Testing nonclassical theories of electromagnetism with ion interferometry.

We discuss using a tabletop ion interferometer to search for deviations from Coulomb's inverse-square law. Such deviations would result from nonclassical effects such as a nonzero photon rest mass. We discuss the theory behind the proposed measurement, explain which fundamental, experimentally controllable parameters are the relevant figures of merit, and calculate the expected performance of such a device in terms of these parameters. The sensitivity to deviations in the exponent of the inverse-square law is predicted to be a few times 10(-22), an improvement by 5 orders of magnitude over current experiments. It could measure a nonzero photon rest mass smaller than 9 x 10(-50) grams, nearly 100 times smaller than current laboratory experiments.

Long-term stability of an area-reversible atom-interferometer Sagnac gyroscope.

We report the first demonstration of a matter-wave interference gyroscope that meets both the short-term noise and long-term stability requirements for high accuracy navigation. This performance level resulted from implementation of a novel technique to precisely reverse the input axis of the gyroscope.

Fluorescence measurements of expanding strongly coupled neutral plasmas.

We report new detailed density profile measurements in expanding strongly coupled neutral calcium plasmas. Using laser-induced fluorescence techniques, we determine plasma densities in the range of 10(5) to 10(9) cm(-3) to with a time resolution limit as small as 7 ns. Strong coupling in the plasma ions is inferred directly from the fluorescence signals. Evidence for strong coupling at late times is presented, confirming a recent theoretical result.

Experimental studies of Bose-Einstein condensation.

We describe several experimental studies of Bose-Einstein condensation in a dilute gas of sodium atoms. These include studies of static and dynamic behavior of the condensate, and of its coherence properties.

Capitated care is ethical.

Medicine is, at its center, a moral enterprise grounded in a covenant of trust. This covenant obliges physicians to be competent and to use their competence in the patient's best interests. Physicians, therefore, are both intellectually and morally obliged to act as advocates for the sick wherever their welfare is threatened and for their health at all times.

Editorial: vision and eye care carve-outs under managed care: what's in it for primary care physicians and their patients?

Tighter budgets mean that fewer health care dollars are available for the primary care physician (PCP) to manage. At the same time, specialists are clamoring for patients whose referral visits are financed from risk pools most likely the responsibility of the PCP. The physician case manager is caught between the pressures of patient and specialist. In fact, some specialists are now advocating carve-outs, which is the removal of certain services--and PCP funding management--from the general medical services capitation paid to the PCP that are directed to a separately contracted group or network. Do carve-outs make sense for patient care, for economics, and for the PCP? We maintain that for comprehensive and integrated vision and eye care services under the management and leadership of ophthalmologist-physicians, carve-outs makes clear and compelling sense. It is one carve-out within managed care where significant savings can be realized without sacrificing quality or patient satisfaction and without compromising the PCP. PCPs and ophthalmologists can work cooperatively to address their own needs and desires while not losing sight of their shared primary objective--giving their patients the best care.

A practical approach to achieving a $950,000 cost savings from a joint anesthesia-pharmacy program.

This report describes a joint anesthesia-pharmacy program to change prescribing and use of neuromuscular blocking agents and narcotic analgesics. The program uses pancuronium and fentanyl as "workhorse" agents with more expensive, shorter acting agents used for short-duration cases and for patients with characteristics such as renal and hepatic insufficiency that may affect the duration of action of other neuromuscular blocking agents. Cost-savings associated with changes in drug-prescribing were tracked. Some savings were applied to the planning and implementation of a pharmacy operating room satellite. A cost-savings exceeding $950,000 during a 3-year period was achieved.

Goldhelox: a soft x-ray solar telescope.

The Goldhelox Project is the construction and use of a near-normal incidence soft x-ray robotic solar telescope by undergraduate students at Brigham Young University. Once it is completed and tested, it will be deployed from a Get-Away-Special (GAS) canister in the bay of a space shuttle. It will image the sun at a wavelength of 171-181Å with a time resolution of 1 sec and a spatial resolution of 2.5 arcsec. The observational bandpass was chosen to image x-rays from highly ionized coronal Fe lines. The data will be an aid in better understanding the beginning phases of solar flares and how flaring relates to the physics of the corona-chromosphere transition region. Goldhelox is tentatively scheduled to fly on a space shuttle sometime in 1995 or 1996. This paper outlines the project goals, basic instrument design, and the unique aspects of making this an undergraduate endeavor.

Origins and clinical relevance of child death review teams.

Interagency child death review teams have emerged in response to the increasing awareness of severe violence against children in the United States. Since 1978, when the first team originated in Los Angeles, Calif, child death review teams have been established across the nation. Approximately 100 million Americans or 40% of the nation's population now live in counties or states served by such teams; most have been formed since 1988. Multiagency child death review involves a systematic, multidisciplinary, and multiagency process to coordinate and integrate data and resources from coroners, law enforcement, courts, child protective services, and health care providers. This article provides an introduction to the unique factors and magnitude of suspicious child deaths, and to the concept and process of interagency child death review. Future expansion of this process should lead to more effective multiagency case management and prevention of future deaths and serious injuries to children from child abuse and neglect.

Comparison of floating gate neural network memory cells in standard VLSI CMOS technology.

Several floating gate MOSFET structures, for potential use as analog memory elements in neural networks, have been fabricated in a standard 2 mum double-polysilicon CMOS process. Their physical and programming characteristics are compared with each other and with similar structures reported in the literature. None of the circuits under consideration require special fabrication techniques. The criteria used to determine the structure most suitable for neural network memory applications include the symmetry of charging and discharging characteristics, programming voltage magnitudes, the area required, and the effectiveness of geometric field enhancement techniques. This work provides a layout for an analog neural network memory based on previously unexplored criteria and results. The authors have found that the best designs (a) use the poly1 to poly2 oxide for injection; (b) need not utilize ;field enhancement' techniques; (c) use poly1 to diffusion oxide for a coupling capacitor; and (d) size capacitor ratios to provide a wide range of possible programming voltages.

Nutritional aspects and swallowing function of patients with Parkinson's disease.

Seven patients with Parkinson's disease and three patients with progressive supranuclear palsy underwent adrenal medullary transplant to the caudate nucleus for treatment of their neurologic disease. Preoperative nutritional assessment demonstrated that a significant number of the Parkinson's patients had mild to moderate nutritional depletion. Motility problems, manifest by dysphagia and delayed gastric emptying causing problems over a number of years, were probably responsible. Of the 10 patients studied, 6 were studied by videofluoroscopy. All patients had variable dysphagia of variable servility with or without aspiration. Etiologic factors included the basic underlying neurologic disease, delay in resumption of anti-parkinsonian medications, use of metoclopramide, and postoperative medical complications leading to a debilitated clinical state.

Effects of low and high carbohydrate feedings in ambulatory patients with chronic obstructive pulmonary disease and chronic hypercapnia.

In a randomized, double-blinded study, patients with chronic obstructive pulmonary disease and hypercapnia were fed low, moderate, and high carbohydrate diets to determine the effect on metabolic and ventilatory values. The low carbohydrate diet consisted of 28% carbohydrate calories and 55% fat calories and resulted in significantly lower production of CO2 (p less than 0.002), respiratory quotient (p less than 0.001), and arterial Pco2 (p less than 0.05). At the end of the 15-day study, both the forced vital capacity (p less than 0.05) and the forced expiratory volume in 1 second (p less than 0.05) had improved by 22% over baseline values. Total calories given surpassed daily caloric requirements. This approach, together with a low carbohydrate, high fat mixture, may be beneficial for such patients.

Cost effectiveness of an enteral products formulary.

The development, implementation, and resultant cost savings of a revised enteral products formulary at a 430-bed, community teaching hospital are described. In 1982, a review of the available enteral nutrition products (ENPs) was performed by the pharmacy and food service departments in conjunction with the pharmacy and therapeutics committee. Three broad categories of products were identified--intact-protein, chemically defined, and modular formulas--with 11 subgroups. Products were then evaluated for inclusion on the restricted formulary on the basis of osmolality; source, quality, and proportions of protein, carbohydrate, and fat; electrolyte, mineral, and vitamin content; and cost. Fourteen products were admitted to the restricted 1983 formulary. Previously, 20 products had been stocked by the pharmacy. Products from two subgroups, blenderized and mild-base diets, were deleted from the formulary because of cost, infrequent use, and availability of suitable alternatives. To decrease inventory carrying costs, products are stocked in vanilla or unflavored form, with flavoring packets available. Educational efforts were undertaken to increase the medical staff's awareness of the revised formulary. Within three months of implementation of the revised formulary, purchase of nonformulary items had ceased. A considerable cost savings was achieved because of the formulary.