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2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus
2019 Novel Coronavirus (2019-nCoV) is an emerging infectious disease closely related to MERS-CoV and SARS-CoV that was first reported in Wuhan City, Hubei Province, China in December 2019. As of January 2020, cases of 2019-nCoV are continuing to be reported in other Eastern Asian countries as well as in the United States, Europe, Australia, and numerous other countries. An unusually high volume of domestic and international travel corresponding to the beginning of the 2020 Chinese New Year complicated initial identification and containment of infected persons. Due to the rapidly rising number of cases and reported deaths, all countries should be considered at risk of imported 2019-nCoV. Therefore, it is essential for prehospital, clinic, and emergency department personnel to be able to rapidly assess 2019-nCoV risk and take immediate actions if indicated. The Identify-Isolate-Inform (3I) tool, originally conceived for the initial detection and management of Ebola virus and later adjusted for other infectious agents, can be adapted for any emerging infectious disease. This paper reports a modification of the 3I tool for use in the initial detection and management of patients under investigation for 2019-nCoV. After initial assessment for symptoms and epidemiological risk factors, including travel to affected areas and exposure to confirmed 2019-nCoV patients within 14 days, patients are classified in a risk-stratified system. Upon confirmation of a suspected 2019-nCoV case, affected persons must immediately be placed in airborne infection isolation and the appropriate public health agencies notified. This modified 3I tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing persons with suspected or confirmed 2019-nCoV
Roots of Ehrhart Polynomials of Smooth Fano Polytopes
V. Golyshev conjectured that for any smooth polytope P of dimension at most
five, the roots z\in\C of the Ehrhart polynomial for P have real part equal
to -1/2. An elementary proof is given, and in each dimension the roots are
described explicitly. We also present examples which demonstrate that this
result cannot be extended to dimension six.Comment: 10 page
Comparative Measurements of Earth and Martian Entry Environments in the NASA Langley HYMETS Facility
Arc-jet facilities play a major role in the development of heat shield materials for entry vehicles because they are capable of producing representative high-enthalpy flow environments. Arc-jet test data is used to certify material performance for a particular mission and to validate or calibrate models of material response during atmospheric entry. Materials used on missions entering Earth s atmosphere are certified in an arc-jet using a simulated air entry environment. Materials used on missions entering the Martian atmosphere should be certified in an arc-jet using a simulated Martian atmosphere entry environment, which requires the use of carbon dioxide. Carbon dioxide has not been used as a test gas in a United States arc-jet facility since the early 1970 s during the certification of materials for the Viking Missions. Materials certified for the Viking missions have been used on every entry mission to Mars since that time. The use of carbon dioxide as a test gas in an arc-jet is again of interest to the thermal protection system community for certification of new heat shield materials that can increase the landed mass capability for Mars bound missions beyond that of Viking and Pathfinder. This paper describes the modification, operation, and performance of the Hypersonic Materials Environmental Test System (HYMETS) arc-jet facility with carbon dioxide as a test gas. A basic comparison of heat fluxes, various bulk properties, and performance characteristics for various Earth and Martian entry environments in HYMETS is provided. The Earth and Martian entry environments consist of a standard Earth atmosphere, an oxygen-rich Earth atmosphere, and a simulated Martian atmosphere. Finally, a preliminary comparison of the HYMETS arc-jet facility to several European plasma facilities is made to place the HYMETS facility in a more global context of arc-jet testing capability
Presurgical tear characteristics and estimated shear modulus as predictors of repair integrity and shoulder function one year after rotator cuff repair
Background: Rotator cuff repair provides pain relief for many patients; however, retears are relatively common and affect approximately 20%-70% of patients after repair. Although magnetic resonance imaging (MRI) offers the ability to assess tissue characteristics such as tear size, retraction, and fatty infiltration, it provides little insight into the quality of the musculotendinous tissues the surgeon will encounter during surgery. However, shear wave elastography (SWE) could provide an indirect assessment of quality (ie, stiffness) by measuring the speed of shear waves propagating through tissue. The objective of this study was to determine the extent to which estimated shear modulus predicts repair integrity and functional outcomes 1 year after rotator cuff repair.
Methods: Thirty-three individuals scheduled to undergo arthroscopic rotator cuff repair were enrolled in this study. Before surgery, shear modulus of the supraspinatus tendon and muscle was estimated using ultrasound SWE. MRIs were obtained before and 1 year after surgery to assess tear characteristics and repair integrity, respectively. Shoulder strength, range of motion, and patient-reported pain and function were assessed before and after surgery. Functional outcomes were compared between groups and across time using a two-factor mixed model analysis of variance. Stepwise regression with model comparison was used to investigate the extent to which MRI and shear modulus predicted repair integrity and function at 1 year after surgery.
Results: At 1 year after surgery, 56.5% of patients had an intact repair. No significant differences were found in any demographic variable, presurgical tear characteristic, or shear modulus between patients with an intact repair and those with a recurrent tear. Compared with presurgical measures, patients in both groups demonstrated significant improvements at 1 year after surgery in pain (P \u3c .01), self-reported function (P \u3c .01), range of motion (P \u3c .01), and shoulder strength (P \u3c .01). In addition, neither presurgical MRI variables (P \u3e .16) nor shear modulus (P \u3e .52) was significantly different between groups at 1 year after surgery. Finally, presurgical shear modulus generally did not improve the prediction of functional outcomes above and beyond that provided by MRI variables alone (P \u3e .22).
Conclusion: Although SWE remains a promising modality for many clinical applications, this study found that SWE-estimated shear modulus did not predict repair integrity or functional outcomes at 1 year after surgery, nor did it add to the prediction of outcomes above and beyond that provided by traditional presurgical MRI measures of tear characteristics. Therefore, it appears that further research is needed to fully understand the clinical utility of SWE for musculoskeletal tissue and its potential use for predicting outcomes after surgical rotator cuff repair
Nordic Post-Graduate Sustainable Design and Engineering Research from a Supervisor Perspective
The multi- and interdisciplinary field of sustainable product innovation is rapidly expanding as an arena for scientific research. Universities in Nordic countries can be considered as an exponent of this type of research, with active research groups in, among others, Göteborg, Helsinki, Lund, Lyngby, Linköping and Trondheim. In the context of a Nordforsk funded project, seven second generation PhD supervisors from these universities, who have been active in this field for many years, discuss funding, publication, research traditions, education and supervision practices related to PhD research in this field. A number of recommendations to improve current practices are made, including the mapping currently existing differences in different academic institutions, studying the cross-over learning effects between academica and non-academic partners, and the development of ‘quality indicators’ of research in the SPI domain
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