Trends and issues in the Medicaid 1915(c) waiver program.

Over the past 15 years, Medicaid 1915(c) home and community-based waivers have made a substantial contribution to States' efforts to transform their long-term care (LTC) systems from largely institutional to community-based systems. By 1997, every State had implemented a waiver program for at least some subgroups of individuals with disabilities, and expenditures increased from $3.8 million in 1982 to more than$8.1 billion in 1997. Emerging, as well as long-standing, policy issues related to the waiver program include concerns with access, variation in availability by disability group, State decisions related to the provision of community-based LTC, and evidence on effectiveness

Monte Carlo Simulation of Lyman Alpha Scattering and Application to Damped Lyman Alpha Systems

A Monte Carlo code to solve the transfer of Lyman alpha (Lya) photons is developed, which can predict the Lya image and two-dimensional Lya spectra of a hydrogen cloud with any given geometry, Lya emissivity, neutral hydrogen density distribution, and bulk velocity field. We apply the code to several simple cases of a uniform cloud to show how the Lya image and emitted line spectrum are affected by the column density, internal velocity gradients, and emissivity distribution. We then apply the code to two models for damped Lya absorption systems: a spherical, static, isothermal cloud, and a flattened, axially symmetric, rotating cloud. If the emission is due to fluorescence of the external background radiation, the Lya image should have a core corresponding to the region where hydrogen is self-shielded. The emission line profile has the characteristic double peak with a deep central trough. We show how rotation of the cloud causes the two peaks to shift in wavelength as the slit is perpendicular to the rotation axis, and how the relative amplitude of the two peaks is changed. In reality, damped Lya systems are likely to have a clumpy gas distribution with turbulent velocity fields, which should smooth the line emission profile, but should still leave the rotation signature of the wavelength shift across the system.Comment: 19 pages, 17 eps figures. One panel is added in Fig.1 to show the recoil effect. Revisions are made in response to the referee's comments. Accepted for publication in Ap

Host Selection of the giant willow aphid (Tuberolachnus salignus)

The giant willow aphid [Tuberolachnus salignus (Gmelin)] has recently become noteworthy as a potential pest species due to the increased uptake of willow, its host-plant, for use in growing biomass for energy production. In this paper we describe host selection studies of T. salignus on short rotation coppice (SRC) willow varieties in laboratory bioassays and field experiments. In laboratory olfactometry tests, T. salignus was significantly attracted to certain SRC willow varieties, but not to others. Field trials during 2007 and 2008 showed that T. salignus infestation levels varied significantly on different SRC willow varieties and that levels are highest on the varieties to which they are most strongly attracted in the laboratory bioassays

Scientific Bounty Among Meteorites Recovered from the Dominion Range, Transantarctic Mountains

The US Antarctic Meteorite Pro-gram has visited the Dominion Range in the Transantarctic Mountains during several different sea-sons, including 1985, 2003, 2008, 2010, 2014 and 2018. Total recovered meteorites from this region is close to 3000. The 1985 (11 samples), 2003 (141 samples), 2008 (521 samples), 2010 (901 samples), 2014 (562 samples) seasons have been fully classified, and 2018 (865 samples) are in the process of being classified and characterized. Given that close to 2200 samples have been classified so far, with more expected in 2020, now is a good time to summarize the state of the collection. Here we describe the significant samples documented from this area, as well as a large meteorite shower that dominates the statistics of the region

Echocardiographic evaluation of velocity ratio, velocity time integral ratio, and pulmonary valve area in dogs with pulmonary valve stenosis.

BackgroundVelocity ratio, velocity time integral (VTI) ratio, and pulmonary valve area indexed to body surface area (iPVA) are methods of assessment of pulmonary valve stenosis (PS) severity that are less dependent on blood flow. Studies evaluating these methods are limited.ObjectivesTo determine the effects of butorphanol, atenolol, and balloon valvuloplasty (BV) on velocity ratio, VTI ratio, iPVA, mean PG, and max PG.AnimalsTwenty-seven dogs with PS (max PG >50 mm Hg).MethodsProspective study. All dogs underwent an echocardiogram at baseline, 5-minutes after administration of butorphanol (0.2-0.25 mg/kg IV), and 2-to-4 weeks after atenolol (1-1.5 mg/kg q12h). Twenty-one of these were evaluated 24-hours after BV.ResultsThere were no significant differences (P > .05) amongst any of the methods of assessment of PS severity after butorphanol. After atenolol, mean (SD) of mean (57.0 [21.0] mm Hg) and max PG (93.1 [33.8] mm Hg) were significantly decreased (P ≤ .047) compared with baseline (65.2 [26.2] mm Hg and 108 [44.4] mm Hg, respectively). After atenolol, there were no significant (P ≥ .12) differences in velocity ratio (0.29 [0.09]), VTI ratio (0.18 [0.05]), or iPVA (0.43 [0.16] cm2 /m2 ) compared with baseline (0.30 [0.09], 0.19 [0.09], 0.44 [0.17] cm2 /m2 , respectively).Conclusions and clinical importanceAtenolol might reduce mean and max PG but does not alter less flow-dependent methods of assessment of PS severity (velocity ratio, VTI ratio, and iPVA) in dogs with PS. Results support an integrative approach to assessment of PS severity that includes less flow-dependent methods, particularly in states of altered flow or right ventricular function

Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting as Confusion, Dysphasia, and Myoclonus

Steroid response encephalopathy associated with autoimmune thyroiditis (SREAT), or Hashimoto's encephalopathy, is a rare disorder believed to be immune-mediated. It is most often characterized by a subacute onset of confusion with altered level of consciousness, seizures, and myoclonus. We describe the case of a 48-year-old gentleman who presented with confusion and dysphasia. Specific clinical features and laboratory results led to a diagnosis of Hashimoto's encephalopathy. This case highlights the core features of this condition and the potential for complete response to steroid therapy

Para uma tanatologia dos estádios Olímpicos

The sociology of sport has over a 30-year history of developing a deeper understanding of urban life by conceptualizing the ways in which sport, both as a dominant cultural form, and as the infrastructure that houses it, is connected to the construct of community and identity.  Olympic stadiums, for example, are projected as symbols of global urban status, focal points for local collective identity, and as verification of urban regeneration success –that is, in a sense, as the concrete embodiment of the Olympic Dream.              So what happens when an Olympic stadium is abandoned or destroyed?  What happens when an Olympic stadium dies?  The purpose of this essay is to provoke thought about the role and meaning of Olympic stadium death. We draw upon media studies, gerontological, and thanatological literature to explore how former Olympic stadiums are presented in global media reports.  Situated in the notion that cultural objects have a biography of a life span much as individuals do (Kopytoff, 1986), we ultimately call for a thanatology of sports stadiums

Spectropolarimetry of the H-alpha line in Herbig Ae/Be stars

Using the HiVIS spectropolarimeter built for the Haleakala 3.7m AEOS telescope, we have obtained a large number of high precision spectropolarimetrc observations (284) of Herbig AeBe stars collected over 53 nights totaling more than 300 hours of observing. Our sample of five HAeBe stars: AB Aurigae, MWC480, MWC120, MWC158 and HD58647, all show systematic variations in the linear polarization amplitude and direction as a function of time and wavelength near the H-alpha line. In all our stars, the H-alpha line profiles show evidence of an intervening disk or outflowing wind, evidenced by strong emission with an absorptive component. The linear polarization varies by 0.2% to 1.5% with the change typically centered in the absorptive part of the line profile. These observations are inconsistent with a simple disk-scattering model or a depolarization model which produce polarization changes centered on the emmissive core. We speculate that polarized absorption via optical pumping of the intervening gas may be the cause.Comment: Accepted for publication in ApJ Letter

Temperature dependence of instantons in QCD

We investigate the temperature dependence of the instanton contents of gluon fields, using unquenched lattice QCD and the cooling method. The instanton size parameter deduced from the correlation function decreases from 0.44fm below the phase-transition temperature $T_c$ ($\approx 150$MeV) to 0.33fm at 1.3 $T_c$. The instanton charge distribution is Poissonian above $T_c$, but it deviates from the convoluted Poisson at low temperature. The topological susceptibility decreases rapidly below $T_c$, showing the apparent restoration of the $U(1)_A$ symmetry already at $T \approx T_c$.Comment: 8 pages TEX, 3 Postscript figures available at http://www.krl.caltech.edu/preprints/MAP.htm

Four-Body Effects in Globular Cluster Black Hole Coalescence

In the high density cores of globular clusters, multibody interactions are expected to be common, with the result that black holes in binaries are hardened by interactions. It was shown by Sigurdsson & Hernquist (1993) and others that 10 solar mass black holes interacting exclusively by three-body encounters do not merge in the clusters themselves, because recoil kicks the binaries out of the clusters before the binaries are tight enough to merge. Here we consider a new mechanism, involving four-body encounters. Numerical simulations by a number of authors suggest that roughly 20-50% of binary-binary encounters will eject one star but leave behind a stable hierarchical triple. If the orbital plane of the inner binary is strongly tilted with respect to the orbital plane of the outer object, a secular Kozai resonance, first investigated in the context of asteroids in the Solar System, can increase the eccentricity of the inner body significantly. We show that in a substantial fraction of cases the eccentricity is driven to a high enough value that the inner binary will merge by gravitational radiation, without a strong accompanying kick. Thus the merged object remains in the cluster; depending on the binary fraction of black holes and the inclination distribution of newly-formed hierarchical triples, this mechanism may allow massive black holes to accumulate through successive mergers in the cores of globular clusters. It may also increase the likelihood that stellar-mass black holes in globular clusters will be detectable by their gravitational radiation.Comment: Submitted to ApJ Letters (includes emulateapj.sty