21 research outputs found
The Antarctic Submillimeter Telescope and Remote Observatory (AST/RO)
AST/RO, a 1.7 m diameter telescope for astronomy and aeronomy studies at
wavelengths between 200 and 2000 microns, was installed at the South Pole
during the 1994-1995 Austral summer. The telescope operates continuously
through the Austral winter, and is being used primarily for spectroscopic
studies of neutral atomic carbon and carbon monoxide in the interstellar medium
of the Milky Way and the Magellanic Clouds. The South Pole environment is
unique among observatory sites for unusually low wind speeds, low absolute
humidity, and the consistent clarity of the submillimeter sky. Four heterodyne
receivers, an array receiver, three acousto-optical spectrometers, and an array
spectrometer are installed. A Fabry-Perot spectrometer using a bolometric array
and a Terahertz receiver are in development. Telescope pointing, focus, and
calibration methods as well as the unique working environment and logistical
requirements of the South Pole are described.Comment: 57 pages, 15 figures. Submitted to PAS
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Factors Associated with Overutilization of Computed Tomography of the Cervical Spine
Introduction: Despite the wide availability of clinical decision rules for imaging of the cervical spine after a traumatic injury (eg, NEXUS C-spine rule and Canadian C-spine rule), there is significant overutilization of computed tomography (CT) imaging in patients who are deemed to be at low risk for a clinically significant cervical spine injury by these clinical decision rules. The purpose of this study was to identify the major factors associated with the overuse of CT cervical spine imaging using a logistic regression model.Methods: This was a retrospective review of all adult patients who underwent CT cervical spine imaging for evaluation of a traumatic injury at a tertiary academic emergency department (ED) and three affiliate community EDs in January and February 2019. We performed multivariable logistic regression to identify factors associated with obtaining CT cervical spine imaging despite low-risk classification by the NEXUS C-spine Rule.Results: A total of 1,051 patients underwent CT cervical spine imaging for traumatic indications during the study period, and 889 patients were included in the analysis. Of these patients, 376 (42.3%) were negative by the NEXUS C-spine rule. Variables that were associated with increased likelihood of unnecessary imaging included age over 65, Emergency Severity Index (ESI) score 2 and 3, arrival as a walk-in, and anticoagulation status. Patients who presented to the tertiary academic ED had a significantly lower likelihood of unnecessary imaging. Twenty-one patients (2.4%) were found to have cervical spine fractures on imaging, two of whom were negative by the NEXUS C-spine rule, but neither had a clinically significant fracture.Conclusion: Cervical spine imaging is vastly overused in patients presenting to the ED with traumatic injuries, as adjudicated using the NEXUS C-spine rule as a reference standard. Older age, ESI level, arrival as a walk-in, and taking anticoagulation drugs were associated with overutilization of CT imaging. Conversely, presenting to the tertiary academic ED was associated with a lower likelihood of undergoing unnecessary imaging. This model can guide future interventions to optimize ED CT utilization and minimize unnecessary testing