Getting the Haves to Come out Behind: Fixing the Distributive Injustices of American Health Care

Hyman criticizes an article by Havighurst and Richman regarding the distributive injustices of US health care. Hyman also offers a guide for implementing policy reforms based on the analysis by Havighurst and Richman

Remarks by David F. Cavers to Duke Students Converning the Origin of and Vision for Law and Contemporary Problems

Objectives To present a method for generating reference maps of typical brain characteristics of groups of subjects using a novel combination of rapid quantitative Magnetic Resonance Imaging (qMRI) and brain normalization. The reference maps can be used to detect significant tissue differences in patients, both locally and globally. Materials and Methods A rapid qMRI method was used to obtain the longitudinal relaxation rate (R1), the transverse relaxation rate (R2) and the proton density (PD). These three tissue properties were measured in the brains of 32 healthy subjects and in one patient diagnosed with Multiple Sclerosis (MS). The maps were normalized to a standard brain template using a linear affine registration. The differences of the mean value ofR1, R2 and PD of 31 healthy subjects in comparison to the oldest healthy subject and in comparison to an MS patient were calculated. Larger anatomical structures were characterized using a standard atlas. The vector sum of the normalized differences was used to show significant tissue differences. Results The coefficient of variation of the reference maps was high at the edges of the brain and the ventricles, moderate in the cortical grey matter and low in white matter and the deep grey matter structures. The elderly subject mainly showed significantly lower R1 and R2 and higher PD values along all sulci. The MS patient showed significantly lower R1 and R2 and higher PD values at the edges of the ventricular system as well as throughout the periventricular white matter, at the internal and external capsules and at each of the MS lesions. Conclusion Brain normalization of rapid qMRI is a promising new method to generate reference maps of typical brain characteristics and to automatically detect deviating tissue properties in the brain

The Role of Attorney Fee Shifting in Public Interest Litigation

BACKGROUND: Brain tissue segmentation of white matter (WM), grey matter (GM), and cerebrospinal fluid (CSF) are important in neuroradiological applications. Quantitative Mri (qMRI) allows segmentation based on physical tissue properties, and the dependencies on MR scanner settings are removed. Brain tissue groups into clusters in the three dimensional space formed by the qMRI parameters R1, R2 and PD, and partial volume voxels are intermediate in this space. The qMRI parameters, however, depend on the main magnetic field strength. Therefore, longitudinal studies can be seriously limited by system upgrades. The aim of this work was to apply one recently described brain tissue segmentation method, based on qMRI, at both 1.5 T and 3.0 T field strengths, and to investigate similarities and differences. METHODS: In vivo qMRI measurements were performed on 10 healthy subjects using both 1.5 T and 3.0 T MR scanners. The brain tissue segmentation method was applied for both 1.5 T and 3.0 T and volumes of WM, GM, CSF and brain parenchymal fraction (BPF) were calculated on both field strengths. Repeatability was calculated for each scanner and a General Linear Model was used to examine the effect of field strength. Voxel-wise t-tests were also performed to evaluate regional differences. RESULTS: Statistically significant differences were found between 1.5 T and 3.0 T for WM, GM, CSF and BPF (p<0.001). Analyses of main effects showed that WM was underestimated, while GM and CSF were overestimated on 1.5 T compared to 3.0 T. The mean differences between 1.5 T and 3.0 T were -66 mL WM, 40 mL GM, 29 mL CSF and -1.99% BPF. Voxel-wise t-tests revealed regional differences of WM and GM in deep brain structures, cerebellum and brain stem. CONCLUSIONS: Most of the brain was identically classified at the two field strengths, although some regional differences were observed

A note on ADCP-based indirect observations of turbulence

A 70-day data set from bottom-mounted ADCPs on the two sides of the Faroe-Bank Channel was analysed using the recorded flow variance and echo intensity in the deeper reaches of the passage as proxies for turbulence. A consistent picture emerged, not least since the data losses (which were ascribed to turbulence-induced activation of the fish-elimination option in the ADCP software) could be shown to co-vary with the internal M-2 tide affecting the vertical shear, which in turn proved to be correlated with the flow variance

Overregulation of Health Care: Musings on Disruptive Innovation Theory

Disruptive innovation theory provides one lens through which to describe how regulations may stifle innovation and increase costs. Basing their discussion on this theory, Curtis and Schulman consider some of the effects that regulatory controls may have on innovation in the health sector

Phase-coherent lightwave communications with frequency combs

Fiber-optical networks are a crucial telecommunication infrastructure in society. Wavelength division multiplexing allows for transmitting parallel data streams over the fiber bandwidth, and coherent detection enables the use of sophisticated modulation formats and electronic compensation of signal impairments. In the future, optical frequency combs may replace multiple lasers used for the different wavelength channels. We demonstrate two novel signal processing schemes that take advantage of the broadband phase coherence of optical frequency combs. This approach allows for a more efficient estimation and compensation of optical phase noise in coherent communication systems, which can significantly simplify the signal processing or increase the transmission performance. With further advances in space division multiplexing and chip-scale frequency comb sources, these findings pave the way for compact energy-efficient optical transceivers.Comment: 17 pages, 9 figure

Basic Numerical Methods in Meteorology and Oceanography

The purpose of this book is to provide an introduction to numerical modelling of the ocean and the atmosphere. It originates from courses given at Stockholm University and is intended to serve as a textbook for students in meteorology and oceanography with a background in mathematics and physics. Focus is on numerical schemes for the most commonly used equations in oceanography and meteorology as well as on the stability, precision and other properties of these schemes. Simple equations capturing the properties of the primitive equations employed in models of the ocean and atmosphere will be used. These model equations are solved numerically on a grid by discretisation, the derivatives of the differential equations being replaced by finite-difference approximations. The focus will be on the basic numerical methods used for oceanographic and atmospheric modelling. These models are based on the Navier-Stokes equations (including the Coriolis effect) and a tracer equation for heat in both the atmosphere and ocean and tracer equations for humidity and salt in the atmosphere and ocean, respectively. A coupled atmospheric and oceanic general circulation model represents the core part of an Earth System climate model. The book starts by presenting the most common types of partial differential equations and finite difference schemes used in meteorology and oceanography. Subsequently the limitations of these numerical schemes as regards stability, accuracy, presence of computational modes and accuracy the computationally determined phase speed are discussed. The shallow-water equations are discretised for different spatial grids and friction and diffusion terms are introduced. Hereafter implicit and semi-implicit schemes are discussed as well as the semi-Lagrangian technique. Coordinates for atmospheric as well as oceanic models are presented as well as a highly simplified 3D model. A brief description is given of how some atmospheric general circulation models use spectral methods as ""horizontal coordinates"". Finally, some ""pen-and-paper"" theoretical exercises and a number of GFD computer exercises are given