The Presumption against Expensive Health Care Consumption

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Tailored codes for small quantum memories

We demonstrate that small quantum memories, realized via quantum error correction in multi-qubit devices, can benefit substantially by choosing a quantum code that is tailored to the relevant error model of the system. For a biased noise model, with independent bit and phase flips occurring at different rates, we show that a single code greatly outperforms the well-studied Steane code across the full range of parameters of the noise model, including for unbiased noise. In fact, this tailored code performs almost optimally when compared with 10,000 randomly selected stabilizer codes of comparable experimental complexity. Tailored codes can even outperform the Steane code with realistic experimental noise, and without any increase in the experimental complexity, as we demonstrate by comparison in the observed error model in a recent 7-qubit trapped ion experiment.Comment: 6 pages, 2 figures, supplementary material; v2 published versio

William H. Sorrell, Attorney General of Vermont, et al. v. IMS Health Inc., et al. - Amicus Brief in Support of Petitioners

On April 26, 2011, the US Supreme Court will hear oral arguments in the Vermont data mining case, Sorrell v. IMS Health Inc. Respondents claim this is the most important commercial speech case in a decade. Petitioner (the State of Vermont) argues this is the most important medical privacy case since Whalen v. Roe. The is an amicus brief supporting Vermont, written by law professors and submitted on behalf of the New England Journal of Medicin

What are talent scouts actually identifying? Investigating the physical and technical skill match activity profiles of drafted and non-drafted U18 Australian footballers

Objective: To compare the physical and technical skill match activity profiles of drafted and non-drafted under 18 (U18) Australian football (AF) players. Design: Cross-sectional observational. Methods: In-game physical and skill variables were assessed for U18 AF players participating within the 2013 and 2014 National U18 AFL Championships. Players originated from one State Academy (n = 55). Ten games were analysed; resulting in 183 observations. Players were sub-divided into two groups; drafted / non-drafted. Microtechnology and a commercial statistical provider allowed the quantification of total distance (m), relative distance (m.min-1), high speed running distance (\u3e 15km.hr-1), high speed running expressed as a percentage of total distance (% total), total disposals, marks, contested possessions, uncontested possessions, inside 50’s and rebound 50’s (n = 10). The effect size (d) of draft outcome on these criterion variables was calculated, with generalised estimating equations (GEE’s) used to model which of these criterion variables was associated with draft outcome. Results: Contested possessions and inside 50’s reflected large effect size differences between groups (d = 1.01, d = 0.92, respectively). The GEE models revealed contested possessions as the strongest predictor of draft outcome, with inside 50’s being the second. Comparatively, the remaining criterion variables were not predictive of draft outcome. Conclusions: Contested possessions and inside 50’s are the most influential in-game variables associated with draft outcome for West Australian players competing within the National U18 AFL Championships. Technically skilled players who win contested possessions and deliver the ball inside 50 may be advantageously positioned for draft success

Structural Sex Discrimination: Why Gynecology Patients Suffer Avoidable Injuries and What the Law Can Do About It

Nearly four million Americans undergo gynecological surgeries each year, but these procedures are unnecessarily risky, as many suffer avoidable lifelong, painful, and disabling injuries. This Article diagnoses the root cause in our legal framework for healthcare finance. It then identifies solutions. America’s public–private system for reimbursing healthcare pays for procedures rather than outcomes, and it pays substantially more for work on male rather than female anatomies. This disparity is due to the federal government’s reliance on a secretive industry committee to set those rates, and the committee’s reliance on junk science surveys, allowing self-interested and gender-biased responses, contrary to objective measures. As payors disvalue the bodies of those needing gynecological care, the medical profession has organized accordingly. Surgical training for Obstetrician Gynecologists (OB-GYNs) is truncated as compared to other surgical disciplines. OB-GYNs are incentivized to pursue a mix of better-paid work, rather than pursue the advanced training and specialized experience necessary to perform surgery consistently. Instead, most OB‑GYNs may perform particular surgeries only a few times per year, a context shown to magnify the risk of preventable injuries. Traditional approaches, under informed consent and medical malpractice laws, take for granted the fundamental economic structure that sets aggregate levels of risk. A range of laws, including a provision in the Affordable Care Act, do promise equal treatment. Close analysis, however, reveals a range of barriers to redress. Congress has made federal payment rates unreviewable by courts, even if illegal. Notwithstanding the federal government’s ironic immunity from its own laws, this Article suggests that private health insurers may be held liable for going along with the federal government’s discrimination. Still it will be difficult for individual patients to assert their interests in reorganizing the medical profession. There are narrow and uncertain paths for legal accountability, but the political economy of this problem is no less daunting. Presently, overall Medicare payments are conceived as a zero-sum game, pitting patients (and doctors) against each other. Nonetheless, Constitutional litigation under the Equal Protection Clause may give voice to those working for the health of women in America

Stroke penumbra defined by an MRI-based oxygen challenge technique: 2. Validation based on the consequences of reperfusion

Magnetic resonance imaging (MRI) with oxygen challenge (T2* OC) uses oxygen as a metabolic biotracer to define penumbral tissue based on CMRO2 and oxygen extraction fraction. Penumbra displays a greater T2* signal change during OC than surrounding tissue. Since timely restoration of cerebral blood flow (CBF) should salvage penumbra, T2* OC was tested by examining the consequences of reperfusion on T2* OC-defined penumbra. Transient ischemia (109±20 minutes) was induced in male Sprague-Dawley rats (n=8). Penumbra was identified on T2*-weighted MRI during OC. Ischemia and ischemic injury were identified on CBF and apparent diffusion coefficient maps, respectively. Reperfusion was induced and scans repeated. T2 for final infarct and T2* OC were run on day 7. T2* signal increase to OC was 3.4% in contralateral cortex and caudate nucleus and was unaffected by reperfusion. In OC-defined penumbra, T2* signal increased by 8.4%±4.1% during ischemia and returned to 3.25%±0.8% following reperfusion. Ischemic core T2* signal increase was 0.39%±0.47% during ischemia and 0.84%±1.8% on reperfusion. Penumbral CBF increased from 41.94±13 to 116.5±25 mL per 100 g per minute on reperfusion. On day 7, OC-defined penumbra gave a normal OC response and was located outside the infarct. T2* OC-defined penumbra recovered when CBF was restored, providing further validation of the utility of T2* OC for acute stroke management

Stroke penumbra defined by an MRI-based oxygen challenge technique: 1. validation using [14C]2-deoxyglucose autoradiography

Accurate identification of ischemic penumbra will improve stroke patient selection for reperfusion therapies and clinical trials. Current magnetic resonance imaging (MRI) techniques have limitations and lack validation. Oxygen challenge T2* MRI (T2* OC) uses oxygen as a biotracer to detect tissue metabolism, with penumbra displaying the greatest T2* signal change during OC. [14C]2-deoxyglucose (2-DG) autoradiography was combined with T2* OC to determine metabolic status of T2*-defined penumbra. Permanent middle cerebral artery occlusion was induced in anesthetized male Sprague-Dawley rats (n=6). Ischemic injury and perfusion deficit were determined by diffusion- and perfusion-weighted imaging, respectively. At 147±32 minutes after stroke, T2* signal change was measured during a 5-minute 100% OC, immediately followed by 125 μCi/kg 2-DG, intravenously. Magnetic resonance images were coregistered with the corresponding autoradiograms. Regions of interest were located within ischemic core, T2*-defined penumbra, equivalent contralateral structures, and a region of hyperglycolysis. A T2* signal increase of 9.22%±3.9% (mean±s.d.) was recorded in presumed penumbra, which displayed local cerebral glucose utilization values equivalent to contralateral cortex. T2* signal change was negligible in ischemic core, 3.2%±0.78% in contralateral regions, and 1.41%±0.62% in hyperglycolytic tissue, located outside OC-defined penumbra and within the diffusion abnormality. The results support the utility of OC-MRI to detect viable penumbral tissue follow

Effective Feedback to Improve Primary Care Prescribing Safety (EFIPPS) a pragmatic three-arm cluster randomised trial:designing the intervention (ClinicalTrials.gov registration NCT01602705)

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