Assessment of Vessel Density on Non-Contrast Computed Tomography to Detect Basilar Artery Occlusion

Introduction: Basilar artery occlusion (BAO) may be clinically occult due to variable and non-specific symptomatology. We evaluated the qualitative and quantitative determination of a hyperdense basilar artery (HDBA) on non-contrast computed tomography (NCCT) brain for the diagnosis of BAO.Methods: We conducted a case control study of patients with confirmed acute BAO vs a control group of suspected acute stroke patients without BAO. Two EM attending physicians, one third-year EM resident, and one medical student performed qualitative and quantitative assessments for the presence of a HDBA on axial NCCT images. Our primary outcome measures were sensitivity and specificity for BAO. Our secondary outcomes were inter-rater and intra-rater reliability of the qualitative and quantitative assessments.Results: We included 60 BAO and 65 control patients in our analysis. Qualitative assessment of the hyperdense basilar artery sign was poorly sensitive (54%–72%) and specific (55%–89%). Quantitative measurement improved the specificity of hyperdense basilar artery assessment for diagnosing BAO, with a threshold of 61.0–63.8 Hounsfield units demonstrating relatively high specificity of 85%–94%. There was moderate inter-rater agreement for the qualitative assessment of HDBA (Fleiss’ kappa statistic 0.508, 95% confidence interval: 0.435–0.581). Agreement improved for quantitative assessments, but still fell in the moderate range (Shrout-Fleiss intraclass correlation coefficient: 0.635). Intra-rater reliability for the quantitative assessments of the two attending physician reviewers demonstrated substantial consistency.Conclusion: Our results highlight the importance of carefully examining basilar artery density when interpreting the NCCT of patients with altered consciousness or other signs and symptoms concerning for an acute basilar artery occlusion. If the Hounsfield unit density of the basilar artery exceeds 61 Hounsfield units, BAO should be highly suspected

Calculating the Expected Value of Sample Information in Practice: Considerations from Three Case Studies

Investing efficiently in future research to improve policy decisions is an important goal. Expected Value of Sample Information (EVSI) can be used to select the specific design and sample size of a proposed study by assessing the benefit of a range of different studies. Estimating EVSI with the standard nested Monte Carlo algorithm has a notoriously high computational burden, especially when using a complex decision model or when optimizing over study sample sizes and designs. Therefore, a number of more efficient EVSI approximation methods have been developed. However, these approximation methods have not been compared and therefore their relative advantages and disadvantages are not clear. A consortium of EVSI researchers, including the developers of several approximation methods, compared four EVSI methods using three previously published health economic models. The examples were chosen to represent a range of real-world contexts, including situations with multiple study outcomes, missing data, and data from an observational rather than a randomized study. The computational speed and accuracy of each method were compared, and the relative advantages and implementation challenges of the methods were highlighted. In each example, the approximation methods took minutes or hours to achieve reasonably accurate EVSI estimates, whereas the traditional Monte Carlo method took weeks. Specific methods are particularly suited to problems where we wish to compare multiple proposed sample sizes, when the proposed sample size is large, or when the health economic model is computationally expensive. All the evaluated methods gave estimates similar to those given by traditional Monte Carlo, suggesting that EVSI can now be efficiently computed with confidence in realistic examples.Comment: 11 pages, 3 figure

Birefringence and Dichroism of the QED Vacuum

We use an analytic form for the Heisenberg-Euler Lagrangian to calculate the birefringent and dichroic properties of the vacuum for arbitrarily strong wrenchless fields. PACS : 12.20.Ds, 42.25.Lc 97.60.Jd, 98.70.RzComment: 8 pages, 2 figures, to appear in Journal of Physics

Cholesterol Alters the Orientation and Activity of the Influenza Virus M2 Amphipathic Helix in the Membrane

The influenza virus M2 amphipathic helix (M2AH) alters membrane curvature in a cholesterol-dependent manner, mediating viral membrane scission during influenza virus budding. Here, we have investigated the biophysical effects of cholesterol on the ability of an M2AH peptide to manipulate membrane properties. We see that the ability of the M2AH to interact with membranes and form an α-helix is independent of membrane cholesterol concentration; however, cholesterol affects the angle of the M2AH peptide within the membrane. This change in membrane orientation affects the ability of the M2AH to alter lipid order. In lowcholesterol membranes, the M2AH is inserted near the level of the lipid head groups, increasing lipid order, which may contribute to generation of the membrane curvature. As the cholesterol content increases, the M2AH insertion becomes flatter and slightly deeper in the membrane below the lipid headgroups, where the polar face can continue to interact with the headgroups while the hydrophobic face binds cholesterol. This changed orientation minimizes lipid packing defects and lipid order changes, likely reducing the generation of membrane curvature. Thus, cholesterol regulates M2 membrane scission by precisely modulating M2AH positioning within the membrane. This has implications for the understanding of many of amphipathic-helix-driven cellular budding processes that occur in specific lipid environments

Unmanned Vehicle Systems & Operations on Air, Sea, Land

Unmanned Vehicle Systems & Operations On Air, Sea, Land is our fourth textbook in a series covering the world of Unmanned Aircraft Systems (UAS) and Counter Unmanned Aircraft Systems (CUAS). (Nichols R. K., 2018) (Nichols R. K., et al., 2019) (Nichols R. , et al., 2020)The authors have expanded their purview beyond UAS / CUAS systems. Our title shows our concern for growth and unique cyber security unmanned vehicle technology and operations for unmanned vehicles in all theaters: Air, Sea and Land – especially maritime cybersecurity and China proliferation issues. Topics include: Information Advances, Remote ID, and Extreme Persistence ISR; Unmanned Aerial Vehicles & How They Can Augment Mesonet Weather Tower Data Collection; Tour de Drones for the Discerning Palate; Underwater Autonomous Navigation & other UUV Advances; Autonomous Maritime Asymmetric Systems; UUV Integrated Autonomous Missions & Drone Management; Principles of Naval Architecture Applied to UUV’s; Unmanned Logistics Operating Safely and Efficiently Across Multiple Domains; Chinese Advances in Stealth UAV Penetration Path Planning in Combat Environment; UAS, the Fourth Amendment and Privacy; UV & Disinformation / Misinformation Channels; Chinese UAS Proliferation along New Silk Road Sea / Land Routes; Automaton, AI, Law, Ethics, Crossing the Machine – Human Barrier and Maritime Cybersecurity.Unmanned Vehicle Systems are an integral part of the US national critical infrastructure The authors have endeavored to bring a breadth and quality of information to the reader that is unparalleled in the unclassified sphere. Unmanned Vehicle (UV) Systems & Operations On Air, Sea, Land discusses state-of-the-art technology / issues facing U.S. UV system researchers / designers / manufacturers / testers. We trust our newest look at Unmanned Vehicles in Air, Sea, and Land will enrich our students and readers understanding of the purview of this wonderful technology we call UV.https://newprairiepress.org/ebooks/1035/thumbnail.jp

Further Development of Verification Check-Cases for Six- Degree-of-Freedom Flight Vehicle Simulations

This follow-on paper describes the principal methods of implementing, and documents the results of exercising, a set of six-degree-of-freedom rigid-body equations of motion and planetary geodetic, gravitation and atmospheric models for simple vehicles in a variety of endo- and exo-atmospheric conditions with various NASA, and one popular open-source, engineering simulation tools. This effort is intended to provide an additional means of verification of flight simulations. The models used in this comparison, as well as the resulting time-history trajectory data, are available electronically for persons and organizations wishing to compare their flight simulation implementations of the same models

Canadian and English students' beliefs about waterpipe smoking: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Waterpipe smoking is becoming popular among western students. The aim was to understand the appeal to students of this form of smoking when other forms of smoking are becoming less common.</p> <p>Methods</p> <p>Waterpipe smokers were identified by snowball sampling and interviewed following a semi-structured schedule in waterpipe cafes and in their homes. Constant comparative analysis was used to derive themes for the analysis.</p> <p>Results</p> <p>Waterpipe smokers saw smoking as an alternative to more expensive nights out in bars. The appeal was related to the communal activity and the novelty of the experience. Respondents had not thought deeply about the health risks and reasoned that if no warnings about waterpipe smoking were apparent (unlike cigarette smoking) then it was probably safe. These observations were reinforced by observations about the mildness of the smoke, the fruit flavours, and beliefs about the filtering of the water. Waterpipe smokers felt no pressure to stop smoking and therefore had not tried to do so, but felt it might be something they did not continue after university. Waterpipe smoking was not linked in students' minds to other forms of smoking except in one individual who was using waterpipe smoking to help quit cigarettes.</p> <p>Conclusion</p> <p>In the absence of public health information, students have fallen back on superficial experiences to form views that waterpipe smoking is less harmful than other forms of smoking and it is currently much more acceptable in student society than other forms of smoking.</p

Precision electron flow measurements in a disk transmission line.

An analytic model for electron flow in a system driving a fixed inductive load is described and evaluated with particle in cell simulations. The simple model allows determining the impedance profile for a magnetically insulated transmission line given the minimum gap desired, and the lumped inductance inside the transition to the minimum gap. The model allows specifying the relative electron flow along the power flow direction, including cases where the fractional electron flow decreases in the power flow direction. The electrons are able to return to the cathode because they gain energy from the temporally rising magnetic field. The simulations were done with small cell size to reduce numerical heating. An experiment to compare electron flow to the simulations was done. The measured electron flow is {approx}33% of the value from the simulations. The discrepancy is assumed to be due to a reversed electric field at the cathode because of the inductive load and falling electron drift velocity in the power flow direction. The simulations constrain the cathode electric field to zero, which gives the highest possible electron flow

Exploring the relative lack of impact of research on ‘ability grouping’ in England: a discourse analytic account

Grouping students by ‘ability’ is a topic of long-standing contention in English education policy, research and practice. While policy-makers have frequently advocated the practice as reflecting educational ‘standards’, research has consistently failed to find significant benefits of ‘ability’ grouping; and indeed has identified disadvantages for some (low-attaining) pupil groups. However, this research evidence has apparently failed to impact on practice in England. This article, contextualised by the authors’ interests in education and social inequality, seeks to do two things. First, it provides a brief analysis of the existing research evidence on the impact of ‘ability’ grouping, with particular reference to socio-economic inequality, identifying seven different explanations for the poorer progress of pupils in low sets that emerge from the literature. Second, it applies Foucaultian ‘analysis of discourse’ to propose potential explanations for the apparent lack of traction of existing research with policy and practice, arguing that practices of ‘ability grouping’ reflect cultural investments in discourses of ‘natural order’ and hierarchy, with particular resonance for the discursive and political habitus of middle-class parents. The authors postulate that investing in a powerful counter-discourse of enlightenment science, illustrated via their current randomised control trial of different approaches to pupil grouping, may offer a means to challenge hegemonic discourses that underpin current classroom practice

Policy Recommendations for Meeting the Grand Challenge to Achieve Equal Opportunity and Justice

This brief was created forSocial Innovation for America’s Renewal, a policy conference organized by the Center for Social Development in collaboration with the American Academy of Social Work & Social Welfare, which is leading theGrand Challenges for Social Work initiative to champion social progress. The conference site includes links to speeches, presentations, and a full list of the policy briefs