Oversight of science and technology policy : joint hearing before the Subcommittee on Science, Technology, and Space of the Senate Committee on Commerce, Science, and Transportation and the Subcommittee on Science, Research, and Technology of the House Committee on Science and Technology ... February 14, 1978

"Serial no. 95-77."

Review of the magnetic fusion program of the Department of Energy : hearing before the Subcommittee on Fossil and Nuclear Energy Research, Development and Demonstration of the Committee on Science and Technology, U.S. House of Representatives, Ninety-fifth Congress, second session, September 18, 1978.

"No. 86."

MHD program review : hearings before the Subcommittee on Fossil and Nuclear Energy Research, Development and Demonstration of the Committee on Science and Technology, U.S. House of Representatives, Ninety-fifth Congress, second session, May 2, 4, August 3, 1978.

"No. 76."

Outcomes after stroke: Basic and instrumental activities of daily living, community reintegration and generic health status

This study describes the discharge destination, basic and instrumental activities of daily living (ADL), community reintegration and generic health status of people after stroke, and explored whether sociodemographic and clinical characteristics were associated with these outcomes. Participants were 51 people, with an initial stroke, admitted to an acute hospital and discharged to the community. Admission and discharge data were obtained by chart review. Follow-up status was determined by telephone interview using the Modified Barthel Index, the Assessment of Living Skills and Resources, the Reintegration to Normal Living Index, and the Short-Form Health Survey (SF-36). At follow up, 57% of participants were independent in basic ADL, 84% had a low risk of experiencing instrumental ADL difficulties, most had few concerns with community reintegration, and SF-36 physical functioning and vitality scores were lower than normative values. At follow up, poorer discharge basic ADL status was associated with poorer instrumental ADL and community reintegration status, and older participants had poorer instrumental ADL, community reintegration and physical functioning. Occupational therapists need to consider these outcomes when planning inpatient and post-discharge intervention for people after stroke.

Carbohydrate supplementation and alterations in neutrophils, and plasma cortisol and myoglobin concentration after intense exercise

The present study examined the effect of carbohydrate supplementation on changes in neutrophil counts, and the plasma concentrations of cortisol and myoglobin after intense exercise. Eight well-trained male runners ran on a treadmill for 1 h at 85% maximal oxygen uptake on two separate occasions. In a double-blind cross-over design, subjects consumed either 750 ml of a 10% carbohydrate (CHO) drink or a placebo drink on each occasion. The order of the trials was counterbalanced. Blood was drawn immediately before and after exercise, and I h after exercise. Immediately after exercise, neutrophil counts (CHO, 49%; placebo, 65%; P < 0.05), plasma concentrations of glucose (CHO, 43%; P

Short-term changes in ocular biometry and refraction after discontinuation of long-term orthokeratology

OBJECTIVE: To assess refractive and biometric changes 1 week after discontinuation of lens wear in subjects who had been wearing orthokeratology (OK) contact lenses for 2 years. METHODS: Twenty-nine subjects aged 6 to 12 years and with myopia of -0.75 to -4.00 diopters (D) and astigmatism of ≤1.00 D participated in the study. Measurements of axial length and anterior chamber depth (Zeiss IOLMaster), corneal power and shape, and cycloplegic refraction were taken 1 week after discontinuation and compared with those at baseline and after 24 months of lens wear. RESULTS: A hyperopic shift was found at 24 months relative to baseline in spherical equivalent refractive error (+1.86±1.01 D), followed by a myopic shift at 1 week relative to 24 months (-1.93±0.92 D) (both P<0.001). Longer axial lengths were found at 24 months and 1 week in comparison to baseline (0.47±0.18 and 0.51±0.18 mm, respectively) (both P<0.001). The increase in axial length at 1 week relative to 24 months was statistically significant (0.04±0.06 mm; P=0.006). Anterior chamber depth did not change significantly over time (P=0.31). Significant differences were found between 24 months and 1 week relative to baseline and between 1-week and 24-month visits in mean corneal power (-1.68±0.80, -0.44±0.32, and 1.23±0.70 D, respectively) (all P≤0.001). Refractive change at 1 week in comparison to 24 months strongly correlated with changes in corneal power (r=-0.88; P<0.001) but not with axial length changes (r=-0.09; P=0.66). Corneal shape changed significantly between the baseline and 1-week visits (0.15±0.10 D; P<0.001). Corneal shape changed from a prolate to a more oblate corneal shape at the 24-month and 1-week visits in comparison to baseline (both P≤0.02) but did not change significantly between 24 months and 1 week (P=0.06). CONCLUSIONS: The effects of long-term OK on ocular biometry and refraction are still present after 1-week discontinuation of lens wear. Refractive change after discontinuation of long-term OK is primarily attributed to the recovery of corneal shape and not to an increase in the axial length.

A Miles és Snow-féle stratégiatipológia kutatási kérdései (Research issues of Miles and Snow strategic typology)

Jelen dolgozat a Miles és Snow (1978) által kidolgozott stratégiai tipológiával kapcsolatos legjelentősebb kutatások megállapításait igyekszik összefoglalni. A szerző az elmúlt három évtized Miles és Snow-i kutatásaiban leginkább érintett területek alapján osztályozza a feldolgozott cikkeket, majd részletesen ismerteti a Kutató, Elemző, Védekező és Reagáló stratégiát követő vállalatokra vonatkozó marketing- és teljesítményimplikációkat. A vizsgálatok korlátainak és hiányosságainak feltárását követően a Miles és Snow-i stratégiai típusok aktuális elméleti, kutatás-módszertani és gyakorlati kihívásainak, valamint alulkutatott aspektusainak bemutatásával a cikk útmutatást kínál a stratégiai menedzsment leendő kutatóinak is. / === / The present paper strives to summarize the findings of the most important and outstanding researches concerning the strategic typology developed by Miles and Snow (1978). The present author classifies the reviewed articles of the past three decades according their mostly covered research areas, then exposes in detail the marketing and performance implications of the Prospector, Analyzer, Defender and Reactor strategic types pursued by the firms. After the exploration of the limitations and deficiencies of the past empirical investigations, by the demonstration of the actual conceptual, methodological and practical challenges as well as the underresearched aspects of strategic types of Miles and Snow, the artricle also offers fruitful guidelines to future researchers of strategic.

Diadenosine polyphosphates after laser in situ keratomileusis and photorefractive keratectomy refractive techniques

Purpose:  To study the concentrations of diadenosine polyphosphates in the ocular surface after PRK and LASIK. Methods:  Sixty-one patients (30 males and 31 females) with ages ranging from 20 to 63 (34.04 ± 9.13 years) were recruited in Balear Institute of Ophthalmology, Palma de Mallorca, Spain. LASIK was performed in 92 eyes of 46 patients and PRK in 25 eyes of 15 patients. Variations in the levels of diadenosine polyphosphate (Ap4A and Ap5A), Schirmer I (Jones test), TBUT, corneal staining together with the Dry Eye Questionnaire to evaluate discomfort and dryness were studied. All tests were performed at the preoperative visit and at 1-day, 2-week, 1-month and 3-month postoperative visits. Results:  Ap4A showed a 5 and 3.5 fold increase at the 1-day visit for LASIK and PRK, respectively. LASIK patients continued having higher statistically significant concentrations (p = 0.01) all over the follow-up. Ap5A showed no significant differences at any visit. Tear volume decreased during the 3 months in LASIK. The PRK cases had a normal volume at 1 month. TBUT in LASIK increased at the 1-day visit (p = 0,002) and decreased from the 2 weeks onwards and for the PRK, decreased by a 35% at the 1-day visit and kept reduced for a month. Discomfort only increased at the 1-day visit (p = 0.007). Dryness frequency was similar in all visits. Conclusions:  Ap4A levels only are increased in refractive surgery patients during the first day after the surgery. This increasing suggests that Ap4A may help accelerating the healing process.

Annotated record and chemical analyses of a polygenetic manganese nodule (slab) from the Scott Plateau, Indian Ocean (core VA-16-13KD)

A large manganese nodule (manganese slab) was dredged from 2100 m on the Scott Plateau by R.V. Valdivia in 1977. It is an irregular ellipsoid, with a maximum dimension of 28 cm, parallel to the sea floor. Chemical analyses show that Mn and Fe proportions are comparable, and total Ni + Cu + Co content averages 0.7%. The nodule has a complex growth history which started with radial upward growth leading to coalescing into a continuous crust. The crust was coated with horizontal layers. After fracturing and infilling of cracks with calcareous sediment, further layers encased the nodule.

"Lancea", Lusitanian Word, and the "Lancienses" Ethnogenesis

Analysis of the word lancea, of Hispanic origin after Varro, and of place names, people´s names and personal names derived from it. It confirms that the spear was the most important weapon in the Bronze Age, belonging to the iuventus and used as heroic and divine symbol. This analysis confirms also the personality of the Lusitanians, a people related to the Celts but with more archaic archaeological, linguistic and cultural characteristics originated in the tradition of the Atlantic Bronze in the II millennium BC. It is also relevant to better know the organisation of Broze and Iron Age societies and the origin of Indo-Europeans peoples in Western Europe and of pre-Roman peoples of Iberia.

Effectiveness and Cost-effectiveness of Outpatient Physiotherapy After Knee Replacement for Osteoarthritis: Study Protocol for a Randomised Controlled Trial

Background: Primary total knee replacement is a common operation that is performed to provide pain relief and restore functional ability. Inpatient physiotherapy is routinely provided after surgery to enhance recovery prior to hospital discharge. However, international variation exists in the provision of outpatient physiotherapy after hospital discharge. While evidence indicates that outpatient physiotherapy can improve short-term function, the longer term benefits are unknown. The aim of this randomised controlled trial is to evaluate the long-term clinical effectiveness and cost-effectiveness of a 6-week group-based outpatient physiotherapy intervention following knee replacement. Methods/design: Two hundred and fifty-six patients waiting for knee replacement because of osteoarthritis will be recruited from two orthopaedic centres. Participants randomised to the usual-care group (n = 128) will be given a booklet about exercise and referred for physiotherapy if deemed appropriate by the clinical care team. The intervention group (n = 128) will receive the same usual care and additionally be invited to attend a group-based outpatient physiotherapy class starting 6 weeks after surgery. The 1-hour class will be run on a weekly basis over 6 weeks and will involve task-orientated and individualised exercises. The primary outcome will be the Lower Extremity Functional Scale at 12 months post-operative. Secondary outcomes include: quality of life, knee pain and function, depression, anxiety and satisfaction. Data collection will be by questionnaire prior to surgery and 3, 6 and 12 months after surgery and will include a resource-use questionnaire to enable a trial-based economic evaluation. Trial participation and satisfaction with the classes will be evaluated through structured telephone interviews. The primary statistical and economic analyses will be conducted on an intention-to-treat basis with and without imputation of missing data. The primary economic result will estimate the incremental cost per quality-adjusted life year gained from this intervention from a National Health Services (NHS) and personal social services perspective. Discussion: This research aims to benefit patients and the NHS by providing evidence on the long-term effectiveness and cost-effectiveness of outpatient physiotherapy after knee replacement. If the intervention is found to be effective and cost-effective, implementation into clinical practice could lead to improvement in patients’ outcomes and improved health care resource efficiency.

Self-reported fatigue and associated factors six years after stroke

Several studies have found that fatigue is one of the most commonly reported symptoms after stroke and the most difficult to cope with. The present study aimed to investigate the presence and severity of self-reported fatigue six years after stroke onset and associated factors. The cohort "Life After Stroke Phase I" (n = 349 persons) was invited at six years to report fatigue (Fatigue Severity Scale 7-item version), perceived impact of stroke and global recovery after stroke (Stroke Impact Scale), anxiety and depression (Hospital Anxiety and Depression Scale), life satisfaction (Life Satisfaction Checklist) and participation in everyday social activities (Frenchay Activities Index). At six years 37% of the 102 participants in this cross-sectional study reported fatigue. The results showed that in nearly all SIS domains the odds for post-stroke fatigue were higher in persons with a higher perceived impact. Furthermore, the odds for post-stroke fatigue were higher in those who had experienced a moderate/severe stroke and had signs of depression and anxiety. Fatigue is still present in one-third of persons as long as six years after stroke onset and is perceived to hinder many aspects of functioning in everyday life. There is an urgent need to develop and evaluate interventions to reduce fatigue.

"Europe-as-hegemony" and discourses in Turkey after 1999: Dialogue with the Europeanisation literature

It is not a prophecy to say that one of the most common concepts that those working on "Europe" would encounter at various points in different capacities would be "Europeanisation". This buzzword has also been crucial in understanding and explaining for Turkey's European orientation path, which acquired a new dimension and has been carried to a more substantive and institutional level with the Helsinki European Council in December 1999 when Turkey was granted formal candidacy status in its application to join the EU. Especially after this date, the concept of "Europeanisation" and the literature attached to it have almost automatically been employed to assess the relationship between Turkey and different aspects of European integration. For this aim, firstly, I present a tri-fold picture of the European studies. According to this categorisation, the studies dealing with the notion of „Europe‟ could be categorised into three groups: the studies which takes "Europe" as a fixed concept ("Europe-as-fixity"), those which subscribe to a notion of "Europe" solely as a construct ("Europe-as-construct") and the studies which take "Europe" as a contestation ("Europe-as-contestation"). After critically locating the Europeanisation literature within this categorisation, I argue that there is both a historical and epistemological need for the Europeanisation literature to address to the conflictual nature of the notion by focusing on how the discourses on "Europe" hegemonised the Turkish political terrain after 1999 and I introduce the notion of "Europe-as-hegemony". The overall argument is that the hegemony of "Europe" does not originate from the automaticity of the relationship between the European and domestic level as stipulated by the Europeanisation literature, but rather from the power of discourses on "Europe" and their ability to hegemonise the political realm. In this respect, this paper offers a novel approach to the Europeanisation literature with a particular focus on the Turkish context where the political is not only given and constructed but is also reflexive and open to contestation and negotiation.

Myocardial edema after ischemia/reperfusion is not stable and follows a bimodal pattern: Imaging and histological tissue characterization

It is widely accepted that edema occurs early in the ischemic zone and persists in stable form for at least 1 week after myocardial ischemia/reperfusion. However, there are no longitudinal studies covering from very early (minutes) to late (1 week) reperfusion stages confirming this phenomenon. This study sought to perform a comprehensive longitudinal imaging and histological characterization of the edematous reaction after experimental myocardial ischemia/reperfusion. The study population consisted of 25 instrumented Large-White pigs (30 kg to 40 kg). Closed-chest 40-min ischemia/reperfusion was performed in 20 pigs, which were sacrificed at 120 min (n = 5), 24 h (n = 5), 4 days (n = 5), and 7 days (n = 5) after reperfusion and processed for histological quantification of myocardial water content. Cardiac magnetic resonance (CMR) scans with T2-weighted short-tau inversion recovery and T2-mapping sequences were performed at every follow-up stage until sacrifice. Five additional pigs sacrificed after baseline CMR served as controls. In all pigs, reperfusion was associated with a significant increase in T2 relaxation times in the ischemic region. On 24-h CMR, ischemic myocardium T2 times returned to normal values (similar to those seen pre-infarction). Thereafter, ischemic myocardium-T2 times in CMR performed on days 4 and 7 after reperfusion progressively and systematically increased. On day 7 CMR, T2 relaxation times were as high as those observed at reperfusion. Myocardial water content analysis in the ischemic region showed a parallel bimodal pattern: 2 high water content peaks at reperfusion and at day 7, and a significant decrease at 24 h. Contrary to the accepted view, myocardial edema during the first week after ischemia/reperfusion follows a bimodal pattern. The initial wave appears abruptly upon reperfusion and dissipates at 24 h. Conversely, the deferred wave of edema appears progressively days after ischemia/reperfusion and is maximal around day 7 after reperfusion.

Physiological and symptomatic responses to cycling and walking in intermittent claudication

To shed light on the potential efficacy of cycling as a testing modality in the treatment of intermittent claudication (IC), this study compared physiological and symptomatic responses to graded walking and cycling tests in claudicants. Sixteen subjects with peripheral arterial disease (resting ankle: brachial index (ABI) < 0.9) and IC completed a maximal graded treadmill walking (T) and cycle (C) test after three familiarization tests on each mode. During each test, symptoms, oxygen uptake (VO2), minute ventilation (VE), respiratory exchange ratio (RER) and heart rate (HR) were measured, and for 10 min after each test the brachial and ankle systolic pressures were recorded. All but one subject experienced calf pain as the primary limiting symptom during T; whereas the symptoms were more varied during C and included thigh pain, calf pain and dyspnoea. Although maximal exercise time was significantly longer on C than T (690 +/- 67 vs. 495 +/- 57 s), peak VO2, peak VE and peak heart rate during C and T were not different; whereas peak RER was higher during C. These responses during C and T were also positively correlated (P < 0.05) with each other, with the exception of RER. The postexercise systolic pressures were also not different between C and T. However, the peak decline in ankle pressures from resting values after C and T were not correlated with each other. These data demonstrate that cycling and walking induce a similar level of metabolic and cardiovascular strain, but that the primary limiting symptoms and haemodynamic response in an individual's extremity, measured after exercise, can differ substantially between these two modes.