Insulation for cryogenic tanks has reduced thickness and weight

Dual seal insulation, consisting of an inner layer of sealed-cell Mylar honeycomb core and an outer helium purge channel of fiber glass reinforced phenolic honeycomb core, is used as a thin, lightweight insulation for external surfaces of cryogenic-propellant tanks

Midwest Surgical Association Impact on patient care of discordance in radiology readings between external overnight radiology services and staff radiology readings at a level 1 trauma center

Abstract BACKGROUND: Overnight radiology services (ORSs) provide computed tomography (CT) scan readings that are automatically reviewed by staff radiologists (SRs) and the trauma service. Discordant readings and their clinical significance were investigated. METHODS: ORS-read CT scans over 3 years were reviewed. A discordant reading was clinically significant if it resulted in a substantive change in patient care. All clinically significant findings were reviewed by a blinded radiologist. RESULTS: Five hundred thirty-four CT scans were identified: 191 (35.8%) head, 187 (35%) cervical, 66 (12.4%) chest, and 90 (16.9%) abdomen/pelvis scans. One hundred twenty-three scans (23%) were abnormal with a DR of 16%: 5 head, 2 cervical, 7 chest, and 6 abdomen/pelvis scans. Seven (6%) scans had clinically significant findings missed: 3 head and 4 abdomen/pelvis scans. ORSs missed 7, and SRs missed 3 clinically significant findings. A blinded radiologist confirmed the clinically significant findings. CONCLUSIONS: The discordant rate of readings for abnormal CT scans was 16% with 37% considered to be clinically significant. ORSs missed 100%, and 29% of the clinically significant findings were identified after SR/trauma service rounds. SR/trauma service review of ORS readings is supported. Ó 2013 Elsevier Inc. All rights reserved. Since the 1990s, teleradiology services have been used by many emergency departments to provide preliminary interpretations on diagnostic images including computed tomography (CT) scans, x-rays, and magnetic resonance imaging (MRI) for overnight emergency and trauma patients. With US-licensed radiologists stationed throughout the nation and overseas, these teleradiology firms were able to maximize the time zone difference and provide 24/7 coverage to many institutions. Their ability to provide overnight coverage, or ''nighthawking,'' was their main appeal. They rapidly became the solution for many hospitals struggling with the economic burden of staffing an overnight shift with potentially sleep-deprived radiologists. These teleradiology firms currently provide overnight coverage for more than 1,500 US emergency departments. 1 Despite their popularity, there are no studies comparing the error rate of preliminary readings of external overnight radiology services (ORSs) with in-house attendin

A Community-Wide Financial Needs Assessment: City of Bryan Community Development Services

City of Bryan Community Developmen

A Community-Wide Financial Needs Assessment: City of Bryan Community Development Services

City of Bryan Community Developmen

Professionalism in the Twilight Zone: A Multicenter, Mixed-Methods Study of Shift Transition Dynamics in Surgical Residencies

Purpose: Duty hours rules sparked debates about professionalism. This study explores whether and why general surgery residents delay departures at the end of a day shift in ways consistent with shift work, traditional professionalism, or a new professionalism. Method: Questionnaires were administered to categorical residents in 13 general surgery programs in 2014 and 2015. The response rate was 76% (N = 291). The 18 items focused on end-of-shift behaviors and the frequency and source of delayed departures. Follow-up interviews (N = 39) examined motives for delayed departures. The results include means, percentages, and representative quotations from the interviews. Results: A minority (33%) agreed that it is routine and acceptable to pass work to night teams, whereas a strong majority (81%) believed that residents exceed work hours in the name of professionalism. Delayed departures were ubiquitous: Only 2 of 291 residents were not delayed for any of 13 reasons during a typical week. The single most common source of delay involved a desire to avoid the appearance of dumping work on fellow residents. In the interviews, residents expressed a strong reluctance to pass work to an on-call resident or night team because of sparse night staffing, patient ownership, an aversion to dumping, and the fear of being seen as inefficient. Conclusions: Resident behavior is shaped by organizational and cultural contexts that require attention and reform. The evidence points to the stunted development of a new professionalism, little role for shift-work mentalities, and uneven expression of traditional professionalism in resident behavior