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IMPORTANCE: Ischemic stroke is associated with increased risk of dementia, but the association of stroke severity and recurrence with risk of impaired cognition is not well known. OBJECTIVE: To examine the risk of dementia after incident ischemic stroke and assess how it differed by stroke severity and recurrence. DESIGN, SETTING, AND PARTICIPANTS: The Atherosclerosis Risk in Communities (ARIC) study is an ongoing prospective cohort of 15 792 community-dwelling individuals from 4 US states (Mississippi, Maryland, Minnesota, and North Carolina). Among them, 15 379 participants free of stroke and dementia at baseline (1987 to 1989) were monitored through 2019. Data were analyzed from April to October 2021. Associations between dementia and time-varying ischemic stroke incidence, frequency, and severity were studied across an average of 4.4 visits over a median follow-up of 25.5 years with Cox proportional hazards models adjusted for sociodemographic characteristics, apolipoprotein E, and vascular risk factors. EXPOSURES: Incident and recurrent ischemic strokes were classified by expert review of hospital records, with severity defined by the National Institutes of Health Stroke Scale (NIHSS; minor, ≤5; mild, 6-10; moderate, 11-15; and severe, ≥16). MAIN OUTCOMES AND MEASURES: Dementia cases adjudicated through expert review of in-person evaluations, informant interviews, telephone assessments, hospitalization codes, and death certificates. In participants with stroke, dementia events in the first year after stroke were not counted. RESULTS: At baseline, the mean (SD) age of participants was 54.1 (5.8) years, and 8485 of 15 379 participants (55.2%) were women. A total of 4110 participants (26.7%) were Black and 11 269 (73.3%) were White. A total of 1378 ischemic strokes (1155 incident) and 2860 dementia cases were diagnosed 1 year or more after incident stroke in participants with stroke, or at any point after baseline in participants without stroke, were identified through December 31, 2019. NIHSS scores were available for 1184 of 1378 ischemic strokes (85.9%). Risk of dementia increased with both the number and severity of strokes. Compared with no stroke, risk of dementia by adjusted hazard ratio was 1.76 (95% CI, 1.49-2.00) for 1 minor to mild stroke, 3.47 (95% CI, 2.23-5.40) for 1 moderate to severe stroke, 3.48 (95% CI, 2.54-4.76) for 2 or more minor to mild strokes, and 6.68 (95% CI, 3.77-11.83) for 2 or more moderate to severe strokes. CONCLUSIONS AND RELEVANCE: In this study, risk of dementia significantly increased after ischemic stroke, independent of vascular risk factors. Results suggest a dose-response association of stroke severity and recurrence with risk of dementia.

Recent research demonstrates that personal mortality salience from annuity contemplation generates an avoidance response, reducing interest in purchasing annuities. However, theoretical models of mortality salience also predict an increased desire for investment in the future circumstances of surviving others (“symbolic immortality”), such as that provided by bequest provisions in an annuity contract. An experimental test confirms that those exposed to higher levels of personal mortality reminders exhibit a greater preference for an annuity paying lower income but with a bequest provision. Thus, the effects of mortality salience can drive annuity decisions, not only at the extensive margin (avoidance of any purchase), but also at the intensive margin (purchasing lower income by including a bequest provision).

This paper describes a new high-pressure, temperature-controlled isotropic cell used for evaluation of the thermal volume change mechanisms of saturated and unsaturated soils under isotropic stress states. Specifically, details of the experimental setup, instrumentation, thermo-mechanical calibration of the device, experimental procedures, and typical results are presented in this paper. The thermal isotropic cell includes suction control using the axis translation technique, saturation control/monitoring using a pore water pressure flow pump, cell pressure control using a high-pressure flow pump, and a stainless steel cell to permit application of isotropic net mean stresses up to 10 MPa. The cell fluid temperature is regulated by circulating heated water through a copper heating coil within the cell, and an internal circulating fan is used to promote homogenous temperature throughout the cell chamber. Non-contact proximity transducers are used to directly measure soil deformation in the radial and axial directions, permitting assessment of thermo-mechanical anisotropic strains during changes in mean effective stress or temperature while also avoiding the need to consider complex thermo-mechanical cell deformations. The high-pressure flow pump and thermal control system are designed to apply changes in net mean stress and temperature at slow rates to characterize the full soil compression and thermal volume change curves, respectively. Along with the thermo-mechanical calibration of the cell, the results from two tests on compacted silt specimen having different initial degrees of saturation are presented that show how the cell can be used to characterize changes in volume and degree of saturation during thermo-mechanical loading. Both normally consolidated soil specimens were contracted during heating, although the specimen with a lower degree of saturation showed slightly greater thermal volume change.

The authors show that silencing the porcine carbohydrate genes CMAHand GGTA1necessary to avoid antibody-mediated rejection in a pig-to-human model also reduces the xenogeneic consumption of human platelets by the porcine liver. Supplemental digital content is available in the text.

A variety of risk assessment questionnaires are used within the financial planning profession to assess client risk preferences. Evidence indicates that the average person overweighs losses relative to an arbitrary reference point. This paper evaluated risk assessment questions on how well they correlate with monetary loss aversion. Twenty-nine Western Texas residents between the ages of 27 and 56 participated in experimental research and filled out several risk assessment questionnaires. Two weeks later their levels of loss aversion were measured using monetary gain and loss scenarios. The individual risk assessment questions were placed into three categories: expected utility theory, prospect theory and self-assessment. Composite measures were created for within-group and between-group comparisons. Statistically significant correlations were found between monetary loss aversion and different composite measures. The results provide financial planners with a group of risk assessment questions that capture loss-averse preferences.

Chronic rhinosinusitis affected 12.5 of the general population in the United States, making it one of the most common causes for patients to seek medical care. Despite a lack of compelling evidence, antibiotics are the most frequently prescribed class of medications for the treatment of chronic sinusitis, demonstrating a deeply rooted belief that bacteria are in some way responsible for the disease.

AbstractFrom 2000–2005, growth in Hispanic homeownership in the United States outpaced other racial and ethnic groups. This corresponds with data from the Survey of Consumer Finances indicating that Hispanic renters experienced a dramatic upsurge in saving for homeownership—relative to renters of other racial and ethnic backgrounds—during the 1998,2001, and 2004 surveys. This relatively higher propensity to save for homeownership largely disappeared in the 2007 survey. Correspondingly, in the second half of the decade Hispanic homeownership fellfaster than did non-Hispanic homeownership. The “bubble” in Hispanic renter homeownership plans corresponded with relative housing price appreciation trends in states with large Hispanic populations such as California and Florida. This suggests that the move to saving for homeownership among Hispanic households may have been primarily a regional economic trend, rather than an ethnic one.

Ultra-thin-film 5 nm Rh/TiOxand Rh/GaN catalytic metal−semiconductor Schottky nanodiodes were fabricated using dc magnetron reactive sputtering, rapid thermal annealing, and electron beam evaporation. The diode barrier heights were characterized in different gas mixtures using current−voltage measurements. Barrier heights were found to vary with the local gas composition for Rh/TiOxnanodiodes but did not vary with gas composition for Rh/GaN nanodiodes. The nanodiodes were also studied during the oxidation of CO by O2and during the oxidation of CO by NO using chemicurrent measurements and gas chromatography. The hot electron chemicurrent was determined from the current in situ during reaction and the thermoelectric current measured in oxidizing conditions. Similar activation energies were measured from both the chemicurrent and gas chromatography, which indicates a correlation between hot electron chemicurrent and catalytic activity.

AbstractThe academic community has not extensively researched residential satisfaction of military households possibly because of the uniformity of housing options offered within a military base environment. The recent passage of the Military Housing Privatization Initiative (MHPI) is the latest in a series of Congressional initiatives to improve housing options for the U.S. armed forces. Improvements in job performance and enlistment retention are listed as potential positive spillover effects. With the passage of MHPI, families of soldiers, particularly junior officers, experience more freedom in gaining access to market rental housing. This research examines the resultsfrom a widespread survey administered by one of the military branches. The overall survey results indicate that military personnel living in privatized housing communities did not have a higher overall satisfaction compared to those living in non-privatized housing. An analysis of military households reactions toward residential environment characteristics showed that these households differ somewhat from traditional households. One characteristic, quality of property management staff, was found to be a significant driver of residential satisfaction among military families, consistent with previous findings in other renter populations. The paper concludes with possible reasons for these differences in terms of drivers of residential satisfaction.

AbstractThe solution to the exploration-exploitation dilemma presented essentially subsumes exploitation into an information-maximizing model. Such a single-maximization model is shown to be (1) more tractable than the initial dual-maximization dilemma, (2) useful in modeling information-maximizing subsystems, and (3) profitably applied in artificial simulations where exploration is costless. However, the model fails to resolve the dilemma in ethological or practical circumstances with objective outcomes, such as inclusive fitness, rather than information outcomes, such as lack of surprise.

AbstractThis article examined how bathrooms (and half-bathrooms) were associated with the self reported satisfaction of residents in comparison to bedrooms, other rooms, overall size, and the presence of such amenities as a dishwasher, disposal, fireplace, balcony/patio, and garage. Cross-tabulations, ordinary least squares, and cumulative logit analyses of data from the 2005 American Housing Survey demonstrated a particularly strong positive relationship between residential satisfaction and the number of bathrooms, greater than for any other housing characteristic measured. A “before and after” longitudinal analysis of homes with remodeling occurring between 1997 and 2005 also revealed a significant positive impact of bathroom additions on the satisfaction of residents. These results appear consistent with housing theoiy suggesting that privacy and control are major components of residential satisfaction.

AbstractAchieving renter satisfaction is critical for residential property managers who desire to reduce the costs of high turnover. While previous research on renter satisfaction has focused on the use of multiple-choice surveys, this study analyzed the text of 464,280 open-ended comments posted from January 1, 2000, to January 1, 2007, on ApartmentRatings.com©, the nation’s largest apartment ratings Web site. Cross-tabulation and ordered logistic analysis of a word frequency coding scheme indicated that several of the most important issues related to residential satisfaction fell into the categories of safety and sanitation. While safety has long been recognized as a critical component of residential satisfaction, issues of sanitation appear uniquely salient for residents of rented apartment housing. The implication for property managers is that a focus on the core issues revealed in this analysis of resident comments may help to achieve greater resident satisfaction and, thereby, reduce resident turnover.

AbstractThis article presented an original economic model of the apartment rental market where service expenditures are invisible to prospective residents (but highly important to current residents), while recruiting expenditures are highly visible to prospective residents (but often inconsequential to current residents). In a competitive market, the model predicts that managers will necessarily favor observable recruiting expenditures, even though such an approach generates greater resident dissatisfaction and turnover, while simultaneously increasing operational costs for the industry as a whole. Evidence drawn from both the 2005 American Housing Survey and the operational expenses of 705,178 unsubsidized apartment units in 71 metropolitan areas appeared consistent with the model. Consumer advocacy and legislative approaches to addressing the issue of asymmetric information among prospective residents were discussed, including a proposal of tax incentives for long-term residency.

In the 1980, 1990, and 2000 censuses, Hispanic households had the lowest rate of homeownership of any major ethnic group. Since 2000, however, growth in Hispanic homeownership has outpaced that of other groups. This article uses a four-stage transitional framework to examine Hispanic home-ownership progression: renting without plans to buy; renting with plans to buy, but not actively saving; renting while saving for a home; and owning a home.Data from the Survey of Consumer Finances indicate that, after we control for other demographic factors, Hispanic renters are much more likely to be actively saving to buy a home than either non-Hispanic white or non-Hispanic black renters. However, Hispanic households are less likely to move from the saving to the owning stage. We find evidence of three explanations for this phenomenon: informational barriers to credit, purchase of foreign homes, and recent entry into the saving stage.

AbstractResearch and popular discussion in the last decade have led to a growing understanding of the importance of social capital for efficient societal functioning. This article considered the relationship of spatial connectedness in the built environment to social connectedness. Using charitable giving as a measure of pro-social behavior, an examination of 15,535 households participating in the Consumer Expenditure Survey revealed an inverse U-shaped relationship between proximity measures and social connectedness. Tobit and double-hurdle analyses showed charitable giving levels and participation initially rising as the number of units per structure rises and then falling for higher density levels. Separately, a probit analysis indicated a positive association between charitable giving participation and the presence of one shared wall, as well as a smaller, but still positive, association with multiple shared walls. Social connectedness appeared to be most strongly encouraged in the “ sweet spot “ between the physical isolation of detached single-family homes and the overcrowding of very large, high-density apartment buildings.

Optical fibers with tiny air holes running along their length have recently aroused great excitement due to their unusual optical properties and their potential for device design. The article describes the new fiber waveguide forms enabled by this technology.

We have studied the volume, protein concentration, total protein, and chymotrypsin and trypsin outputs in pure pancreatic juice (PPJ) following endoscopic cannulation of the pancreatic duct in 11 male and 2 female patients with advanced alcoholic cirrhosis (AC). Results were compared to those obtained from 21 nonalcoholic volunteers (NAV) and 26 chronic alcoholic (CA) patients without cirrhosis. Intravenous stimulation with secretin followed 10 min later by intravenous cholecystokinin-pancreozymin (CCK-PZ) resulted in highly significant increases in volumes during both phases of pancreatic stimulation in AC compared to NAV and CA. Protein concentration and total output during secretin stimulation was not different among the three groups. During CCK-PZ stimulation, CA exhibited a significant elevation in protein concentration and total output compared to NAV and AC. Although total chymotrypsin output was lower in secretin-stimulated CA than other groups, no other differences between the groups were observed in either of the hormone-stimulation phases. Marked elevations in trypsin output were observed in secretin-stimulated AC and in CCK-PZ-stimulated AC and CA. The high PPJ volume and the relatively low protein concentration observed in AC may effect a washout phenomenon resulting in a decreased tendency for ductal protein precipitation in these patients.

Presents the short story 'Peggy Hagerman's Bikini.'

The interpretation to be placed on the numerous instances of reinfection in syphilis that have been recorded in the literature since the introduction of modern spirocheticidal therapy becomes of great practical importance to all syphilologists.The fact that so few cases of reinfection had been recorded during the centuries through which the disease has been recognized and treated made many of the older syphilographers doubt its occurrence. Interest, therefore, in this subject, prior to the introduction of modern laboratory methods of diagnosis and to the advent of the arsphenamins in treatment, was largely theoretical.Lipschutz, 1 in 1917, was able to compile 357 cases of reinfection recorded in the literature, the majority of which, however, were reported before our modern methods of therapy, and many of them are quite questionable because of essential points lacking in the case narratives.Among those who have reported cases recently are White, 2 Lesser,

The conditions diagnosed in a study of 485 cases showing lesions of the genitalia clinically suspicious of venereal disease are presented in Table 1.This series constitutes all the material of this type seen in the skin and syphilis clinic of the outpatient department of Lakeside Hospital and in private practice by me and my associate, Dr. Harold N. Cole, from Aug. 1, 1920, to Feb. 1, 1922, a period of eighteen months. The methods employed in coming to a final diagnosis will be briefly outlined.HISTORYThe history of the case is often helpful, if accurate data can be obtained. In chancroid, the incubation period is short, as a rule less than ten days; while in syphilis the incubation period is usually from ten days to six weeks. We have found the history to be the least reliable of all clinical aids, and it should not be the sole

A few years ago the terms "American doctor" and " Philadelphia doctor" were current in Europe as synonyms for incompetency. This fact was most disagreeably impressed on my mind when as United States consul at Aix-la-Chapelle I was asked to testify in a case before the German courts touching the value of a Buchanan diploma.The circumstances connected with this German trial were vividly recalled last month by one who seemed anxious to equal the record of Buchanan in selling medical degrees to all comers.A young pharmacist who had never studied at a medical school asked me if I thought a medical degree from the Wisconsin Eclectic Medical College worth $35. In response to my questions, he submitted certain letters, the first from the president of the institution which offered the diploma (see Journal, Vol. xxvi, p. 838), the second, which we herewith give, from the Secretary of State of

This timely challenge to editors and publishers was presented as an address before the recent AASDJ and AATJ convention in Columbus, Ohio. Mr. Wiggins is a former editor of the St. Paul Pioneer Press and St. Paul Dispatch.