Relationship of national institutes of health stroke scale to 30-day mortality in medicare beneficiaries with acute ischemic stroke.

BackgroundThe National Institutes of Health Stroke Scale (NIHSS), a well-validated tool for assessing initial stroke severity, has previously been shown to be associated with mortality in acute ischemic stroke. However, the relationship, optimal categorization, and risk discrimination with the NIHSS for predicting 30-day mortality among Medicare beneficiaries with acute ischemic stroke has not been well studied.Methods and resultsWe analyzed data from 33102 fee-for-service Medicare beneficiaries treated at 404 Get With The Guidelines-Stroke hospitals between April 2003 and December 2006 with NIHSS documented. The 30-day mortality rate by NIHSS as a continuous variable and by risk-tree determined or prespecified categories were analyzed, with discrimination of risk quantified by the c-statistic. In this cohort, mean age was 79.0 years and 58% were female. The median NIHSS score was 5 (25th to 75th percentile 2 to 12). There were 4496 deaths in the first 30 days (13.6%). There was a strong graded relation between increasing NIHSS score and higher 30-day mortality. The 30-day mortality rates for acute ischemic stroke by NIHSS categories were as follows: 0 to 7, 4.2%; 8 to 13, 13.9%; 14 to 21, 31.6%; 22 to 42, 53.5%. A model with NIHSS alone provided excellent discrimination whether included as a continuous variable (c-statistic 0.82 [0.81 to 0.83]), 4 categories (c-statistic 0.80 [0.79 to 0.80]), or 3 categories (c-statistic 0.79 [0.78 to 0.79]).ConclusionsThe NIHSS provides substantial prognostic information regarding 30-day mortality risk in Medicare beneficiaries with acute ischemic stroke. This index of stroke severity is a very strong discriminator of mortality risk, even in the absence of other clinical information, whether used as a continuous or categorical risk determinant. (J Am Heart Assoc. 2012;1:42-50.)

Ground-level climate at a peatland wind farm in Scotland is affected by wind turbine operation

The global drive to produce low-carbon energy has resulted in an unprecedented deployment of onshore wind turbines, representing a significant land use change for wind energy generation with uncertain consequences for local climatic conditions and the regulation of ecosystem processes. Here, we present high-resolution data from a wind farm collected during operational and idle periods that shows the wind farm affected several measures of ground-level climate. Specifically, we discovered that operational wind turbines raised air temperature by 0.18 °C and absolute humidity (AH) by 0.03 g m−3 during the night, and increased the variability in air, surface and soil temperature throughout the diurnal cycle. Further, the microclimatic influence of turbines on air temperature and AH decreased logarithmically with distance from the nearest turbine. These effects on ground-level microclimate, including soil temperature, have uncertain implications for biogeochemical processes and ecosystem carbon cycling, including soil carbon stocks. Consequently, understanding needs to be improved to determine the overall carbon balance of wind energy

Use of waveform lidar and hyperspectral sensors to assess selected spatial and structural patterns associated with recent and repeat disturbance and the abundance of sugar maple (Acer saccharum Marsh.) in a temperate mixed hardwood and conifer forest.

Abstract Waveform lidar imagery was acquired on September 26, 1999 over the Bartlett Experimental Forest (BEF) in New Hampshire (USA) using NASA\u27s Laser Vegetation Imaging Sensor (LVIS). This flight occurred 20 months after an ice storm damaged millions of hectares of forestland in northeastern North America. Lidar measurements of the amplitude and intensity of ground energy returns appeared to readily detect areas of moderate to severe ice storm damage associated with the worst damage. Southern through eastern aspects on side slopes were particularly susceptible to higher levels of damage, in large part overlapping tracts of forest that had suffered the highest levels of wind damage from the 1938 hurricane and containing the highest levels of sugar maple basal area and biomass. The levels of sugar maple abundance were determined through analysis of the 1997 Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) high resolution spectral imagery and inventory of USFS Northern Research Station field plots. We found a relationship between field measurements of stem volume losses and the LVIS metric of mean canopy height (r2 = 0.66; root mean square errors = 5.7 m3/ha, p \u3c 0.0001) in areas that had been subjected to moderate-to-severe ice storm damage, accurately documenting the short-term outcome of a single disturbance event

On the alleged duality of the Galactic halo

We examine the kinematics of the Galactic halo based on SDSS/SEGUE data by Carollo et al. (2007, 2010). We find that their claims of a counter-rotating halo are the result of substantial biases in distance estimates (of order 50%): the claimed retrograde component, which makes up only a tiny fraction of the entire sample, prone to contaminations, is identified as the tail of distance overestimates. The strong overestimates also result in a lift in the vertical velocity component, which explains the large altitudes those objects were claimed to reach. Errors are worst for the lowest metallicity stars, which explains the metal-poor nature of the artificial component. We also argue that measurement errors were not properly accounted for and that the use of Gaussian fitting on intrinsically non-Gaussian Galactic components invokes the identification of components that are distorted or even artificial. Our evaluation of the data leads to a revision of the estimated velocity ellipsoids and does not yield any reliable evidence for a counterrotating halo component. If a distinct counterrotating halo component exists it must be far weaker than claimed by Carollo et al. Finally we note that their revised analysis presented in Beers et al. (2011) does not alleviate our main concerns.Comment: 17 pages, 12 figures, submitted to MNRA

Quantum teleportation on a photonic chip

Quantum teleportation is a fundamental concept in quantum physics which now finds important applications at the heart of quantum technology including quantum relays, quantum repeaters and linear optics quantum computing (LOQC). Photonic implementations have largely focussed on achieving long distance teleportation due to its suitability for decoherence-free communication. Teleportation also plays a vital role in the scalability of photonic quantum computing, for which large linear optical networks will likely require an integrated architecture. Here we report the first demonstration of quantum teleportation in which all key parts - entanglement preparation, Bell-state analysis and quantum state tomography - are performed on a reconfigurable integrated photonic chip. We also show that a novel element-wise characterisation method is critical to mitigate component errors, a key technique which will become increasingly important as integrated circuits reach higher complexities necessary for quantum enhanced operation.Comment: Originally submitted version - refer to online journal for accepted manuscript; Nature Photonics (2014

The Metallicity Distribution Functions of SEGUE G and K dwarfs: Constraints for Disk Chemical Evolution and Formation

We present the metallicity distribution function (MDF) for 24,270 G and 16,847 K dwarfs at distances from 0.2 to 2.3 kpc from the Galactic plane, based on spectroscopy from the Sloan Extension for Galactic Understanding and Exploration (SEGUE) survey. This stellar sample is significantly larger in both number and volume than previous spectroscopic analyses, which were limited to the solar vicinity, making it ideal for comparison with local volume-limited samples and Galactic models. For the first time, we have corrected the MDF for the various observational biases introduced by the SEGUE target selection strategy. The SEGUE sample is particularly notable for K dwarfs, which are too faint to examine spectroscopically far from the solar neighborhood. The MDF of both spectral types becomes more metal-poor with increasing |Z|, which reflects the transition from a sample with small [alpha/Fe] values at small heights to one with enhanced [alpha/Fe] above 1 kpc. Comparison of our SEGUE distributions to those of two different Milky Way models reveals that both are more metal-rich than our observed distributions at all heights above the plane. Our unbiased observations of G and K dwarfs provide valuable constraints over the |Z|-height range of the Milky Way disk for chemical and dynamical Galaxy evolution models, previously only calibrated to the solar neighborhood, with particular utility for thin- and thick-disk formation models.Comment: 70 pages, 25 figures, 7 tables. Accepted by The Astrophysical Journa

Finite-temperature Fermi-edge singularity in tunneling studied using random telegraph signals

We show that random telegraph signals in metal-oxide-silicon transistors at millikelvin temperatures provide a powerful means of investigating tunneling between a two-dimensional electron gas and a single defect state. The tunneling rate shows a peak when the defect level lines up with the Fermi energy, in excellent agreement with theory of the Fermi-edge singularity at finite temperature. This theory also indicates that defect levels are the origin of the dissipative two-state systems observed previously in similar devices.Comment: 5 pages, REVTEX, 3 postscript figures included with epsfi

Does social media usage matter? An analysis of online practices and digital media perceptions of communication practitioners in Europe

A key aspect for understanding and explaining online communication is the micro level of communication practitioners’ social media usage and their general attitudes towards digital platforms. This paper investigates how public relations practitioner's personal and professional use of social media is related to their perceptions of social media. A quantitative methodology was applied to perform this research. A population of 2710 professionals from 43 European countries working on different hierarchical levels both in communication departments and agencies across Europe were surveyed as part of a larger transnational online survey. Results show that practitioners with a high level of usage of social media give more importance to social media channels, influence of social media on internal and external stakeholders and relevance of key gatekeepers and stakeholders along with a better self-estimation of competences. Issues about diverse levels of overestimation of social media use, application and importance in the professional arena are also debated

2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention, 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischem

In the article by Levine et al, “2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention, 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease, 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction, 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes, and 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery,” which published online March 29, 2016, and appeared in the September 6, 2016, issue of the journal ( Circulation. 2016;134:e123–e155. DOI: 10.1161/CIR.0000000000000404.), several corrections were needed. 1. On pages e124 and e134, corrections have been made to the section 5 title: 2. On pages e124 and e135, corrections have been made to the section 6 title: 3. On page