Jiayi Wang

A study of the structural perfection of icosahedral quasicrystalline grains of various alloys and Al-Cu-Fe), grown by different slow solidification techniques was performed using high-resolution diffraction, including recording rocking curves combined with X-ray topography and phase contrast radiography, at a third-generation synchrotron radiation source . For Al-Pd-Mn, additional coherent diffraction and diffuse scattering measurements were also carried out. After evaluating the potentialities of the techniques used, in the light of the criteria defined for crystals, it is shown that the structural perfection of icosahedral quasicrystals is quite comparable with that of metallic crystals but is considerably influenced by either uniform phason strains which can destroy the quasiperiodic long-range order, or by long-wavelength phason fluctuations leading to diffuse scattering. The structural perfection was also found to be extremely variable across the as-grown quasicrystalline grains and to be dependent on the presence and characteristics of inhomogeneities often included in the quasicrystalline matrix. Regarding the grains that we used, it has been impossible to distinguish a clear influence of either the type of alloy or the growth method. It has, however, been noticed that Al-Pd-Mn and Al-Cu-Fe grains appeared less defective than Zn-Mg-RE grains and that the microstructure of these latter grains looks like that of crystals grown by the same technique. Annealing and mechanical polishing effects have also been analysed in the case of Al-Pd-Mn grains. It appeared that annealing improves the quasicrystalline lattice perfection by lowering phason strains insofar as no precipitates are nucleated. Mechanical polishing can introduce defects, located at the external surfaces, having the shape of bands

The histone H3 variant CENP-A is required for epigenetic specification of centromere identity through a loading mechanism independent of DNA sequence. Using multiphoton absorption and DNA cleavage at unique sites by I-SceI endonuclease, we demonstrate that CENP-A is rapidly recruited to double-strand breaks in DNA, along with three components associated with CENP-A at centromeres. The centromere-targeting domain of CENP-A is both necessary and sufficient for recruitment to double-strand breaks. CENP-A accumulation at DNA breaks is enhanced by active nonhomologous end-joining but does not require DNA-PKcs or Ligase IV, and is independent of H2AX. Thus, induction of a double-strand break is sufficient to recruit CENP-A in human and mouse cells. Finally, since cell survival after radiation-induced DNA damage correlates with CENP-A expression level, we propose that CENP-A may have a function in DNA repair.

IMPORTANCE: Most evaluations of pay-for-performance incentives have focused on large-group practices. Thus, the effect of P4P in small practices, where many US residents receive care, is largely unknown. Furthermore, whether electronic health records with chronic disease management capabilities support small-practice response to P4P has not been studied. OBJECTIVE: To assess the effect of P4P incentives on quality in EHR-enabled small practices in the context of an established quality improvement initiative. DESIGN, SETTING, AND PARTICIPANTS: A cluster-randomized trial of small primary care clinics in New York City from April 2009 through March 2010. A city program provided all participating clinics with the same EHR software with decision support and patient registry functionalities and quality improvement specialists offering technical assistance. INTERVENTIONS: Incentivized clinicswere paid for each patient whose care met the performance criteria, but they received higher payments for patients with comorbidities, who had Medicaid insurance, or who were uninsured. Quality reports were given quarterly to both the intervention and control groups. MAIN OUTCOMES AND MEASURES: Comparison of differences in performance improvement, from the beginning to the end of the study, between control and intervention clinics for aspirin or antithrombotic prescription, blood pressure control, cholesterol control, and smoking cessation interventions. Mixed-effects logistic regression was used to account for clustering of patients within clinics, with a treatment by time interaction term assessing the statistical significance of the effect of the intervention. RESULTS: Participating clinics had similar baseline characteristics, with a mean of 4592 patients at the intervention group clinics and 3042 at the control group clinics. Intervention clinics had greater adjusted absolute improvement in rates of appropriate antithrombotic prescription, blood pressure control, and in smoking cessation interventions. Intervention clinics performed better on all measures for Medicaid and uninsured patients except cholesterol control, but no differences were statistically significant. CONCLUSIONS AND RELEVANCE: Among small EHR-enabled clinics, a P4P incentive program compared with usual care resulted in modest improvements in cardiovascular care processes and outcomes. Because most proposed P4P programs are intended to remain in place more than a year, further research is needed to determine whether this effect increases or decreases over time. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00884013.