Public health and the economy could be served by reallocating medical expenditures to social programs.

As much as 30% of US health care spending in the United States does not improve individual or population health. To a large extent this excess spending results from prices that are too high and from administrative waste. In the public sector, and particularly at the state level, where budget constraints are severe and reluctance to raise taxes high, this spending crowds out social, educational, and public-health investments. Over time, as spending on medical care increases, spending on improvements to the social determinants of health are starved. In California the fraction of General Fund expenditures spent on public health and social programs fell from 34.8% in fiscal year 1990 to 21.4% in fiscal year 2014, while health care increased from 14.1% to 21.3%. In spending more on healthcare and less on other efforts to improve health and health determinants, the state is missing important opportunities for health-promoting interventions with a strong financial return. Reallocating ineffective medical expenditures to proven and cost-effective public health and social programs would not be easy, but recognizing its potential for improving the public's health while saving taxpayers billions of dollars might provide political cover to those willing to engage in genuine reform. National estimates of the percent of medical spending that does not improve health suggest that approximately $5 billion of California's public budget for medical spending has no positive effect on health. Up to 10,500 premature deaths could be prevented annually by reallocating this portion of medical spending to public health. Alternatively, the same expenditure could help an additional 418,000 high school students to graduate

Validation of Satellite Rainfall Products for Western Uganda.

Central equatorial Africa is deficient in long-term, ground-based measurements of rainfall; therefore, the aim of this study is to assess the accuracy of three high-resolution, satellite-based rainfall products in western Uganda for the 2001–10 period. The three products are African Rainfall Climatology, version 2 (ARC2); African Rainfall Estimation Algorithm, version 2 (RFE2); and 3B42 from the Tropical Rainfall Measuring Mission, version 7 (i.e., 3B42v7). Daily rainfall totals from six gauges were used to assess the accuracy of satellite-based rainfall estimates of rainfall days, daily rainfall totals, 10-day rainfall totals, monthly rainfall totals, and seasonal rainfall totals. The northern stations had a mean annual rainfall total of 1390 mm, while the southern stations had a mean annual rainfall total of 900 mm. 3B42v7 was the only product that did not underestimate boreal-summer rainfall at the northern stations, which had ~3 times as much rainfall during boreal summer than did the southern stations. The three products tended to overestimate rainfall days at all stations and were borderline satisfactory at identifying rainfall days at the northern stations; the products did not perform satisfactorily at the southern stations. At the northern stations, 3B42v7 performed satisfactorily at estimating monthly and seasonal rainfall totals, ARC2 was only satisfactory at estimating seasonal rainfall totals, and RFE2 did not perform satisfactorily at any time step. The satellite products performed worst at the two stations located in rain shadows, and 3B42v7 had substantial overestimates at those stations

Population pressure and global markets drive a decade of forest cover change in Africa\u27s Albertine Rift

Africa\u27s Albertine Rift region faces a juxtaposition of rapid human population growth and protected areas, making it one of the world\u27s most vulnerable biodiversity hotspots. Using satellite-derived estimates of forest cover change, we examined national socioeconomic, demographic, agricultural production, and local demographic and geographic variables, to assess multilevel forces driving local forest cover loss and gain outside protected areas during the first decade of this century. Because the processes that drive forest cover loss and gain are expected to be different, and both are of interest, we constructed models of significant change in each direction. Although rates of forest cover change varied by country, national population change was the strongest driver of forest loss for all countries – with a population doubling predicted to cause 2.06% annual cover loss, while doubling tea production predicted to cause 1.90%. The rate of forest cover gain was associated positively with increased production of the local staple crop cassava, but negatively with local population density and meat production, suggesting production drivers at multiple levels affect reforestation. We found a small but significant decrease in loss rate as distance from protected areas increased, supporting studies suggesting higher rates of landscape change near protected areas. While local population density mitigated the rate of forest cover gain, loss was also correlated with lower local population density, an apparent paradox, but consistent with findings that larger scale forces outweigh local drivers of deforestation. This implicates demographic and market forces at national and international scales as critical drivers of change, calling into question the necessary scales of forest protection policy in this biodiversity hotspot. Using a satellite derived estimate of forest cover change for both loss and gain added a dynamic component to more traditionally static and unidirectional studies, significantly improving our understanding of landscape processes and drivers at work

Metabolic and hormonal studies of Type 1 (insulin-dependent) diabetic patients after successful pancreas and kidney transplantation

Long-term normalization of glucose metabolism is necessary to prevent or ameliorate diabetic complications. Although pancreatic grafting is able to restore normal blood glucose and glycated haemoglobin, the degree of normalization of the deranged diabetic metabolism after pancreas transplantation is still questionable. Consequently glucose, insulin, C-peptide, glucagon, and pancreatic polypeptide responses to oral glucose and i.v. arginine were measured in 36 Type 1 (insulin-dependent) diabetic recipients of pancreas and kidney allografts and compared to ten healthy control subjects. Despite normal HbA1 (7.2±0.2%; normal <8%) glucose disposal was normal only in 44% and impaired in 56% of the graft recipients. Normalization of glucose tolerance was achieved at the expense of hyperinsulinaemia in 52% of the subjects. C-peptide and glucagon were normal, while pancreatic polypeptide was significantly higher in the graft recipients. Intravenous glucose tolerance (n=21) was normal in 67% and borderline in 23%. Biphasic insulin release was seen in patients with normal glucose tolerance. Glucose tolerance did not deteriorate up to 7 years post-transplant. In addition, stress hormone release (cortisol, growth hormone, prolactin, glucagon, catecholamines) to insulin-induced hypoglycaemia was examined in 20 graft recipients and compared to eight healthy subjects. Reduced blood glucose decline indicates insulin resistance, but glucose recovery was normal, despite markedly reduced catecholamine and glucagon release. These data demonstrate the effectiveness of pancreatic grafting in normalizing glucose metabolism, although hyperinsulinaemia and deranged counterregulatory hormone response are observed frequently

Physical education as Olympic education

Introduction In a recent paper (Parry, 1998, p. 64), I argued that the justification of PE activities lies in their capacity to facilitate the development of certain human excellences of a valued kind. Of course, the problem now lies in specifying those ‘human excellences of a valued kind’, and (for anyone) this task leads us into the area of philosophical anthropology. I suggested that the way forward for Physical Education lies in the philosophical anthropology (and the ethical ideals) of Olympism, which provide a specification of a variety of human values and excellences which: •have been attractive to human groups over an impressive span of time and space •have contributed massively to our historically developed conceptions of ourselves •have helped to develop a range of artistic and cultural conceptions that have defined Western culture. •have produced a range of physical activities that have been found universally satisfying and challenging. Although physical activities are widely considered to be pleasurable, their likelihood of gaining wide acceptance lies rather in their intrinsic value, which transcends the simply hedonic or relative good. Their ability to furnish us with pleasurable experiences depends upon our prior recognition in them of opportunities for the development and expression of valued human excellences. They are widely considered to be such opportunities for the expression of valued human excellences because, even when as local instantiations, their object is to challenge our common human propensities and abilities. I claimed that Olympic ideals may be seen not merely as inert ‘ideals’, but living ideas which have the power to remake our notions of sport in education, seeing sport not as mere physical activity but as the cultural and developmental activity of an aspiring, achieving, well-balanced, educated and ethical individual. This paper seeks to make good that claim by trying to develop a case for Physical Education as Olympic Education. I begin by setting out various accounts and conceptions of the Olympic Idea; then I suggest a unifying and organising account of the philosophical anthropology of Olympism; and this is followed by the practical application of that account in two examples of current ethical issues. Finally, I seek to present an account of Physical Education as Olympic Education

On rationality of the intersection points of a line with a plane quartic

We study the rationality of the intersection points of certain lines and smooth plane quartics C defined over F_q. For q \geq 127, we prove the existence of a line such that the intersection points with C are all rational. Using another approach, we further prove the existence of a tangent line with the same property as soon as the characteristic of F_q is different from 2 and q \geq 66^2+1. Finally, we study the probability of the existence of a rational flex on C and exhibit a curious behavior when the characteristic of F_q is equal to 3.Comment: 17 pages. Theorem 2 now includes the characteristic 2 case; Conjecture 1 from the previous version is proved wron

Research of the Additional Losses Occurring in Optical Fiber at its Multiple Bends in the Range Waves 1310nm, 1550nm and 1625nm Long

Article is devoted to research of the additional losses occurring in the optical fiber at its multiple bends in the range waves of 1310 nanometers, 1550 nanometers and 1625 nanometers long. Article is directed on creation of the external factors methods which allow to estimate and eliminate negative influence. The automated way of calculation of losses at a bend is developed. Results of scientific researches are used by engineers of "Kazaktelekom" AS for practical definition of losses service conditions. For modeling the Wolfram|Alpha environment - the knowledge base and a set of computing algorithms was chosen. The greatest losses are noted on wavelength 1310nm and 1625nm. All dependences are nonlinear. Losses with each following excess are multiplicative

Fingolimod and tumor-infiltrating lymphocytes in checkpoint-inhibitor treated cancer patients.

Immune checkpoint inhibitors (ICIs) are emerging as the new standard of care for treating various metastatic cancers. It is known that effective anti-tumor immune responses are associated with a stronger presence of tumor-infiltrating lymphocytes (TILs) in solid tumor tissue. Cancer patients with relapsing-remitting multiple sclerosis (RRMS) are often under continuous treatment with fingolimod, an immune-modulating drug that inhibits lymphocyte egress from secondary lymphatic organs. Little is known about the effect of fingolimod on ICI cancer therapy, as fingolimod may limit the number of TILs. Here we present three patients with RRMS, who developed various cancers during fingolimod treatment. Histology of all tumors consistently showed low numbers of TILs. A second biopsy taken from one of the tumors, a melanoma, revealed a significant increase of TILs after stopping fingolimod and starting pembrolizumab, indicating a surge in the number and re-invigoration of T cells. Our study suggests that fingolimod limits the number of TILs in solid tumors and may, thus, inhibit anti-cancer immune responses

FTIR-based spectroscopic analysis in the identification of clinically aggressive prostate cancer

Fourier transform infrared (FTIR) spectroscopy is a vibrational spectroscopic technique that uses infrared radiation to vibrate molecular bonds within the sample that absorbs it. As different samples contain different molecular bonds or different configurations of molecular bonds, FTIR allows us to obtain chemical information on molecules within the sample. Fourier transform infrared microspectroscopy in conjunction with a principal component-discriminant function analysis (PC-DFA) algorithm was applied to the grading of prostate cancer (CaP) tissue specimens. The PC-DFA algorithm is used alongside the established diagnostic measures of Gleason grading and the tumour/node/metastasis system. Principal component-discriminant function analysis improved the sensitivity and specificity of a three-band Gleason score criterion diagnosis previously reported by attaining an overall sensitivity of 92.3% and specificity of 99.4%. For the first time, we present the use of a two-band criterion showing an association of FTIR-based spectral characteristics with clinically aggressive behaviour in CaP manifest as local and/or distal spread. This paper shows the potential for the use of spectroscopic analysis for the evaluation of the biopotential of CaP in an accurate and reproducible manner