Association between physician characteristics and payments from industry in 2015-2017: observational study.

OBJECTIVE:To investigate the association between physician characteristics and the value of industry payments. DESIGN:Observational study. SETTING AND PARTICIPANTS:Using the 2015-2017 Open Payments reports of industry payments linked to the Physician Compare database, we examined the association between physician characteristics (physician sex, years in practice, medical school attended and specialty) and the industry payment value, adjusting for other physician characteristic and institution fixed effects (effectively comparing physicians practicing at the same institution). MAIN OUTCOME MEASURES:Our primary outcome was the value of total industry payments to physicians including (1) general payments (all forms of payments other than those classified for research purpose, eg, consulting fees, food, beverage), (2) research payments (payments for research endeavours under a written contract or protocol) and (3) ownership interests (eg, stock or stock options, bonds). We also investigated each category of payment separately. RESULTS:Of 544 264 physicians treating Medicare beneficiaries, a total of $5.8 billion in industry payments were made to 365 801 physicians during 2015-2017. The top 5% of physicians, by cumulative payments, accounted for 91% of industry payments. Within the same institution, male physicians, physicians with 21-30 years in practice and physicians who attended top 50 US medical schools (based on the research ranking) received higher industry payments. Across specialties, orthopaedic surgeons, neurosurgeons and endocrinologists received the highest payments. When we investigated individual types of payment, we found that orthopaedic surgeons received the highest general payments; haematologists/oncologists were the most likely to receive research payments and surgeons were the most likely to receive ownership interests compared with other types of physicians. CONCLUSIONS:Industry payments to physicians were highly concentrated among a small number of physicians. Male sex, longer length of time in clinical practice, graduated from a top-ranked US medical school and practicing certain specialties, were independently associated with higher industry payments

Hydrogen-Poor Disks in Compact X-Ray Binaries

We show that accretion disks in several compact X-ray binaries with hydrogen-depleted donors are likely subject to a thermal ionization instability, unless they are strongly irradiated. These disks are particularly interesting in that their MHD-turbulent properties in the neutral phase may be quite different from those of standard, hydrogen-rich disks.Comment: 10 pages, accepted for publication in ApJ

Identifying metabolites by integrating metabolome databases with mass spectrometry cheminformatics.

Novel metabolites distinct from canonical pathways can be identified through the integration of three cheminformatics tools: BinVestigate, which queries the BinBase gas chromatography-mass spectrometry (GC-MS) metabolome database to match unknowns with biological metadata across over 110,000 samples; MS-DIAL 2.0, a software tool for chromatographic deconvolution of high-resolution GC-MS or liquid chromatography-mass spectrometry (LC-MS); and MS-FINDER 2.0, a structure-elucidation program that uses a combination of 14 metabolome databases in addition to an enzyme promiscuity library. We showcase our workflow by annotating N-methyl-uridine monophosphate (UMP), lysomonogalactosyl-monopalmitin, N-methylalanine, and two propofol derivatives

Hot White Dwarf Donors in Ultracompact X-Ray Binaries

The discovery of two accreting millisecond X-ray pulsars in binaries with 43 minute orbital periods allows for a new probe of the donor's structure. For XTE J1751-305, only a hot white dwarf (WD) can fill the Roche Lobe. A cold He WD is a possible solution for XTE J0929-314, though I will show that evolutionary arguments make a hot WD more likely. In addition to being larger than the T=0 models, these finite entropy, low-mass (<0.03 solar masses) WDs have a minimum mass for a fixed core temperature. If they remain hot as they lose mass and expand, they can ``evaporate'' to leave an isolated millisecond radio pulsar. They also adiabatically expand upon mass loss at a rate faster than the growth of the Roche radius if the angular momentum deposited in the disk is not returned to the donor. If the timescale of the resulting runaway mass transfer is shorter than the viscous timescale in the outer disk, then the mass transfer instability of Ruderman and Shaham for He WDs would be realized. However, my estimates of these timescales still makes the instability unlikely for adiabatic responses. I close by noting the possible impact of finite T WDs on our understanding of AM CVn binaries.Comment: to appear in Astrophysical Journal Letter