Background: Lower socioeconomic status is associated with worse outcomes after stroke. We evaluated the differences in acute revascularization treatments in patients with acute ischemic stroke (AIS) who were materially deprived compared to those who were not. Methods: In a population-based cohort study, we used linked administrative data to identify community-dwelling adults hospitalized for AIS between 2017-2022 in Ontario, Canada. The main exposure was neighborhood-level material deprivation quintiles. Multivariable logistic regression was used to obtain the adjusted odds ratio (aOR) of receiving revascularization treatments (thrombolysis or thrombectomy) for patients in each deprivation quintile compared to the least deprived quintile. Results: We identified 57,709 patients (median age 74 years; 45.9% female). Compared to patients in the least deprived quintile, those with higher deprivation were younger and more likely to have hypertension and diabetes, but less likely to have atrial fibrillation. Compared to patients in the least deprived quintile, fewer patients in the very deprived quintile (17.9% vs 19.6%, aOR 0.88, 95%CI [0.82,0.95]) and in the most deprived quintile (16.6% vs 19.6%, 0.77 [0.71,0.83]) received revascularization treatments. Conclusions: Our results suggest disparities in the use of acute ischemic stroke revascularization treatments by socioeconomic status despite access to universal health care.

Words’ morphemic structure and their orthographic representations vary across languages. How do bilingual experiences with structurally distinct languages influence children's morphological processes for word reading? Focusing on English literacy in monolinguals and bilinguals (N = 350, ages 5–9), we first revealed unique contributions of derivational (friend-li-est) and compound (girl-friend) morphology to early word reading. We then examined mechanisms of bilingual transfer in matched samples of Spanish–English and Chinese–English dual first language learners. Results revealed a principled cross-linguistic interaction between language group (Spanish vs. Chinese bilinguals) and type of morphological awareness. Specifically, bilinguals’ proficiency with the type of morphology that was less characteristic of their home language explained greater variance in their English literacy. These findings showcase the powerful effects of bilingualism on word reading processes in children who have similar reading proficiency but different language experiences, thereby advancing theoretical perspectives on literacy across diverse learners.

We report the experimental results of the commissioning phase in the 10 PW laser beamline of the Shanghai Superintense Ultrafast Laser Facility (SULF). The peak power reaches 2.4 PW on target without the last amplifying during the experiment. The laser energy of 72 ± 9 J is directed to a focal spot of approximately 6 μm diameter (full width at half maximum) in 30 fs pulse duration, yielding a focused peak intensity around 2.0 × 1021 W/cm2. The first laser-proton acceleration experiment is performed using plain copper and plastic targets. High-energy proton beams with maximum cut-off energy up to 62.5 MeV are achieved using copper foils at the optimum target thickness of 4 μm via target normal sheath acceleration. For plastic targets of tens of nanometers thick, the proton cut-off energy is approximately 20 MeV, showing ring-like or filamented density distributions. These experimental results reflect the capabilities of the SULF-10 PW beamline, for example, both ultrahigh intensity and relatively good beam contrast. Further optimization for these key parameters is underway, where peak laser intensities of 1022–1023 W/cm2 are anticipated to support various experiments on extreme field physics.

This paper investigates potential biodiversity valuation tools which actuaries could use in their work. It is an initial research paper into a selection of UK-based biodiversity valuation tools identified by the Department for Environment and Rural Affairs in its publication “Enabling a Natural Capital Approach Guidance”. The “Enabling a Natural Capital Approach Guidance” publication is seen as a comprehensive practical guide to natural capital and therefore is determined a sensible starting point on which to base this research. This research paper is not intended to be an exhaustive exploration of all biodiversity tools available, but rather is intended to identify a selection of tools which may be candidates for further research into their actuarial use case. We conclude that there are tools which merit additional research, and we recommend that these tools be further investigated to understand (i) the specific actuarial use case(s), (ii) whether the tools are applicable to direct infrastructure investments only or a broad range of asset classes, and (iii) whether their scope can be extended beyond the UK.

Given the importance of angiostrongyliasis as an emerging infectious disease of humans, companion animals, and wildlife, the current study focused on the transmission dynamics of first- and third-stage larvae of the parasitic nematode, Angiostrongylus cantonensis. The migration of infective larvae and their subsequent distribution within the Lymnaeidae snail, Bullastra lessoni, were investigated over time using microscopic examination of histological sections and fresh tissue. Snails were divided into four anatomical regions: (i) anterior and (ii) posterior cephalopedal masses, (iii) mantle skirt and (iv) visceral mass. The viability of free-swimming third-stage larvae, after their release from snail tissues, was evaluated in vitro by propidium iodide staining and infectivity by in vivo infection of Wistar rats. Snails were sequentially dissected over time to assess the number and anatomical distribution of larvae within each snail and hence infer their migration pathway. Herein, ongoing larval migratory activity was detected over 28 days post-infection. A comparison of infection rates and the larval distribution within the four designated snail regions demonstrated a significant relationship between anatomical region and density of infective larvae, with larvae mostly distributed in the anterior cephalopedal mass (43.6 ± 10.8%) and the mantle skirt (33.0 ± 8.8%). Propidium iodide staining showed that free-swimming third-stage larvae retained viability for between 4 and 8 weeks when stored under laboratory conditions. In contrast to viability, larval infectivity in rats remained for up to 2 weeks only. Knowledge gained from the current work could provide information on the development of new approaches to controlling the transmission of this parasite.

OBJECTIVES/GOALS: To determine the impact of fertility preserving treatment (FPT) on likelihood of live birth in a cohort of reproductive-age women (18-45 y) after diagnosis of gynecologic malignancy or pre-malignancy METHODS/STUDY POPULATION: We performed a retrospective cohort study of women ages 18-45 seen by gynecologic oncologists for newly diagnosed cervical cancer (CC), endometrial intraepithelial neoplasia (EIN) or endometrial cancer (EC), and borderline ovarian tumor (BOT) or invasive ovarian cancer (OC) at an academic center from 2015-2019, excluding women who completed childbearing. Our primary outcome was live birth after diagnosis and our exposure was FPT defined as services received by reproductive endocrinology and infertility specialists. We performed Pearsons Chi-squared and log binomial regression to assess association between live birth and FPT with adjustment for patient demographic and disease factors. RESULTS/ANTICIPATED RESULTS: Out of 220 women (median age 36 y), most were White (54% vs. 25% Black) and 37% percent were diagnosed with BOT/OC (vs. 35% EIN/EC; 28% CC). After diagnosis of disease, 19% of women (n=41) had documented FPT and 8% of women (n= 17) had a live birth. By the end of follow-up, 6% of women who did not receive FPT had a live birth (n=11/178) compared to 15% of those who did (n=6/40, p=0.12). In univariate regression, women who received FPT were 2.4 times more likely to have a live birth after disease diagnosis that those who did not receive FPT (p-value = 0.06). However, after adjusting for age at diagnosis, relationship status, disease stage and disease type, the association between FPT and live birth was less robust (RR = 1.4, p-value = 0.6). DISCUSSION/SIGNIFICANCE: In this study, a minority of women had FPT or live births. Our data suggest that FPT benefit should be considered in context of age, relationship status, and disease characteristics for reproductive-age women diagnosed with gynecologic malignancies. Given the complexity, women should be offered referral for consultation with a fertility specialist.

Background: Ancillary tests are indicated to diagnose death by neurological criteria whenever clinical neurological examination is unreliable, but their use is variable and subject to debate. Methods: Survey of Canadian intensivists providing care for potential organ donors. We included closed-ended questions and different clinical scenarios regarding the use of ancillary tests. Results: Among 550 identified intensivists, 249 completed the survey. Respondents indicated they would be comfortable diagnosing death based on neurological examination without ancillary tests in the following scenarios: movement in response to stimulation (48%), spontaneous peripheral movement (31%), inability to evaluate upper/lower extremity responses (34%) or both oculocephalic and oculo-caloric reflexes (17%), presence of high cervical spinal cord injury (16%) and within 24 hours of hypoxemic-ischemic brain injury (15%). Furthermore, 93% agreed that ancillary tests should always be conducted when a complete neurological examination is impossible, 89% if there remains possibility of residual sedative effect and 59% in suspected isolated brainstem death. Conclusions: Our findings suggest that Canadian intensivists have different perceptions on what constitutes a complete and reliable clinical neurological examination for determining death by neurologic criteria. Some self-reported practices also diverge from national recommendations. Further investigation and education are required to align and standardize medical practice across physicians and systems.

In the coastal ocean, interactions of waves and currents with large roughness elements, similar in size to wave orbital excursions, generate drag and dissipate energy. These boundary layer dynamics differ significantly from well-studied small-scale roughness. To address this problem, we derived spatially and phase-averaged momentum equations for combined wave–current flows over rough bottoms, including the canopy layer containing obstacles. These equations were decomposed into steady and oscillatory parts to investigate the effects of waves on currents, and currents on waves. We applied this framework to analyse large-eddy simulations of combined oscillatory and steady flows over hemisphere arrays (diameter $D$), in which current ($U_c$), wave velocity ($U_w$) and period ($T$) were varied. In the steady momentum budget, waves increase drag on the current, and this is balanced by the total stress at the canopy top. Dispersive stresses from oscillatory flow around obstacles are increasingly important as $U_w/U_c$ increases. In the oscillatory momentum budget, acceleration in the canopy is balanced by pressure gradient, added-mass and form drag forces; stress gradients are small compared to other terms. Form drag is increasingly important as the Keulegan–Carpenter number $KC=U_wT/D$ and $U_c/U_w$ increase. Decomposing the drag term illustrates that a quadratic relationship predicts the observed dependences of steady and oscillatory drag on $U_c/U_w$ and $KC$. For large roughness elements, bottom friction is well represented by a friction factor ($f_w$) defined using combined wave and current velocities in the canopy layer, which is proportional to drag coefficient and frontal area per unit plan area, and increases with $KC$ and $U_c/U_w$.

A study of 1,558 US households in June 2020 evaluated utilization of online grocery shopping during the COVID-19 pandemic, influences on utilization, and plans for future online grocery shopping. Nearly 55 percent of respondents shopped online in June 2020; 20 percent were first-timers. Cragg model estimates showed influences on online shopping likelihood and frequency included demographics, employment, and prior online shopping. Illness concerns increased likelihood, while food shortage concerns increased frequency of online shopping. A multinomial probit suggested 58 percent respondents planned to continue online grocery shopping regardless of pandemic conditions.