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A 52-year-old woman visited the neurologist because of drooping eyelids, which had not changed much over the past 10 years. She felt socially disabled because of the constant need to tilt her head upwards. Old photographs showed slight drooping from her mid-teens onwards. At one point she had experienced transient double vision. Speaking, swallowing, and limb muscle strength were reportedly normal. The family history was negative.
Coronavirus disease-2019 precipitated the rapid deployment of novel therapeutics, which led to operational and logistical challenges for healthcare organizations. Four health systems participated in a qualitative study to abstract lessons learned, challenges, and promising practices from implementing neutralizing monoclonal antibody (nMAb) treatment programs. Lessons are summarized under three themes that serve as critical building blocks for health systems to rapidly deploy novel therapeutics during a pandemic: (1) clinical workflows, (2) data infrastructure and platforms, and (3) governance and policy. Health systems must be sufficiently agile to quickly scale programs and resources in times of uncertainty. Real-time monitoring of programs, policies, and processes can help support better planning and improve program effectiveness. The lessons and promising practices shared in this study can be applied by health systems for distribution of novel therapeutics beyond nMAbs and toward future pandemics and public health emergencies.
Chapter 3 examines mythical, historical, and scientific facts. It offers a brief history of East Asian international relations, paying particular attention to the Chinese World Order, the Khmer Empire, and post-colonial Filipino historiography as samples for how to theorize histories from an IR perspective. The chapter discusses war and peace as well as political economy, the subject matters important for East Asian history and IR theory. It also offers a section on impacts and lessons of history, illustrating how history contributes to background knowledge, historiography and belief systems, foreign policy analysis, and IR theory. A better understanding of East Asian history allows us to contextualize contemporary issues without which we may not be able to put together a puzzle. Historical experiences inform our belief system, into which people typically fit new events or factors as explanation. History is evolutionary by nature, whether we frame it that way explicitly or not.
The caliph Al Mansur literally forged the city plan in fire in 762 CE. His Round City was an architectural symbol of order in a vast combustible empire. Ninth-century Baghdad had relations extending from the Atlantic to China, with tranches of coins found as far afield as Scandinavia. The city was by design the heart of a vast city network at a time of pronounced urbanization, an urban golden age by standard reckonings. At the height of Abbasid power its population was an estimated 840,000. It thereby stretched the geographic boundaries of time and space across Eurasia, a Silk Roads terminus in its own right. Baghdad was one of the world’s preeminent “open cities,” incubating trade, knowledge in art, astronomy, mathematics, amidst a myriad of other cross-cultural exchanges. It attracted generations of scientists, philosophers, planners, and literati, especially from Central Asia. Migratory flows included a durable revolving network linking Baghdad to Merv and other key centers of learning and trade along the Silk Roads. Rapidly expanding Islamic civilization had to develop new forms of city building to spread Dar al Islam (the realm of Islam) across vast disparate realms.
A 68-year-old woman was referred because of slowly progressive difficulty climbing stairs. Four years earlier, she had had ptosis surgery of both eyes. Her mother had been diagnosed with progressive external ophthalmoplegia at the age of 69 years. She denied having swallowing difficulties, but her daughter stressed that eating biscuits took her much longer than others.
Committed to the same Aristotelian and Ptolemaic principles as their European counterparts, Arab astronomers produced highly accurate records of celestial motions and sought solutions to the same discrepancies between observation and theory. But none of these involved questioning geocentrism; astronomy was often pursued as an aid to religious observance, giving accurate times for holidays and rituals. Copernicus drew on Islamic writings as on many others, but claims that his heliocentrism in some way depended on them are unacceptable, given their unquestioning geocentrism. In his great work on Chinese science, Joseph Needham showed that it was often superior to Western natural philosophy both empirically and in its understanding of basic natural processes. He attributed its failure to produce a Copernican-Newtonian revolution to various external factors. But the notion that it had such potential rests on the false assumption that its strengths were the ground out of which a science capable of overturning the bases of its own practices might emerge. Such a capacity depends instead on the presence of conditions favorable to rendering the sphere of science autonomous. Only in the nineteenth century, spurred by modern chemistry, biology and physics brought by Western medical missionaries, would Chinese science take this turn.
A growing number of interventional procedures and diagnostic studies performed in the radiology department require moderate sedation. During the past decades interventional radiology has evolved from a referral-based specialty to a clinical specialty, a change reflected in its recognition as an independent medical specialty by the American Board of Medical Specialties [1]. This paradigm shift has been accompanied by an increase in the scope and volume of practice, and in the commensurate requirement for moderate sedation.
When they occur, azimuthal thermoacoustic oscillations can detrimentally affect the safe operation of gas turbines and aeroengines. We develop a real-time digital twin of azimuthal thermoacoustics of a hydrogen-based annular combustor. The digital twin seamlessly combines two sources of information about the system: (i) a physics-based low-order model; and (ii) raw and sparse experimental data from microphones, which contain both aleatoric noise and turbulent fluctuations. First, we derive a low-order thermoacoustic model for azimuthal instabilities, which is deterministic. Second, we propose a real-time data assimilation framework to infer the acoustic pressure, the physical parameters, and the model bias and measurement shift simultaneously. This is the bias-regularized ensemble Kalman filter, for which we find an analytical solution that solves the optimization problem. Third, we propose a reservoir computer, which infers both the model bias and measurement shift to close the assimilation equations. Fourth, we propose a real-time digital twin of the azimuthal thermoacoustic dynamics of a laboratory hydrogen-based annular combustor for a variety of equivalence ratios. We find that the real-time digital twin (i) autonomously predicts azimuthal dynamics, in contrast to bias-unregularized methods; (ii) uncovers the physical acoustic pressure from the raw data, i.e. it acts as a physics-based filter; (iii) is a time-varying parameter system, which generalizes existing models that have constant parameters, and capture only slow-varying variables. The digital twin generalizes to all equivalence ratios, which bridges the gap of existing models. This work opens new opportunities for real-time digital twinning of multi-physics problems.
A boy was born at 33 weeks’ gestational age via caesarean delivery because of a transverse position and difficulties in obtaining an adequate cardiotocography. Pregnancy had been complicated by fetal growth restriction with an abdominal circumference at p10, and polyhydramnios. His mother had noticed a reduction in fetal movements the day before delivery. Immediately after birth, he was hypotonic, pale, bradycardic, and without spontaneous breathing. Resuscitation was started with bag and mask ventilation and thoracic compressions. Heart rate and oxygen levels quickly normalized. However, breathing remained insufficient. Arterial CO2 levels rose to 14.0 kPa (ref 4.7–6.4) and he was intubated. He was the first child of unrelated parents. His mother had been diagnosed with obesity and gestational diabetes. The maternal grandmother had a sister whose daughter had a son who had died two days after birth more than 20 years earlier.
This chapter looks at the ways how, from 1948 onwards, the meaning of the trials changed in light of the broader Cold War context internationally and intensifying criticism domestically. Administratively, the trials were coming to an end. They had, from the perspective of the public authorities, succeeded in their original purposes of securing inner peace and stability during the early months following the liberation. Yet, from 1948 onwards, they became acutely relevant in light of the new political threats and challenges the Norwegian state faced, at the same time as the authorities sought to defend their legacy in light of mounting criticism from some sentenced collaborators and public intellectuals. This chapter therefore argues that the final stages of the trials assumed a renewed demonstrative dimension as the government sought to reassert its administrative and interpretative authority over the trials in a changed political context.
This chapter introduces layered architecture for molecular communication. Inspired by, but distinct from, layered architecture in conventional communication networks, this chapter introduces a layered design that is appropriate for molecular communication applications. Models and functionalities of each layer are discussed.
This chapter analyzes interactions between the Mansfeld Regiment and its surroundings, including confessional conflict, fights, burials, and the regiment’s effect on local demographics. The Mansfelders were both Protestant and Catholic, but the regiment was quartered in a Catholic land. Its members fought with or plundered locals. However, its effects on baptism, marriage, and death rates in most of the areas I analyzed were ambiguous. The exception is tiny Pontestura: Not only was the effect of numerous armies magnified in such a small town, but wrongdoings there were less likely to come to the attention of the authorities. I also locate a woman who may have been the wife of the enigmatic regimental secretary Mattheus Steiner in local baptismal records, exemplifying that interactions between Mansfelders and locals were not solely hostile. This chapter examines military death rates, which were awful even outside of combat, and may find evidence of the great Italian plague of 1629–1631 in the deaths of soldiers and other marginal men.