North Carolina Hospitals\u27 Dilemma: The Inherent Conflict between Carolina ACCESS and the Emergency Medical Treatment and Active Labor Act

This comment will show that Carolina ACCESS\u27 Emergency Room Policy forces hospitals into a difficult situation. On one hand, the EMTALA binds emergency departments to appropriately screen all persons who enter its doors. On the other hand, Carolina ACCESS tells a hospital that it will pay for only certain services leaving the hospital to make a choice: lower its exam standards thus risking liability under EMTALA, or conduct an appropriate exam and then suffer the economic loss when the patient\u27s condition is deemed non-emergent

North Carolina Hospitals\u27 Dilemma: The Inherent Conflict between Carolina ACCESS and the Emergency Medical Treatment and Active Labor Act

This comment will show that Carolina ACCESS\u27 Emergency Room Policy forces hospitals into a difficult situation. On one hand, the EMTALA binds emergency departments to appropriately screen all persons who enter its doors. On the other hand, Carolina ACCESS tells a hospital that it will pay for only certain services leaving the hospital to make a choice: lower its exam standards thus risking liability under EMTALA, or conduct an appropriate exam and then suffer the economic loss when the patient\u27s condition is deemed non-emergent

Detection of proteoglycan loss from articular cartilage using Brillouin microscopy, with applications to osteoarthritis

© 2019, OSA - The Optical Society. All rights reserved. The degeneration of articular cartilage (AC) occurs in osteoarthritis (OA), which is a leading cause of pain and disability in middle-aged and older people. The early diseaserelated changes in cartilage extra-cellular matrix (ECM) start with depletion of proteoglycan (PG), leading to an increase in tissue hydration and permeability. These early compositional changes are small (<10%) and hence difficult to register with conventional non-invasive imaging technologies (magnetic resonance and ultrasound imaging). Here we apply Brillouin microscopy for detecting changes in the mechanical properties and composition of porcine AC. OA-like degradation is mimicked by enzymatic tissue digestion, and we compare Brillouin microscopy measurements against histological staining of PG depletion over varying digestion times and enzyme concentrations. The non-destructive nature of Brillouin imaging technology opens new avenues for creating minimally invasive arthroscopic devices for OA diagnostics and therapeutic monitoring

Epidemiological patterns of hepatitis B virus (HBV) in highly endemic areas

This paper uses meta-analysis of published data and a deterministic mathematical model of hepatitis B virus (HBV) transmission to describe the patterns of HBV infection in high endemicity areas. We describe the association between the prevalence of carriers and a simple measure of the rate of infection, the age at which half the population have been infected (A50), and assess the contribution of horizontal and perinatal transmission to this association. We found that the two main hyper-endemic areas of sub-Saharan Africa and east Asia have similar prevalences of carriers and values of A50, and that there is a negative nonlinear relationship between A50 and the prevalence of carriers in high endemicity areas (Spearman's Rank, P = 0·0086). We quantified the risk of perinatal transmission and the age-dependent rate of infection to allow a comparison between the main hyper-endemic areas. East Asia was found to have higher prevalences of HBeAg positive mothers and a greater risk of perinatal transmission from HBeAg positive mothers than sub-Saharan Africa, though the differences were not statistically significant. However, the two areas have similar magnitudes and age-dependent rates of horizontal transmission. Results of a simple compartmental model suggest that similar rates of horizontal transmission are sufficient to generate the similar patterns between A50 and the prevalences of carriers. Interrupting horizontal transmission by mass immunization is expected to have a significant, nonlinear impact on the rate of acquisition of new carriers

Evidence for reversible control of magnetization in a ferromagnetic material via spin-orbit magnetic field

Conventional computer electronics creates a dichotomy between how information is processed and how it is stored. Silicon chips process information by controlling the flow of charge through a network of logic gates. This information is then stored, most commonly, by encoding it in the orientation of magnetic domains of a computer hard disk. The key obstacle to a more intimate integration of magnetic materials into devices and circuit processing information is a lack of efficient means to control their magnetization. This is usually achieved with an external magnetic field or by the injection of spin-polarized currents. The latter can be significantly enhanced in materials whose ferromagnetic properties are mediated by charge carriers. Among these materials, conductors lacking spatial inversion symmetry couple charge currents to spin by intrinsic spin-orbit (SO) interactions, inducing nonequilibrium spin polarization tunable by local electric fields. Here we show that magnetization of a ferromagnet can be reversibly manipulated by the SO-induced polarization of carrier spins generated by unpolarized currents. Specifically, we demonstrate domain rotation and hysteretic switching of magnetization between two orthogonal easy axes in a model ferromagnetic semiconductor.Comment: 10 pages including supplemental materia

A theory-grounded framework of Open Source Software adoption in SMEs

This is a post-peer-review, pre-copyedit version of an article published in European Journal of Information Systems. The definitive publisher-authenticated version Macredie, RD and Mijinyawa, K (2011), "A theory-grounded framework of Open Source Software adoption in SMEs", European Journal of Informations Systems, 20(2), 237-250 is available online at: http://www.palgrave-journals.com/ejis/journal/v20/n2/abs/ejis201060a.html.The increasing popularity and use of Open Source Software (OSS) has led to significant interest from research communities and enterprise practitioners, notably in the small business sector where this type of software offers particular benefits given the financial and human capital constraints faced. However, there has been little focus on developing valid frameworks that enable critical evaluation and common understanding of factors influencing OSS adoption. This paper seeks to address this shortcoming by presenting a theory-grounded framework for exploring these factors and explaining their influence on OSS adoption, with the context of study being small- to medium-sized Information Technology (IT) businesses in the U.K. The framework has implications for this type of business – and, we will suggest, more widely – as a frame of reference for understanding, and as tool for evaluating benefits and challenges in, OSS adoption. It also offers researchers a structured way of investigating adoption issues and a base from which to develop models of OSS adoption. The study reported in this paper used the Decomposed Theory of Planned Behaviour (DTPB) as a basis for the research propositions, with the aim of: (i) developing a framework of empirical factors that influence OSS adoption; and (ii) appraising it through case study evaluation with 10 U.K. Small- to medium-sized enterprises in the IT sector. The demonstration of the capabilities of the framework suggests that it is able to provide a reliable explanation of the complex and subjective factors that influence attitudes, subjective norms and control over the use of OSS. The paper further argues that the DTPB proved useful in this research area and that it can provide a variety of situation-specific insights related to factors that influence the adoption of OSS

The β4-Subunit of the Large-Conductance Potassium Ion Channel KCa1.1 Regulates Outflow Facility in Mice

Purpose: The large-conductance calcium-activated potassium channel KCa1.1 (BKCa, maxi-K) influences aqueous humor outflow facility, but the contribution of auxiliary β-subunits to KCa1.1 activity in the outflow pathway is unknown. Methods: Using quantitative polymerase chain reaction, we measured expression of β-subunit genes in anterior segments of C57BL/6J mice (Kcnmb1-4) and in cultured human trabecular meshwork (TM) and Schlemm's canal (SC) cells (KCNMB1-4). We also measured expression of Kcnma1/KCNMA1 that encodes the pore-forming α-subunit. Using confocal immunofluorescence, we visualized the distribution of β4 in the conventional outflow pathway of mice. Using iPerfusion, we measured outflow facility in enucleated mouse eyes in response to 100 or 500 nM iberiotoxin (IbTX; N = 9) or 100 nM martentoxin (MarTX; N = 12). MarTX selectively blocks β4-containing KCa1.1 channels, whereas IbTX blocks KCa1.1 channels that lack β4. Results: Kcnmb4 was the most highly expressed β-subunit in mouse conventional outflow tissues, expressed at a level comparable to Kcnma1. β4 was present within the juxtacanalicular TM, appearing to label cellular processes connecting to SC cells. Accordingly, KCNMB4 was the most highly expressed β-subunit in human TM cells, and the sole β-subunit in human SC cells. To dissect functional contribution, MarTX decreased outflow facility by 35% (27%, 42%; mean, 95% confidence interval) relative to vehicle-treated contralateral eyes, whereas IbTX reduced outflow facility by 16% (6%, 25%). Conclusions: The β4-subunit regulates KCa1.1 activity in the conventional outflow pathway, significantly influencing outflow function. Targeting β4-containing KCa1.1 channels may be a promising approach to lower intraocular pressure to treat glaucoma

Accumbens Cholinergic Interneurons Mediate Cue-Induced Nicotine Seeking and Associated Glutamatergic Plasticity

Nicotine, the primary addictive substance in tobacco, is widely abused. Relapse to cues associated with nicotine results in increased glutamate release within nucleus accumbens core (NAcore), modifying synaptic plasticity of medium spiny neurons (MSNs), which contributes to reinstatement of nicotine seeking. However, the role of cholinergic interneurons (ChIs) within the NAcore in mediating these neurobehavioral processes is unknown. ChIs represent less than 1% of the accumbens neuronal population and are activated during drug seeking and reward-predicting events. Thus, we hypothesized that ChIs may play a significant role in mediating glutamatergic plasticity that underlies nicotine-seeking behavior. Using chemogenetics in transgenic rats expressing Cre under the control of the choline acetyltransferase (ChAT) promoter, ChIs were bidirectionally manipulated before cue-induced reinstatement. Following nicotine self-administration and extinction, ChIs were activated or inhibited before a cue reinstatement session. Following reinstatement, whole-cell electrophysiology from NAcore MSNs was used to assess changes in plasticity, measured via AMPA/NMDA (A/N) ratios. Chemogenetic inhibition of ChIs inhibited cued nicotine seeking and resulted in decreased A/N, relative to control animals, whereas activation of ChIs was unaltered, demonstrating that ChI inhibition may modulate plasticity underlying cue-induced nicotine seeking. These results demonstrate that ChI neurons play an important role in mediating cue-induced nicotine reinstatement and underlying synaptic plasticity within the NAcore

Organizing For Developing Radically Innovative Product: Application of "Quantum Evolution "Theory in Bioecology

Developing radically innovative products is an important issue for many firms. This study addresses how to organize and manage new product development teams to develop radically innovative products. We hypothesize that there exists the optimal combination of conditions to develop radically innovative products through the use of quantum evolution theory found in bioecology and test empirically using the joint covariations approach. Our results show that radically innovative product can be developed in the new product development teams with the combination of high diversity, high integration, and high autonomy