope propagation. The numerical analysis suggests that, for the propagation ranges less than 60 km examined, the influence of azimuthal coupling is negligible compared to the inherent uncertainty in the environment itself

Near-infrared and X-ray obscuration to the nucleus of the Seyfert 2 galaxy NGC 3281

We present the results of a near-infrared and X-ray study of the Seyfert 2 galaxy NGC 3281. Emission from the Seyfert nucleus is detected in both regions of the electromagnetic spectrum, allowing us to infer both the equivalent line of sight hydrogen column density, N_H = 71.0(+11.3,-12.3)e26/m^2 and the extinction due to dust, A_V = 22+/-11 magnitudes (90% confidence intervals). We infer a ratio of N_H/A_V which is an order of magnitude larger than that determined along lines of sight in the Milky Way and discuss possible interpretations. We consider the most plausible explanation to be a dense cloud in the foreground of both the X-ray and infrared emitting regions which obscures the entire X-ray source but only a fraction of the much larger infrared source.Comment: 23 pages including 9 figure

Vibrational interference of Raman and high-harmonic generation pathways

Experiments have shown that the internal vibrational state of a molecule can affect the intensity of high harmonic light generated from that molecule. This paper presents a model which explains this modulation in terms of interference between different vibrational states occurring during the high harmonic process. In addition, a semiclassical model of the continuum electron propagation is developed which connects with rigorous treatments of the electron-ion scattering

Launch Vehicle Manual Steering with Adaptive Augmenting Control:In-Flight Evaluations of Adverse Interactions Using a Piloted Aircraft

An Adaptive Augmenting Control (AAC) algorithm for the Space Launch System (SLS) has been developed at the Marshall Space Flight Center (MSFC) as part of the launch vehicle's baseline flight control system. A prototype version of the SLS flight control software was hosted on a piloted aircraft at the Armstrong Flight Research Center to demonstrate the adaptive controller on a full-scale realistic application in a relevant flight environment. Concerns regarding adverse interactions between the adaptive controller and a potential manual steering mode were also investigated by giving the pilot trajectory deviation cues and pitch rate command authority, which is the subject of this paper. Two NASA research pilots flew a total of 25 constant pitch rate trajectories using a prototype manual steering mode with and without adaptive control, evaluating six different nominal and off-nominal test case scenarios. Pilot comments and PIO ratings were given following each trajectory and correlated with aircraft state data and internal controller signals post-flight