Strengthening Primary and Chronic Care: State Innovations to Transform and Link Small Practices

Presents case studies of state policies for reorganizing and improving primary and chronic care delivery among small practices, including leadership and convening, payment incentives, infrastructure support, feedback and monitoring, and certification

Absence of reflection as a function of the coupling constant

We consider solutions of the one-dimensional equation $-u'' +(Q+ \lambda V) u = 0$ where $Q: \mathbb{R} \to \mathbb{R}$ is locally integrable, $V : \mathbb{R} \to \mathbb{R}$ is integrable with supp$(V) \subset [0,1]$, and $\lambda \in \mathbb{R}$ is a coupling constant. Given a family of solutions $\{u_{\lambda} \}_{\lambda \in \mathbb{R}}$ which satisfy $u_{\lambda}(x) = u_0(x)$ for all $x<0$, we prove that the zeros of $b(\lambda) := W[u_0, u_{\lambda}]$, the Wronskian of $u_0$ and $u_{\lambda}$, form a discrete set unless $V \equiv 0$. Setting $Q(x) := -E$, one sees that a particular consequence of this result may be stated as: if the fixed energy scattering experiment $-u'' + \lambda V u = Eu$ gives rise to a reflection coefficient which vanishes on a set of couplings with an accumulation point, then $V \equiv 0$.Comment: To appear in Journal of Mathematical Physic

Potential effects of environmental change on mining wastes in a hyperarid climate

Three desert washes were sampled to evaluate the transport of contaminated sediments from abandoned mining sites to downwash environments. The area of concern is an extreme arid climate considered stable and not to pose pathways for contaminated sediments to impact downwash environments. Research of mine wastes in Nelson, Nevada has shown that residual geogenic and anthropogenic trace elements have been mobilized in surface sediments as a result of storm event. Cyanide and trace elements, especially mercury and lead, have transported to 6000 m downwash from source areas. Short term environmental impacts appear to be minimal because of present-day environmental conditions. However, climate shifts caused by the El Nino Southern Oscillations or even a dramatic climate shift might increase regional precipitation promoting a more rapid erosion of contaminated sediment. Currently, wash sediments do not contain levels of CN- or trace elements that pose threats to the environment; however, if erosion and transport of mining waste increased because of additional precipitation, then CN- and trace elements loading in storm water would increase, with their possibly delivery to Lake Mohave

Beagle to the Moon: nn experiment package to measure polar ice and volatiles in permanently shadowed areas or beneath the lunar surface

The Beagle Science Package is a flight qualified set of instruments which should be deployed to the lunar surface to answer the questions about water and volatiles present in permanently shadowed regions and/or beneath the surface

Early Archean tonalite gneiss in the upper peninsula of Michigan

Geochronological results on tonalite gneiss of northern Michigan that is 3.56 Ga or slightly older is presented. Tonalitic augen gneiss and structurally overlying biotite gneiss and schist are exposed in a dome near Watersmeet. They are part of an extensive gneiss terrane of southern Minnesota, Wisconsin and Michigan that includes rocks of early to late Archean ages and lies south of the Wawa volcanic subprovince. Two samples of the augen gneiss and one of the biotite gneiss show zircon grains of similar shape, zoning, color, and development of crystal faces. These zircons give Pb/U isotopic ratios that plot on a chord of 3,560 + or - 40 m.y. upper intersect and of 1,250 + or m.y. lower intersect. The 3,560 m.y. number is believed to be a minimum age because analysis of one of the least discordant zircon fractions by ion microprobe that gave a nearly concordant age of 3,650 m.y. The 1,250 m.y. lower intersect is without geological significance: it is interpreted to be a result of multiple lead loss at 2.7, 1.8, and 0.5 Ga by U/Pb in zircon. Archean rocks 10 to 25 km northwest of the Watersmeet dome give a 2.75 Ga age on zircons. Quartz monzonite here is dated at 2.65 Ga

Collection of anthropometry from older and physically impaired persons: traditional methods versus TC2 3-D body scanner

With advances in technology it is now possible to collect a wide range of anthropometric data, to a high degree of accuracy, using 3D light-based body scanners. This gives the potential to speed up the collection of anthropometric data for design purposes, to decrease processing time and data input required, and to reduce error due to inaccuracy of measurements taken using more traditional methods and equipment (anthropometer, stadiometer and sitting height table). However, when the data collection concerns older and/or physically impaired people there are serious issues for consideration when deciding on the best method to collect anthropometry. This paper discusses the issues arising when collecting data using both traditional methods of data collection and a first use by the experimental team of the TC2 3D body scanner, when faced with a ‘non-standard’ sample, during an EPSRC funded research project into issues surrounding transport usage by older and physically impaired people. Relevance to industry: Designing products, environments and services so that the increasing ageing population, as well as the physically impaired, can use them increases the potential market. To do this, up-to-date and relevant anthropometry is often needed. 3D light-based bodyscanners offer a potential fast way of obtaining this data, and this paper discusses some of the issues with using one scanner with older and disabled people

Theoretical investigation into the possibility of very large moments in Fe16N2

We examine the mystery of the disputed high-magnetization \alpha"-Fe16N2 phase, employing the Heyd-Scuseria-Ernzerhof screened hybrid functional method, perturbative many-body corrections through the GW approximation, and onsite Coulomb correlations through the GGA+U method. We present a first-principles computation of the effective on-site Coulomb interaction (Hubbard U) between localized 3d electrons employing the constrained random-phase approximation (cRPA), finding only somewhat stronger on-site correlations than in bcc Fe. We find that the hybrid functional method, the GW approximation, and the GGA+U method (using parameters computed from cRPA) yield an average spin moment of 2.9, 2.6 - 2.7, and 2.7 \mu_B per Fe, respectively.Comment: 8 pages, 3 figure

Contamination in complex healthcare trials:the falls in care homes (FinCH) study experience

BACKGROUND: Trials are at risk of contamination bias which can occur when participants in the control group are inadvertently exposed to the intervention. This is a particular risk in rehabilitation studies where it is easy for trial interventions to be either intentionally or inadvertently adopted in control settings. The Falls in Care Homes (FinCH) trial is used in this paper as an example of a large randomised controlled trial of a complex intervention to explore the potential risks of contamination bias. We outline the FinCH trial design, present the potential risks from contamination bias, and the strategies used in the design of the trial to minimise or mitigate against this. The FinCH trial was a multi-centre randomised controlled trial, with embedded process evaluation, which evaluated whether systematic training in the use of the Guide to Action Tool for Care Homes reduced falls in care home residents. Data were collected from a number of sources to explore contamination in the FinCH trial. Where specific procedures were adopted to reduce risk of, or mitigate against, contamination, this was recorded. Data were collected from study e-mails, meetings with clinicians, research assistant and clinician network communications, and an embedded process evaluation in six intervention care homes. During the FinCH trial, there were six new falls prevention initiatives implemented outside the study which could have contaminated our intervention and findings. Methods used to minimise contamination were: cluster randomisation at the level of care home; engagement with the clinical community to highlight the risks of early adoption; establishing local collaborators in each site familiar with the local context; signing agreements with NHS falls specialists that they would maintain confidentiality regarding details of the intervention; opening additional research sites; and by raising awareness about the importance of contamination in research among participants. CONCLUSION: Complex rehabilitation trials are at risk of contamination bias. The potential for contamination bias in studies can be minimized by strengthening collaboration and dialogue with the clinical community. Researchers should recognise that clinicians may contaminate a study through lack of research expertise

Investigating photoexcitation-induced mitochondrial damage by chemotherapeutic corroles using multimode optical imaging

We recently reported that a targeted, brightly fluorescent gallium corrole (HerGa) is highly effective for breast tumor detection and treatment. Unlike structurally similar porphryins, HerGa exhibits tumor-targeted toxicity without the need for photoexcitation. We have now examined whether photoexcitation further modulates HerGa toxicity, using multimode optical imaging of live cells, including two-photon excited fluorescence, differential interference contrast (DIC), spectral, and lifetime imaging. Using two-photon excited fluorescence imaging, we observed that light at specific wavelengths augments the HerGa-mediated mitochondrial membrane potential disruption of breast cancer cells in situ. In addition, DIC, spectral, and fluorescence lifetime imaging enabled us to both validate cell damage by HerGa photoexcitation and investigate HerGa internalization, thus allowing optimization of light dose and timing. Our demonstration of HerGa phototoxicity opens the way for development of new methods of cancer intervention using tumor-targeted corroles

Redox-Active Nanomaterials For Nanomedicine Applications

Nanomedicine utilizes the remarkable properties of nanomaterials for the diagnosis, treatment, and prevention of disease. Many of these nanomaterials have been shown to have robust antioxidative properties, potentially functioning as strong scavengers of reactive oxygen species. Conversely, several nanomaterials have also been shown to promote the generation of reactive oxygen species, which may precipitate the onset of oxidative stress, a state that is thought to contribute to the development of a variety of adverse conditions. As such, the impacts of nanomaterials on biological entities are often associated with and influenced by their specific redox properties. In this review, we overview several classes of nanomaterials that have been or projected to be used across a wide range of biomedical applications, with discussion focusing on their unique redox properties. Nanomaterials examined include iron, cerium, and titanium metal oxide nanoparticles, gold, silver, and selenium nanoparticles, and various nanoscale carbon allotropes such as graphene, carbon nanotubes, fullerenes, and their derivatives/variations. Principal topics of discussion include the chemical mechanisms by which the nanomaterials directly interact with biological entities and the biological cascades that are thus indirectly impacted. Selected case studies highlighting the redox properties of nanomaterials and how they affect biological responses are used to exemplify the biologically-relevant redox mechanisms for each of the described nanomaterials