National Electoral Winners and Losers: Satisfaction with Democracy Predicated on Institutional Context

How does being an electoral winner or loser shape a citizen’s satisfaction with democracy? More importantly, how does the voter’s institutional context moderate this relationship? In this paper, I demonstrate that the institutional context of a democracy interacts with a citizen’s national- level electoral loser status to moderate the relationship between the individual’s status as a loser and her satisfaction with democracy in her country. I also explore the way winning and losing at different levels of representation interact to formulate satisfaction with democracy. Using cross-sectional survey data from the Comparative Study of Electoral Systems nested in 75 different country-election year cases over the time period of 1996 to 2012, I find mixed evidence that electoral losers are more likely to be satisfied with democracy when their chosen party is more favored by the party vote/seat share discrepancy. Unlike losing voters, winning voters do not appear to be more or less likely to be satisfied based on the vote/seat discrepancy. I also find mixed support for the idea that winning at the national level produces greater satisfaction than winning at the district level

Narrative form and Mahler’s musical thinking

The close relationship between music and other art forms is a well-established feature of fin-de-siècle Vienna. Interdisciplinary study since the 1970s, of the relationship between literature and music, reflects among other things a recovery of nineteenth-century concerns. This article equates Mahler's development of symphonic form with a development of narrative form within his works, by linking three phases of his symphonic output with his literary interests. The first phase links the early symphonies with the early nineteenth-century author Jean Paul. His novel Titan provides the subtitle of Mahler's First Symphony, and correspondences can be discerned between the character of Albano, the hero of the novel, and Mahler at this stage of his career (1888). The opening of the Finale of the symphony shows narratological similarity to the opening of the final volume of the novel. The second phase links the middle-period instrumental symphonies with Dostoevsky, who became Mahler's greatest literary and moral hero. The Fifth, Sixth and Seventh Symphonies exhibit narrative structures different from those of the earlier symphonies; rather than ending with indivdualistic triumph, after the manner of Jean Paul, they pose the Dostoevskian question of whether some sort of redemption of their material is possible. The third phase links the late works with Mahler's contemporaries Robert Musil and Marcel Proust. In this context, the ending of Mahler's Ninth Symphony can be seen as a adaptation of musical narrativity analogous to the Modernist extension of the lengthy novels of these two authors

Breaking the Curve with CANDELS: A Bayesian Approach to Reveal the Non-Universality of the Dust-Attenuation Law at High Redshift

Dust attenuation affects nearly all observational aspects of galaxy evolution, yet very little is known about the form of the dust-attenuation law in the distant Universe. Here, we model the spectral energy distributions (SEDs) of galaxies at z = 1.5--3 from CANDELS with rest-frame UV to near-IR imaging under different assumptions about the dust law, and compare the amount of inferred attenuated light with the observed infrared (IR) luminosities. Some individual galaxies show strong Bayesian evidence in preference of one dust law over another, and this preference agrees with their observed location on the plane of infrared excess (IRX, $L_{\text{TIR}}/L_{\text{UV}}$) and UV slope ($\beta$). We generalize the shape of the dust law with an empirical model, $A_{\lambda,\delta}=E(B-V)\ k_\lambda\ (\lambda/\lambda_V)^\delta$ where $k_\lambda$ is the dust law of Calzetti et al. (2000), and show that there exists a correlation between the color excess ${E(B-V)}$ and tilt $\delta$ with ${\delta=(0.62\pm0.05)\log(E(B-V))}$+ ${(0.26~\pm~0.02)}$. Galaxies with high color excess have a shallower, starburst-like law, and those with low color excess have a steeper, SMC-like law. Surprisingly, the galaxies in our sample show no correlation between the shape of the dust law and stellar mass, star-formation rate, or $\beta$. The change in the dust law with color excess is consistent with a model where attenuation is caused by by scattering, a mixed star-dust geometry, and/or trends with stellar population age, metallicity, and dust grain size. This rest-frame UV-to-near-IR method shows potential to constrain the dust law at even higher ($z>3$) redshifts.Comment: 20 pages, 18 figures, resubmitted to Ap

CANDELS: The Contribution of the Observed Galaxy Population to Cosmic Reionization

We present measurements of the specific ultraviolet luminosity density from a sample of 483 galaxies at 6<z<8. These galaxies were selected from new deep near-infrared HST imaging from the CANDELS, HUDF09 and ERS programs. In contrast to the majority of previous analyses, which assume that the distribution of galaxy ultraviolet (UV) luminosities follows a Schechter distribution, and that the distribution continues to luminosities far below our observable limit, we investigate the contribution to reionization from galaxies which we can observe, free from these assumptions. We find that the observable population of galaxies can sustain a fully reionized IGM at z=6, if the average ionizing photon escape fraction (f_esc) is ~30%. A number of previous studies have measured UV luminosity densities at these redshifts that vary by 5X, with many concluding that galaxies could not complete reionization by z=6 unless a large population of galaxies fainter than the detection limit were invoked, or extremely high values of f_esc were present. The observed UV luminosity density from our observed galaxy samples at z=7-8 is not sufficient to maintain a fully reionized IGM unless f_esc>50%. Combining our observations with constraints on the emission rate of ionizing photons from Ly-alpha forest observations at z=6, we can constrain f_esc<34% (2-sigma) if the observed galaxies are the only contributors to reionization, or <13% (2-sigma) if the luminosity function extends to M_UV = -13. These escape fractions are sufficient to complete reionization by z=6. These constraints imply that the volume ionized fraction of the IGM becomes less than unity at z>7, consistent with a number of complementary reionization probes. If faint galaxies dominate reionization, future JWST observations will probe deep enough to see them, providing an indirect constraint on the ionizing photon escape fraction [abridged].Comment: 16 pages, 7 figures, Submitted to the Astrophysical Journa

Measuring the evolution of contemporary western popular music

Popular music is a key cultural expression that has captured listeners' attention for ages. Many of the structural regularities underlying musical discourse are yet to be discovered and, accordingly, their historical evolution remains formally unknown. Here we unveil a number of patterns and metrics characterizing the generic usage of primary musical facets such as pitch, timbre, and loudness in contemporary western popular music. Many of these patterns and metrics have been consistently stable for a period of more than fifty years, thus pointing towards a great degree of conventionalism. Nonetheless, we prove important changes or trends related to the restriction of pitch transitions, the homogenization of the timbral palette, and the growing loudness levels. This suggests that our perception of the new would be rooted on these changing characteristics. Hence, an old tune could perfectly sound novel and fashionable, provided that it consisted of common harmonic progressions, changed the instrumentation, and increased the average loudness.Comment: Supplementary materials not included. Please see the journal reference or contact the author

Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design

Abstract Background About half of people with glaucoma do not adhere to their recommended medications. Interventions for other chronic conditions have successfully utilized reminder systems and motivational interviewing (MI)-based counseling. This study was designed to pilot a personalized intervention that leverages these strategies to assess their impact on medication adherence in glaucoma patients. Methods Glaucoma patients taking ≥ 1 medication will be pre-screened by telephone survey for adherence to their medication(s). Those who self-report poor adherence will be enrolled in a 3-month monitoring period to measure medication adherence using electronic medication monitors. Participants who are non-adherent (take </=80% of their medication doses) over the 3-month run in phase will be eligible for the study. We plan to enroll 57 participants who are non-adherent to their medications. Participants’ adherence will then be continuously measured with electronic medication monitors, by self-report, and via pharmacy refill data over 2 years, during which two successively more resource-intensive components of an intervention aimed to improve medication adherence will be administered. The first component is a 3-month period of reminders (audio and/or visual) and text message or automated phone call if a dose of medication is not taken within a pre-specified time frame. The second component is a 6-month MI-based counseling program with a trained glaucoma counselor. This component uses the eyeGuide, a computer-based personalized behavior change program that enables para-professional staff to provide personalized education and counseling for glaucoma. The primary outcome is change in medication adherence. The secondary outcomes include changes in clinical outcomes (intraocular pressure, IOP, and IOP fluctuation) and psychosocial mediators of adherence (e.g., competence, energy for change and satisfaction). Participants will undergo semi-structured interviews at 12 months to give feedback about the counseling program in order to improve it. Discussion This pilot study will provide insight into ways to deliver more personalized health care to non-adherent glaucoma patients in order to better support them in managing their chronic disease. Trial registration Retrospectively registered with ClinicalTrials.gov ( NCT03159247 ).https://deepblue.lib.umich.edu/bitstream/2027.42/145182/1/40814_2018_Article_320.pd

Differences between Breast Conservation‐Eligible Patients and Unilateral Mastectomy Patients in Choosing Contralateral Prophylactic Mastectomies

There has been an increasing use of bilateral mastectomy (BM) for breast cancer. We sought to examine our trends among breast conservation (BCT) candidates and women recommended for unilateral mastectomy (UM). Our prospective breast cancer database was queried for women with a first‐time, unilateral breast cancer. Patient and histologic factors and surgical treatment, including reconstruction, were evaluated. A detailed chart review was performed among patients from two representative time periods as to the reasons the patient underwent mastectomy. We identified 3,892 women between 2000 and 2012 of whom 60% underwent BCT, 1092 (28%) had UM and 12% underwent BM. BM rose from 4% in 2000 to a high of 19% in 2011, increasing around 2002 for women <40. BCT was less likely with decreasing age (p < 0.0001), lobular histology (p < 0.0001), higher stage (p < 0.0001) and decreasing BMI (p < 0.0001). Among mastectomy patients, contralateral mastectomy was associated with decreasing age (p < 0.0001), Caucasian race (p < 0.0001), and lower stage (p = 0.005). Over time, indications for mastectomy decreased while patients deemed BCT‐eligible opting for UM or BM increased dramatically. Increases in the use of BM are in large part among women who were otherwise BCT‐eligible. Factors associated with BM use are different for BCT‐eligible patients and those recommended for UM. A better understanding of the factors driving individual patient choices is needed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135041/1/tbj12648_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135041/2/tbj12648.pd

Eye Care Providers' Attitudes Towards Tele-ophthalmology

Background: The rapid rise of e-health and remote care systems will likely change the practice patterns of ophthalmologists. Although telemedicine practices are thriving in many specialties of medicine, telemedicine for ophthalmology has been limited primarily to asynchronous care for diabetic retinopathy. The goal of this research was to evaluate perspectives on and familiarity with telemedicine among eye care providers at a large tertiary-care medical center via an anonymous, descriptive survey. Results: In total, 58 eye care physicians completed surveys (response rates of 86% for physicians-in-training and 49% for faculty physicians, respectively). Although a majority of both faculty and physicians-in-training were willing to participate in telemedicine services, trainees were more likely to be willing to interpret photographs than faculty (p=0.04). Most respondents (71%) indicated that they did not use telemedicine. Over half had received photographs (via phone or e-mail) for interpretation from referring physicians (54%) or patients (56%) within the past 3 months. A majority of providers (82%) would be willing to participate in telemedicine for consultations and for interpreting photographs, but a majority (59%) had low confidence in remote care for providing an opinion on patient care. Conclusions: Most eye care providers viewed telemedicine as part of the future of eye care but were concerned about the use of telemedicine. Although most providers did not practice telemedicine, over half of them were comfortable managing eye care consultations (including patients' photographs) via the Internet.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140282/1/tmj.2014.0115.pd

Renal insufficiency as a predictor of cardiovascular outcomes and mortality in elderly individuals

AbstractObjectivesThis study was designed to evaluate the relationship between elevated creatinine levels and cardiovascular events.BackgroundEnd-stage renal disease is associated with high cardiovascular morbidity and mortality. The association of mild to moderate renal insufficiency with cardiovascular outcomes remains unclear.MethodsWe analyzed data from the Cardiovascular Health Study, a prospective population-based study of subjects, aged >65 years, who had a serum creatinine measured at baseline (n = 5,808) and were followed for a median of 7.3 years. Proportional hazards models were used to examine the association of creatinine to all-cause mortality and incident cardiovascular mortality and morbidity. Renal insufficiency was defined as a creatinine level ≥1.5 mg/dl in men or ≥1.3 mg/dl in women.ResultsAn elevated creatinine level was present in 648 (11.2%) participants. Subjects with elevated creatinine had higher overall (76.7 vs. 29.5/1,000 years, p < 0.001) and cardiovascular (35.8 vs. 13.0/1,000 years, p < 0.001) mortality than those with normal creatinine levels. They were more likely to develop cardiovascular disease (54.0 vs. 31.8/1,000 years, p < 0.001), stroke (21.1 vs. 11.9/1,000 years, p < 0.001), congestive heart failure (38.7 vs. 17/1,000 years, p < 0.001), and symptomatic peripheral vascular disease (10.6 vs. 3.5/1,000 years, p < 0.001). After adjusting for cardiovascular risk factors and subclinical disease measures, elevated creatinine remained a significant predictor of all-cause and cardiovascular mortality, total cardiovascular disease (CVD), claudication, and congestive heart failure (CHF). A linear increase in risk was observed with increasing creatinine.ConclusionsElevated creatinine levels are common in older adults and are associated with increased risk of mortality, CVD, and CHF. The increased risk is apparent early in renal disease

SMART APPLIANCE SYSTEM

The invention describes a smart appliance system. The system receives instructions from a user over a network to control an appliance. The system then transmits these instructions to the appliance to control the appliance. The system causes the appliance to operate according to the transmitted instructions