Supporting State Policymakers' Implementation of Federal Health Reform

Outlines the capacities states will need to implement federal healthcare reform in the areas of information and analysis, strategic implementation and planning, topic-specific technical assistance, communications, and coordination and integration

Terahertz Waveguiding in Silicon-Core Fibers

We propose the use of a silicon-core optical fiber for terahertz (THz) waveguide applications. Finite-difference time-domain simulations have been performed based on a cylindrical waveguide with a silicon core and silica cladding. High-resistivity silicon has a flat dispersion over a 0.1 - 3 THz range, making it viable for propagation of tunable narrowband CW THz and possibly broadband picosecond pules of THz radiation. Simulations show the propagation dynamics and the integrated intensity, from which transverse mode profiles and absorption lengths are extraced. It is found that for 140 - 250 micron core diameters the mode is primarily confined to the core, such that the overall absorbance is only slightly less than in bulk polycrystalline silicon.Comment: 6 pages, 3 figures, journal submissio

The real distribution of the English "group genitive"

The English possessive ’s (POSSLS) is widely regarded as a clitic which attaches at the right edge of noun phrases. The so-called “group genitive”, where POSSLS attaches after a postmodifier (the man in the corner’s hat), is crucial to theoretical accounts. We evaluate both theoretical and descriptive treatments. We then describe the actual use of POSSLS in the spoken component of the British National Corpus, with particular attention to postmodified possessors, demonstrating that the crucial pattern is surprisingly marginal and that at least one other pattern has been missed entirely. This leads to discussions of grammaticality versus usage, of postmodification, and of the factors that condition the use of possLs and their relevance to theory.</jats:p

A State Policymakers' Guide to Federal Health Reform: Part I: Anticipating How Federal Health Reform Will Affect State Roles

Examines how federal healthcare reform will affect states' tools and roles in connecting people to services, promoting coordination and integration, improving care for those with complex needs, being results-oriented, and increasing efficiencies

Why are spine surgery patients lost to follow-up?

Long-term outcome studies are frequently hindered by a decreasing frequency of patient follow-up with the treating surgeon over time. Whether this attrition represents a “loss of faith” in their index surgeon or the realities of a geographically mobile society has never been assessed in a population of patients undergoing spinal surgery. The purpose of this article is to determine the frequency with which patients who have undergone prior surgery and develop new problems attempt to follow-up with their index spine surgeon. The study design was a population survey. All patients seen at two university-based spine centers over a 3-month period were surveyed regarding prior spine surgery. The questionnaire asked details of the previous operation, whether the patient had sought follow-up with their index surgeon, why the patient did not continue treatment with that surgeon, and whether the patient was satisfied with their prior treatment. Sixty-nine patients completed the survey. Prior operations were lumbar (53 patients) and cervical (16). When asked the reason for not seeing their prior surgeon, 10 patients (15%) stated that they (the patient) had moved and 16 (23%) responded that their surgeon no longer practiced in the area. Thirteen (19%) were unhappy with their previous care, 22 (32%) were seeking a second opinion, and 7 (10%) were told they needed more complex surgery. Thirty-seven (54%) discussed their symptoms with their original surgeon before seeking another surgeon. Although 32 patients (46%) had not discussed their new complaints with their index surgeon, only 3 patients (4%) chose not to return to their prior surgeon despite having the opportunity to do so. Forty-nine patients (71%) were satisfied with their prior surgical care, and 42 patients (61%) would undergo the index operation again. Most of the patients seen at the authors' practices after undergoing prior spine surgery elsewhere failed to follow up with their prior spine surgeon for geographical reasons. It appears that the majority of patients who develop new spinal complaints will seek out their treating surgeon when possible. This suggests that patient attrition over long-term follow-up may reflect a geographically mobile population rather than patient dissatisfaction with prior treatment

Fragile antiferromagnetism in the heavy-fermion compound YbBiPt

We report results from neutron scattering experiments on single crystals of YbBiPt that demonstrate antiferromagnetic order characterized by a propagation vector, $\tau_{\rm{AFM}}$ = ($\frac{1}{2} \frac{1}{2} \frac{1}{2}$), and ordered moments that align along the [1 1 1] direction of the cubic unit cell. We describe the scattering in terms of a two-Gaussian peak fit, which consists of a narrower component that appears below $T_{\rm{N}}~\approx 0.4$ K and corresponds to a magnetic correlation length of $\xi_{\rm{n}} \approx$ 80 $\rm{\AA}$, and a broad component that persists up to $T^*\approx$ 0.7 K and corresponds to antiferromagnetic correlations extending over $\xi_{\rm{b}} \approx$ 20 $\rm{\AA}$. Our results illustrate the fragile magnetic order present in YbBiPt and provide a path forward for microscopic investigations of the ground states and fluctuations associated with the purported quantum critical point in this heavy-fermion compound.Comment: 5 pages, 3 figure

Pre-amplification methods for tracking low-grade Plasmodium falciparum populations during scaled-up interventions in Southern Zambia

Background: Malaria is receding in many endemic countries with intervention scale -up against the disease. However, this resilient scourge may persist in low-grade submicroscopic infections among semi-immune members of the population, and be poised for possible resurgence, creating challenges for detection and assessment of intervention impact. Parasite genotyping methods, such as the molecular barcode, can identify specific malaria parasite types being transmitted and allow tracking and evaluation of parasite population structure changes as interventions are applied. This current study demonstrates application of pre-amplification methods for successful detection and genotyping of residual Plasmodium falciparum infections during a dramatic malarial decline. Methods: The study was a prospective cross-sectional design and based on a 2,000 sq km vicinity of Macha Mission Hospital in southern Zambia. Willing and predominantly asymptomatic residents of all ages were screened for malaria by microscopy during the 2005 and 2008 transmission seasons, with simultaneous collection of dried blood spots (DBS) on filter paper, and extraction of Plasmodium falciparum DNA was performed. Plasmodium falciparum infections were genotyped using a 24 SNP-based molecular barcode assay using real-time PCR. Submicroscopic parasitaemia samples were subjected to pre-amplification using TaqMan PreAmp Master Mix following the manufacturer’s instructions before SNP barcode analysis. Results: There was a dramatic decline of malaria between 2005 and 2008, and the geometric mean parasite density (95% CI) fell from 704/μL (390–1,271) in 2005 to 39/μL (23–68) in 2008, culminating in a large proportion of submicroscopic infections of which 90% failed to yield ample DNA for standard molecular characterization among 2008 samples. Pre-amplification enabled successful detection and genotyping of 74% of these low-grade reservoir infections, overall, compared to 54% that were detectable before pre-amplification (p <0.0005, n = 84). Furthermore, nine samples negative for parasites by microscopy and standard quantitative PCR amplification were positive after pre-amplification. Conclusions: Pre-amplification allows analysis of an otherwise undetectable parasite population and may be instrumental for parasites identification, tracking and assessing the impact of interventions on parasite populations during malaria control and elimination programmes when parasitaemia is expected to decline to submicroscopic levels

A conserved filamentous assembly underlies the structure of the meiotic chromosome axis.

The meiotic chromosome axis plays key roles in meiotic chromosome organization and recombination, yet the underlying protein components of this structure are highly diverged. Here, we show that 'axis core proteins' from budding yeast (Red1), mammals (SYCP2/SYCP3), and plants (ASY3/ASY4) are evolutionarily related and play equivalent roles in chromosome axis assembly. We first identify 'closure motifs' in each complex that recruit meiotic HORMADs, the master regulators of meiotic recombination. We next find that axis core proteins form homotetrameric (Red1) or heterotetrameric (SYCP2:SYCP3 and ASY3:ASY4) coiled-coil assemblies that further oligomerize into micron-length filaments. Thus, the meiotic chromosome axis core in fungi, mammals, and plants shares a common molecular architecture, and likely also plays conserved roles in meiotic chromosome axis assembly and recombination control