Miracle-dz/UniFAR-FTUs huggingface dataset:
External Validation of the ASTRAL and DRAGON Scores for Prediction of Functional Outcome in Stroke

Background and Purpose— ASTRAL (Acute Stroke Registry and Analysis of Lausanne) and DRAGON (includes dense middle cerebral artery sign, prestroke modified Rankin Scale score, age, glucose, onset to treatment, National Institutes of Health Stroke Scale score) are 2 recently developed scores for predicting functional outcome after acute stroke in unselected acute ischemic stroke patients and in patients treated with intravenous thrombolysis, respectively. We aimed to perform external validation of these scores to assess their predictive performance in the large multicentre Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register. Methods— We calculated the ASTRAL and DRAGON scores in 36 131 and 33 716 patients, respectively, registered in Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register between 2003 and 2013. The proportion of patients with 3-month modified Rankin Scale scores of 3 to 6 was observed for each score point and compared with the predicted proportion according to the risk scores. Calibration was assessed using calibration plots, and predictive performance was assessed using area under the curve of the receiver operating characteristic. Multivariate logistic regression coefficients for the variables in the 2 scores were compared with the original derivation cohorts. Results— The ASTRAL showed an area under the curve of 0.790 (95% confidence interval, 0.786–0.795) and the DRAGON an area under the curve of 0.774 (95% confidence interval, 0.769–0.779). All ASTRAL parameters except range of visual fields and all DRAGON parameters were significantly associated with functional outcome in multivariate analysis. Conclusions— The ASTRAL and DRAGON scores show an acceptable predictive performance. ASTRAL does not require imaging-data and therefore may have an advantage for the use in prehospital patient assessment. Prospective studies of both scores evaluating the impact of their use on patient outcomes after intravenous thrombolysis and endovascular therapy are needed.
Enhancement of wind energy conversion systems active and reactive power control via flywheel energy storage systems integration

The penetration level of wind energy conversion systems is increasing steadily. The random and stochastic nature of wind energy may lead to serious problems onto the electrical system Stability, Controllability, and Power quality. Generally, Energy Storage Systems (ESS) can improve wind generation grid interconnection in terms of power quality, and System Controllability. Flywheel Energy Storage Systems (FESS) have long life span, and high number of charging and discharging cycles that make them a perfect companion to wind integration as compared to other energy storage technologies. In this paper, low speed PMSM based flywheel energy storage system is integrated with Direct-Drive (DD) variable speed PMSG based Wind Energy Conversion System. This integration is proposed in two schemes named as First Topology (Modified STATCOM), and Second Topology (ON DC LINK). Matlab / Simulink model is conducted for the both configurations. Simulation results will show effectiveness of the integrated system in Active Power Smoothing while maximizing the harvested wind power through Optimal Torque Control Maximum Power Point Tracking, and Dynamic VAR Compensation as well. A comparative study is performed between the two topologies to highlight the merits, demerits, and suitability of each one.
Brightness as a function of current amplitude in human retinal electrical stimulation.

PURPOSE With the goal of eventually restoring functional vision in patients with retinal degenerative diseases, USC/Second Sight Medical Products, Inc. chronically implanted blind human subjects with a prototype epiretinal prosthesis consisting of a 4 x 4 array of 16 stimulating electrodes. To accurately represent a visual scene, a visual prosthesis must convey luminance information across a range of brightness levels. To achieve this, the brightness of phosphenes produced by an individual electrode should scale appropriately with luminance, and the same luminance should produce equivalently bright phosphenes across the entire electrode array. The goal was to examine how apparent brightness changes as a function of stimulation intensity across electrodes. METHODS As described in previous studies, electrical stimulation of intact cells of the neural retina using this prosthetic device reliably elicits visual percepts in human subjects blinded by retinitis pigmentosa. Here, apparent brightness for a range of electrical amplitudes was measured using both subjective magnitude rating and brightness-matching procedures in chronically implanted human subjects. RESULTS It was found that apparent brightness can be described as a power function of stimulation intensity. The same model can also predict brightness matching across electrodes. CONCLUSIONS These results suggest that a relatively simple model for scaling current across electrodes may be capable of producing equivalently bright phosphenes across an entire array. (ClinicalTrials.gov number, NCT00279500.).
Does the “Rule of Nines” Apply to Morbidly Obese Burn Victims?

Assessing the percent BSA involved in a burn is essential in patient management. The “Rule of Nines” is one traditional method of estimating BSA. This rule assumes that adults have the same distribution of BSA percentages, regardless of body shape and weight. With increasing obesity, the percentages assigned to each body part may deviate from this formula. This project investigates the applicability of the “Rule of Nines” to the obese patient population. Two hundred obese adults underwent three-dimensional whole body scanning using a commercially available white light scanning device. Software was programmed to determine the surface area of the arms, torso, and legs. A measurement of TBSA and percentages associated with those body parts was derived. Additional software was used to quantify body shapes as android, gynecoid, or mixed. Height, weight, body mass index, and sex were tabulated and a statistical analysis was performed. The average surface area of the torso, arms, and legs differed among the obese and nonobese population. The surface area of the torso, arms, and legs in the obese patient was 52, 7, and 15% respectively compared with 36, 9, and 18% in the nonobese population (P = .98). Android shapes had an average torso surface area of 53% while gynecoid shapes had an average torso surface area of 48% (P = .97). A “rule of sevens” appears to be a more appropriate method for estimating BSA in the morbidly obese patient.
Enhanced dielectric constant and relaxor behavior realized by dual stage sintering of Sr0.5Ba0.5Nb2O6

The relaxor ferroelectric compound, Sr0.5Ba0. 5Nb2O6 (SBN50) was synthesized by solid state reaction followed by sintering under two different conditions: single and dual stage sintering. The impact of sintering process on structural and dielectric properties has been studied in detail using X-ray diffraction, scanning electron microscopy and broadband dielectric spectroscopy. The crystal structure determined by performing Rietveld refinement of X-ray diffractogram was found to be identical in both cases. SBN50 crystallizes in the ferroelectric tetragonal tungsten bronze, P4bm structure. It was observed that uniform grain growth can be controlled by dual stage sintering and relatively narrow distribution of grains can be achieved with an average grain size of ∼15 μm. The dielectric studies show that SBN50 exhibits a relaxor ferroelectric behavior with the transformation taking place at ∼ 380 K due to formation of polar nano regions. Although both single and dual stage sintered SBN50 exhibits relaxor behavi.
Developing Multicultural Self-awareness Through a Transformative Learning Experience

The purpose of this qualitative case study was to explore the ways that a change in perspective can create a better understanding of cultural identity. This study addressed: (1) How does a self-awareness transformative learning experience develop critical cultural competence in career and technical education instructors? (2) How does the practice of critical reflection construct career and technical education instructors’ ability to develop self-awareness of critical cultural competence? (3) How does involvement in critical discourse construct career and technical education instructors’ ability to develop self-awareness of critical cultural competence? A three-phase professional development experience rooted in multicultural education provided key elements of transformative learning.
Model for Predicting the Mechanical Properties of Composites at Elevated Temperatures

A model is presented for predicting the changes in the mechanical properties of organic matrix composites exposed to elevated temperatures. The model can be used to calculate changes in the tensile, compressive and shear strengths and moduli as func tions of exposure time. The model also provides the decrease in the stress ratio with time and the time of failure.
Incidence of blindness and severe visual impairment in Germany: projections for 2030.

PURPOSE Estimates of the incidences of severe visual impairment and blindness (SVI/B) and their causes are key to good health service planning. Thus, the database of Germany's largest state's blind registry was used to estimate current incidence rates (IR) and to project rates for Germany in 2010 and 2030. METHODS The sample consisted of 3328 blind/severely visually impaired individuals newly registered between 2000 and 2008. According to German law, SVI and B were defined as visual acuity equal to or below 20/1000 and 20/400, respectively, in the better seeing eye. Data of the reference population were stratified by age and sex and were used to estimate current IRs. Standardized IRs were estimated for Germany for 2010 and 2030 using national demographic projections. RESULTS Age-related macular degeneration (AMD) accounted for 50% of all incidence of SVI/B (5.56/100,000 personyears (PY), followed by glaucoma (15%; 1.65/100,000 PY) and diabetic eye disease (10%; 1.16/100,000 PY). All current IRs will rise by 2030, with the most pronounced increase in AMD. By 2030, a national AMD IR of 9.5/100,000 PY is expected, accounting for 57% of all incidence of SVI/B in Germany. The incidence of SVI/B in women will be more than twofold compared to men in 2030 (9187 vs. 3716 incident cases in 2030). CONCLUSIONS There will be a dramatic increase of SVI/B by 2030 in Germany, leading to a substantial increase in the need for health and social service provision, with a focus on visually impaired elderly women.
Understanding changes in the b-wave of the ERG caused by heterogeneous receptor damage.

PURPOSE To understand better the relationship between heterogeneous receptor damage and the changes in the b-wave of the rod ERG. METHODS A computational model of the b-wave is used to simulate b-waves from retinas with two regions (a healthier and a more affected region) differing in area and sensitivity. The peak-to-peak amplitudes of the simulated b-waves are fitted with a Naka-Rushton equation, and the parameters log K and Vmax are estimated. Insights gained from these simulations are tested against rod ERGs and rod visual fields from patients with autosomal dominant retinitis pigmentosa (n = 11) and cone-rod dystrophy (n = 17). RESULTS In the simulated retinas, Vmax decreases when the more affected region of receptors is less sensitive than the healthier region by more than 0.5 log unit. However, the relative change in Vmax does not match the relative area of the more affected region unless this region is depressed by 2.0 log units or more. As the more affected region loses sensitivity, log K at first increases but then decreases and approaches the log K of the healthier region for losses greater than 2.0 log units or so relative to the healthier region. For the patients' data, the simulations predict the general relationships observed between the summary statistics of the visual fields (e.g., area of field and mean of log sensitivity changes in the field) and the changes in log K and Vmax. CONCLUSION A decrease in Vmax indicates that regions of the patient's retina have lost 0.5 log unit or more of sensitivity. An increase in log K indicates that either the healthiest part of the patient's retina is abnormal by at most delta log K, a large part of the retina has lost considerable sensitivity (i.e., 0.5 to 2.0 log units) but is still contributing to the response, or both.
Screening for Remote History of Mild Traumatic Brain Injury in VHA: A Critical Literature Review

Objective:The authors reviewed the existing literature on the Veterans Health Administration's (VHA's) traumatic brain injury (TBI) screening and evaluation program to provide a qualitative synthesis and critical review of results focusing on the psychometric properties of the screen. Methods:All studies of the VHA's screening and evaluation process were reviewed, both those involving primary data collection and those relying upon VHA data. Diagnostic statistics were summarized and also recalculated on the basis of a positive screening rate of 20%, the observed rate within the VHA, and an estimated population prevalence of TBI of 15% within the Department of Veterans Affairs (VHA). Results:The TBI screen within the VHA is administered to nearly every eligible patient. The majority of clinical presentations are deemed to be due to mental health and/or a combination of mental health and TBI factors. The screen has good internal consistency, variable test-retest reliability, and questionable validity, with poor agreement between the TBI screen and criterion standards overall. Studies based on nonrepresentative samples reported high sensitivity. Assuming the VHA's TBI screening rate of 20% in a hypothetical sample, sensitivity is poor (the screen misses 30%-60% of TBI cases). However, specificity remains adequate. Studies based on samples with high rates of TBI reported much higher positive predictive values (and slightly lower negative predictive values) than those observed when a hypothetical TBI prevalence of 15% was used. Conclusion:Questions remain about the validity of the TBI screen. Future research should address the utility of screening for TBI.
Low‐dose valganciclovir for cytomegalovirus prophylaxis in intermediate‐risk liver transplantation recipients

Liver transplantation recipients (LTRs) who are seropositive for cytomegalovirus (CMV) (recipient seropositive [R+]) are at intermediate risk for CMV disease. A preventative strategy following transplant is considered standard of care. Current guidelines recommend high‐dose valganciclovir (VGCV; 900 mg/day adjusted for renal function) for prophylaxis given limited data on the efficacy and safety of low‐dose VGCV (450 mg/day adjusted for renal function). We describe our experience using low‐dose VGCV prophylaxis for R+ LTRs at our institution. A single‐center, retrospective study was conducted using a database of 364 LTRs over a 4‐year period (2011‐2014). Adult first‐time R+ LTRs receiving low‐dose VGCV prophylaxis were included. The primary endpoint was CMV disease at 1 year after transplant. Patients were compared with historical controls receiving high‐dose VGCV prophylaxis. Secondary endpoints were biopsy‐proven rejection and leukopenia on VGCV. With respect to leukopenia, patients receiving low‐dose VGCV were compared with a group of D+R– patients from the database receiving high‐dose VGCV. Univariate analyses were performed using chi‐squared, Fisher's exact, and Wilcoxon rank sum tests. A total of 200 R+ LTRs met inclusion criteria. Median age was 60 years (interquartile range [IQR], 54‐66 years), and 129 (65%) LTRs were male. Median Model for End‐Stage Liver Disease score was 22 (IQR, 14‐31), and 178 (89%) patients received deceased donor transplants. CMV disease occurred in only 9 (5%) patients, similar to rates in previous studies of LTRs receiving high‐dose VGCV. Biopsy‐proven rejection occurred in 18 (9%) patients. Patients received VGCV prophylaxis for a median of 3.4 (IQR, 3.1‐4.3) months; 151 (76%) R+ LTRs receiving low‐dose VGCV developed leukopenia. Premature VGCV discontinuation and granulocyte‐colony stimulating factor use were infrequent and not significantly different between the 2 groups. In conclusion, low‐dose VGCV was safe and effective for prevention of CMV disease in our cohort of 200 R+ LTR and should be considered as an option in future guidelines. Liver Transplantation 24 616–622 2018 AASLD.
Transfer to High-Volume Centers Associated With Reduced Mortality After Endovascular Treatment of Acute Stroke

Background and Purpose— Some have argued that it may be beneficial to expand the availability of endovascular revascularization services to lower-volume hospitals to minimize the morbidity associated with transfer to larger endovascular centers. We compared the outcomes after revascularization of patients directly admitted to a low-volume center and those transferred to a high-volume center. Methods— We searched a national database of hospital-reported outcomes for patients who underwent endovascular revascularization for acute ischemic stroke. Hospitals were categorized as low, medium, or high procedural volume hospitals. Outcomes of inpatient admissions were collected and compared on the basis of admission source and hospital procedural volume. Results— A total of 118 institutions with 8533 patients were included. Mortality rate (14.9% versus 18.6%; P=0.049) and mortality index (1.1 versus 1.6; P=0.048) were significantly lower among directly admitted relative to transferred patients. For all patients, there were significant differences in institutional mortality rate (low: 19.7%, medium: 14.9%, high: 9.8%; P=0.003) and mortality index (low: 1.5, medium: 1.1, high: 0.8; P=0.004) between low-, medium-, and high-volume hospitals. For transferred patients to high-volume centers, both mortality rate (high: 10.0% versus low: 20.4%; P=0.005) and mortality index (high: 0.8 versus low: 1.5; P=0.034) were significantly lower than that observed for directly admitted patients to low-volume hospitals. Conclusions— We report a beneficial effect of treatment at high-volume hospitals in spite of the detrimental effects of transfer. These findings argue for the centralization of care.
Robust identification of dynamically distinct regions in stratified turbulence

We present a new robust method for identifying three dynamically distinct regions in a stratified turbulent flow, which we characterise as quiescent flow, intermittent layers and turbulent patches. The method uses the cumulative filtered distribution function of the local density gradient to identify each region. We apply it to data from direct numerical simulations of homogeneous stratified turbulence, with unity Prandtl number, resolved on up to $8192\times 8192\times 4096$ grid points. In addition to classifying regions consistently with contour plots of potential enstrophy, our method identifies quiescent regions as regions where $\unicode[STIX]{x1D716}/\unicode[STIX]{x1D708}N^{2}\sim O(1)$ , layers as regions where $\unicode[STIX]{x1D716}/\unicode[STIX]{x1D708}N^{2}\sim O(10)$ and patches as regions where $\unicode[STIX]{x1D716}/\unicode[STIX]{x1D708}N^{2}\sim O(100)$ . Here, $\unicode[STIX]{x1D716}$ is the dissipation rate of turbulence kinetic energy, $\unicode[STIX]{x1D708}$ is the kinematic viscosity and $N$ is the (overall) buoyancy frequency. By far the highest local dissipation and mixing rates, and the majority of dissipation and mixing, occur in patch regions, even when patch regions occupy only 5 % of the flow volume. We conjecture that treating stratified turbulence as an instantaneous assemblage of these different regions in varying proportions may explain some of the apparently highly scattered flow dynamics and statistics previously reported in the literature.
Unintended Side Effects of Transformation Are Very Rare in Cryptococcus neoformans

Received wisdom in the field of fungal biology holds that the process of editing a genome by transformation and homologous recombination is inherently mutagenic. However, that belief is based on circumstantial evidence. We provide the first direct measurement of the effects of transformation on a fungal genome by sequencing the genomes of 29 transformants and 30 untransformed controls with high coverage. Contrary to the received wisdom, our results show that transformation of DNA segments flanked by long targeting sequences, followed by homologous recombination and selection for a drug marker, is extremely safe. If a transformation deletes a gene, that may create selective pressure for a few compensatory mutations, but even when we deleted a gene, we found fewer than two point mutations per deletion strain, on average. We also tested these strains for changes in gene expression and found only a few genes that were consistently differentially expressed between the wild type and strains modified by genomic insertion of a drug resistance marker. As part of our report, we provide the assembled genome sequence of the commonly used laboratory strain Cryptococcus neoformans var. grubii strain KN99α.
Genetic effect of MTHFR C677T polymorphism on the structural covariance network and white‐matter integrity in Alzheimer's disease

The 677 C to T transition in the MTHFR gene is a genetic determinant for hyperhomocysteinemia. We investigated whether this polymorphism modulates gray matter (GM) structural covariance networks independently of white‐matter integrity in patients with Alzheimer's disease (AD). GM structural covariance networks were constructed by 3D T1‐magnetic resonance imaging and seed‐based analysis. The patients were divided into two genotype groups: C homozygotes (n = 73) and T carriers (n = 62). Using diffusion tensor imaging and white‐matter parcellation, 11 fiber bundle integrities were compared between the two genotype groups. Cognitive test scores were the major outcome factors. The T carriers had higher homocysteine levels, lower posterior cingulate cortex GM volume, and more clusters in the dorsal medial lobe subsystem showing stronger covariance strength. Both posterior cingulate cortex seed and interconnected peak cluster volumes predicted cognitive test scores, especially in the T carriers. There were no between‐group differences in fiber tract diffusion parameters. The MTHFR 677T polymorphism modulates posterior cingulate cortex‐anchored structural covariance strength independently of white matter integrities. Hum Brain Mapp 38:3039–3051, 2017. © 2017 Wiley Periodicals, Inc.
Sodium signaling and astrocyte energy metabolism

The Na+ gradient across the plasma membrane is constantly exploited by astrocytes as a secondary energy source to regulate the intracellular and extracellular milieu, and discard waste products. One of the most prominent roles of astrocytes in the brain is the Na+‐dependent clearance of glutamate released by neurons during synaptic transmission. The intracellular Na+ load collectively generated by these processes converges at the Na,K‐ATPase pump, responsible for Na+ extrusion from the cell, which is achieved at the expense of cellular ATP. These processes represent pivotal mechanisms enabling astrocytes to increase the local availability of metabolic substrates in response to neuronal activity. This review presents basic principles linking the intracellular handling of Na+ following activity‐related transmembrane fluxes in astrocytes and the energy metabolic pathways involved. We propose a role of Na+ as an energy currency and as a mediator of metabolic signals in the context of neuron–glia interactions. We further discuss the possible impact of the astrocytic syncytium for the distribution and coordination of the metabolic response, and the compartmentation of these processes in cellular microdomains and subcellular organelles. Finally, we illustrate future avenues of investigation into signaling mechanisms aimed at bridging the gap between Na+ and the metabolic machinery. GLIA 2016;64:1667–1676