To inform the design of future informatics systems that support the chronic care model. We describe the development and functionality of a decision support system for the chronic care model of depression treatment, known as collaborative care. Dissemination of evidence-based collaborative care models has been slow, and fidelity to the evidence base has been poor during implementation initiatives. Implementation could be facilitated by a decision support system for depression care managers, the cornerstone of the collaborative care model. The Net Decision Support System (https://www.netdss.net/) is a free Web-based system that was developed to support depression care manager activities and to facilitate the dissemination of collaborative care models that maintain high fidelity to the evidence base. The NetDSS was based on intervention materials used for a randomized trial of depression care management that improved clinical outcomes compared with usual care. The NetDSS was developed jointly by a cross-functional design team of psychiatrists, depression care managers, information technology specialists, technical writers, and researchers. The NetDSS has the following functional capabilities: patient registry, patient encounter scheduler, trial management, clinical decision support, progress note generator, and workload and outcomes report generator. The NetDSS guides the care manager through a self-documenting patient encounter using evidence-based scripts and self-scoring instruments. The NetDSS has been used to provide evidence-based depression care management to more than 1700 primary care patients. Intervention protocols can be successfully converted to Web-based decision support systems that facilitate the implementation of evidence-based chronic care models into routine care with high fidelity.

The (12)C/(13)C abundance ratio in ethane in the atmosphere of Titan has been measured at 822 cm(-1) from high spectral resolution ground-based observations. The value, 89(8), coincides with the telluric standard and also agrees with the ratio seen in the outer planets. It is almost identical to the result for ethane on Titan found by the composite infrared spectrometer (CIRS) on Cassini. The (12)C/(13)C ratio for ethane is higher than the ratio measured in atmospheric methane by Cassini/Huygens GCMS, 82.3(1), representing an enrichment of (12)C in the ethane that might be explained by a kinetic isotope effect of approximately 1.1 in the formation of methyl radicals. If methane is being continuously resupplied to balance photochemical destruction, then we expect the isotopic composition in the ethane product to equilibrate at close to the same (12)C/(13)C ratio as that in the supply. The telluric value of the ratio in ethane then implies that the methane reservoir is primordial.

The response to melatonin expression is one way that circadian rhythms of many biological processes are regulated. To evaluate the relationship between the melatonin receptor 1A (MTNR1A) gene and reproductive performance, records were compared in Dorset and 3/4-Dorset x 1/4-East Friesian ewes expressing different genotypes at the MTNR1A gene in the Cornell University sheep flock. There were 116 ewes with first lambing records, consisting of 91 Dorset and 25 crossbred ewes. Of these, 104 ewes had second lambing records. Genotypes were determined by PCR amplification of a fragment of the ovine MTNR1A gene followed by digestion with MnlI and RsaI restriction enzymes. The effects of breed, year of birth, season of birth or season of first conception, and each polymorphism on days to first lambing and days between first and second lambings were evaluated. Our results show that ewes with at least 1 M allele are able to conceive at younger ages, better able to breed and conceive out-of-season, and have shorter intervals between first and second lambings than ewes expressing only the m allele. The results presented in this study show, for the first time, an association of the MTNR1A gene and lambing frequency and confirm the importance of the MTNR1A gene as a potential DNA marker for out-of-season breeding.

OBJECTIVE: To demonstrate the technique of stereotactic microsurgical endoscopic removal of intraventricular tumors or colloid cysts assisted by intraoperative computed tomography. METHODS: We adapted a tubular "ventriculoport" for stereotactic insertion of an endoscope into the ventricle. This facilitated microsurgical resection of 14 intraventricular tumors or colloid cysts by use of intraoperative stereotactic microsurgical endoscopic removal of intraventricular tumors or colloid cysts assisted by intraoperative computed tomography. RESULTS: Gross total resection was achieved in 12 patients and confirmed by intraoperative computed tomographic scanning and postoperative magnetic resonance imaging. Patients with preoperative hydrocephalus had relief of their symptoms. Perioperative morbidity was limited to mild headache associated with postoperative pneumocephalus. The average length of stay was 3.6 days. Twelve patients had significant improvement in their symptoms. CONCLUSION: The combination of intraoperative computed tomography-guided stereotactic technique and rigid endoscopy facilitated an accurate, minimally invasive, microsurgical removal of these intraventricular masses. This approach minimized retraction and provided satisfactory visualization.

Jupiter's moon Io is known to host active volcanoes. In February and March 2007, the New Horizons spacecraft obtained a global snapshot of Io's volcanism. A 350-kilometer-high volcanic plume was seen to emanate from the Tvashtar volcano (62 degrees N, 122 degrees W), and its motion was observed. The plume's morphology and dynamics support nonballistic models of large Io plumes and also suggest that most visible plume particles condensed within the plume rather than being ejected from the source. In images taken in Jupiter eclipse, nonthermal visible-wavelength emission was seen from individual volcanoes near Io's sub-Jupiter and anti-Jupiter points. Near-infrared emission from the brightest volcanoes indicates minimum magma temperatures in the 1150- to 1335-kelvin range, consistent with basaltic composition.

The New Horizons (NH) spacecraft observed Io's aurora in eclipse on four occasions during spring 2007. NH Alice ultraviolet spectroscopy and concurrent Hubble Space Telescope ultraviolet imaging in eclipse investigate the relative contribution of volcanoes to Io's atmosphere and its interaction with Jupiter's magnetosphere. Auroral brightness and morphology variations after eclipse ingress and egress reveal changes in the relative contribution of sublimation and volcanic sources to the atmosphere. Brightnesses viewed at different geometries are best explained by a dramatic difference between the dayside and nightside atmospheric density. Far-ultraviolet aurora morphology reveals the influence of plumes on Io's electrodynamic interaction with Jupiter's magnetosphere. Comparisons to detailed simulations of Io's aurora indicate that volcanoes supply 1 to 3% of the dayside atmosphere.

The New Horizons spacecraft observed Jupiter's icy satellites Europa and Ganymede during its flyby in February and March 2007 at visible and infrared wavelengths. Infrared spectral images map H2O ice absorption and hydrated contaminants, bolstering the case for an exogenous source of Europa's "non-ice" surface material and filling large gaps in compositional maps of Ganymede's Jupiter-facing hemisphere. Visual wavelength images of Europa extend knowledge of its global pattern of arcuate troughs and show that its surface scatters light more isotropically than other icy satellites.

Although lightning has been seen on other planets, including Jupiter, polar lightning has been known only on Earth. Optical observations from the New Horizons spacecraft have identified lightning at high latitudes above Jupiter up to 80 degrees N and 74 degrees S. Lightning rates and optical powers were similar at each pole, and the mean optical flux is comparable to that at nonpolar latitudes, which is consistent with the notion that internal heat is the main driver of convection. Both near-infrared and ground-based 5-micrometer thermal imagery reveal that cloud cover has thinned substantially since the 2000 Cassini flyby, particularly in the turbulent wake of the Great Red Spot and in the southern half of the equatorial region, demonstrating that vertical dynamical processes are time-varying on seasonal scales at mid- and low latitudes on Jupiter.

Several observations of Jupiter's atmosphere made by instruments on the New Horizons spacecraft have implications for the stability and dynamics of Jupiter's weather layer. Mesoscale waves, first seen by Voyager, have been observed at a spatial resolution of 11 to 45 kilometers. These waves have a 300-kilometer wavelength and phase velocities greater than the local zonal flow by 100 meters per second, much higher than predicted by models. Additionally, infrared spectral measurements over five successive Jupiter rotations at spatial resolutions of 200 to 140 kilometers have shown the development of transient ammonia ice clouds (lifetimes of 40 hours or less) in regions of strong atmospheric upwelling. Both of these phenomena serve as probes of atmospheric dynamics below the visible cloud tops.