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We constructed a new taxonomy for inferential thinking, a construct called Integrative Inferential Reasoning (IIR). IIR extends Pearson and Johnson's (1978) framework of "text-implicit" and "script-implicit" question-answer relations, and integrates several other prominent literacy theories to form a unified inferential reasoning construct, that is positioned as a type of cognitive processing disposition. We validated our construct using a researcher-made IIR instrument which was administered to 72 primary-grade students. Participants answered open-ended inference questions about various aspects of visual narratives presented in comic-strip format. We categorized participants' responses as exemplifying one of the levels of IIR: text-implicit, script-implicit, or a combination of both. We used item response models to validate the ordinal nature of IIR, and its structure. Specifically, we fit Masters' (1982) partial credit model and obtained a Wright map, mean location data, and reliability estimates. Results confirmed that the IIR construct behaves ordinally. Additionally, age was found to be a reliable predictor of IIR, and item types (each modeled as a separate dimension) were found to have reasonable latent correlations between the dimensions. This research provides theoretical and practical insights for the pedagogy and assessment of narrative comprehension.

This paper studies the notion of virtuality in the Bohr-Kramers-Slater theory of 1924. We situate the virtual entities of BKS within the tradition of the correspondence principle and the radiation theory of the Bohr model. We show how, in this context, virtual oscillators emerged as classical substitute radiators and were used to describe the otherwise elusive quantum transitions. They played an effective role in the quantum theory of radiation while remaining categorically distinct and ontologically separated from the quantum world of the Bohr model. The notion of virtuality thus differs markedly from its counterpart in quantum mechanics or QFT. [ABSTRACT FROM AUTHOR]

Objective: The Trans Woman Voice Questionnaire (TWVQ) is commonly used to quantify self‐perceptions of voice for trans women seeking gender‐affirming voice care, but the interpretation of TWVQ scores remains challenging. The objective of this study was to use item‐response theory (IRT) to evaluate the relationship between TWVQ items and persons on a common scale and identify improvements to increase the meaningfulness of TWVQ scores. Methods: A retrospective review of TWVQ scores from trans women patients between 2018–2020 was performed. Rasch‐family models were used to generate item‐person maps positioning respondent location and item difficulty estimates on a logit scale, which was then converted into a scaled score using linear transformations. Results: TWVQ responses from 86 patients were analyzed. Initial item‐person maps demonstrated that the middle response categories ("sometimes" and "often") performed inconsistently across items (poor threshold banding); interpretability improved when these ratings were scored as one category. The models were rerun using revised scoring, which retained high reliability (0.93) and supported a unidimensional construct. Updated item‐person maps revealed four scaled score zones (≤54, >54 to ≤101, >101 to ≤140, and >140) that each corresponded to an increasing pattern of item thresholds (probability of selecting one response category vs. others). These ranges can be interpreted as minimal, low, moderate, and high, respectively. Conclusions: Empiric data from Rasch analysis supports new interval scoring for the TWVQ that advances the clinical and research utility of the instrument and lays the foundation for future improvements in clinical care and outcomes assessment. Level of Evidence: NA Laryngoscope, 133:1197–1204, 2023 [ABSTRACT FROM AUTHOR]

After General Relativity was established in essentially its present form in 1915 it was celebrated as a great success of mathematical physics. But the initial hopes for this theory as a basis for all of physics began to fade in the next several decades, as General Relativity was relegated to the margins of theoretical physics. Its fate began to rise in the 1950's in a revival of interest and research that over time made gravitational physics one of the hottest research topics it is today. One center of this renaissance was Princeton, where two relative newcomers explored new and different approaches to gravitational physics. Robert Dicke showed that gravity is not as inaccessible to experiment as was thought, and John Wheeler propelled it into the mainstream by proposing highly original and imaginative consequences of Einstein's theory. We will concentrate on these ideas that, in his characteristically intriguing style, Wheeler called "Daring Conservatism" -- a term well known to his associates, but one he never mentioned in print. With the aid of unpublished manuscripts and notes we will explore Daring Conservatism's origin and motivation, its successes and failures, and the legacy it left behind.

The article discusses the unjust nature of underresourced health systems that are tasked with providing care to refugee populations across the globe. Topics covered include how individuals displaced by conflict and violence continue to bear the burdens of war decades later, the challenges of providing quality medical and surgical care for elderly patients in refugee camp settings and the population's absence in global surveys and health data.

Background Mycobacterium tuberculosis (Mtb) strains resistant to isoniazid and rifampin (multidrug-resistant tuberculosis [MDR-TB]) are increasingly reported worldwide, requiring renewed focus on the nuances of drug resistance. Patients with low-level moxifloxacin resistance may benefit from higher doses, but limited clinical data on this strategy are available. Methods We conducted a 5-year observational cohort study of MDR-TB patients at a tertiary care center in India. Participants with Mtb isolates resistant to isoniazid, rifampin, and moxifloxacin (at the 0.5 µg/mL threshold) were analyzed according to receipt of high-dose moxifloxacin (600 mg daily) as part of a susceptibility-guided treatment regimen. Univariable and multivariable Cox proportional hazard models assessed the relationship between high-dose moxifloxacin and unfavorable treatment outcomes. Results Of 354 participants with MDR-TB resistant to moxifloxacin, 291 (82.2%) received high-dose moxifloxacin. The majority experienced good treatment outcomes (200 [56.5%]), which was similar between groups (56.7% vs 54.0%, P  = .74). Unfavorable outcomes were associated with greater extent of radiographic disease, lower initial body mass index, and concurrent treatment with fewer drugs with confirmed phenotypic susceptibility. Treatment with high-dose moxifloxacin was not associated with improved outcomes in either unadjusted (hazard ratio [HR], 1.2 [95% confidence interval {CI},.6–2.4]) or adjusted (HR, 0.8 [95% CI,.5–1.4]) models but was associated with joint pain (HR, 3.2 [95% CI, 1.2–8.8]). Conclusions In a large observational cohort, adding high-dose (600 mg) moxifloxacin to a drug susceptibility test–based treatment regimen for MDR-TB was associated with increased treatment-associated side effects without improving overall outcomes and should be avoided for empiric treatment of moxifloxacin-resistant MDR-TB. [ABSTRACT FROM AUTHOR]

Hyaluronan (HA) is abundant in the skin; while HA can be synthesized by the synthases (HAS1-3), HAS2 is the leading contributor. Dysregulation and accumulation of HA is implicated in the pathogenesis of diseases such as keloid scarring, lymphedema and metastatic melanoma. To understand how HA synthesis contributes to skin physiology, and pathologic and fibrotic disorders, we propose the development of skin-specific HA inhibition model, which tests an optimal delivery system of topical 4-methylumbelliferone (4-MU). A design-of-experiments (DOE) approach was employed to develop an optimal 4-MU skin-delivery formulation comprising propylene glycol, ethanol, and water, topically applied to dorsal skin in male and female C57BL/6J wildtype mice to determine the effect on HAS gene expression and HA inhibition. Serum and skin samples were analyzed for HA content along with analysis of expression of HAS1-3, hyaluronidases (HYAL 1-2), and KIAA1199. Using results from DOE and response surface methodology with genetic algorithm optimization, we developed an optimal topical 4-MU formulation to result in -70% reduction of HA in dorsal skin, with validation demonstrating ~50% reduction in HA in dorsal skin. 4-MU topical application resulted in significant decrease in skin HAS2 expression in female mice only. Histology showed thicker dermis in male mice, whereas female mice had thinner dermal layer with more adiposity; and staining for HAbinding protein showed that topical 4-MU resulted in breakdown in HA. Our data suggest a topical 4-MU formulation-based dermal HA inhibition model that would enable elucidating the skin-specific effects of HA in normal and pathologic states. [ABSTRACT FROM AUTHOR]