Myopic Voters and Natural Disaster Policy

Do voters effectively hold elected officials accountable for policy decisions? Using data on natural disasters, government spending, and election returns, we show that voters reward the incumbent presidential party for delivering disaster relief spending, but not for investing in disaster preparedness spending. These inconsistencies distort the incentives of public officials, leading the government to underinvest in disaster preparedness, thereby causing substantial public welfare losses. We estimate that $1 spent on preparedness is worth about$15 in terms of the future damage it mitigates. By estimating both the determinants of policy decisions and the consequences of those policies, we provide more complete evidence about citizen competence and government accountabilit

Meteoroid Fragmentation as Revealed in Head- and Trail-Echoes Observed with the Arecibo UHF and VHF Radars

We report recent 46.8/430 MHz (VHF/UHF) radar meteor observations at Arecibo Observatory (AO) that reveal many previously unreported features in the radar meteor return - including flare-trails at both UHF and VHF - that are consistent with meteoroid fragmentation. Signature features of fragmentation include strong intra-pulse and pulse-to-pulse fading as the result of interference between or among multiple meteor head-echo returns and between head-echo and impulsive flare or "point" trail-echoes. That strong interference fading occurs implies that these scatterers exhibit well defined phase centers and are thus small compared with the wavelength. These results are consistent with and offer advances beyond a long history of optical and radar meteoroid fragmentation studies. Further, at AO, fragmenting and flare events are found to be a large fraction of the total events even though these meteoroids are likely the smallest observed by the major radars. Fragmentation is found to be a major though not dominate component of the meteors observed at other HPLA radars that are sensitive to larger meteoroids

Principles of Quantitative Fluid and Cation Replacement in Extreme Hyperglycemia

Hyperglycemia may cause profound deficits of water, sodium and potassium through osmotic diuresis, which continues during treatment as long as there is glucosuria. Replacement fluids should cover both the deficits at presentation and the ongoing losses during treatment. At presentation with hyperglycemia, quantitative estimates of the deficits in water, sodium and potassium are based on rapid body weight changes, which indicate changes in body water, and on the serum sodium concentration corrected to a normal serum glucose level. The corrected serum sodium concentration provides a measure of the water deficit relative to the cation deficit (sodium, plus potassium) that is useful in guiding the choice of monovalent cation concentration in the initial replacement fluids. Monitoring clinical status, serum chemistries (glucose, sodium, potassium, total carbon dioxide), urine flow rate, and urine chemistries (sodium and potassium) during the course of fluid and cation replacement therapy is critical. This monitoring guides the volume and composition of replacement solutions for deficits developing during treatment and the management of potassium balance and acid-base abnormalities, including metabolic acidosis, respiratory acidosis, rarely, and others

Principles of Management of Severe Hyponatremia

Hyponatremia represents a serious health hazard.1 Hospitalized patients,2 nursing home residents,3 women,4,5 and children6 exhibit high frequency and/or severity of hyponatremia. Hyponatremia developing during the course of other morbid conditions increases their severity.7–10 Estimates of direct costs for treating hyponatremia in the United States ranged between $1.61 and$3.6 billion.11 Clinical manifestations of hyponatremia are universal12,13 and range from subtle (disturbances of balance, problems in cognition detected only during specific testing) to life-threatening manifestations of increased intracranial pressure with life-threatening hypoxia14–16 and noncardiac pulmonary edema.17 Although the treating physicians must make an accurate diagnosis based on well-established and described clinical criteria,1 treatment is also guided by the severity of these manifestations. The magnitude and rate of increase in serum sodium concentration ([Na]) during treatment are critical. Overcorrection of chronic hyponatremia may lead to osmotic myelinolysis,18–21 whereas undercorrection may fail to prevent life-threatening manifestations.1,2

Kompleksi fibronektinskih fragmenata i imunoglobulina G u gingivalnoj tečnosti osoba obolelih od parodontopatije

Introduction Fibronectin (FN) can interact with immunoglobulin G (IgG) molecules affecting the process of physiological elimination and causing abnormal deposition of immune complexes. The aim of the study was to analyze interaction between FN fragments and IgG molecules with different glycosylation profiles in gingival crevicular fluid (GCF) of patients with periodontal disease and healthy controls. Material and Methods The study included 30 patients with moderate and advanced periodontitis and 22 healthy subjects. IgG and FN content in GCF were measured as well as the presence of FN and galactose expression on IgG molecules. Results IgG content in GCF was five times higher in patients with moderate (p lt 0.01) and eight time higher in patients with advanced periodontitis (p lt 0.001) compared to healthy subjects. Also, hypogalactosylated forms of IgG were found in higher concentration in GCF of patients with advanced periodontitis compared to moderate periodontitis and healthy subjects (p lt 0.05). FN fragments of molecular mass 48 - 53 kDa were the most commonly found fragments in all three groups. Furthermore, in patients with advanced periodontitis, fibronectin fragments were attached to IgG molecules. Conclusion IgG and FN fragments form complexes in GCF in patients with periodontal disease and healthy subjects.Uvod Fibronektin može da interreaguje s molekulima imunoglobulina G (IgG) i utiče na normalan klirens ili poremećeno deponovanje imunskih kompleksa. Cilj ovog rada je bio da se ispita veza između fibronektina i IgG različitih glikoformi u gingivalnoj tečnosti osoba obolelih od parodontopatije i parodontalno zdravih ispitanika. Materijal i metode rada U studiju je uključeno 30 pacijenata s umerenom i uznapredovalom parodontopatijom i 22 parodontalno zdrave osobe. U gingivalnoj tečnosti određivan je sadržaj IgG i fibronektina dot blot i imunoblot tehnikama. IgG iz gingivalnih tečnosti su afinitetno izolovani i analizirani na prisustvo fibronektina i ekspresiju galaktoze. Rezultati Sadržaj IgG u gingivalnoj tečnosti osoba s umerenom parodontopatijom bio je oko pet puta veći u odnosu na sadržaj IgG kod zdravih osoba (p lt 0,01), dok je kod uznapredovalih oblika bio oko osam puta veći (p lt 0,001). Takođe, hipogalaktozilovane forme IgG su većoj meri postojale kod osoba sa uznapredovalom parodontopatijom u odnosu na zdrave i osobe s umerenom parodontopatijom (p lt 0,05). U sve tri analizirane grupe dominirali su fibronektinski fragmenti od 48 do 53 kDa. Uočeno je da su IgG izolovani iz gingivalne tečnosti vezani za fragmente fibronektina, pri čemu su IgG osoba sa uznapredovalom parodontopatijom, imali najveću količinu ovih vezanih fragmenata. Zaključak Dobijeni rezultati pokazuju da IgG gingivalne tečnosti zdravih i osoba s parodontopatijom formiraju komplekse sa fibronektinom

Reduction of Na/K-ATPase potentiates marinobufagenin-induced cardiac dysfunction and myocyte apoptosis

Background: Na/K-ATPase decrease has been reported in patients with heart failure and is related to cardiac dysfunction. Results: Reducing Na/K-ATPase activates caspase 9 and induces cardiac dilation when treated with marinobufagenin. Conclusion: Reduction of Na/K-ATPase potentiates marinobufagenin-induced cardiac myocyte apoptosis. Significance: Decreased Na/K-ATPase content together with increased cardiotonic steroids levels is a novel mechanism that may account for cardiac dysfunction

Protein Carbonylation of an Amino Acid Residue of the Na/K‐ATPase α1 Subunit Determines Na/K‐ATPase Signaling and Sodium Transport in Renal Proximal Tubular Cells

Background We have demonstrated that cardiotonic steroids, such as ouabain, signaling through the Na/K‐ATPase, regulate sodium reabsorption in the renal proximal tubule. By direct carbonylation modification of the Pro222 residue in the actuator (A) domain of pig Na/K‐ATPase α1 subunit, reactive oxygen species are required for ouabain‐stimulated Na/K‐ATPase/c‐Src signaling and subsequent regulation of active transepithelial 22Na+ transport. In the present study we sought to determine the functional role of Pro222 carbonylation in Na/K‐ATPase signaling and sodium handling. Methods and Results Stable pig α1 knockdown LLC‐PK1‐originated PY‐17 cells were rescued by expressing wild‐type rat α1 and rat α1 with a single mutation of Pro224 (corresponding to pig Pro222) to Ala. This mutation does not affect ouabain‐induced inhibition of Na/K‐ATPase activity, but abolishes the effects of ouabain on Na/K‐ATPase/c‐Src signaling, protein carbonylation, Na/K‐ATPase endocytosis, and active transepithelial 22Na+ transport. Conclusions Direct carbonylation modification of Pro224 in the rat α1 subunit determines ouabain‐mediated Na/K‐ATPase signal transduction and subsequent regulation of renal proximal tubule sodium transport

Expanding usability analysis with intrinsic motivation concepts to learn about CDSS adoption: a case study

Objectives Despite many clinical decision support systems (CDSSs) being rated as highly usable, CDSSs have not been widely adopted in clinical practice. We posit that there are factors aside from usability that impact adoption of CDSSs; in particular we are interested in the role played by MDs intrinsic motivation to use computer-based support. Our research aim is to investigate the relationship between usability and intrinsic motivation in order to learn about adoption of CDSS in clinical practice. Methods Following the evaluation of a CDSS, 19 MDs completed a 2 part questionnaire about their intrinsic motivation to use computer-based support in general and the usability of the evaluated CDSS. Results The analysis of MDs motivation to use computer-based support demonstrated that MDs are comfortable using computer-based support and in general find using it quite easy (a motivation rating of 0.66 on a (0, 1) scale was computed). However MDs also reported a perceived lack of competence associated with a lack of prior experience using technology in practice, which results in pressure and tension. The considered CDSS scored highly on all usability dimensions and a usability rating of 0.74 was recorded. The examination of the relationship between motivation and usability suggested that users who were motivated to use computer-based support experienced better usability than those who reported low levels of motivation. Conclusions Our small case study suggests that an important factor supplementing the usability of CDSSs is intrinsic motivation to use computer-based support in general. We posit that the lack of such a measure thus far in CDSS evaluation may to some extent explain seeming MD satisfaction with CDSSs on one hand, but their limited adoption on the other. We recommend that clinical managers responsible for deploying CDSS should invest in training MDs to use technology underlying computer-based support applications instead of focusing only on the features of the specific CDSS to be deployed

Adolescent-led marriage in Somaliland and Puntland: A surprising interaction of agency and social norms.

INTRODUCTION: Child marriage, formal and informal unions when one or both spouses are under 18, disproportionately affects adolescent girls over boys. It has serious consequences for girls' health, wellbeing, and development. Little is known about the ways in which girls' agency and contextual social norms - unwritten rules of (un)acceptable behaviour in a group - intersect to affect child marriage practices. This paper investigates norms and agency as facilitators and obstacles to adolescent girls' marriage in Somaliland and Puntland. METHODS: Participants (n = 156) were men and women living in Somaliland and Puntland. We conducted 36 qualitative semi-structured individual interviews (12 men and 24 women). We also held 15 focus group discussions (8 in Somaliland and 7 in Puntland) with 6-10 people each (n = 120). Mixed focus groups were conducted with men and women together, and were segregated by age. RESULTS: Technology and economic deprivation were important contextual factors in explaining the prevalence of child marriage. Participants reported that adolescent girls' and boys' increased agency contributed to, rather than decreased, child marriage. Access to technology expanded adolescents' freedom from their parents' control. Adolescents used that freedom within the existing system of social norms that rewarded early (as opposed to later) marriage. CONCLUSIONS: Effective interventions that aim to reduce marriage among adolescents living in Somalia (where marriage can be a protective strategy) should integrate a social norms perspective to avoid increasing adolescent-led marriage