Background

Acute stroke codes may be activated for anisocoria, but how often these codes lead to a final stroke diagnosis or alteplase treatment is unknown. The purpose of this study was to assess the frequency of anisocoria in stroke codes that ultimately resulted in alteplase administration.

Methods

We retrospectively assessed consecutive alteplase-treated patients from a prospectively-collected stroke registry between February 2015 and July 2018. Based on the stroke code exam, patients were categorized as having isolated anisocoria [A+(only)], anisocoria with other findings [A+(other)], or no anisocoria [A-]. Baseline demographics, stroke severity, alteplase time metrics, and outcomes were also collected.

Results

Ninety-six patients received alteplase during the study period. Of the 94 who met inclusion criteria, there were 0 cases of A+(only). There were 9 cases of A+(other) (9.6%). A+(other) exhibited higher baseline National Institutes of Health (NIH) Stroke Scale scores compared to A- (17 versus 7; P = .0003), and no additional differences in demographics or alteplase time metrics. Final stroke diagnosis and other outcome measures were no different between A+(other) and A-. Of the A+ patients without pre-existing anisocoria, 5 of 6 (83%) had posterior circulation events or diffuse subarachnoid hemorrhage.

Conclusions

In this exploratory analysis, zero patients with isolated anisocoria received alteplase treatment. Anisocoria as a part of the neurologic presentation occurred in 10% of alteplase patients, and was strongly associated with a posterior circulation event. Therefore, we conclude that anisocoria has a higher likelihood of leading to alteplase treatment when identified in the presence of other neurologic deficits.

Next generation high-precision neutrino scattering experiments have the goal of measuring the as-of-yet unknown parameters governing neutrino oscillation. This effort is hampered by the use of large nuclear targets: secondary interactions within a nucleus can confuse the interpretation of experimental data, leading to ambiguities about the initial neutrino interaction in scattering events. The distribution of energies for neutrino events must instead be inferred from the responses of a sum of dissimilar event topologies. For this reason, precise neutrino cross sections on nucleon targets are of vital importance to the neutrino oscillation experimental program. On the other hand, the necessary experimental data for neutrino scattering with elementary targets are scarce because of the weak interaction cross section, which leads to poorly-constrained nucleon and nuclear cross sections. Lattice QCD is uniquely positioned to provide the requisite nucleon amplitudes needed to enable high-precision oscillation experiments. In particular, LQCD has the ability to probe axial matrix elements that are challenging to isolate or completely inaccessible to experiments. In these proceedings, I will discuss some of my work to quantify neutrino cross sections with realistic uncertainty estimates, primarily focusing on neutrino quasielastic scattering and the nucleon axial form factor. I will also outline how the needs of next-generation neutrino oscillation experimental programs can be met with modern dedicated LQCD computations.

Engle and Conant (2002) show how productive disciplinary engagement (PDE) for students can be attained through learning environments structured to support problematizing subject matter, give students authority to address content problems, hold students accountable to others and disciplinary norms, and provide students with resources. This paper considers how one classroom's involvement in a scientific investigation embodied and extended the PDE framework. In this U.S. based classroom, 5th grade non-native and English language learning students engaged in scientific inquiry and contributed their findings to a greater scientific community. This paper proposes that these students experienced PDE at both initial and deeper levels, where students’ initial PDE in scientific activities served as a resource for PDE at a more discipline-specific level.

This document provides a brief report of activities conducted for a final capstone project in Scripps Institution of Oceanography’s Master of Advanced Studies graduate degree program in Marine Biodiversity and Conservation. The project leverages Geographic Information System tools to facilitate community engagement with local marine protected areas in the Honduran Bay Islands, and included a three-week visit to the field site to train and educate local stakeholders using the tools that were created. The following report will be divided into a brief introduction, summaries of the activities and methodology utilized prior to the field visit, activities conducted during the three-week field visit, and then final recommendations and future prospects for the project. It will also link to all products and materials created as part of this project, which have been made freely available for public use in local environmental education initiatives.