The financial burden of hospitalization from life-threatening infectious diseases on the U.S. healthcare system is substantial and continues to increase. The purpose of this study was to identify key predictors of high hospital charges for infective endocarditis at a major university-affiliated cardiac care centre in West Virginia.

A retrospective electronic medical records’ review was undertaken of all adult patients admitted for endocarditis between 2014–2018. Multiple linear regression analysis assessed the total charges billed to the patient account for their endocarditis hospitalization in the medical record.

Hospital charges have increased 12-fold during 2014–2018. Among the 486 patients, the median hospital charge was $198 678. About 47% of the patients underwent surgery incurring 70% of the total charges. Patients with hospital stays of ≥50 days accounted for a third of all charges. The multiple linear regression model accounted for 85% of the linear variance in the hospital charges. Median charges increased by 30.87% for patients with ≥9 consultations, 60.32% for those who died in the hospital, and 81.85% for those who underwent surgical intervention.

The study findings showed that complex care requiring multiple consultations, surgical interventions, and longer hospital stays were significantly associated with higher hospital charges for endocarditis treatment.

A disk-shaped massive colony of Tetradium, from the Middle Ordovician Bobcaygeon Formation in southern Ontario, displays features of a coral microatoll. This is the first pre-Holocene coral microatoll yet described, indicating that some tabulate corals in level-bottom communities were growing as microatolls as do many modern colonial skeleton-secreting organisms.

The microatoll therefore is not strictly a Quaternary or even Cenozoic phenomenon, but has a fossil record that may span most of the Phanerozoic. This indicates that the special conditions necessary for microatoll growth have existed outside of reef environments, and were present before the advent of scleractinian coral reefs. It may be possible to use ancient microatolls to estimate absolute water depths at low tide, thereby providing a means for estimating maximum water depths on a local and regional scale.

Public disclosure of industry payments to physicians is one way to address financial conflicts of interest in medicine. As part of the Patient Protection and Affordable Care Act, the Physician Payment Sunshine Act (PPSA) requires pharmaceutical, medical device, and biologics manufacturers who have at least one product reimbursed by Medicare or Medicaid to disclose payments to physicians and teaching hospitals on a public website starting in 2014. The physician payment data will contain individual physician names, monetary values, and specific products connected to payments.

According to the Final Regulations issued by the Centers for Medicare and Medicaid Services (CMS) in February 2013, the law will make transparent the extent and nature of relationships between physicians, teaching hospitals, and manufacturers.

Two varieties of oil-seed rape were drilled in 1979–81 at a range of seed rates. Percentage establishment, plant weight, height, and the ratio of seed to total aboveground dry matter were lower in high-density plots. Seed yields were not increased when the seed rate was raised from 9·0 to 13·5 kg/ha (Expts 1 and 2) or from 4·5 to 18·0 kg/ha (Expt 3) owing to a compensating reduction in the number of pods per plant. Seed quality and 1000-seed weight were not influenced by the seed-rate treatments.

The objective of this study was to examine the effect of the chemical growth regulator chlormequat on the yield and yield components of oil-seed rape. Although this chemical is widely used in wheat production systems, its use as a morpho-regulator for oil-seed rape has not been examined thoroughly. A few Eastern European experiments have been published. Voskerusa (1972) applied it at 2, 4, 6 and 8 kg/ha to winter varieties in Czechoslovakia. His results, which agree with those of Fabry & Hannich (1972), demonstrated reduced winter kill using an autumn application. However, studies on modern varieties such as Rafal, now widely grown in European Economic Community countries, have not been reported in detail.

Spatial and temporal variation in seedling dynamics was assessed using records of community-wide seedling demography collected with identical monitoring methods at four tropical lowland forests in Panama, Malaysia, Ecuador and French Guiana for periods of between 3 and 10 y. At each site, the fates of between 8617 and 391 777 seedlings were followed through annual censuses of the 370–1008 1-m2 seedling plots. Within-site spatial and inter-annual variation in density, recruitment, growth and mortality was compared with among-site variability using Bayesian hierarchical modelling to determine the generality of each site's patterns and potential for meaningful comparisons among sites. The Malaysian forest, which experiences community-wide masting, was the most variable in both seedling density and recruitment. However, density varied year-to-year at all sites (CVamong years at site = 8–43%), driven largely by high variability in recruitment rates (CV = 40–117%). At all sites, recruitment was more variable than mortality (CV = 5–64%) or growth (CV = 12–51%). Increases in mortality rates lagged 1 y behind large recruitment events. Within-site spatial variation and inter-annual differences were greater than differences among site averages in all rates, emphasizing the value of long-term comparative studies when generalizing how spatial and temporal variation drive patterns of recruitment in tropical forests.

A constant-pressure axisymmetric turbulent boundary layer along a circular cylinder of radius a is studied at large values of the frictional Reynolds number a+ (based upon a) with the boundary-layer thickness δ of order a. Using the equations of mean motion and the method of matched asymptotic expansions, it is shown that the flow can be described by the same two limit processes (inner and outer) as are used in two-dimensional flow. The condition that the two expansions match requires the existence, at the lowest order, of a log region in the usual two-dimensional co-ordinates (u+, y+). Examination of available experimental data shows that substantial log regions do in fact exist but that the intercept is possibly not a universal constant. Similarly, the solution in the outer layer leads to a defect law of the same form as in two-dimensional flow; experiment shows that the intercept in the defect law depends on δ/a. It is concluded that, except in those extreme situations where a+ is small (in which case the boundary layer may not anyway be in a fully developed turbulent state), the simplest analysis of axisymmetric flow will be to use the two-dimensional laws with parameters that now depend on a+ or δ/a as appropriate.

Organophosphorous poisoning causing isolated laryngeal paralysis has only been rarely reported before. We describe a case of difficult extubation in a patient with organophosphorous poisoning, the cause of which was found to be bilateral vocal fold palsy. This is a type of intermediate paralysis that recovers with time. Such a condition should be thought of as a cause of dyspnoea or difficult extubation in patients with organophosphorous poisoning.