The CIA’s Past and Future

As the 100th birthday of Sherman Kent, the “father of Intelligence Analysis” approaches, Ex-Patt looks at the CIA and its direction

Altered resting-state network connectivity in stroke patients with and without apraxia of speech

Motor speech disorders, including apraxia of speech (AOS), account for over 50% of the communication disorders following stroke. Given its prevalence and impact, and the need to understand its neural mechanisms, we used resting state functional MRI to examine functional connectivity within a network of regions previously hypothesized as being associated with AOS (bilateral anterior insula (aINS), inferior frontal gyrus (IFG), and ventral premotor cortex (PM)) in a group of 32 left hemisphere stroke patients and 18 healthy, age-matched controls. Two expert clinicians rated severity of AOS, dysarthria and nonverbal oral apraxia of the patients. Fifteen individuals were categorized as AOS and 17 were AOS-absent. Comparison of connectivity in patients with and without AOS demonstrated that AOS patients had reduced connectivity between bilateral PM, and this reduction correlated with the severity of AOS impairment. In addition, AOS patients had negative connectivity between the left PM and right aINS and this effect decreased with increasing severity of non-verbal oral apraxia. These results highlight left PM involvement in AOS, begin to differentiate its neural mechanisms from those of other motor impairments following stroke, and help inform us of the neural mechanisms driving differences in speech motor planning and programming impairment following stroke

Why are probabilistic laws governing quantum mechanics and neurobiology?

We address the question: Why are dynamical laws governing in quantum mechanics and in neuroscience of probabilistic nature instead of being deterministic? We discuss some ideas showing that the probabilistic option offers advantages over the deterministic one.Comment: 40 pages, 8 fig

A proposal for a coordinated effort for the determination of brainwide neuroanatomical connectivity in model organisms at a mesoscopic scale

In this era of complete genomes, our knowledge of neuroanatomical circuitry remains surprisingly sparse. Such knowledge is however critical both for basic and clinical research into brain function. Here we advocate for a concerted effort to fill this gap, through systematic, experimental mapping of neural circuits at a mesoscopic scale of resolution suitable for comprehensive, brain-wide coverage, using injections of tracers or viral vectors. We detail the scientific and medical rationale and briefly review existing knowledge and experimental techniques. We define a set of desiderata, including brain-wide coverage; validated and extensible experimental techniques suitable for standardization and automation; centralized, open access data repository; compatibility with existing resources, and tractability with current informatics technology. We discuss a hypothetical but tractable plan for mouse, additional efforts for the macaque, and technique development for human. We estimate that the mouse connectivity project could be completed within five years with a comparatively modest budget.Comment: 41 page

Neighborhood variations in the use of hospital emergency rooms for primary care

The purpose of the paper is to analyze neighborhood variations in the use of emergency rooms (ERs) as settings for primary care within Oklahoma County, part of the Oklahoma City MSA. The location of patients taken from a sample of ER records in four large hospitals were aggregated to census tracts. Tract visition rates were estimated and related to the socio-economic character and the relative location of the tracts for two periods--'physicians' office hours' and 'non-office hours'. The results show that for the city as a whole primary care use in emergency rooms is associated with the socio-economic status and relative location of a residential area. Tracts with lower socio-economic status have higher rates of emergency rooms use for primary care than those of higher status. This relationship is true both during physicians' office hours as well as during the times their offices are closed. When visitation rates are analyzed separately for individual hospitals, location rather than neighborhood socio-economic characteristics is paramount. It was concluded that while primary care visits to emergency rooms are higher in lower socio-economic status neighborhoods, and that this is a function of the more accessible location of emergency rooms to these neighborhoods as well as to socio-economic effects on use.

The urban transition and the evolution of the medical care delivery system in America

This essay traces the evolution of the American urban medical care delivery system and examines the implications in terms of social and spatial variations in accessability to medical care. It is suggested that the foundations of the present medical care delivery system were laid during the urban transformation which took place in the latter part of the nineteenth century, when changes in the division of labor, specialization, the role of the family, urban transportation technology and attitudes to social protectionism interacted with changes in science, medical technology and professional organization to produce radical changes in both the settings used to provide medical care and their relative accessability to different sub-groups of the population. The medical care delivery system is thus interpreted largely as a product of the overall dynamic of urbanization rather than of scientific discovery, medical technology and the influence of key medical practitioners and professional organizations.