Racial differences in neurocognitive outcomes post-stroke: The impact of healthcare variables

AbstractObjectives:The present study examined differences in neurocognitive outcomes among non-Hispanic Black and White stroke survivors using the NIH Toolbox-Cognition Battery (NIHTB-CB), and investigated the roles of healthcare variables in explaining racial differences in neurocognitive outcomes post-stroke.Methods:One-hundred seventy adults (91 Black; 79 White), who participated in a multisite study were included (age:M=56.4;SD=12.6; education:M=13.7;SD=2.5; 50% male; years post-stroke: 1–18; stroke type: 72% ischemic, 28% hemorrhagic). Neurocognitive function was assessed with the NIHTB-CB, using demographically corrected norms. Participants completed measures of socio-demographic characteristics, health literacy, and healthcare use and access. Stroke severity was assessed with the Modified Rankin Scale.Results:An independent samplesttest indicated Blacks showed more neurocognitive impairment (NIHTB-CB Fluid Composite T-score:M=37.63;SD=11.67) than Whites (Fluid T-score:M=42.59,SD=11.54;p=.006). This difference remained significant after adjusting for reading level (NIHTB-CB Oral Reading), and when stratified by stroke severity. Blacks also scored lower on health literacy, reported differences in insurance type, and reported decreased confidence in the doctors treating them. Multivariable models adjusting for reading level and injury severity showed that health literacy and insurance type were statistically significant predictors of the Fluid cognitive composite (p&lt;.001 andp=.02, respectively) and significantly mediated racial differences on neurocognitive impairment.Conclusions:We replicated prior work showing that Blacks are at increased risk for poorer neurocognitive outcomes post-stroke than Whites. Health literacy and insurance type might be important modifiable factors influencing these differences. (JINS, 2017,23, 640–652)</jats:p

Dense bottom gravity currents and their impact on pelagic methanotrophy at oxic/anoxic transition zones

We show that inflows of oxygenated waters into sulfidic layers have a strong impact on biogeochemical transformation at oxic/anoxic transition zones. Taking the pelagic methane dynamics in the Gotland Basin as an example, we performed our studies when one of the largest inflows ever recorded entered the Baltic Sea in March 2015. An inflowing gravity current transported oxic waters into the sulfidic deep layers and freshly generated a near-bottom secondary redox interface. At the upper slope, where the inflowing water masses were vigorously turbulent and the main and secondary redox interfaces in close contact to each other, methane oxidation rates inside the transition zone were found to be higher compared to the weakly turbulent basin interior. At the main redox interface in the basin center, lateral intrusions of oxygenated waters into intermediate water depth may have stimulated the growth of the methanotrophic community and their activity

Associations between Cognition, Gender and Monocyte Activation among HIV Infected Individuals in Nigeria.

The potential role of gender in the occurrence of HIV-related neurocognitive impairment (NCI) and associations with markers of HIV-related immune activity has not been previously examined. In this study 149 antiretroviral-naïve seropositive subjects in Nigeria (SP, 92 women and 57 men) and 58 seronegative (SN, 38 women and 20 men) were administered neuropsychological testing that assessed 7 ability domains. From the neuropsychological test scores was calculated a global deficit score (GDS), a measure of overall NCI. Percentages of circulating monocytes and plasma HIV RNA, soluble CD163 and soluble CD14 levels were also assessed. HIV SP women were found to be younger, more educated and had higher CD4+ T cell counts and borderline higher viral load measures than SP men. On the neuropsychological testing, SP women were more impaired in speed of information processing and verbal fluency and had a higher mean GDS than SN women. Compared to SP men, SP women were also more impaired in speed of information processing and verbal fluency as well as on tests of learning and memory. Numbers of circulating monocytes and plasma sCD14 and sCD163 levels were significantly higher for all SP versus all SN individuals and were also higher for SP women and for SP men versus their SN counterparts. Among SP women, soluble CD14 levels were slightly higher than for SP men, and SP women had higher viral load measurements and were more likely to have detectable virus than SP men. Higher sCD14 levels among SP women correlated with more severe global impairment, and higher viral load measurements correlated with higher monocyte numbers and sCD14 and sCD14 levels, associations that were not observed for SP men. These studies suggest that the risk of developing NCI differ for HIV infected women and men in Nigeria and, for women, may be linked to effects from higher plasma levels of HIV driving activation of circulating monocytes

On the structure of maximal solvable extensions and of Levi extensions of nilpotent algebras

We establish an improved upper estimate on dimension of any solvable algebra s with its nilradical isomorphic to a given nilpotent Lie algebra n. Next we consider Levi decomposable algebras with a given nilradical n and investigate restrictions on possible Levi factors originating from the structure of characteristic ideals of n. We present a new perspective on Turkowski's classification of Levi decomposable algebras up to dimension 9.Comment: 21 pages; major revision - one section added, another erased; author's version of the published pape

The electronic structure of (C59N)2 from high energy spectroscopy

We report the results of a detailed study of the occupied and unoccupied electronic structure of dimers of the new heterofullerene C59N by means of photoemission and electron energy-loss spectroscopy. A close similarity is found between the electronic structures of pristine (C59N)2 and C60 with an additional broadening of the spectra in the former due to the distortion of the fullerene cage caused both by dimerization and the chemical substitution. Both the occupied and unoccupied electronic states, as well as the interband transitions between them, attest to the high degree of molecular character retained in the solid state. Comparison of the shake-up structures in the C1s and N1s X-ray photo emission spectra confirm that the highest lying occupied states in the heterofullerene have a strong degree of N character, whereas the lowest lying unoccupied states have mainly C character. We also present the optical conductivity of the heterofullerene (derived from the loss function), which shows an optical gap of 1.4 eV, some 0.4 eV smaller than that of C60

Financial Transaction Tax: Small is Beautiful

The case for taxing financial transactions merely to raise more revenues from the financial sector is not particularly strong. Better alternatives to tax the financial sector are likely to be available. However, a tax on financial transactions could be justified in order to limit socially undesirable transactions when more direct means of doing so are unavailable for political or practical reasons. Some financial transactions are indeed likely to do more harm than good, especially when they contribute to the systemic risk of the financial system. However, such a financial transaction tax should be very small, much smaller than the negative externalities in question, because it is a blunt instrument that also drives out socially useful transactions. There is a case for taxing over-the-counter derivative transactions at a somewhat higher rate than exchange-based derivative transactions. More targeted remedies to drive out socially undesirable transactions should be sought in parallel, which would allow, after their implementation, to reduce or even phase out financialtransaction taxes

All solvable extensions of a class of nilpotent Lie algebras of dimension n and degree of nilpotency n-1

We construct all solvable Lie algebras with a specific n-dimensional nilradical n_(n,2) (of degree of nilpotency (n-1) and with an (n-2)-dimensional maximal Abelian ideal). We find that for given n such a solvable algebra is unique up to isomorphisms. Using the method of moving frames we construct a basis for the Casimir invariants of the nilradical n_(n,2). We also construct a basis for the generalized Casimir invariants of its solvable extension s_(n+1) consisting entirely of rational functions of the chosen invariants of the nilradical.Comment: 19 pages; added references, changes mainly in introduction and conclusions, typos corrected; submitted to J. Phys. A, version to be publishe

Realizations of Real Low-Dimensional Lie Algebras

Using a new powerful technique based on the notion of megaideal, we construct a complete set of inequivalent realizations of real Lie algebras of dimension no greater than four in vector fields on a space of an arbitrary (finite) number of variables. Our classification amends and essentially generalizes earlier works on the subject. Known results on classification of low-dimensional real Lie algebras, their automorphisms, differentiations, ideals, subalgebras and realizations are reviewed.Comment: LaTeX2e, 39 pages. Essentially exetended version. Misprints in Appendix are correcte