Facing Up to Unpalatable Evidence for the Sake of Our Patients

Paul Mullen discusses Seena Fazel and colleagues' paper on the association between violent behavior and having been diagnosed with a schizophrenic disorder, and its implications for care of these individuals

Racial Disparities in Intravenous Recombinant Tissue Plasminogen Activator Use Persist at Primary Stroke Centers.

BACKGROUND: Primary stroke centers (PSCs) utilize more recombinant tissue plasminogen activator (rt-PA) than non-PSCs. The impact of PSCs on racial disparities in rt-PA use is unknown. METHODS AND RESULTS: We used data from the Nationwide Inpatient Sample from 2004 to 2010, limited to states that publicly reported hospital identity and race. Hospitals certified as PSCs by The Joint Commission were identified. Adults with a diagnosis of ischemic stroke were analyzed. Rt-PA use was defined by the International Classification of Diseases, 9th Revision procedure code 99.10. Discharges (304 152 patients) from 26 states met eligibility criteria, and of these 71.5% were white, 15.0% black, 7.9% Hispanic, and 5.6% other. Overall, 24.7% of white, 27.4% of black, 16.2% of Hispanic, and 29.8% of other patients presented to PSCs. A higher proportion received rt-PA at PSCs than non-PSCs in all race/ethnic groups (white 7.6% versus 2.6%, black 4.8% versus 2.0%, Hispanic 7.1% versus 2.4%, other 7.2% versus 2.5%, all P CONCLUSIONS: Racial disparities in intravenous rt-PA use were not reduced by presentation to PSCs. Black patients were less likely to receive thrombolytic treatment than white patients at both non-PSCs and PSCs. Hispanic patients were less likely to be seen at PSCs relative to white patients and were less likely to receive intravenous rt-PA in the fully adjusted model

Geometrical Defects in Josephson Junction Arrays

Dislocations and disclinations in a lattice of Josephson junctions will affect the dynamics of vortex excitations within the array. These defects effectively distort the space in which the excitations move and interact. The interaction energy between such defects and excitations are determined and vortex trajectories in twisted lattices are calculated. Finally, possible experiments observing these effects are presented.Comment: 26 pages including 5 figure

First Principles Analysis of Electron-Phonon Interaction in Graphene

The electron-phonon interaction in monolayer graphene is investigated by using density functional perturbation theory. The results indicate that the electron-phonon interaction strength is of comparable magnitude for all four in-plane phonon branches and must be considered simultaneously. Moreover, the calculated scattering rates suggest an acoustic phonon contribution that is much weaker than previously thought, revealing the role of optical phonons even at low energies. Accordingly it is predicted, in good agreement with a recent measurement, that the intrinsic mobility of graphene may be more than an order of magnitude larger than the high values reported in suspended samples.Comment: 12 pages, 4 figure

Deviations from the local field approximation in negative streamer heads

Negative streamer ionization fronts in nitrogen under normal conditions are investigated both in a particle model and in a fluid model in local field approximation. The parameter functions for the fluid model are derived from swarm experiments in the particle model. The front structure on the inner scale is investigated in a 1D setting, allowing reasonable run-time and memory consumption and high numerical accuracy without introducing super-particles. If the reduced electric field immediately before the front is >= 50kV/(cm bar), solutions of fluid and particle model agree very well. If the field increases up to 200kV/(cm bar), the solutions of particle and fluid model deviate, in particular, the ionization level behind the front becomes up to 60% higher in the particle model while the velocity is rather insensitive. Particle and fluid model deviate because electrons with high energies do not yet fully run away from the front, but are somewhat ahead. This leads to increasing ionization rates in the particle model at the very tip of the front. The energy overshoot of electrons in the leading edge of the front actually agrees quantitatively with the energy overshoot in the leading edge of an electron swarm or avalanche in the same electric field.Comment: The paper has 17 pages, including 15 figures and 3 table

Augmenter of liver regeneration enhances the success rate of fetal pancreas transplantation in rodents

Background. Treatment of fetal pancreas (FP) isografts with insulin- like growth factor-I greatly improves the rate of conversion to euglycemia in diabetic rats. Complete knowledge of other factors that may facilitate the engraftment and function of FP in vivo is still embryonic. Augmenter of liver regeneration (ALR) is a newly described polypeptide growth factor found in weanling rat livers. ALR has trophic effects on regenerating liver. We studied the effects of in situ administration of this agent on FP isografts in rats. Methods. Streptozotocin-diabetic Lewis rats (blood glucose >300 mg/dl) received 16 FP isografts transplanted intramuscularly. ALR was delivered from day 1 through day 14, in doses of 40 or 400 ng/kg/d. Animals were followed for 3 months with serial weights and blood glucose monitoring. These animals were compared with those treated with vehicle alone. Results. Of the group treated with ALR at 40 ng/kg/day for 14 days, 89% (eight of nine) were euglycemic (P=0.0003). Of the group treated with ALR at 400 ng/kg/day for 14 days, 88% (seven of eight) were euglycemic (P=0.0007). Of the group treated with vehicle alone, none of the six were euglycemic. Euglycemia is defined here as glucose<200 mg/dl for 3 days. Pathology of the intramuscular transplant site showed patches of islet tissue embedded in fat. These patches demonstrated insulin immunoreactivity. Conclusions. Diabetes was reversed in a significantly greater proportion of FP + ALR-treated recipients than those animals treated with vehicle alone. Local delivery of growth factors my be used as an adjunct to FP transplantation to improve the rate of success. This in situ model may be useful to further evaluate other soluble factors

Analysis of experimental shaft seal data for high-performance turbomachines, as for Space Shuttle main engines

High-pressure, high-temperature seal flow (leakage) data for nonrotating and rotating Raleigh-step and convergent-tapered-bore seals were characterized in terms of a normalized flow coefficient. The data for normalized Rayleigh-steip and nonrotating tapered-bore seals were in reasonable agreement with theory, but data for the rotating tapered-bore seals were not. The tapered-bore-seal operational clearances estimated from the flow data were significantly larger than calculated. Although clearances are influenced by wear from conical to cylindrical geometry and errors in clearance corrections, the problem was isolated to the shaft temperature - rotational speed clearance correction. The geometric changes support the use of some conical convergence in any seal. Under these conditions rotation reduced the normalized flow coefficiently by nearly 10 percent

An accurate effective action for `baby' to `adult' skyrmions

Starting with a Chern-Simons theory, we derive an effective action for interacting quantum Hall skyrmions that takes into account both large-distance physics and short-distance details as well. We numerically calculate the classical static skyrmion profile from this action and find excellent agreement with other, microscopic calculations over a wide range of skyrmion sizes including the experimentally relevant one. This implies that the essential physics of this regime might be captured by a continuum classical model rather than resorting to more microscopic approaches. We also show that the skyrmion energy closely follows the formula suggested earlier by Sondhi et al. for a broad parameter range of interest as well.Comment: 13 pages (Revtex) + 3 ps-figure

Development of light weight magnesium alloys for low temperature applications Annual progress report, Jun. 19, 1965 - Mar. 20, 1966

Lightweight magnesium alloys for cryogenic application