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We answer questions of Arhangel'skiĭ using spaces defined from combinatorial objects. We first establish further convergence properties of a space constructed from □ ( κ ) showing it is Fréchet-Urysohn for finite sets and a w-space that is not a W-space. We also show that under additional assumptions it may be not bi-sequential, and so providing a consistent example of an absolutely Fréchet α1 space that is not bisequential. In addition, if we do not require the space being α1, we can construct a ZFC example of a countable absolutely Fréchet space that is not bisequential from an almost disjoint family of subsets of the natural numbers.

Purpose: Patient experience tools are used throughout health care to evaluate physician and departmental performance. In radiation medicine, these tools are important in evaluating patient-specific metrics throughout their care journey. This study compared patient experience outcomes from a central tertiary cancer program with network clinics in a health care network. Methods and Materials: Radiation medicine patient experience surveys (Press Ganey, LLC) were collected from a central facility and 5 network locations from January 2017 through June 2021. Surveys were distributed to patients after treatment completion. The study cohort was divided into the central facility and satellites. Questions were converted to a 0 to 100 scale from the Likert scale (1-5). To compare scores between site types, 2-way analysis of variance tests for the significance of sites adjusted for years of operations and adjustments for multiple comparisons (Dunnett's test) were completed on each question. Results: The number of consecutively returned surveys analyzed was 3777; a response rate of 33.3% was observed. The central site conducted 117,583 linear accelerator, 1425 Gamma Knife, 273 stereotactic radiosurgery, and 830 stereotactic body radiation therapy procedures. All satellites combined conducted 76,788 linear accelerator, 131 Gamma Knife, 95 stereotactic radiosurgery, and 355 stereotactic body radiation therapy procedures. The central facility fared better than the satellites on “Convenience of parking” (95.9 vs 87.9; P = .0001) but worse in other domains of care. Conclusions: All sites yielded exemplary patient experience rates. Community clinics scored higher than the main campus. The higher scores at the network sites require a deeper analysis of factors influencing the central facility, as the survey did not account for varying patient volumes and disparities in care complexity across sites. Attributes to satellites include lower patient volumes and easily navigable layouts. These results counter the impression that increased resources at the main campus create a better patient experience relative to network clinics and suggest that high-volume tertiary facilities will require unique initiatives to improve the patient experience.

Summary: In the brain, the complement system plays a crucial role in the immune response and in synaptic elimination during normal development and disease. Here, we sought to identify pathways that modulate the production of complement component 4 (C4), recently associated with an increased risk of schizophrenia. To design a disease-relevant assay, we first developed a rapid and robust 3D protocol capable of producing large numbers of astrocytes from pluripotent cells. Transcriptional profiling of these astrocytes confirmed the homogeneity of this population of dorsal fetal-like astrocytes. Using a novel ELISA-based small-molecule screen, we identified epigenetic regulators, as well as inhibitors of intracellular signaling pathways, able to modulate C4 secretion from astrocytes. We then built a connectivity map to predict and validate additional key regulatory pathways, including one involving c-Jun-kinase. This work provides a foundation for developing therapies for CNS diseases involving the complement cascade.

Abstract Objective Clinicians rely on patient self‐report of impairment during seizures for decisions including driving eligibility. However, the reliability of patient reports on cognitive and behavioral functions during seizures remains unknown. Methods We administered a daily questionnaire to epilepsy patients undergoing continuous video‐EEG monitoring, asking about responsiveness, speech, memory, awareness, and consciousness during seizures in the preceding 24 hours. We also administered a questionnaire upon admission about responsiveness, speech, and awareness during seizures. Subjective questionnaire answers were compared with objective behavioral ratings on video review. Criteria for agreement were Cohen’s kappa >0.60 and proportions of positive and negative agreement both >0.75. Results We analyzed 86 epileptic seizures in 39 patients. Memory report on the daily questionnaire met criteria for agreement with video review (κ = 0.674 for early, 0.743 for late recall). Subjective report of awareness also met agreement criteria with video ratings of memory (κ = 0.673 early, 0.774 late). Concordance for speech was relatively good (κ = 0.679) but did not meet agreement criteria, nor did responsiveness or consciousness. On the admission questionnaire, agreement criteria were met for subjective report of awareness versus video ratings of memory (κ = 0.814 early, 0.806 late), but not for other comparisons. Interpretation Patient self‐report of memory or awareness showed the best concordance with objective memory impairment during seizures. Self‐report of impairment in other categories was less reliable. These findings suggest that patient reports about impaired memory during seizures may be most reliable, and otherwise determining functional impairments should be based on objective observations.

Individuals that maintain healthy skeletal tissue tend to live healthier, happier lives as proper muscle function enables maintenance of independence and actuation of autonomy. The onset of skeletal muscle decline begins around the age of 30, and muscle atrophy is associated with a number of serious morbidities and mortalities. Satellite cells are responsible for regeneration of skeletal muscle and enter a reversible non-dividing state of quiescence under homeostatic conditions. In response to injury, satellite cells are able to activate and re-enter the cell cycle, creating new cells to repair and create nascent muscle fibres while preserving a small population that can return to quiescence for future regenerative demands. However, in aged muscle, satellite cells that experience prolonged quiescence will undergo programmed cellular senescence, an irreversible non-dividing state that handicaps the regenerative capabilities of muscle. This review examines how periodic activation and cycling of satellite cells through exercise can mitigate senescence acquisition and myogenic decline.

Human and environmental water needs can come into conflict in dam-regulated river systems. Here, Chen and Olden investigate the potential for the use of fish–flow modeling to make recommendations for the management of native and nonnative fish species whilst providing water for society.

Accurate automated segmentation of remote sensing data could benefit applications from land cover mapping and agricultural monitoring to urban development surveyal and disaster damage assessment. While convolutional neural networks (CNNs) achieve state-of-the-art accuracy when segmenting natural images with huge labeled datasets, their successful translation to remote sensing tasks has been limited by low quantities of ground truth labels, especially fully segmented ones, in the remote sensing domain. In this work, we perform cropland segmentation using two types of labels commonly found in remote sensing datasets that can be considered sources of “weak supervision”: (1) labels comprised of single geotagged points and (2) image-level labels. We demonstrate that (1) a U-Net trained on a single labeled pixel per image and (2) a U-Net image classifier transferred to segmentation can outperform pixel-level algorithms such as logistic regression, support vector machine, and random forest. While the high performance of neural networks is well-established for large datasets, our experiments indicate that U-Nets trained on weak labels outperform baseline methods with as few as 100 labels. Neural networks, therefore, can combine superior classification performance with efficient label usage, and allow pixel-level labels to be obtained from image labels.

Light emitted diode (LED) is becoming more popular in the illumination field, and the design of LED lighting is generally made to provide illumination at lower power usage, helping save energy. A power electronic converter is needed to provide the power conversion for these LEDs to meet high efficiency, reduce components, and have low voltage ripple magnitude. The power supply for LED is revisited in this paper. The LEDs connected in series with diode, transistor, or inductor paths are examined. The formulation for each of the cases is described, including the classical converters of buck, boost, buck−boost, and Ćuk. The circuit reductions of the classic circuit, circuit without the capacitor, and without a freewheeling diode are studied. Using LED to replace freewheeling diodes is proposed for circuit component reduction. General equations for different connection paths have been developed. The efficiency and output ripple amplitude of the proposed power converters are investigated. Analytical study shows that the efficiency of proposed circuits can be high and voltage ripple magnitude of proposed circuits can be low. The results show that the proposed circuit topologies can be easily adapted to design LED lighting, which can meet the criteria of high efficiency, minimum components, and low-voltage ripple magnitude at the same time.

Mature skeletal myofibers are elongated and multinucleated cells. Many stem/progenitor cell types, including committed muscle stem (satellite cells) and progenitor (myoblasts) cells, muscle-derived stem cells, myogenic endothelial cells, and mesenchymal stem/stromal cells, have been shown to exhibit skeletal myogenesis under appropriate inductive conditions. Committed muscle stem/progenitor cells and multipotent stem/progenitor cells which have skeletal myogenic capacity can typically be differentiated into skeletal myofibers in vitro following extended low-serum exposure. Differentiated cells exhibit distinct fiber-like elongated morphology with multiple nuclei and express unique muscle molecular markers indicating myogenesis, including desmin (early) and fast- and/or slow-myosin heavy chain (mature).