Defining the Problem and Searching for Solutions: Health Care Providers and Consumers

A panel consisting of health care providers and consumers discussed defining the problem and searching for solutions. Richard Buxbaum of the Greater Cleveland Hospital Association addressed uncompensated care, otherwise known as charity care, as a problem for hospitals. Mandating employer based health insurance was offered as a solution. Frank Kimbler of the Federation for Community Planning gave an overview of the consumer side of the uninsured problem. He mentioned a joint pilot project to insure the working poor. Henry Manning of Metrohealth explained how price competition between hospitals creates a problem for urban teaching hospitals which bear the costs of caring for the poor and training doctors. He also shared figures for unreimbursed care costs accrued by Metrohealth in various categories. Dr. van Heeckeren presented the physician\u27s view on the insurance issue. The panel then answered questions

A Linked Coptic Dictionary Online

We describe a new project publishing a freely available online dictionary for Coptic. The dictionary encompasses comprehensive cross-referencing mechanisms, including linking entries to an online scanned edition of Crum’s Coptic Dictionary, internal cross-references and etymological information, translated searchable definitions in English, French and German, and linked corpus data which provides frequencies and corpus look-up for headwords and multiword expressions. Headwords are available for linking in external projects using a REST API. We describe the challenges in encoding our dictionary using TEI XML and implementing linking mechanisms to construct a Web interface querying frequency information, which draw on NLP tools to recognize inflected forms in context. We evaluate our dictionary’s coverage using digital corpora of Coptic available online

On the importance of hydrodynamic interactions in polyelectrolyte electrophoresis

The effect of hydrodynamic interactions on the free-solution electrophoresis of polyelectrolytes is investigated with coarse-grained molecular dynamics simulations. By comparing the results to simulations with switched-off hydrodynamic interactions, we demonstrate their importance in modelling the experimentally observed behaviour. In order to quantify the hydrodynamic interactions between the polyelectrolyte and the solution, we present a novel way to estimate its effective charge. We obtain an effective friction that is different from the hydrodynamic friction obtained from diffusion measurements. This effective friction is used to explain the constant electrophoretic mobility for longer chains. To further emphasize the importance of hydrodynamic interactions, we apply the model to end-labeled free-solution electrophoresis.Comment: 15 pages, 7 figures; accepted for publication in J. Phys.: Condens. Matte

Worker heterogeneity, new monopsony, and training

A worker's output depends not only on his/her own ability but also on that of colleagues, who can facilitate the performance of tasks that each individual cannot accomplish on his/her own. We show that this common-sense observation generates monopsony power and is sufficient to explain why employers might expend resources on training employees even when the training is of use to other firms. We show that training will take place in better-than-average or ‘good’ firms enjoying greater monopsony power, whereas ‘bad’ firms will have low-ability workers unlikely to receive much training

Intravascular ultrasound scanning improves long-term patency of iliac lesions treated with balloon angioplasty and primary stenting

AbstractPurpose: Underdeployment of an intravascular stent has been identified as a cause of restenosis or occlusion of a treated arterial lesion. Intravascular ultrasound (IVUS) has been shown to initially improve the anatomic and clinical stenting. The purpose of this study was to determine whether the use of IVUS increased long-term patency of this intervention. Methods: Between March 1992 and October 1995, 71 limbs (52 patients) with symptomatic aortoiliac occlusive disease underwent balloon angioplasty with primary stenting. IVUS and arteriography were used in 49 limbs (36 patients) to evaluate stent deployment. Arteriography alone was used in 22 limbs (16 patients) to evaluate stent deployment. Patients were captured prospectively in a vascular registry and retrospectively reviewed. Results: Mean age of patients treated with IVUS was 61.1 ± 9.0 years (range, 38-85) versus 70.0 ± 10.1 years (range, 57-87) in patients treated without IVUS (P <.01). There was no difference between the groups with respect to preoperative comorbidities, ankle-brachial indices, or number of stents per limb. Mean follow-up for IVUS patients was 62.1 ± 7.3 months (range, 15-81) and 57.9 ± 8.7 months (range, 8-80) for patients treated without IVUS (P = not significant). In 40% (20/49) of limbs, IVUS demonstrated inadequate stent deployment at the time of the original procedure. Kaplan-Meier 3- and 6-year primary patency estimates were 100% and 100% in the IVUS group and 82% and 69%, respectively, in limbs treated without IVUS (P <.001). There have been no secondary procedures performed in limbs treated with IVUS and a 23% (5/22) secondary intervention rate in the non-IVUS group (P <.05). Overall Kaplan-Meier survival estimates at 3 and 6 years for all patients were 84% and 67%, respectively. Conclusion: Balloon angioplasty and primary stenting of symptomatic aortoiliac occlusive lesions is a durable treatment option. Long-term follow-up of treated patients shows outcomes that are comparable with direct surgical intervention. IVUS significantly improved the long-term patency of iliac arterial lesions treated with balloon angioplasty and stenting by defining the appropriate angioplasty diameter endpoint and adequacy of stent deployment. (J Vasc Surg 2002;35:316-23.

Old World megadroughts and pluvials during the Common Era

Climate model projections suggest widespread drying in the Mediterranean Basin and wetting in Fennoscandia in the coming decades largely as a consequence of greenhouse gas forcing of climate. To place these and other “Old World” climate projections into historical perspective based on more complete estimates of natural hydroclimatic variability, we have developed the “Old World Drought Atlas” (OWDA), a set of year-to-year maps of tree-ring reconstructed summer wetness and dryness over Europe and the Mediterranean Basin during the Common Era. The OWDA matches historical accounts of severe drought and wetness with a spatial completeness not previously available. In addition, megadroughts reconstructed over north-central Europe in the 11th and mid-15th centuries reinforce other evidence from North America and Asia that droughts were more severe, extensive, and prolonged over Northern Hemisphere land areas before the 20th century, with an inadequate understanding of their causes. The OWDA provides new data to determine the causes of Old World drought and wetness and attribute past climate variability to forced and/or internal variability

Truth and Deception at the Rhetorical Structure Level

This paper furthers the development of methods to dis- tinguish truth from deception in textual data. We use rhetorical structure theory (RST) as the analytic framework to identify systematic differences between deceptive and truthful stories in terms of their coher- ence and structure. A sample of 36 elicited personal stories, self-ranked as truthful or deceptive, is manu- ally analyzed by assigning RST discourse relations among each story’s constituent parts. A vector space model (VSM) assesses each story’s position in multi- dimensional RST space with respect to its distance from truthful and deceptive centers as measures of the story’s level of deception and truthfulness. Ten human judges evaluate independently whether each story is deceptive and assign their confidence levels (360 evaluations total), producing measures of the expected human ability to recognize deception. As a robustness check, a test sample of 18 truthful stories (with 180 additional evaluations) is used to determine the reli- ability of our RST-VSM method in determining decep- tion. The contribution is in demonstration of the discourse structure analysis as a significant method for automated deception detection and an effective complement to lexicosemantic analysis. The potential is in developing novel discourse-based tools to alert information users to potential deception in computer- mediated texts

Possible origins of macroscopic left-right asymmetry in organisms

I consider the microscopic mechanisms by which a particular left-right (L/R) asymmetry is generated at the organism level from the microscopic handedness of cytoskeletal molecules. In light of a fundamental symmetry principle, the typical pattern-formation mechanisms of diffusion plus regulation cannot implement the "right-hand rule"; at the microscopic level, the cell's cytoskeleton of chiral filaments seems always to be involved, usually in collective states driven by polymerization forces or molecular motors. It seems particularly easy for handedness to emerge in a shear or rotation in the background of an effectively two-dimensional system, such as the cell membrane or a layer of cells, as this requires no pre-existing axis apart from the layer normal. I detail a scenario involving actin/myosin layers in snails and in C. elegans, and also one about the microtubule layer in plant cells. I also survey the other examples that I am aware of, such as the emergence of handedness such as the emergence of handedness in neurons, in eukaryote cell motility, and in non-flagellated bacteria.Comment: 42 pages, 6 figures, resubmitted to J. Stat. Phys. special issue. Major rewrite, rearranged sections/subsections, new Fig 3 + 6, new physics in Sec 2.4 and 3.4.1, added Sec 5 and subsections of Sec