Incentive Compatible Reimbursement Schemes for Physicians

We consider physicians with fixed capacity levels. If a physician’s capacity exceeds demand, she may have an incentive to overtreat, i.e., she may provide unnecessary treatments to use up idle capacity. By contrast, with excess demand she may undertreat, i.e., she may not provide necessary treatments since other activities are financially more attractive. We first show that simple fee-for-service reimbursement schemes do not provide proper incentives. If insurers use, however, fee-for-service schemes with quantity restrictions, they solve the fraudulent physician problem

Study of the effect of natural antioxidants in polyethylene: Performance of β-carotene

The effect of β-carotene on the behaviour of polyethylene stabilized with α-tocopherol and a phosphonite antioxidant was studied under processing and storage conditions. The amount of β-carotene ranged between 0 and 2000 ppm. The polymer was characterised by different methods after processing then during and after storage at ambient temperature in light and dark. β-Carotene hinders the oxidation of polyethylene and does not increase the chain extension reactions during processing, though more vinyl groups and phosphonite molecules react. β-Carotene colours polyethylene strongly already at low concentrations. The reactions of the polymer and β-carotene are affected strongly by the storage conditions. The presence of β-carotene does not influence the stabilizing efficiency of the primary and secondary antioxidants. In dark the molecular structure of the polymer does not change appreciably, while the reactions of β-carotene lead to an increase in the yellowness index. In light the molecular characteristics of polyethylene undergo significant changes indicating long chain branching. The polymer fades rapidly after an induction period. The length of the induction period is not influenced by light. The rate of the degradation reactions of β-carotene during storage is controlled by its concentration and film thickness. Visible autoaccelerated decomposition in light renders β-carotene candidate as an indicator in active packaging materials

Conserved natural IgM antibodies mediate innate and adaptive immunity against the opportunistic fungus Pneumocystis murina

Natural IgM antibodies in diverse species recognize conserved carbohydrates in fungal cell walls and influence early host defense against Pneumocystis in mice

Identification of Upper Respiratory Tract Pathogens Using Electrochemical Detection on an Oligonucleotide Microarray

Bacterial and viral upper respiratory infections (URI) produce highly variable clinical symptoms that cannot be used to identify the etiologic agent. Proper treatment, however, depends on correct identification of the pathogen involved as antibiotics provide little or no benefit with viral infections. Here we describe a rapid and sensitive genotyping assay and microarray for URI identification using standard amplification and hybridization techniques, with electrochemical detection (ECD) on a semiconductor-based oligonucleotide microarray. The assay was developed to detect four bacterial pathogens (Bordetella pertussis, Streptococcus pyogenes, Chlamydia pneumoniae and Mycoplasma pneumoniae) and 9 viral pathogens (adenovirus 4, coronavirus OC43, 229E and HK, influenza A and B, parainfluinza types 1, 2, and 3 and respiratory syncytial virus. This new platform forms the basis for a fully automated diagnostics system that is very flexible and can be customized to suit different or additional pathogens. Multiple probes on a flexible platform allow one to test probes empirically and then select highly reactive probes for further iterative evaluation. Because ECD uses an enzymatic reaction to create electrical signals that can be read directly from the array, there is no need for image analysis or for expensive and delicate optical scanning equipment. We show assay sensitivity and specificity that are excellent for a multiplexed format

He, Ne and Ar 'snapshot' of the subcontinental lithospheric mantle from CO2 well gases

The subcontinental lithospheric mantle (SCLM) constitutes a significant portion of the upper mantle sourcing magmatic volatiles to the continents above, yet its geochemical signature and evolution remain poorly constrained. Here we present new interpretation of noble gas datasets from two magmatic CO2 fields in the SW US, namely Bravo Dome and Sheep Mountain, which provide a unique insight into the volatile character of the SCLM sourcing the Cenozoic volcanism in the region. We identify that reduction of 3He/4Hemantle ratio within the Sheep Mountain CO2 field can be attributed to radiogenic production within the SCLM. Using a Reduced Chi-Squared minimisation on the variation of derived 4He/21Necrust ratios within samples from the Sheep Mountain field, combined with a radiogenically raised 21Ne/22Nemantle end member, we resolve 3He/4Hemantle ratios of 2.59 ± 0.15 to 3.00 ± 0.18 Ra. These values correspond with a 21Ne/22Nemantle value of 0.136. Using these 3He/4Hemantle end member values with 21Nemantle resolved from Ne three component analysis, we derive the elemental 3He/22Nemantle of 2.80 ± 0.16 and radiogenic 4He/21Ne*mantle range of 1.11 ± 0.11 to 1.30 ± 0.14. A second Reduced Chi-Squared minimisation performed on the variation of 21Ne/40Arcrust ratios has allowed us to also determine both the 4He/40Armantle range of 0.78 to 1.21 and 21Ne/40Armantle of 7.66 ± 1.62 to 7.70 ± 1.54 within the field. Combining these ratios with the known mantle production ranges for 4He/21Ne and 4He/40Ar allows resolution of the radiogenic He/Ne and He/Ar ratios corresponding to the radiogenically lowered 3He/4Hemantle ratios. Comparing these values with those resolved from the Bravo Dome field allows identification of a clear and coherent depletion of He to Ne and He to Ar in both datasets. This depletion can only be explained by partial degassing of small melt fractions of asthenospheric melts that have been emplaced into the SCLM. This is the first time that it has been possible to resolve and account for both the mantle He/Ne and He/Ar ratios within a SCLM source. The data additionally rule out the involvement of a plume component in the mantle source of the two gas fields and hence any plume influence on the Colorado Plateau Uplift event

‘Oh you pretty thing!’: How David Bowie ‘unlocked everybody’s inner queen’ in spite of the music press

The 1967 Sexual Offence Act decriminalised homosexual acts between men allowing gay men to discuss their sexuality in public. Few prominent popular musicians came-out until 1972 when David Bowie claimed that he was bisexual in an interview with Melody Maker. Music papers and Bowie had substantial cultural power: Bowie was a rising star and music papers recruited journalists who discussed and perpetuated social change. The subsequent conversation, however, reinforced negative stereotypes in constructing the queer subject and tried to safeguard commercial concerns due to the assumption that the market for popular music avoided queer music. This undermined arguments that associate permissive legislation with a permissive media and society, but, to some, representation alone empowered people and destabilised preconceptions about queer identity.Published versio

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS