A Health Plan Work in Progress: Hospital-Physician Price and Quality Transparency

Assesses health plans' efforts to provide consumers with price and quality comparisons on hospitals and doctors in twelve metropolitan areas. Looks at the plans' motives and strategies, as well as the limitations, risks, and challenges of transparency

Health and Wellness: The Shift From Managing Illness to Promoting Health

Examines the rise in health plan initiatives to promote wellness as a way for employers to manage costs and to engage employees in their own healthcare decisions through wellness activities, behavior modification programs, and health risk assessments

A comparison of the in vitro and in planta responses of Phytophthora cinnamomi isolates to phosphite

Research in plant pathology often relies on testing interactions between a fungicide and a pathogen in vitro and extrapolating from these results what may happen in planta. Likewise, results from glasshouse experiments are used to estimate what will happen if the fungicide is applied in the field. However, it is difficult to obtain conditions in vitro and in the glasshouse which reflect the conditions where the fungicide may eventually be used, in the field. The aim of this paper is to compare results of the effect of phosphite on P. cinnamomi isolates in vitro and in planta

Drifter studies in warm core rings

The results of multiple deployments of surface drifters in warm core rings of the Gulf Stream are presented. Four satellite drifters (tracked by the Argos system) were deployed on nine separate occasions and two LORAN-C drifters (operated by the University of Miami) were deployed three times. Drifter studies were conducted during four cruises aboard the R/V Endeavor in 1982 in conjunction with the Warm Core Rings Experiment and one cruise of the USNS Bartlett in January 1983 which was sponsored by the Office of Naval Research. Translational velocities and periods of rotation are provided for two rings: 82B and 82H.National Science Foundation under grant OCE80-1698

Edge Shear Flows and Particle Transport near the Density Limit in the HL-2A Tokamak

Edge shear flow and its effect on regulating turbulent transport have long been suspected to play an important role in plasmas operating near the Greenwald density limit $n_G$. In this study, equilibrium profiles as well as the turbulent particle flux and Reynolds stress across the separatrix in the HL-2A tokamak are examined as $n_G$ is approached in ohmic L-mode discharges. As the normalized line-averaged density $\bar{n}_e/n_G$ is raised, the shearing rate of the mean poloidal flow $\omega_{\rm sh}$ drops, and the turbulent drive for the low-frequency zonal flow (the Reynolds power $\mathcal{P}_{Re}$) collapses. Correspondingly, the turbulent particle transport increases drastically with increasing collision rates. The geodesic acoustic modes (GAMs) gain more energy from the ambient turbulence at higher densities, but have smaller shearing rate than low-frequency zonal flows. The increased density also introduces decreased adiabaticity which not only enhances the particle transport but is also related to a reduction in the eddy-tilting and the Reynolds power. Both effects may lead to the cooling of edge plasmas and therefore the onset of MHD instabilities that limit the plasma density

Driving calmodulin protein towards conformational shift by changing ionization states of select residues

Proteins are complex systems made up of many conformational sub-states which are mainly determined by the folded structure. External factors such as solvent type, temperature, pH and ionic strength play a very important role in the conformations sampled by proteins. Here we study the conformational multiplicity of calmodulin (CaM) which is a protein that plays an important role in calcium signaling pathways in the eukaryotic cells. CaM can bind to a variety of other proteins or small organic compounds, and mediates different physiological processes by activating various enzymes. Binding of calcium ions and proteins or small organic molecules to CaM induces large conformational changes that are distinct to each interacting partner. In particular, we discuss the effect of pH variation on the conformations of CaM. By using the pKa values of the charged residues as a basis to assign protonation states, the conformational changes induced in CaM by reducing the pH are studied by molecular dynamics simulations. Our current view suggests that at high pH, barrier crossing to the compact form is prevented by repulsive electrostatic interactions between the two lobes. At reduced pH, not only is barrier crossing facilitated by protonation of residues, but also conformations which are on average more compact are attained. The latter are in accordance with the fluorescence resonance energy transfer experiment results of other workers. The key events leading to the conformational change from the open to the compact conformation are (i) formation of a salt bridge between the N-lobe and the linker, stabilizing their relative motions, (ii) bending of the C-lobe towards the N-lobe, leading to a lowering of the interaction energy between the two-lobes, (iii) formation of a hydrophobic patch between the two lobes, further stabilizing the bent conformation by reducing the entropic cost of the compact form, (iv) sharing of a Ca+2 ion between the two lobes

3D Visualisation of Additive Occlusion and Tunable Full-Spectrum Fluorescence in Calcite

From biomineralization to synthesis, organic additives provide an effective means of controlling crystallisation processes. There is growing evidence that these additives are often occluded within the crystal lattice, where this promises an elegant means of creating nanocomposites and tuning physical properties. Here, we use the incorporation of sulfonated fluorescent dyes to gain new understanding of additive occlusion in calcite (CaCO3), and to link morphological changes to occlusion mechanisms. We demonstrate that these additives are incorporated within specific zones, as defined by the growth conditions, and show how occlusion can govern changes in crystal shape. Fluorescence spectroscopy and lifetime imaging microscopy also show that the dyes experience unique local environments within different zones. Our strategy was then extended to simultaneously incorporate mixtures of dyes, whose fluorescence cascade creates calcite nanoparticles that fluoresce white. This offers a simple strategy for generating biocompatible and stable fluorescent nanoparticles whose output can be tuned as required

Double-outlet right ventricle: Morphologic demonstration using nuclear magnetic resonance imaging

Sixteen patients with double-outlet right ventricle, aged 1 week to 29 years (median 5 months), were studied with a 1.5 tesla nuclear magnetic resonance (NMR) imaging scanner. Two-dimensional echocardiography was performed in all patients. Thirteen patients underwent angiography, including nine who underwent subsequent surgical correction. Three patients underwent postmortem examination.Small children and infants were scanned inside a 32 cm diameter proton head coil. Multiple 5 mm thick sections separated by 0.5 mm and gated to the patient's electrocardiogram were acquired with a spin-echo sequence and an echo time of 30 ms. A combination of standard and oblique imaging planes was used. Imaging times were <90 min. The NMR images were technically unsuitable in one patient because of excessive motion artifact.In the remaining patients, the diagnosis of double outlet right ventricle was confirmed and correlated with surgical and postmortern findings. The NMR images were particularly valuable in demonstrating the interrelations between the great arteries and the anatomy of the outlet septum and the spatial relations between the ventricular septal defect and the great arteries. Although the atrioventricular (AV) valves were not consistently demonstrated, NMR imaging in two patients identified abnormalities of the mitral valve that were not seen with two-dimensional echocardiography. In one patient who had a superoinferior arrangement of the ventricles, NMR imaging was the most useful imaging technique for demonstrating the anatomy.In patients with double-outlet right ventricle, NMR imaging can provide clinically relevant and accurate morphologic information that may contribute to future improvement in patient management

Distinct roles for dynein light intermediate chains in neurogenesis, migration, and terminal somal translocation

Cytoplasmic dynein participates in multiple aspects of neocortical development. These include neural progenitor proliferation, morphogenesis, and neuronal migration. The cytoplasmic dynein light intermediate chains (LICs) 1 and 2 are cargo-binding subunits, though their relative roles are not well understood. Here, we used in utero electroporation of shRNAs or LIC functional domains to determine the relative contributions of the two LICs in the developing rat brain. We find that LIC1, through BicD2, is required for apical nuclear migration in neural progenitors. In newborn neurons, we observe specific roles for LIC1 in the multipolar to bipolar transition and glial-guided neuronal migration. In contrast, LIC2 contributes to a novel dynein role in the little-studied mode of migration, terminal somal translocation. Together, our results provide novel insight into the LICs' unique functions during brain development and dynein regulation overall.This project was supported by National Institutes of Health grants HD40182 and GM105536 to R.B. Vallee and the Fundação para Ciência e a Tecnologia MDPhD Scholarship PD/BD/113766/2015 to J.C. Gonçalves. During the final year, T.J. Dan-tas was supported by the Porto Neurosciences and Neurologic Disease Research Initiative at Instituto de Investigação e Inovação em Saúde (Norte-01-0145-FED ER-000008