The Princess and the Pea: The Assurance of Voluntary Compliance Between the Texas Attorney General and Aetna\u27s Texas HMOs and Its Impact on Financial Risk Shifting by Managed Care

The Texas Attorney General attempts to regulate managed care organizations and their shifting of financial risk by utilizing Assurance Voluntary Compliance to make the costs associated with the provisions of health insurance more transparent. A primary technique used to shift financial risk to providers of healthcare services is through the use of downstream entities which are commonly provider-sponsored organizations. It is the relationship between the downstream entity and the individual physicians that ultimately affects patient care, the doctor-patient relationship, and the quality of care. The regulatory community throughout the United States has made the regulation of downstream entities its number one priority. It was in this context that then-Texas Attorney General Dan Morales filed suit against six health maintenance organizations (“HMO”) in December 1998, which ultimately led to the creation of Assurance Voluntary Compliance. The Assurance Voluntary Compliance led to HMO’s introducing “consumer driven” health plans. These new health plans call for the consumer to bear a greater responsibility of risk. In effect, the consumer is being called upon to assume the role of insurer in the consumer’s own health care expenditures. In the long term, it is unlikely that consumers will be able to manage risk, control costs, and ensure quality better than the managed care industry, employers, and health care providers that the consumers will be forced to replace

Theoretical proposal for a biosensing approach based on a linear array of immobilized gold nanoparticles

We propose a sensing mechanism for detection of analytes that can specifically recognized. The sensor is based on closely-spaced chains of functionalized gold nanoparticles (NPs) immobilized on a waveguide surface, with the signal detected by evanescent waveguide absorption spectroscopy. The localized surface plasmon spectrum of a linear array of closely-spaced, hemispherical gold NPs is calculated using the discrete dipole approximation. The plasmon band is found to broaden to a nanowirelike spectrum when a dielectric coating is put on the particles, and the light polarization is along the NP chain. The origin of this broadening is shown to be the polarization-dependent overlap of the evanescent fields of adjacent NPs upon application of the dielectric coating. These features suggests a mechanism for biosensing with an improved sensitivity compared with traditional NP biosensor methods

Transcriptomic footprints disclose specificity of reactive oxygen species signaling in Arabidopsis

Reactive oxygen species ( ROS) are key players in the regulation of plant development, stress responses, and programmed cell death. Previous studies indicated that depending on the type of ROS ( hydrogen peroxide, superoxide, or singlet oxygen) or its subcellular production site ( plastidic, cytosolic, peroxisomal, or apoplastic), a different physiological, biochemical, and molecular response is provoked. We used transcriptome data generated from ROS-related microarray experiments to assess the specificity of ROS-driven transcript expression. Data sets obtained by exogenous application of oxidative stress-causing agents ( methyl viologen, Alternaria alternata toxin, 3-aminotriazole, and ozone) and from a mutant ( fluorescent) and transgenic plants, in which the activity of an individual antioxidant enzyme was perturbed ( catalase, cytosolic ascorbate peroxidase, and copper/zinc superoxide dismutase), were compared. In total, the abundance of nearly 26,000 transcripts of Arabidopsis ( Arabidopsis thaliana) was monitored in response to different ROS. Overall, 8,056, 5,312, and 3,925 transcripts showed at least a 3-, 4-, or 5- fold change in expression, respectively. In addition to marker transcripts that were specifically regulated by hydrogen peroxide, superoxide, or singlet oxygen, several transcripts were identified as general oxidative stress response markers because their steady-state levels were at least 5- fold elevated in most experiments. We also assessed the expression characteristics of all annotated transcription factors and inferred new candidate regulatory transcripts that could be responsible for orchestrating the specific transcriptomic signatures triggered by different ROS. Our analysis provides a framework that will assist future efforts to address the impact of ROS signals within environmental stress conditions and elucidate the molecular mechanisms of the oxidative stress response in plants

Cascading ecological effects from local extirpation of an ecosystem engineer in the Arava desert

The extinction of a single species from a local community may carry little cost in terms of species diversity, yet its loss eliminates its biotic and abiotic interactions. We describe such a scenario in the Arava desert, where different cultural and law enforcement practices exclude Dorcas gazelles (Gazella dorcas (Linnaeus, 1758)) from the Jordanian side of the border while protecting their populations on the Israeli side. We found that gazelles break the soil crust, formed in desert systems after annual flooding, thereby creating patches of loose and cooler sand that are used by pit-building antlions (Neuroptera: Myrmeleontidae). When we artificially broke the soil crust on both sides of the border, we found a significant increase in antlion density in these patches, but only on the Israeli side. On the Jordanian side, where no gazelles have been observed since the early 1980s, no antlions colonized either control or manipulated plots. Additional choice/no-choice feeding experiments, in which we offered antlions to lizards and birds, revealed that the effect of humans on gazelles cascades farther, as antlions serve as a palatable food source for both groups. Thus, the human-mediated loss of nontrophic interactions between gazelles and antlions cascades to the loss of trophic interactions between antlions and their predators

NO, ROS, and cell death associated with caspase-like activity increase in stress-induced microspore embryogenesis of barley

Under specific stress treatments (cold, starvation), in vitro microspores can be induced to deviate from their gametophytic development and switch to embryogenesis, forming haploid embryos and homozygous breeding lines in a short period of time. The inductive stress produces reactive oxygen species (ROS) and nitric oxide (NO), signalling molecules mediating cellular responses, and cell death, modifying the embryogenic microspore response and therefore, the efficiency of the process. This work analysed cell death, caspase 3-like activity, and ROS and NO production (using fluorescence probes and confocal analysis) after inductive stress in barley microspore cultures and embryogenic suspension cultures, as an in vitro system which permitted easy handling for comparison. There was an increase in caspase 3-like activity and cell death after stress treatment in microspore and suspension cultures, while ROS increased in non-induced microspores and suspension cultures. Treatments of the cultures with a caspase 3 inhibitor, DEVD-CHO, significantly reduced the cell death percentages. Stress-treated embryogenic suspension cultures exhibited high NO signals and cell death, while treatment with S-nitrosoglutathione (NO donor) in control suspension cultures resulted in even higher cell death. In contrast, in microspore cultures, NO production was detected after stress, and, in the case of 4-day microspore cultures, in embryogenic microspores accompanying the initiation of cell divisions. Subsequent treatments of stress-treated microspore cultures with ROS and NO scavengers resulted in a decreasing cell death during the early stages, but later they produced a delay in embryo development as well as a decrease in the percentage of embryogenesis in microspores. Results showed that the ROS increase was involved in the stress-induced programmed cell death occurring at early stages in both non-induced microspores and embryogenic suspension cultures; whereas NO played a dual role after stress in the two in vitro systems, one involved in programmed cell death in embryogenic suspension cultures and the other in the initiation of cell division leading to embryogenesis in reprogrammed microspores

Binary Mixtures of SH- and CH3-Terminated Self-Assembled Monolayers to Control the Average Spacing Between Aligned Gold Nanoparticles

This paper presents a method to control the average spacing between organometallic chemical vapor deposition (OMCVD) grown gold nanoparticles (Au NPs) in a line. Focused ion beam patterned CH3-terminated self-assembled monolayers are refilled systematically with different mixtures of SH- and CH3-terminated silanes. The average spacing between OMCVD Au NPs is demonstrated systematically to decrease by increasing the v/v% ratio of the thiols in the binary silane mixtures with SH- and CH3-terminated groups