Original Communications Decreased Plasma Fibronectin during Starvation in Man

ABSTRACT. This study evaluated the effect of 5 days of starvation followed b

Connecting the Dots: A Rare Cause of Pulmonary Nodules in a 13-Year-Old Boy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140177/1/ped.2014.0392.pd

The Structure and Properties of Solar Active Regions and Quiet-Sun Areas Observed in Soft X-Rays with Yohkoh/SXT and in the Extreme-Ultraviolet with SERTS

We observed two solar active regions (NOAA regions 7563 and 7565), quiet-Sun areas, and a coronal hole region simultaneously with Goddard Space Flight Center's Solar EUV Rocket Telescope and Spectrograph (SERTS) and with the Yohkoh Soft X-ray Telescope (SXT) on 1993 August 17. SERTS provided spatially resolved active region and quiet-Sun slit spectra in the 280 to 420 A wavelength range, and images in the lines of He II λ303.8, Mg IX λ368.1, Fe XV λ284.1, and Fe XVI λλ335.4 and 360.8 SXT provided images through multiple broadband filters in both the full-frame imaging mode and the partial-frame imaging mode. The SERTS images in Fe XV (log Tmax = 6.33, where Tmax is the temperature which maximizes the fractional ion abundance in the available ionization equilibrium calculations, i.e., the formation temperature) and Fe XVI (log Tmax = 6.43) exhibit remarkable morphological similarity to the SXT images. Whereas the Fe XV and XVI images outline the loop structures seen with SXT, the cooler He II (log Tmax = 4.67) and Mg IX (log Tmax = 5.98) images outline loop footpoints. In addition, the Mg IX emission outlines other structures not necessarily associated with the hot loops; these may be cool (T 1 × 106 K) loops. From the spatially resolved slit spectra, we obtained emission-line profiles for lines of He II λ303.8, Mg IX λ368.1, Fe XIII λ348.2, Si XI λ303.3, Fe XIV λ334.2, Fe XV λ284.1, and Fe XVI λ335.4 for each spatial position. Based upon the spatial variations of the line intensities, active region 7563 systematically narrows when viewed with successively hotter lines, and appears narrowest in the broadband soft X-ray emission. The active region width (full width at half-maximum intensity) diminishes linearly with log Tmax; the linear fit yields an extrapolated effective log Tmax of 6.51 ± 0.01 for the X-ray emission. The most intense, central core straddles the magnetic neutral line. Active region and quiet-Sun one-dimensional temperature scans were derived from intensity ratios of spatially resolved SERTS slit spectral lines, and from coregistered SXT filter ratios. The highest plasma temperatures were measured in the most intense, central core of region 7563. The temperatures derived from Fe XVI λ335.4/Fe XV λ284.1 and Fe XVI λ335.4/Fe XIV λ334.2 vary significantly (based upon the measurement uncertainties) but not greatly (factors of less than 1.5) across the slit. The average log T values derived from the above two ratios for region 7563 are 6.39 ± 0.04 and 6.32 ± 0.02, respectively. Somewhat larger systematic variations were obtained from all available SXT filter ratios. The average active region log T values derived from the SXT AlMgMn/thin Al, thick Al/thin Al, and thick Al/AlMgMn filter ratios are 6.33 ± 0.03, 6.45 ± 0.02, and 6.49 ± 0.03, respectively. Active region and quiet-Sun one-dimensional density scans were derived from intensity ratios of spatially resolved SERTS slit spectral lines of Fe XIII and Fe XIV. The derived densities show neither systematic nor significant variations along the slit in either the active region or the quiet-Sun, despite the fact that the intensities themselves vary substantially. This indicates that the product of the volume filling factor and the path length (fΔl) must be greater by factors of 3-5 in the active region core than in the outskirts. Furthermore, the derived active region densities are ~2 times the quiet-Sun densities. This density difference is adequate to explain the factor of ~4 intensity difference in Fe XII and Fe XIII between the active and quiet areas, but it is not adequate to explain the factor of ~8 intensity difference in Fe XIV between the active and quiet areas. We attribute the latter to a greater fΔl in the active regions. Statistically significant Doppler shifts are not detected in region 7563 or in the quiet-Sun with any of the EUV lines

A Comprehensive Pediatric Asthma Management Program Reduces Emergency Department Visits and Hospitalizations

We evaluated the impact of a comprehensive pediatric asthma management program (the Children's Asthma Wellness Program, CAWP) on the frequency of emergency department (ED) visits and hospital admissions. The CAWP generally consisted of 4 clinic sessions over a 1-year period, but some patients attended fewer clinic sessions, and some required additional clinic sessions due to incomplete asthma control. Patients were evaluated and treated by pediatric pulmonologists, nurse asthma care coordinator/educator, and social worker. We retrospectively reviewed program results over an 8-year period (2005?2013). We compared ED visits and hospital admissions before and after participation in the CAWP. There were 254 children referred to the CAWP; 172 children were enrolled. Fifty-four children (31%) received >6 sessions due to incomplete asthma control. On average, children requiring additional clinic sessions were older and more likely to be African American, hold Medicaid insurance, and have severe asthma. We obtained a minimum of 1-year preprogram and 1-year postprogram administrative data for 86 children (50%). Using each participating child as his/her own control, we found that taking part in the program decreased the risk of ED visits to 0.26 times the preprogram rate (P?Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140178/1/ped.2015.0561.pd

The Algorithm Theoretical Basis Document for the Derivation of Range and Range Distributions from Laser Pulse Waveform Analysis for Surface Elevations, Roughness, Slope, and Vegetation Heights

The primary purpose of the GLAS instrument is to detect ice elevation changes over time which are used to derive changes in ice volume. Other objectives include measuring sea ice freeboard, ocean and land surface elevation, surface roughness, and canopy heights over land. This Algorithm Theoretical Basis Document (ATBD) describes the theory and implementation behind the algorithms used to produce the level 1B products for waveform parameters and global elevation and the level 2 products that are specific to ice sheet, sea ice, land, and ocean elevations respectively. These output products, are defined in detail along with the associated quality, and the constraints, and assumptions used to derive them

Using the Teamlet Model to Improve Chronic Care in an Academic Primary Care Practice

Team care can improve management of chronic conditions, but implementing a team approach in an academic primary care clinic presents unique challenges. To implement and evaluate the Teamlet Model, which uses health coaches working with primary care physicians to improve care for patients with diabetes and/or hypertension in an academic practice. Process and outcome measures were compared before and during the intervention in patients seen with the Teamlet Model and in a comparison patient group. First year family medicine residents, medical assistants, health workers, and adult patients with either type 2 diabetes or hypertension in a large public health clinic. Health coaches, in coordination with resident primary care physicians, met with patients before and after clinic visits and called patients between visits. Measurement of body mass index, assessment of smoking status, and formulation of a self-management plan prior to and during the intervention period for patients in the Teamlet Model group. Testing for LDL and HbA1C and the proportion of patients at goal for blood pressure, LDL, and HbA1C in the Teamlet Model and comparison groups in the year prior to and during implementation. Teamlet patients showed improvement in all measures, though improvement was significant only for smoking, BMI, and self-management plan documentation and testing for LDL (p = 0.02), with a trend towards significance for LDL at goal (p = 0.07). Teamlet patients showed a greater, but non-significant, increase in the proportion of patients tested for HbA1C and proportion reaching goal for blood pressure, HgbA1C, and LDL compared to the comparison group patients. The difference for blood pressure was marginally significant (p = 0.06). In contrast, patients in the comparison group were significantly more likely to have had testing for LDL (P = 0.001). The Teamlet Model may improve chronic care in academic primary care practices