Doctors at Risk: A Problem As Viewed by Decision Analysis

The authors closely analyze a case in which a Peer Review Organization cited a physician for treatment with potential for significant adverse effect. They also critique the regulatory scheme under which peer review occurs and conclude that such regulation interferes with physicians\u27 primary obligations, fails to encourage cost-effective behavior and may decrease the quality of medical care

A high excitation HII region in the faint dwarf elliptical galaxy A0951+68

We present the results of BVRI imaging and optical spectroscopy of the dwarf galaxy A0951+68. The images reveal that, although this galaxy is classified as a dwarf elliptical, it has some properties that are similar to dwarf irregular galaxies. It contains two bright knots of emission, one of which is red and unresolved and the other blue and resolved. The blue knot also shows a high excitation emission line spectrum. The observed line ratios indicate that this is an HII region, although with some line ratios that are border-line with those in AGN. The emission line luminosity is consistent with ionisation by a single, very luminous O star, or several smaller O stars, but the extended blue light in the knot shows that this has occurred as part of a substantial recent star formation event. We find that the metal abundance, while low compared to typical large galaxies, actually seems to be high for such a low luminosity dwarf. The position of A0951 in the literature is incorrect and we provide the correct value.Comment: 8 pages, Latex, 4 encapsulated postscript figures included, 1 separate JPEG figure; to be published in Monthly Notice

A Prograde, Low-Inclination Orbit for the Very Hot Jupiter WASP-3b

We present new spectroscopic and photometric observations of the transiting exoplanetary system WASP-3. Spectra obtained during two separate transits exhibit the Rossiter-McLaughlin (RM) effect and allow us to estimate the sky-projected angle between the planetary orbital axis and the stellar rotation axis, lambda = 3.3^{+2.5}_{-4.4} degrees. This alignment between the axes suggests that WASP-3b has a low orbital inclination relative to the equatorial plane of its parent star. During our first night of spectroscopic measurements, we observed an unexpected redshift briefly exceeding the expected sum of the orbital and RM velocities by 140 m/s. This anomaly could represent the occultation of material erupting from the stellar photosphere, although it is more likely to be an artifact caused by moonlight scattered into the spectrograph.Comment: 23 pages, 4 figures, Accepted for publication in The Astrophysical Journal, Replacement includes revised citation

Sedimentary framework of mainland fringing reef development, Cape Tribulation Area

Mainland fringing reefs with a diverse coral fauna have developed in the Cape Tribulation area primarily upon coastal sediment bodies such as beach shoals and creek mouth bars. Growth on steep rocky headlands is minor. The reefs have extensive sandy beaches to landward, and an irregular outer margin. Typically there is a raised platform of dead nef along the outer edge of the reef, and dead coral columns lie buried under the reef flat. Live coral growth is restricted to the outer reef slope. Seaward of the reefs is a narrow wedge of muddy, terrigenous sediment, which thins offshore. Beach, reef and inner shelf sediments all contain 50% terrigenous material, indicating the reefs have always grown under conditions of heavy terrigenous influx. The relatively shallow lower limit of coral growth (ca 6m below ADD) is typical of reef growth in turbid waters, where decreased light levels inhibit coral growth. Radiocarbon dating of material from surveyed sites confirms the age of the fossil coral columns as 33304110 ybp, indicating that they grew during the late postglacial sea-level high (ca 5500-6500 ybp). The former thriving reef-flat was killed by a post-5500 ybp sea-level fall of ca 1 m. Although this study has not assessed the community structure of the fringing reefs, nor whether changes are presently occurring, it is clear the corals present today on the fore-reef slope have always lived under heavy terrigenous influence, and that the fossil reef-flat can be explained as due to the mid-Holocene fall in sea-level. A medium term programme is required to record sediment loading and coral community structure, and to establish the environmental vulnerability of these reefs

Palliative care and Parkinson's disease : meeting summary and recommendations for clinical research

Introduction: Palliative care is an approach to caring for patients and families affected by serious illnesses that focuses on the relief of suffering through the management of medical symptoms, psychosocial issues, advance care planning and spiritual wellbeing. Over the past decade there has been an emerging clinical and research interest in the application of palliative care approaches to Parkinson’s disease (PD) and outpatient palliative care services are now offered by several movement disorders centers. Methods: An International Working Group Meeting on PD and Palliative Care supported by the Parkinson’s Disease Foundation was held in October 2015 to review the current state of the evidence and to make recommendations for clinical research and practice. Results: Topics included: 1) Defining palliative care for PD; 2) Lessons from palliative care for heart failure and other chronic illnesses; 3) Patient and caregiver Needs; 4) Needs assessment tools; 5) Intervention strategies; 6) Predicting prognosis and hospice referrals; 7) Choice of appropriate outcome measures; 8) Implementation, dissemination and education research; and 9) Need for research collaborations. We provide an overview of these discussions, summarize current evidence and practices, highlight gaps in our knowledge and make recommendations for future research. Conclusions: Palliative Care for PD is a rapidly growing area which holds great promise for improving outcomes for PD patients and their caregivers. While clinical research in this area can build from lessons learned in other diseases, there is a need for observational, methodological and interventional research to address the unique needs of PD patients and caregivers

Vector bundles on the projective line and finite domination of chain complexes

Finitely dominated chain complexes over a Laurent polynomial ring in one indeterminate are characterised by vanishing of their Novikov homology. We present an algebro-geometric approach to this result, based on extension of chain complexes to sheaves on the projective line. We also discuss the K-theoretical obstruction to extension.Comment: v1: 11 page

A preliminary examination of differential decomposition patterns in mass graves

This study represents a preliminary, quantitative approach to the examination of differential decomposition patterns in mass graves. Five pairs of mass graves, each containing the carcasses of 21 rabbits, were used to examine decomposition rates at four fixed positions within the burial. A pair of graves was exhumed at approximately 100 accumulated degree day (ADD) intervals. At exhumation the total body score (TBS) and internal carcass temperature of each rabbit were recorded. Although there was no significant difference between decomposition rates for core and deep-positioned carcasses (p = 0.13), all other position differences were significant (p < 0.001). Decomposition occurred fastest in shallow carcasses, followed by mid-outer carcasses; both deep and core carcasses exhibited a slower rate. Internal carcass temperature was significantly influenced by carcass location within the mass grave; there was a mean internal temperature difference of ca. 1 oC between deep and shallow carcasses (30 cm apart). Adipocere formation was minimal and confined, with the exception of a single individual in the mid- periphery, to the deepest level. Decomposition rate may be as affected by the compactness of a mass as by interment depth and/or peripheral substrate contact, and further investigation into the role of oxygenation and pH are required

Color Transformations for the 2MASS Second Incremental Data Release

Transformation equations are presented to convert colors and magnitudes measured in the AAO, ARNICA, CIT, DENIS, ESO, LCO (Persson standards), MSSSO, SAAO, and UKIRT photometric systems to the photometric system inherent to the 2MASS Second Incremental Data Release. The transformations have been derived by comparing 2MASS photometry with published magnitudes and colors for stars observed in these systems. Transformation equations have also been derived indirectly for the Bessell & Brett (1988) and Koornneef (1983) homogenized photometric systems.Comment: To appear in AJ, May 200