Space-Based Capstone: Public-Private-Academic Partnership in the Making

The Electronic Systems Engineering Technology (ESET) Program at Texas A&M University provides a recognized undergraduate program with an emphasis in electronics, communication, embedded systems, testing, instrumentation and control systems. The program combines engineering and industrial knowledge and methods to develop, design, and implement new innovative products through a two-semester long Senior Capstone Project. Capstone is designed to prepare future engineers by bridging the gap between the classroom and industry. Students are required to form teams of two to six members which allows them to develop the skills necessary to succeed in a diverse industry setting. Each team is required to use their knowledge and skills to design, develop, document, and deliver a real-world project equivalent to the assignments they will soon receive as professional engineers. Following NASA’s approval for funding the development of a research facility named Hermes, a Capstone team, named Microgravity Automated Research Systems (MARS), was sponsored by T STAR, a local space commercialization company, to develop the electronics portion of the facility. Hermes will reside on the International Space Station for five years in the hopes of streamlining the development of experiments that require extended periods of time in microgravity environments. The Hermes facility will host and manage up to four experiments at a time while allowing for the downlink of experiment data to an Earth station, and the uplink of commands to change experiment parameters. Experiments will adhere to a power budget and communication standard established by MARS so that experiments can be swapped out during the facility’s lifetime. MARS will work with the Mobile Integrated Solutions Laboratory (MISL), an undergraduate applied research lab, in order to prepare them to maintain support for Hermes in the future.Cockrell School of Engineerin

Fruit and Vegetable Intake, Food Security, Barriers to Healthy Eating, and Empowerment Among Dietetic Interns and Physician Assistant Interns: A Cross-Sectional Pilot Study

Students are required to complete supervised practice hours prior to becoming Registered Dietitians and Physician Assistants. Research suggests that environmental and social factors affect dietetic interns’ diets during their internship, although these factors have not been studied among physician assistant interns. This cross-sectional study utilized an online survey to compare dietetic interns’ (n = 81) and physician assistant interns’ (n = 79) fruit and vegetable intake, food security, barriers to healthy eating, and empowerment for making healthy dietary choices during an internship. Differences were assessed via independent t-tests and chi-square distributions. The significance was set at p \u3c 0.05. Dietetic interns had a higher vegetable intake (p = 0.002) while physician assistant interns had higher rates of food insecurity (p = 0.040). Dietetic interns reported a greater impact on their dietary choices due to mental fatigue (p = 0.006), while physician assistant interns’ dietary choices were more heavily impacted by peer influence, interactions with patients, and interactions with preceptors (p \u3c 0.05). There was not a group difference in overall empowerment (p = 0.157), although both groups rated empowerment for asking for help with food and nutrition challenges the lowest of the empowerment sub-items. Addressing interns’ unique needs may support students’ educational success and wellbeing once they are professionals, promote a diverse workforce, and ensure optimal care for patients

Multicenter Study of the Treatment of Appendicitis in America Acute, Perforated, and Gangrenous (MUSTANG), an EAST Multicenter Study

Objective: We sought to describe contemporary presentation, treatment, and outcomes of patients presenting with acute (A), perforated (P), and gangrenous (G) appendicitis in the United States. Summary Background Data: Recent European trials have reported that medical (antibiotics only) treatment of acute appendicitis is an acceptable alternative to surgical appendectomy. However, the type of operation (open appendectomy) and average duration of stay are not consistent with current American practice and therefore their conclusions do not apply to modern American surgeons. Methods: This multicenter prospective observational study enrolled adults with appendicitis from January 2017 to June 2018. Descriptive statistics were performed. P and G were combined into a "complicated" outcome variable and risk factors were assessed using multivariable logistic regression. Results: A total 3597 subjects were enrolled across 28 sites: median age was 37 (27-52) years, 1918 (53%) were male, 90% underwent computed tomography (CT) imaging, 91% were initially treated by appendectomy (98% laparoscopic), and median hospital stay was 1 (1-2) day. The 30-day rates of Emergency Department (ED) visit and readmission were 10% and 6%. Of 219 initially treated with antibiotics, 35 (16%) required appendectomy during index hospitalization and 12 (5%) underwent appendectomy within 30 days, for a cumulative failure rate of 21%. Overall, 2403 (77%) patients had A, whereas 487 (16%) and 218 (7%) patients had P and G, respectively. On regression analysis, age, symptoms >48 hours, temperature, WBC, Alvarado score, and appendicolith were predictive of "complicated" appendicitis, whereas co-morbidities, smoking, and ED triage to appendectomy >6 hours or >12 hours were not. Conclusion: In the United States, the majority of patients presenting with appendicitis receive CT imaging, undergo laparoscopic appendectomy, and stay in the hospital for 1 day. One in five patients selected for initial non-operative management required appendectomy within 30 days. In-hospital delay to appendectomy is not a risk factor for "complicated" appendicitis

Fractal model and Lattice Boltzmann Method for Characterization of Non-Darcy Flow in Rough Fractures

The irregular morphology of single rock fracture significantly influences subsurface fluid flow and gives rise to a complex and unsteady flow state that typically cannot be appropriately described using simple laws. Yet the fluid flow in rough fractures of underground rock is poorly understood. Here we present a numerical method and experimental measurements to probe the effect of fracture roughness on the properties of fluid flow in fractured rock. We develop a series of fracture models with various degrees of roughness characterized by fractal dimensions that are based on the Weierstrass–Mandelbrot fractal function. The Lattice Boltzmann Method (LBM), a discrete numerical algorithm, is employed for characterizing the complex unsteady non-Darcy flow through the single rough fractures and validated by experimental observations under the same conditions. Comparison indicates that the LBM effectively characterizes the unsteady non-Darcy flow in single rough fractures. Our LBM model predicts experimental measurements of unsteady fluid flow through single rough fractures with great satisfactory, but significant deviation is obtained from the conventional cubic law, showing the superiority of LBM models of single rough fractures

Appendicitis in Pregnancy: A Post-Hoc Analysis of an EAST Multicenter Study

Objective: To compare the presentation, management, and outcomes of appendicitis in pregnant and non-pregnant females of childbearing age (18-45 years). Methods: This was a post-hoc analysis of a prospectively collected database (January 2017-June 2018) from 28 centers in America. We compared pregnant and non-pregnant females' demographics, clinical presentation, laboratory data, imaging findings, management, and clinical outcomes. Results: Of the 3,597 subjects, 1,010 (28%) were of childbearing age, and 41 were pregnant: The mean age of the pregnant subjects was 30 +/- 8 years at a median gestational age of 15 (range 10-23) weeks. The two groups had similar demographics and clinical presentation, but there were differences in management and outcomes. For example, in pregnant subjects, abdominal ultrasound scans (US) plus magnetic resonance imaging (MRI) was the most frequently used imaging method (41%) followed by MRI alone (29%), US alone (22%), computed tomography (CT) (5%), and no imaging (2%). Despite similar American Association for the Surgery of Trauma Emergency General Surgery Clinical and Imaging Grade at presentation, pregnant subjects were more likely to be treated with antibiotics alone (15% versus 4%; p = 0.008). Pregnant subjects were less likely to have simple appendicitis and were more likely to have complicated (perforated or gangrenous) appendicitis or a normal appendix. With the exception of index hospital length of stay, there were no significant differences between the groups in clinical outcomes at index hospitalization or at 30 days. Conclusion: Almost 1 in 20 women of childbearing age presenting with appendicitis is pregnant. Appendicitis most commonly affects women in early to mid-pregnancy. Compared with non-pregnant women of childbearing age, pregnant women presenting with appendicitis undergo non-operative management more often and are less likely to have simple appendicitis. Compared with non-pregnant patients, they have similar clinical outcomes at both index hospitalization and 30 days after discharge

Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure The ARIES-HM3 Randomized Clinical Trial

IMPORTANCE Left ventricular assist devices (LVADs) enhance quality and duration of life in advanced heart failure. The burden of nonsurgical bleeding events is a leading morbidity. Aspirin as an antiplatelet agent is mandated along with vitamin K antagonists (VKAs) with continuous-flow LVADs without conclusive evidence of efficacy and safety. OBJECTIVE To determine whether excluding aspirin as part of the antithrombotic regimen with a fully magnetically levitated LVAD is safe and decreases bleeding. DESIGN, SETTING, and PARTICIPANTS This international, randomized, double-blind, placebo-controlled study of aspirin (100 mg/d) vs placebo with VKA therapy in patients with advanced heart failure with an LVAD was conducted across 51 centers with expertise in treating patients with advanced heart failure across 9 countries. The randomized population included 628 patients with advanced heart failure implanted with a fully magnetically levitated LVAD (314 in the placebo group and 314 in the aspirin group), of whom 296 patients in the placebo group and 293 in the aspirin group were in the primary analysis population, which informed the primary end point analysis. The study enrolled patients from July 2020 to September 2022; median follow-up was 14 months. Intervention Patients were randomized in a 1:1 ratio to receive aspirin (100 mg/d) or placebo in addition to an antithrombotic regimen. MAIN OUTCOMES AND MEASURES The composite primary end point, assessed for noninferiority (−10% margin) of placebo, was survival free of a major nonsurgical (>14 days after implant) hemocompatibility-related adverse events (including stroke, pump thrombosis, major bleeding, or arterial peripheral thromboembolism) at 12 months. The principal secondary end point was nonsurgical bleeding events. RESULTS Of the 589 analyzed patients, 77% were men; one-third were Black and 61% were White. More patients were alive and free of hemocompatibility events at 12 months in the placebo group (68%) vs those taking aspirin (74%). Noninferiority of placebo was demonstrated (absolute between-group difference, 6.0% improvement in event-free survival with placebo [lower 1-sided 97.5% CI, −1.6%]; P < .001). Aspirin avoidance was associated with reduced nonsurgical bleeding events (relative risk, 0.66 [95% confidence limit, 0.51-0.85]; P = .002) with no increase in stroke or other thromboembolic events, a finding consistent among diverse subgroups of patient characteristics. CONCLUSIONS AND RELEVANCE In patients with advanced heart failure treated with a fully magnetically levitated LVAD, avoidance of aspirin as part of an antithrombotic regimen, which includes VKA, is not inferior to a regimen containing aspirin, does not increase thromboembolism risk, and is associated with a reduction in bleeding events. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0406915