Democratic Backsliding and the Balance Wheel Hypothesis: Partisanship and State Funding for Higher Education in the United States.

The balance wheel hypothesis-a classic tenet of USA state-level policy analysis that suggests state funding for higher education varies in response to macroeconomic cycles-has held up to scrutiny over time. However, new social conditions within the Republican Party, namely growing hostility toward independent institutions, call for a more nuanced understanding of the relationship between state budgets and higher education. Drawing on recent research in political science and political economy, we conceptualize declining state appropriations to higher education in Republican-dominated U.S. states as an instance of democratic backsliding. Using a panel of state-level data we found that political partisanship conditioned state appropriations to higher education during and after the Great Recession. Our finding that the balance wheel operated differently in states with and without unified Republican control not only suggests partisan hostility toward higher education is a potentially worrisome indicator of democratic backsliding, but also the importance of updating models to consider the extent to which they still hold as contexts change over time.

Inequalities and Inequities in Pediatric Respiratory Diseases.

Social inequality refers to disparities in society that have the effect of limiting a group's socioeconomic, educational, and intellectual potential. Inequity in health means any limitation to access comprehensive health services that also hinders the achievement of well-being and favorable health outcomes. Strategies for more equitable growth to eradicate global poverty would contribute to reducing health inequities and improve health care outcomes. Coordinated efforts between governments, private sector, families, and interested stakeholders are needed. This article discusses inequality and inequity in pediatric respiratory diseases, the challenges confronted, and the strategies needed to mitigate these disparities.

Hispanic Infants with cystic fibrosis show low CFTR mutation detection rates in the Illinois newborn screening program.

States develop specific protocols for cystic fibrosis (CF) newborn screening to reflect the population served. We hypothesized that mutation distribution and detection rates would differ between Hispanic and non-Hispanic CF patients diagnosed by IL newborn screen with more Hispanic infants carrying mutations not detected by the state panel. Data from CF cases diagnosed via newborn screen in IL between 3/1/2008 and 10/31/2010 were reviewed. More Hispanic infants with CF had one or more undefined mutations after screening, in comparison to non-Hispanic Caucasian patients (40% vs. 9.5%; p < 0.002). The risk of having a positive diagnosis of CF with only one mutation noted by positive newborn screen increases 2-fold in Hispanic Caucasian versus non-Hispanic Caucasian infants (5% vs. 2.4%). Health care providers must be aware of the limitations of CF newborn screening to ensure appropriate counseling and prompt referral for a positive newborn screen, even when zero or one mutations are identified.

Healthcare inequalities in paediatric respiratory diseases.

Identifying that health inequalities exist is not enough; nor does the knowledge that a patient has a high-risk genotype or comes from a higher risk socioeconomic background does not, by itself, help the patient. To thoroughly examine the origins of health disparities, a broad view of environmental and molecular influences must be included. As these factors are identified, it is important to focus on interventions that can change outcomes for patients. Tools for education, community involvement, literacy, and environmental safety need to be developed, tested and disseminated. The basic science of health disparities must move forward in a coordinated fashion by structuring research that is an integrated effort between basic sciences, clinical medicine and include all traditionally underserved communities. Only through these collaborations can we hope to eliminate health inequalities in the future.

Elevated vascular endothelial growth factor is correlated with elevated erythropoietin in stable, young cystic fibrosis patients.

Angiogenesis is an important mechanism of airway remodeling in lung disease. We previously demonstrated that serum vascular endothelial growth factor (VEGF) is elevated in cystic fibrosis (CF) patients and declines with therapy for pulmonary exacerbation. We hypothesized that VEGF is elevated early in the course of CF and is associated with markers of tissue hypoxia. A prospective, single-visit evaluation of thirty stable infants and children with CF was performed. Serum was analyzed for VEGF and for other markers of tissue hypoxia (erythropoietin (EPO), insulin-like growth factor binding protein-1 (IGFBP-1)) and for inflammatory mediators (IL-1 beta, IL-6, IL-8, and tumor necrosis factor alpha (TNFα)) using Meso Scale multi-spot serum immunoassays. Measurements were correlated between assay groups; and with age in months and pulmonary function (FEV0.5 or FEV1). VEGF, EPO, TNFα and IL-8 were elevated compared to published normative values. VEGF levels were not significantly correlated with any inflammatory mediators. However, VEGF correlated with EPO (r=0.505; P<0.05). There was no correlation between lung function and markers of inflammation or tissue hypoxia. VEGF is elevated in young, stable infants and children suggesting angiogenesis as a contributing mechanism for early lung disease in CF. VEGF elevation does not show significant correlation with inflammatory mediators known to be increased in CF, but is significantly correlated with EPO levels. We propose that VEGF elevation and angiogenesis contribute to early lung disease and may result from a direct tissue hypoxia pathway in CF.

Increased prevalence of risk factors for morbidity and mortality in the US Hispanic CF population.

Hispanic ethnicity is an independent risk factor for increased morbidity and mortality in cystic fibrosis (CF) patients. In order to compare the prevalence of risk factors for morbidity and mortality between the Hispanic CF population and the non-Hispanic CF population, we performed a cross-sectional study of patients in the 2004 Cystic Fibrosis Foundation Patient Registry. Among 22,714 CF patients, 1,511 were identified as ethnic Hispanic. Hispanic patients were diagnosed earlier (2.8 vs. 3.3 years, P = 0.005) and acquired Pseudomonas aeruginosa at a younger age (6.6 years vs. 10 years, P < 0.001). FEV(1) was lower for Hispanic patients (81.5% vs. 87% predicted for those under 18 years old [P < 0.001] and 2.1 L vs. 2.3 L for those 18 years and older [P = 0.01]). Hispanic patients had similar or better nutritional status. Hispanic patients were more likely to be diagnosed with liver disease (OR 1.31 [1.1, 1.56]) but less likely to be diagnosed with depression (OR 0.53 [0.39, 0.68]), bone and joint disease (OR 0.55 [0.41, 0.71]), or CF-related diabetes (OR 0.53 [0.43, 0.62]). Hispanic patients had lower median income by zip code ($41,930 vs. $47,341; P < 0.001), a higher rate of government insurance (55.2% vs. 32.0%; P < 0.001), and greater percentage of mothers with less than a high school education (26.7% vs. 6.5%; P < 0.001). We conclude that there is an increased prevalence of important risk factors for morbidity and mortality in the Hispanic CF population.

Enhanced photoluminescence from group 14 metalloles in aggregated and solid solutions.

The unusual photoluminescence characteristics of a series of six group 14 metalloles (1,1-dimethyl-2,3,4,5-tetraphenylmetalloles and 1,1-diphenyl-2,3,4,5-tetraphenylmetalloles) containing silicon, germanium, or tin have been investigated. Although the compounds are weakly luminescent in dilute fluid solution at room temperature, they undergo a substantial enhancement of photoluminescence when forced to aggregate, as in mixed solvent systems. The compounds also exhibit considerable emission when incorporated into rigid room-temperature glasses of sucrose octaacetate. Absorption and emission characteristics of the compounds, including luminescence quantum yields, in fluid solution, solution-phase aggregates, and room-temperature glasses are reported. Quantum yields increase by as much as 2 orders of magnitude in the aggregates and glasses, compared to fluid solution. Experimental evidence supports the conclusion that the aggregation-induced enhancement of luminescence results from restricted intramolecular rotations in the packed metalloles. The unusual aggregation-induced enhancement of these compounds makes them potentially useful for the fabrication of a variety of electrooptical devices and sensors. In addition, the X-ray crystal structure of hexaphenylgermole is reported.