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  • 1
    Language: English
    In: Journal of Pain and Symptom Management, February 2015, Vol.49(2), pp.351-352
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jpainsymman.2014.11.073 Byline: Thomas Christian Author Affiliation: Cambridge, MA
    Keywords: Medicine
    ISSN: 0885-3924
    E-ISSN: 1873-6513
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  • 2
    Language: English
    In: Journal of Pain and Symptom Management, February 2016, Vol.51(2), pp.393-394
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jpainsymman.2015.12.277 Byline: Thomas Christian Author Affiliation: Abt Associates, Cambridge, MA
    Keywords: Medicine
    ISSN: 0885-3924
    E-ISSN: 1873-6513
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  • 3
    Language: English
    In: Journal of Pain and Symptom Management, February 2016, Vol.51(2), pp.393-393
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jpainsymman.2015.12.276 Byline: Thomas Christian Author Affiliation: Abt Associates, Cambridge, MA
    Keywords: Medicine
    ISSN: 0885-3924
    E-ISSN: 1873-6513
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  • 4
    Language: English
    In: Journal of Pain and Symptom Management, February 2017, Vol.53(2), pp.348-349
    Description: An abstract of a study by Christian et al examining how beneficiaries utilize physician and nurse practitioner services while receiving General Inpatient (GIP) care is presented. Among the 1.5 million GIP days serviced in FY2014, the majority of days (52.4%) were not associated with any recorded physician or nurse practitioner services. Rates of the absence of these services were particularly high among hospice GIP days provided in (Acute) Inpatient Facilities (69.1% of days missing physician/nurse practitioner services), Long-Term Care Hospitals (84.3% missing services), and Skilled Nursing Facilities (85.3% missing services). Moreover, one in five hospice episodes that have at least three days of sequential GIP care did not have any physician or nurse practitioner services recorded from either the hospice or Part B claims; this was true for more than half of such episodes beginning in long-term care hospitals or skilled nursing facilities. Over two-thirds of all GIP days are serviced in hospice inpatient units and that cancer was the most common primary hospice diagnosis at admission among GIP days.
    Keywords: Medicine
    ISSN: 0885-3924
    E-ISSN: 1873-6513
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  • 5
    Article
    Article
    Language: English
    In: Urology, April 2013, Vol.81(4), pp.830-830
    Keywords: Medicine
    ISSN: 0090-4295
    E-ISSN: 1527-9995
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  • 6
    Language: English
    In: Preventive Medicine, September 2012, Vol.55(3), pp.215-218
    Description: To explore the extent to which commuters reallocate time away from their spouse, children, and friends. An analytic sample of adult, full-time employed, urban-dwelling respondents is drawn from the nationally representative American Time Use Survey (2003–2010). Seemingly Unrelated Regressions are utilized to calculate adjusted mean number of daily minutes spent with spouse, own children, and friends at several commuting durations. Mean {median} daily commuting time was 54.5 {50} minutes (the range was 6–210 min). For those commuting 60 min daily, a one hour commuting time increase is associated with a 21.8 minute decrease in time males spent with their spouse, an 18.6 minute decrease in time with children, and a 7.2 minute decrease in time with friends. A one hour increase in commuting time is associated with an 11.9 minute decrease in time females spent with friends, only, with no significant impact on time females spent with either spouse or children. This was the first study to utilize time diary data to explore the relationship between commuting length and time spent with others. These estimates will inform researchers interested in time usages' impacts on physical and mental health. ► Time use data was used to quantify trade-offs between commutes and time with others. ► Long commutes were associated with males spending less time with spouse and children. ► Commuting time was associated with males and females spending less time with friends.
    Keywords: Commuting ; Time Use ; Social Relationships ; Social Capital ; Adults ; United States ; Medicine ; Public Health
    ISSN: 0091-7435
    E-ISSN: 1096-0260
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  • 7
    In: Journal of Fluid Mechanics, 2015, Vol.764, pp.193-218
    Description: Abstract Quantitative results for the linear stability of planar Stokes layers subject to small, high-frequency perturbations are obtained for both a narrow channel and a flow approximating the classical semi-infinite Stokes layer. Previous theoretical and experimental predictions of the critical Reynolds number for the classical flat Stokes layer have differed widely with the former exceeding the latter by a factor of two or three. Here it is demonstrated that only a 1 % perturbation, at an appropriate frequency, to the nominal sinusoidal wall motion is enough to result in a reduction of the theoretical critical Reynolds number of as much as 60 %, bringing the theoretical conditions much more in line with the experimentally reported values. Furthermore, within the various experimental observations there is a wide variation in reported critical conditions and the results presented here may provide a new explanation for this behaviour.
    Keywords: Papers; Boundary Layers; Boundary Layer Stability
    ISSN: 0022-1120
    E-ISSN: 1469-7645
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  • 8
    Language: English
    In: Journal of Molecular Biology, 2010, Vol.400(2), pp.204-217
    Description: Enzymes that use distinct active site structures to perform identical reactions are known as analogous enzymes. The isolation of analogous enzymes suggests the existence of multiple enzyme structural pathways that can catalyze the same chemical reaction. A fundamental question concerning analogous enzymes is whether their distinct active-site structures would confer the same or different kinetic constraints to the chemical reaction, particularly with respect to the control of enzyme turnover. Here, we address this question with the analogous enzymes of bacterial TrmD and its eukaryotic and archaeal counterpart Trm5. TrmD and Trm5 catalyze methyl transfer to synthesize the m1G37 base at the 3′ position adjacent to the tRNA anticodon, using -adenosyl methionine (AdoMet) as the methyl donor. TrmD features a trefoil-knot active-site structure whereas Trm5 features the Rossmann fold. Pre-steady-state analysis revealed that product synthesis by TrmD proceeds linearly with time, whereas that by Trm5 exhibits a rapid burst followed by a slower and linear increase with time. The burst kinetics of Trm5 suggests that product release is the rate-limiting step of the catalytic cycle, consistent with the observation of higher enzyme affinity to the products of tRNA and AdoMet. In contrast, the lack of burst kinetics of TrmD suggests that its turnover is controlled by a step required for product synthesis. Although TrmD exists as a homodimer, it showed half-of-the-sites reactivity for tRNA binding and product synthesis. The kinetic differences between TrmD and Trm5 are parallel with those between the two classes of aminoacyl-tRNA synthetases, which use distinct active site structures to catalyze tRNA aminoacylation. This parallel suggests that the findings have a fundamental importance for enzymes that catalyze both methyl and aminoacyl transfer to tRNA in the decoding process.
    Keywords: Trm5 ; Trmd ; Burst Kinetics ; Trna(M1g37) ; Half-of-the-Sites Reactivity ; Biology ; Chemistry
    ISSN: 0022-2836
    E-ISSN: 1089-8638
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  • 9
    Language: English
    In: Biochemistry-US, 17 September 2012, Vol.51((21) ; 05, 2012)
    Description: Minor groove hydrogen bonding (HB) interactions between DNA polymerases (pols) and N3 of purines or O2 of pyrimidines have been proposed to be essential for DNA synthesis from results obtained using various nucleoside analogues lacking the N3 or O2 contacts that interfered with primer extension. Because there has been no direct structural evidence to support this proposal, we decided to evaluate the contribution of minor groove HB interactions with family B pols. We have used RB69 DNA pol and 3-deaza-2'-deoxyadenosine (3DA), an analogue of 2-deoxyadenosine, which has the same HB pattern opposite T but with N3 replaced with a carbon atom. We then determined pre-steady-state kinetic parameters for the insertion of dAMP opposite dT using primer/templates (P/T)-containing 3DA. We also determined three structures of ternary complexes with 3DA at various positions in the duplex DNA substrate. We found that the incorporation efficiency of dAMP opposite dT decreased 10{sup 2}-10{sup 3}-fold even when only one minor groove HB interaction was missing. Our structures show that the HB pattern and base pair geometry of 3DA/dT is exactly the same as those of dA/dT, which makes 3DA an optimal analogue for probing minor groove HB interactions between a DNA polymerase and a nucleobase. In addition, our structures provide a rationale for the observed 10{sup 2}-10{sup 3}-fold decrease in the rate of nucleotide incorporation. The minor groove HB interactions between position n-2 of the primer strand and RB69pol fix the rotomer conformations of the K706 and D621 side chains, as well as the position of metal ion A and its coordinating ligands, so that they are in the optinal orientation for DNA synthesis.
    Keywords: 08 Hydrogen ; Bonding ; Carbon ; Chains ; DNA ; DNA Polymerases ; Efficiency ; Geometry ; Hydrogen ; Kinetics ; Nucleosides ; Nucleotides ; Orientation ; Purines ; Pyrimidines ; Synthesis ; Chemistry ; Anatomy & Physiology
    ISSN: 0006-2960
    E-ISSN: 1520-4995
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  • 10
    In: Journal of the American Geriatrics Society, October 2015, Vol.63(10), pp.2043-2051
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/jgs.13677/abstract Byline: Pedro Gozalo, Natalie E. Leland, Thomas J. Christian, Vincent Mor, Joan M. Teno Keywords: volume effect; skilled nursing facility; postacute care; hip fracture Objectives To examine the effect of the relationship between volume (number of hip fracture admissions during the 12 months before participant's fracture) and other facility characteristics on outcomes. Design Prospective observational study. Setting U.S. skilled nursing facilities (SNFs) admitting individuals discharged from the hospital after treatment for hip fracture between 2000 and 2007 (N = 15,439). Participants Community-dwelling fee-for-service Medi-care beneficiaries aged 75 and older admitted to U.S. hospitals for their first hip fracture and discharged to a SNF for postacute care from 2000 to 2007 (N = 512,967). Measurements Successful discharge from SNF to community, defined as returning to the community within 30 days of hospital discharge to the SNF and remaining in the community without being institutionalized for at least 30 days, was examined using Medicare administrative data, propensity score matching, and instrumental variables. Results The overall rate of successful discharge to the community was 31%. Of the 15,439 facilities, the facility interquartile range varied from 0% (25th percentile) to 42% (75th percentile). An important determinant of variation in discharge rate was SNF volume of hip fracture admissions. Unadjusted successful discharge from SNF to community was 43.7% in high-volume facilities (〉24 admissions/year), versus 18.8% in low-volume facilities (1-6 admissions/year). This facility volume effect persisted after adjusting for participant and facility characteristics associated with outcomes (e.g., adjusted odds ratio = 2.06, 95% confidence interval = 1.91-2.21 for volume of 25 vs 3 admissions per year). Conclusion In community-dwelling persons with their first hip fracture, successful return to the community varies substantially according to SNF provider volume and staffing characteristics.
    Keywords: Volume Effect ; Skilled Nursing Facility ; Postacute Care ; Hip Fracture
    ISSN: 0002-8614
    E-ISSN: 1532-5415
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