Interview with Sandy Maisel by Mike Hastings

Biographical NoteLouis Sandy Maisel was born on October 25, 1945, in Buffalo, New York. He attended Harvard, where he became involved with various campus and political organizations, and Columbia University, where he earned his Ph.D. in political science. In 1971 he settled in Maine, working on Bill Hathaway’s campaign for Senate, teaching at Colby College, and volunteering for Maine Democrats, including George Mitchell. In 1977, Maisel was the research director for the House Commission on Administrative Review. In 1978, he ran unsuccessfully in the congressional primary in Maine. At the time of this interview he was professor of government at Colby College and director of its Goldfarb Center for Public Affairs and Civic Engagement. SummaryInterview includes discussion of: family background and education and political upbringing; an anecdote about his father getting a telegram to have dinner with President Truman; Buffalo, New York; Harvard as compared to Yale and small liberal arts colleges like Colby; Louise Day Hicks; protests when Maisel was at Columbia in the late 1960s; his doctoral dissertation on housing policy in Congress; the political scene at Colby College; Waterville, Maine in 1971 and today; mill town politics in Waterville; working on Bill Hathaway’s campaign in 1972; George Heffernan; monitoring moving votes precinct by precinct; doing publicity for Max McCarthy in New York; organizing Colby students to volunteer for Mitchell; Mitchell and Joe Brennan; Mitchell’s 1974 campaign; Maisel’s 1978 run for Congress; the Obey Commission; Emery’s appeal in a general election; Maine politics; writing From Obscurity to Oblivion; politics in northern Maine versus southern Maine, and the congressional districts; Maisel’s view on the candidates in 2010 Maine state elections; campaign financing in Maine and the Clean Election law; the press’s impact in statewide politics; Mitchell’s joke about Colby and Bowdoin; Mitchell’s role in Middle East affairs; Mitchell and his brother “Swisher’; and Mitchell’s image at Colby

Plasma adrenomedullin is associated with short-term mortality and vasopressor requirement in patients admitted with sepsis

Introduction: The incidence of death among patients admitted for severe sepsis or septic shock is high. Adrenomedullin (ADM) plays a central role in initiating the hyperdynamic response during the early stages of sepsis. Pilot studies indicate an association of plasma ADM with the severity of the disease. In the present study we utilized a novel sandwich immunoassay of bioactive plasma ADM in patients hospitalized with sepsis in order to assess the clinical utility.Methods: We enrolled 101 consecutive patients admitted to the emergency department with suspected sepsis in this study. Sepsis was defined by fulfillment of at least two systemic inflammatory response syndrome (SIRS) criteria plus clinical suspicion of infection. Plasma samples for ADM measurement were obtained on admission and for the next four days. The 28-day mortality rate was recorded.Results: ADM at admission was associated with severity of disease (correlation with Acute Physiology and Chronic Health Evaluation II (APACHE II) score: r = 0.46; P <0.0001). ADM was also associated with 28-day mortality (ADM median (IQR): survivors: 50 (31 to 77) pg/mL; non-survivors: 84 (48 to 232) pg/mL; P <0.001) and was independent from and additive to APACHE II (P = 0.02). Cox regression analysis revealed an additive value of serial measurement of ADM over baseline assessment for prediction of 28-day mortality (P < 0.01). ADM was negatively correlated with mean arterial pressure (r = -0.39; P <0.0001), and it strongly discriminated those patients requiring vasopressor therapy from the others (ADM median (IQR): no vasopressors 48 (32 to 75) pg/mL; with vasopressors 129 (83 to 264) pg/mL, P <0.0001).Conclusions: In patients admitted with sepsis, severe sepsis or septic shock plasma ADM is strongly associated with severity of disease, vasopressor requirement and 28-day mortality

Thermomechanical response of NiTi shape-memory nanoprecipitates in TiV alloys

We study the properties of NiTi shape-memory nanoparticles coherently embedded in TiV matrices using three-dimensional atomistic simulations based on the modified embedded-atom method. To this end, we develop and present a suitable NiTiV potential for our simulations. Employing this potential, we identify the conditions under which the martensitic phase transformation of such a nanoparticle is triggered—specifically, how these conditions can be tuned by modifying the size of the particle, the composition of the surrounding matrix, or the temperature and strain state of the system. Using these insights, we establish how the transformation temperature of such particles can be influenced and discuss the practical implications in the context of shape-memory strengthened alloys

Short-Term Serial Sampling of Natriuretic Peptides in Patients Presenting With Chest Pain

ObjectivesThe purpose of this study was to characterize the diagnostic and prognostic utility of short-term dynamic changes in natriuretic peptides in patients presenting with chest pain.BackgroundAlthough single levels of natriuretic peptides in patients admitted for acute coronary syndromes (ACS) have important prognostic value, it is unclear whether serial sampling of natriuretic peptides might have both diagnostic and prognostic value in the setting of chest pain.MethodsWe followed 276 patients for 90 days who presented to the emergency department with chest pain. We sampled brain natriuretic peptide (BNP) and amino-terminal (NT)-proBNP up to 5 times within 24 h of presentation and again at discharge. Follow-up data was collected at 30 and 90 days after admission. Adverse events included emergency department visits for chest pain, cardiac readmission, and death. We assessed the prognostic and diagnostic value of baseline natriuretic peptide measurements with receiver-operating characteristic analyses.ResultsNatriuretic peptides were diagnostic for congestive heart failure (CHF) and new-onset CHF but less so for ACS. The prognostic utility of serial sampling was evaluated through testing the statistical contribution of each future time point (as well as variability over time) over and above the baseline values in logistic regression models.ConclusionsBaseline elevated BNP and NT-proBNP concentrations were predictive of adverse events at 30 and 90 days. Serial sampling did not improve the prognostic value of BNP or NT-proBNP

Practical approach on frail older patients attended for acute heart failure

Acute heart failure (AHF) is a multi-organ dysfunction syndrome. In addition to known cardiac dysfunction, non-cardiac comorbidity, frailty and disability are independent risk factors of mortality, morbidity, cognitive and functional decline, and risk of institutionalization. Frailty, a treatable and potential reversible syndrome very common in older patients with AHF, increases the risk of disability and other adverse health outcomes. This position paper highlights the need to identify frailty in order to improve prognosis, the risk-benefits of invasive diagnostic and therapeutic procedures, and the definition of older-person-centered and integrated care plans