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NASA’s all-sky survey mission, the Transiting Exoplanet Survey Satellite (TESS), is specifically engineered to detect exoplanets that transit bright stars. Thus far, TESS has successfully identified approximately 400 transiting exoplanets, in addition to roughly 6 000 candidate exoplanets pending confirmation. In this study, we present the results of our ongoing project, the Validation of Transiting Exoplanets using Statistical Tools (VaTEST). Our dedicated effort is focused on the confirmation and characterisation of new exoplanets through the application of statistical validation tools. Through a combination of ground-based telescope data, high-resolution imaging, and the utilisation of the statistical validation tool known as TRICERATOPS, we have successfully discovered eight potential super-Earths. These planets bear the designations: TOI-238b (1.61$^{+0.09} _{-0.10}$ R$_\oplus$), TOI-771b (1.42$^{+0.11} _{-0.09}$ R$_\oplus$), TOI-871b (1.66$^{+0.11} _{-0.11}$ R$_\oplus$), TOI-1467b (1.83$^{+0.16} _{-0.15}$ R$_\oplus$), TOI-1739b (1.69$^{+0.10} _{-0.08}$ R$_\oplus$), TOI-2068b (1.82$^{+0.16} _{-0.15}$ R$_\oplus$), TOI-4559b (1.42$^{+0.13} _{-0.11}$ R$_\oplus$), and TOI-5799b (1.62$^{+0.19} _{-0.13}$ R$_\oplus$). Among all these planets, six of them fall within the region known as ‘keystone planets’, which makes them particularly interesting for study. Based on the location of TOI-771b and TOI-4559b below the radius valley we characterised them as likely super-Earths, though radial velocity mass measurements for these planets will provide more details about their characterisation. It is noteworthy that planets within the size range investigated herein are absent from our own solar system, making their study crucial for gaining insights into the evolutionary stages between Earth and Neptune.
OBJECTIVES/GOALS: to investigate the potential impact of grandparental factors and multigenerational epigenetic inheritance on the development of ASD METHODS/STUDY POPULATION: Our study recruited participants from the CHARGE (Child Autism Risks from Genetics and the Environment) study, including grandparents, parents, and children. A questionnaire was used to gather information about the participants’ exposure to environmental factors. Saliva samples werecollected from 349 participants. Newborn dried blood spotsfrom probands and parents are still being collected from the California New born Registry. DNA was extracted from 349 saliva samples from 85 families and subjected to whole genome bisulfite sequencing (WGBS) to analyze DNA methylation. Sequence alignments and bioinformatic analyses will be performed using R packages called DMRichR and Comethyl. RESULTS/ANTICIPATED RESULTS: Sequence alignments and bioinformatic analyses are ongoing, utilizing DMRichR to identify individual genomic loci associated with ASD in each of the three generations and Comethyl to compare correlation patterns between methylation marks and selected variables, including grand parental exposures. New born blood spot collections of parents and probands are ongoing and will be used to identify potential ASD epigenomic signatures that are tissue and life-stage independent. DISCUSSION/SIGNIFICANCE: This research will provide new insights into the increased prevalence and underlying etiology of ASD that should pave the way for future research in the field. DNA Methylation signatures can help create molecular biomarkers which can be used together with behavioral clinical tests for diagnosis of ASD.
In 2008, the Centers for Medicare and Medicaid Services (CMS) stopped reimbursing for hospital-acquired conditions (HACs) not present on admission (POA). We sought to understand why this policy did not impact central line–associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) trends.
Design
Retrospective cohort study.
Setting
Acute-care hospitals in the United States.
Participants
Fee-for-service Medicare patients discharged January 1, 2007, through December 31, 2011.
Methods
Using inpatient Medicare claims data, we analyzed billing practices before and after the HAC policy was implemented, including the use and POA designation of codes for CLABSI or CAUTI. For the 3-year period following policy implementation, we determined the impact on diagnosis-related groups (DRG) determining reimbursement as well as hospital characteristics associated with the reimbursement impact.
Results
During the study period, 65,205,607 Medicare fee-for-service hospitalizations occurred at 3,291 acute-care, nonfederal US hospitals. Based on coding, CLABSI and CAUTI affected 0.23% and 0.06% of these hospitalizations, respectively. In addition, following the HAC policy, 82% of the CLABSI codes and 91% of the CAUTI codes were marked POA, which represented a large increase in the use of this designation. Finally, for the small numbers of CLABSI and CAUTI coded as not POA, financial impacts were detected on only 0.4% of the hospitalizations with a CLABSI code and 5.7% with a CAUTI code.
Conclusions
Part of the reason the HAC policy did not have its intended impact is that billing codes for CLABSI and CAUTI were rarely used, were commonly listed as POA in the postpolicy period, and infrequently impacted hospital reimbursement.
In 2012, the Centers for Medicare and Medicaid Services expanded a 2008 program that eliminated additional Medicare payment for mediastinitis following coronary artery bypass graft (CABG) to include Medicaid. We aimed to evaluate the impact of this Medicaid program on mediastinitis rates reported by the National Healthcare Safety Network (NHSN) compared with the rates of a condition not targeted by the program, deep-space surgical site infection (SSI) after knee replacement.
DESIGN
Interrupted time series with comparison group.
METHODS
We included surveillance data from nonfederal acute-care hospitals participating in the NHSN and reporting CABG or knee replacement outcomes from January 2009 through June 2017. We examined the Medicaid program’s impact on NHSN-reported infection rates, adjusting for secular trends. The data analysis used generalized estimating equations with robust sandwich variance estimators.
RESULTS
During the study period, 196 study hospitals reported 273,984 CABGs to the NHSN, resulting in 970 mediastinitis cases (0.35%), and 294 hospitals reported 555,395 knee replacements, with 1,751 resultant deep-space SSIs (0.32%). There was no significant change in incidence of either condition during the study. Mediastinitis models showed no effect of the 2012 Medicaid program on either secular trend during the postprogram versus preprogram periods (P=.70) or an immediate program effect (P=.83). Results were similar in sensitivity analyses when adjusting for hospital characteristics, restricting to hospitals with consistent NHSN reporting or incorporating a program implementation roll-in period. Knee replacement models also showed no program effect.
CONCLUSIONS
The 2012 Medicaid program to eliminate additional payments for mediastinitis following CABG had no impact on reported mediastinitis rates.
The kinetics of Ge lateral overgrowth on SiO2 with line-shaped Si seeds is examined. The growth process is described by the difference between the growth rates of Ge on (100) planes (GR100) and <311> facets (GR311). The theoretical calculations well reproduce the growth kinetics. It is shown that narrowing the line-seeds helps Ge coalescence and flat film formation.
In October 2008, Medicare ceased additional payment for hospital-acquired conditions not present on admission. We evaluated the policy’s differential impact in hospitals with high vs low operating margins. Medicare’s payment policy may have had an impact on reducing central line–associated bloodstream infections in hospitals with low operating margins.
Infect. Control Hosp. Epidemiol. 2015;37(1):100–103
The 2008 Centers for Medicare & Medicaid Services hospital-acquired conditions policy limited additional payment for conditions deemed reasonably preventable.
OBJECTIVE
To examine whether this policy was associated with decreases in billing rates for 2 targeted conditions, vascular catheter-associated infections (VCAI) and catheter-associated urinary tract infections (CAUTI).
STUDY POPULATION
Adult Medicare patients admitted to 569 acute care hospitals in California, Massachusetts, or New York and subject to the policy.
DESIGN
We used an interrupted times series design to assess whether the hospital-acquired conditions policy was associated with changes in billing rates for VCAI and CAUTI.
RESULTS
Before the policy, billing rates for VCAI and CAUTI were increasing (prepolicy odds ratio per quarter for VCAI, 1.17 [95% CI, 1.11–1.23]; for CAUTI, 1.19 [1.16–1.23]). The policy was associated with an immediate drop in billing rates for VCAI and CAUTI (odds ratio for change at policy implementation for VCAI, 0.75 [95% CI, 0.69–0.81]; for CAUTI, 0.87 [0.79–0.96]). In the postpolicy period, we observed a decreasing trend in the billing rate for VCAI and a leveling-off in the billing rate for CAUTI (postpolicy odds ratio per quarter for VCAI, 0.98 [95% CI, 0.97–0.99]; for CAUTI, 0.99 [0.97–1.00]).
CONCLUSIONS
The Centers for Medicare & Medicaid Services hospital-acquired conditions policy appears to have been associated with immediate reductions in billing rates for VCAI and CAUTI, followed by a slight decreasing trend or leveling-off in rates. These billing rates, however, may not correlate with changes in clinically meaningful patient outcomes and may reflect changes in coding practices.
Infect. Control Hosp. Epidemiol. 2015;36(8):871–877
Policymakers may wish to align healthcare payment and quality of care while minimizing unintended consequences, particularly for safety net hospitals.
OBJECTIVE
To determine whether the 2008 Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in safety net compared with non–safety net hospitals.
DESIGN
Interrupted time-series design.
SETTING AND PARTICIPANTS
Nonfederal acute care hospitals that reported central line–associated bloodstream infection and ventilator-associated pneumonia rates to the Centers for Disease Control and Prevention’s National Health Safety Network from July 1, 2007, through December 31, 2013.
RESULTS
We did not observe changes in the slope of targeted infection rates in the postpolicy period compared with the prepolicy period for either safety net (postpolicy vs prepolicy ratio, 0.96 [95% CI, 0.84–1.09]) or non–safety net (0.99 [0.90–1.10]) hospitals. Controlling for prepolicy secular trends, we did not detect differences in an immediate change at the time of the policy between safety net and non–safety net hospitals (P for 2-way interaction, .87).
CONCLUSIONS
The Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy did not have an impact, either positive or negative, on already declining rates of central line–associated bloodstream infection in safety net or non–safety net hospitals. Continued evaluations of the broad impact of payment policies on safety net hospitals will remain important as the use of financial incentives and penalties continues to expand in the United States.
Limited studies exist regarding whether incorporating micronutrient supplements during tuberculosis (TB) treatment may improve cell-mediated immune response. We examined the effect of micronutrient supplementation on lymphocyte proliferation response to mycobacteria or T-cell mitogens in a randomized trial conducted on 423 patients with pulmonary TB. Eligible participants were randomly assigned to receive a daily dose of micronutrients (vitamins A, B-complex, C, E, and selenium) or placebo at the time of initiation of TB treatment. We found no overall effect of micronutrient supplements on lymphocyte proliferative responses to phytohaemagglutinin or purified protein derivatives in HIV-negative and HIV-positive TB patients. Of HIV-negative TB patients, the micronutrient group tended to show higher proliferative responses to concanavalin A than the placebo group, although the clinical relevance of this finding is not readily notable. The role of nutritional intervention in this vulnerable population remains an important area of future research.
Monitor of All-sky X-ray Image (MAXI) on board International Space Station is capable ofobserving gamma-ray bursts (GRBs) and sending notices of GRBs or other transient events,using real time connection to the ground. MAXI observed 32 GRBs or short X-ray transientsas of the end of September 2012. Among them, eleven events were simultaneously detected byother satellites. The observed rate of the MAXI GRBs is about one event per month. Thisrate is comparable to a past observation with larger effective area and larger field ofview. The fact indicates that MAXI has better sensitivity to observe GRBs because of lowbackground. The distribution of the spectral hardness of MAXI GRBs is similar to theresults of a past instrument, which is sensitive to similar energy range.
There are few data on circulatory pro-inflammatory cytokine levels and cytokine gene polymorphisms in H. pylori-positive patients. A cross-sectional study was conducted to examine the effects of H. pylori infection, gastric atrophy, and the IL-8 T-251A polymorphism on plasma IL-8 levels in 98 Japanese adults. Seventy-one subjects were positive for H. pylori infection. The geometric mean of plasma IL-8 concentration was significantly higher in subjects with H. pylori infection than in those without (P=0·001). The development of atrophy was negatively associated with IL-8 levels in the H. pylori-positive subjects, although not significantly. Plasma IL-8 levels in the T/T genotype were associated with H. pylori infection and atrophy status (P=0·016). Our findings suggested that circulating IL-8 levels were associated with H. pylori infection. The effect of H. pylori infection on plasma IL-8 levels was not clearly modified by the IL-8 T-251A polymorphism.
Focusing properties and mechanisms are experimentally investigated of an intense pulsed light-ion beam or a medium-mass ion beam extracted from racetrack type magnetically insulated diodes. Quantitative determinations are made for three factors that affect the focusing ability of the beam, i.e., local divergence angle, deviation angle from ideal trajectory and space-charge effect. Behaviour of electrons in an anodecathode gap as well as neutralizing process of the ion beam by electrons are studied in connection with beam focusing. It is found that there is a close correlation between ion yield and electron irradiation on the anode. By adopting a perforated cathode instead of a vane cathode to ensure good uniformity of electric field in the accelerating gap, we have succeeded in significantly reducing the divergence angle. Several new diagnostic techniques and methods have been developed, yielding information such as the time-resolved trajectory and profile or incident angle of the beam. Electron temperature of the anode plasma is theoretically anticipated from the ions observed experimentally. From an estimate of beam divergence due to a space-charge effect, it is suggested that ‘breakeven’ can be achieved without using conventional z-discharged plasma channels if a bunch of boron beams is utilized.
In the daily RATAN-600 monitoring of the radio variability of the microquasar GRS1915+105 we detected a clear correlation of the flaring radio emission and X-rays “spikes” at 2–12 keV emission (1–2 Crab) detected with RXTE (ASM data) during nine bright (200–600 mJy) radio flares in October 2005. The spectra of these flares in maximum were optically thick at ν<2.3 GHz and optically thin at ν≥2.3 GHz. During radio flares the spectra of the X-ray spikes became definitely softer than those of a quiescent radio state. Thus these data indicated transitions from very high/hard states to high/soft ones during which massive ejections are probably happened, and the ejections are detected as the radio flares.
Oncomelania nosophora (Gastropoda: Pomatiopsidae) is the intermediate host of Schistosoma japonicum in Japan. Although most of the snails were eliminated during the 20th century, they are still found in two areas in Japan. One area is in the Kofu Basin, including Nirasaki City, in Yamanashi Prefecture. The other is the Obitsu River Basin in Kisarazu City, Chiba Prefecture. Snails collected in Nirasaki and Kisarazu were exposed to 3 geographical strains of S. japonicum originating from Japan, China, and the Philippines. Both isolates of O. nosophora showed high susceptibility to the Japanese strain of S. japonicum (74·0%–82·2% for the Nirasaki isolate and 58·0%–56·0% for the Kisarazu isolate) and low susceptibility to the Chinese strain (0·0%–1·3% and 1·4%–7·9% respectively). In contrast, the susceptibility of the snails to the Philippine strain was significantly different (P<0·01) between the isolates (3·3%–6·6% for the Nirasaki isolate and 31·9%–75·9% for the Kisarazu isolate). To examine the differences in infectivity in detail, we conducted histological observations of snails exposed to the Philippine strain at 3 h, 1, 3, and 15 days after miracidial exposure. We found differences in the development of the parasite between the isolates of snails from early after exposure.
The High Energy Transient Explorer 2 is a small scientific satellite designed to detect and localize gamma-ray bursts (GRBs). The coordinates of GRBs detected by HETE-2 will be distributed to interested ground-based observers within seconds of burst detection, thereby allowing detailed observations of the initial phases of GRBs. HETE-2 was launched successfully on October 9, 2000. The GRB positions will start to be delivered after a few months of the complete testing and calibration of the spacecraft system and the science instruments.
A comparative study was conducted on the ontogenetic variation in morphometry of a total of 29 shell-bearing molluscan species occurring on an intertidal stony shore in south-western Japan. The relationships between shell size and total weight and between shell size and flesh weight were all highly significant on logarithmic scales with the slopes having values of about three. The arcsine-transformed proportion of shell weight out of total weight varied among and within different morphological/taxonomic groups, ranging from 58.6% in Acanthochiton defilippi to 76.4% in Nerita albicilla. The allometry of shell weight was analysed by regressing the arcsine transformed values of the proportion of shell weight against total weight in each species. The slope (β) of the regression varied substantially among different taxa, with all three possible cases, i.e. β > 0, β [ape ] 0 and β < 0, being observed. Thus, depending on molluscan species, the proportion of shell mass either (1) increases, (2) does not change, or (3) decreases with increasing body mass. Variation in the value of β was to some extent explained by the proportion of shell mass of young individuals of each species; species with relatively high proportions of shell mass in small individuals tended to have low β. Interspecifically, it was shown that shell mass scaled in proportion to body mass for this assemblage of 29 species. Consideration was given to the theoretical background of variation in shell morphometry, with particular reference to the shell as a defence structure.
We report on the spectral and temporal properties of the 50 ms pulsar PSR B0540–69 using ASCA archival data obtained during 1993 to 1995. From the spectral analysis it was found that the spectra of the whole (nebular and pulsed) emission and pulsed emission in the range 1-10 keV can be represented by a single power law of photon index, Γ = 2.00 ± 0.02 and Γpulsed = 1.7 ± 0.3 respectively. The parameters for pulse frequency change during 1993-1995 were obtained using the 9 pulse frequency measurements with ASCA. The parameters derived from the ASCA observations are consistent with the previous measurements, suggesting high stability of this pulsar, ΔΩ/Ω ≲ 0.5 × 10−7 over the past 10 years. These results confirm similarity of this pulsar with the Crab pulsar.