Patient Understanding of Coordinated Medical Treatment Success within the Minnesota Medical Home Model: An Exploratory Qualitative Inquiry

The US health care system is often described as a complex, fragmented system where patients experience less access, coordinated, and comprehensive care that is ultimately more costly (Rosenberg, 2009). The problem addressed in this study was to understand coordinated medical treatment in the medical home model from the patient perspective. This study provides the opportunity to increase the understanding of the factors affecting coordinated medical treatment success

Effects of neutrino oscillations and neutrino magnetic moments on elastic neutrino-electron scattering

We consider elastic antineutrino-electron scattering taking into account possible effects of neutrino masses and mixing and of neutrino magnetic moments and electric dipole moments. Having in mind antineutrinos produced in a nuclear reactor we compute, in particular, the weak-electromagnetic interference terms which are linear in the magnetic (electric dipole) moments and also in the neutrino masses. We show that these terms are, however, suppressed compared to the pure weak and electromagnetic cross section. We also comment upon the possibility of using the electromagnetic cross section to investigate neutrino oscillations.Comment: 12 pages, REVTEX file, no figures, submitted to Phys.Rev.

Distributed Computing Grid Experiences in CMS

The CMS experiment is currently developing a computing system capable of serving, processing and archiving the large number of events that will be generated when the CMS detector starts taking data. During 2004 CMS undertook a large scale data challenge to demonstrate the ability of the CMS computing system to cope with a sustained data-taking rate equivalent to 25% of startup rate. Its goals were: to run CMS event reconstruction at CERN for a sustained period at 25 Hz input rate; to distribute the data to several regional centers; and enable data access at those centers for analysis. Grid middleware was utilized to help complete all aspects of the challenge. To continue to provide scalable access from anywhere in the world to the data, CMS is developing a layer of software that uses Grid tools to gain access to data and resources, and that aims to provide physicists with a user friendly interface for submitting their analysis jobs. This paper describes the data challenge experience with Grid infrastructure and the current development of the CMS analysis system

Bulky and Modular 3,3′-Bipyrazoles as Ligands: Synthesis, Characterization, and Catalytic Activity of Pd Complexes

In the present study, the properties of a new bidentate N,N′-chelating ligand class that bears an electron-excessive 3,3′-bipyrazole core have been investigated. The ligands are easily accessible in a three-step procedure by condensation with diethyl oxalate followed by tandem condensation with hydrazine hydrate and finally by aryl- or alkylation exclusively at the N-1,1′-pyrazole positions to furnish overall eleven new ligands with different electronic properties. After structural analysis of the ligands, their coordination to palladium, copper, and cobalt has been studied. These ligands coordinate the 2,2′-pyrazolyl nitrogen atoms in a bidentate fashion to the metals to realize complexes with an (L)MX2 motif. We present two crystal structures of Pd and Cu complexes, which to the best of our knowledge represent the first d8 and d9 2,2′-bipyrazole compounds coordinated through bidentate complexation. Initial catalytic experiments have been performed with palladium complexes with three bipyrazole ligands of this new class; the palladium-catalyzed copper-free Wacker oxidation of different alkenes showed superior activity compared to 2,2′-bipyridines. We attribute this to a higher redox potential of the 3,3′-bipyrazoles, which are ― besides electronic effects ― also strongly influenced by steric effects. These might be enforced by the extended ligand backbone, the choice of the wingtip substitution, and the smaller coordination cavity within the N2,N2′ atoms compared to 2,2′-bipyridine ligands

T helper cell subsets specific for pseudomonas aeruginosa in healthy individuals and patients with cystic fibrosis

Background: We set out to determine the magnitude of antigen-specific memory T helper cell responses to Pseudomonas aeruginosa in healthy humans and patients with cystic fibrosis. Methods: Peripheral blood human memory CD4+ T cells were co-cultured with dendritic cells that had been infected with different strains of Pseudomonas aeruginosa. The T helper response was determined by measuring proliferation, immunoassay of cytokine output, and immunostaining of intracellular cytokines. Results: Healthy individuals and patients with cystic fibrosis had robust antigen-specific memory CD4+ T cell responses to Pseudomonas aeruginosa that not only contained a Th1 and Th17 component but also Th22 cells. In contrast to previous descriptions of human Th22 cells, these Pseudomonal-specific Th22 cells lacked the skin homing markers CCR4 or CCR10, although were CCR6+. Healthy individuals and patients with cystic fibrosis had similar levels of Th22 cells, but the patient group had significantly fewer Th17 cells in peripheral blood. Conclusions: Th22 cells specific to Pseudomonas aeruginosa are induced in both healthy individuals and patients with cystic fibrosis. Along with Th17 cells, they may play an important role in the pulmonary response to this microbe in patients with cystic fibrosis and other conditions

Spontaneous splenic rupture in an active duty Marine upon return from Iraq: a case report

<p>Abstract</p> <p>Introduction</p> <p>Atraumatic splenic rupture is a rare event that has been associated with several infectious disease processes. In the active duty military population, potential exposure to these pathogens is significant. Here we discuss the case of an active duty Marine with spontaneous splenic rupture upon return from a six-month deployment in Iraq.</p> <p>Case presentation</p> <p>A previously healthy 30-year-old Caucasian male active duty Marine presented with abdominal pain, fever and diarrhea after deployment to Iraq in support of Operation Iraqi Freedom. Based on clinical and radiographic evidence, a diagnosis of spontaneous splenic rupture was ultimately suspected. After exploratory laparotomy with confirmation of rupture, splenectomy was performed, and the patient made a full, uneventful recovery. Histopathologic examination revealed mild splenomegaly with a ruptured capsule of undetermined cause.</p> <p>Conclusion</p> <p>Spontaneous splenic rupture is a rare event that may lead to life-threatening hemorrhage if not diagnosed and treated quickly. Although the cause of this patient's case was unknown, atraumatic splenic rupture has been associated with a variety of infectious diseases and demonstrates some risks the active duty military population may face while on deployment. Having an awareness of these pathogens and their role in splenic rupture, clinicians caring for military personnel must be prepared to recognize and treat this potentially fatal complication.</p

Anomalously large oxygen-ordering contribution to the thermal expansion of untwinned YBa2Cu3O6.95 single crystals: a glass-like transition near room temperature

We present high-resolution capacitance dilatometry studies from 5 - 500 K of untwinned YBa2Cu3Ox (Y123) single crystals for x ~ 6.95 and x = 7.0. Large contributions to the thermal expansivities due to O-ordering are found for x ~ 6.95, which disappear below a kinetic glass-like transition near room temperature. The kinetics at this glass transition is governed by an energy barrier of 0.98 +- 0.07 eV, in very good agreement with other O-ordering studies. Using thermodynamic arguments, we show that O-ordering in the Y123 system is particularly sensitive to uniaxial pressure (stress) along the chain axis and that the lack of well-ordered chains in Nd123 and La123 is most likely a consequence of a chemical-pressure effect.Comment: 4 pages, 3 figures, submitted to PR

Vaccines against toxoplasma gondii : challenges and opportunities

Development of vaccines against Toxoplasma gondii infection in humans is of high priority, given the high burden of disease in some areas of the world like South America, and the lack of effective drugs with few adverse effects. Rodent models have been used in research on vaccines against T. gondii over the past decades. However, regardless of the vaccine construct, the vaccines have not been able to induce protective immunity when the organism is challenged with T. gondii, either directly or via a vector. Only a few live, attenuated T. gondii strains used for immunization have been able to confer protective immunity, which is measured by a lack of tissue cysts after challenge. Furthermore, challenge with low virulence strains, especially strains with genotype II, will probably be insufficient to provide protection against the more virulent T. gondii strains, such as those with genotypes I or II, or those genotypes from South America not belonging to genotype I, II or III. Future studies should use animal models besides rodents, and challenges should be performed with at least one genotype II T. gondii and one of the more virulent genotypes. Endpoints like maternal-foetal transmission and prevention of eye disease are important in addition to the traditional endpoint of survival or reduction in numbers of brain cysts after challenge

To d , or not to d : recent developments and comparisons of regularization schemes

We give an introduction to several regularization schemes that deal with ultraviolet and infrared singularities appearing in higher-order computations in quantum field theories. Comparing the computation of simple quantities in the various schemes, we point out similarities and differences between them