Strategic argument mapping

Includes bibliographical references (p. 38)

Medical Grade Water Generation for Intravenous Fluid Production on Exploration Missions

This document describes the intravenous (IV) fluids requirements for medical care during NASA s future Exploration class missions. It further discusses potential methods for generating such fluids and the challenges associated with different fluid generation technologies. The current Exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. Conclusions on the fluid volume requirements are presented, and the feasibility of various fluid generation options are discussed. A separate report will document a more complete trade study on the options to provide the required fluids.At the time this document was developed, NASA had not yet determined requirements for medical care during Exploration missions. As a result, this study was based on the current requirements for care onboard the International Space Station (ISS). While we expect that medical requirements will be different for Exploration missions, this document will provide a useful baseline for not only developing hardware to generate medical water for injection (WFI), but as a foundation for meeting future requirements. As a final note, we expect WFI requirements for Exploration will be higher than for ISS care, and system capacity may well need to be higher than currently specified

A multilevel intervention to promote colorectal cancer screening among community health center patients: results of a pilot study

Background: Colorectal cancer screening rates are low among poor and disadvantaged patients. Patient navigation has been shown to increase breast and cervical cancer screening rates, but few studies have looked at the potential of patient navigation to increase colorectal cancer screening rates. Methods: The objective was to determine the feasibility and effectiveness of a patient navigator-based intervention to increase colorectal cancer screening rates in community health centers. Patients at the intervention health center who had not been screened for colorectal cancer and were designated as "appropriate for outreach" by their primary care providers received a letter from their provider about the need to be screened and a brochure about colorectal cancer screening. Patient navigators then called patients to discuss screening and to assist patients in obtaining screening. Patients at a demographically similar control health center received usual care. Results: Thirty-one percent of intervention patients were screened at six months, versus nine percent of control patients (p < .001). Conclusion: A patient navigator-based intervention, in combination with a letter from the patient's primary care provider, was associated with an increased rate of colorectal cancer screening at one health center as compared to a demographically similar control health center. Our study adds to an emerging literature supporting the use of patient navigators to increase colorectal cancer screening in diverse populations served by urban health centers

Know Your Value: Negotiation Skill Development for Junior Investigators in the Academic Environment—A Report from the American Society of Preventive Oncology\u27s Junior Members Interest Group

The American Society of Preventive Oncology (ASPO) is a professional society for multidisciplinary investigators in cancer prevention and control. One of the aims of ASPO is to enable investigators at all levels to create new opportunities and maximize their success. One strategy adopted by ASPO was to develop the Junior Members Interest Group in 1999. The Interest Group membership includes predoctoral fellows, postdoctoral fellows, and junior faculty members who are provided career development and training opportunities (1). Responsibilities of the members of the Junior Members Interest Group include serving on the ASPO Executive Committee and the Program Planning Committee and organizing professional development sessions at ASPO\u27s annual meeting. As part of the 2014 ASPO annual meeting, the Junior Members Interest Group organized a session entitled “Negotiation Skill Development for Junior Investigators in the Academic Environment.” This interactive session was designed to provide early-career investigators an opportunity to practice their negotiation skills and to receive expert advice and strategies to effectively negotiate new faculty positions in an academic environment. The session focused primarily on negotiating an initial academic appointment from a graduate student or postdoctoral fellow to an assistant professor–level position. In addition to the main focus, the session also covered renegotiation for assistant and associate-level investigators as they navigate through their careers. The session began with an interactive exercise led by Dr. Stephanie A.N. Silvera (Associate Professor of Public Health, Montclair State University, Montclair, NJ) where participants engaged in a mock salary negotiation session with another member of the audience (Table 1). Following the negotiation exercise, Dr. Silvera led a debriefing session. Next, four panelists at different levels in their academic careers were invited to provide their personal perspectives on the topic of effective negotiation: Dr. Faith Fletcher (Assistant Professor of Community Health Sciences, the University of Illinois at Chicago, Chicago, IL) to provide the perspective of a first-year faculty member; Dr. Stephanie A.N. Silvera (Associate Professor of Public Health, Montclair State University, Montclair, NJ) to provide the perspective of a recently tenured faculty member; Dr. Karen Basen-Engquist (Professor of Behavioral Science and Director of the Center for Energy Balance, University of Texas MD Anderson Cancer Center, Houston, TX) to provide the perspective of a senior faculty member; and Dr. Peter G. Shields (Professor and Deputy Director of the Ohio State University Comprehensive Cancer Center, Columbus, OH) to provide the perspective of a senior faculty member with extensive experience on the employer side of an academic appointment negotiation. This report summarizes the main themes that emerged from the negotiation exercise debriefing, the speakers\u27 advice and recommendations, and responses to audience questions during the session

Structural and chemical heterogeneity in ancient glass probed using gas overcondensation, X-ray tomography, and solid-state NMR

Rare ancient glasses have complex, multi-scale structures requiring more sophisticated and non-destructive pore characterisation techniques than usual. Homotattic patch models for nitrogen adsorption gave better fits to the isotherm data, more accurate void space descriptors, and also greater understanding of the underlying physical factors affecting adsorption, than standard BET. These homotattic patch models revealed the critical role of iron impurities in determining adsorption behaviour. Non-destructive sodium-23 NMR relaxometry validated the homotattic patch model for some natron glasses, and, in turn, was validated using multiple quantum magic-angle spinning (MQMAS) 23Na NMR. X-ray tomography images of the glasses showed the presence of large macroporous bubbles, while FEG-SEM revealed nanopores within the glass matrix. A newly-developed, gas overcondensation technique, suitable for small amounts of low porosity material, assessed the inter-relationship between the disparate levels in this hierarchical porosity. This technique demonstrated that the nanoporosity did not form a ‘corona’ around the bubbles, due to leaching from the glass, as initially supposed from tomography data, but was completely disconnected, and, thus, is probably associated with glass alkalinity. Gas overcondensation is demonstrated as a non-destructive alternative to mercury porosimetry for probing multi-scale porosity in rare artefacts

Balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension: the UK experience.

OBJECTIVE: Inoperable chronic thromboembolic pulmonary hypertension (CTEPH) managed medically has a poor prognosis. Balloon pulmonary angioplasty (BPA) offers a new treatment for inoperable patients. The national BPA service for the UK opened in October 2015 and we now describe the treatment of our initial patient cohort. METHODS: Thirty consecutive, inoperable, anatomically suitable, symptomatic patients on stable medical therapy for CTEPH were identified and offered BPA. They initially underwent baseline investigations including Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) quality of life (QoL) questionnaire, cardiopulmonary exercise test, 6 min walk distance (6MWD), transthoracic echocardiography, N-terminal probrain natriuretic peptide (NT pro-BNP) and right heart catheterisation. Serial BPA sessions were then performed and after completion, the treatment effect was gauged by comparing the same investigations at 3 months follow-up. RESULTS: A median of 3 (IQR 1-6) BPA sessions per patient resulted in a significant improvement in functional status (WHO functional class ≥3: 24 vs 4, p<0.0001) and QoL (CAMPHOR symptom score: 8.7±5.4 vs 5.6±6.1, p=0.0005) with reductions in pulmonary pressures (mean pulmonary artery pressure: 44.7±11.0 vs 34.4±8.3 mm Hg, p<0.0001) and resistance (pulmonary vascular resistance: 663±281 vs 436±196 dyn.s.cm-5, p<0.0001). Exercise capacity improved (minute ventilation/carbon dioxide production: 55.3±12.2 vs 45.0±7.8, p=0.03 and 6MWD: 366±107 vs 440±94 m, p<0.0001) and there was reduction in right ventricular (RV) stretch (NT pro-BNP: 442 (IQR 168-1607) vs 202 (IQR 105-447) pg/mL, p<0.0001) and dimensions (mid RV diameter: 4.4±1.0 vs 3.8±0.7 cm, p=0.002). There were no deaths or life-threatening complications and the mild-moderate per-procedure complication rate was 10.5%. CONCLUSIONS: BPA is safe and improves the functional status, QoL, pulmonary haemodynamics and RV dimensions of patients with inoperable CTEPH

Processes associated with ionic current rectification at a 2D-titanate nanosheet deposit on a microhole poly(ethylene terephthalate) substrate

Films of titanate nanosheets (approx. 1.8-nm layer thickness and 200-nm size) having a lamellar structure can form electrolyte-filled semi-permeable channels containing tetrabutylammonium cations. By evaporation of a colloidal solution, persistent deposits are readily formed with approx. 10-μm thickness on a 6-μm-thick poly(ethylene-terephthalate) (PET) substrate with a 20-μm diameter microhole. When immersed in aqueous solution, the titanate nanosheets exhibit a p.z.c. of − 37 mV, consistent with the formation of a cation conducting (semi-permeable) deposit. With a sufficiently low ionic strength in the aqueous electrolyte, ionic current rectification is observed (cationic diode behaviour). Currents can be dissected into (i) electrolyte cation transport, (ii) electrolyte anion transport and (iii) water heterolysis causing additional proton transport. For all types of electrolyte cations, a water heterolysis mechanism is observed. For Ca 2+ and Mg 2+ ions, water heterolysis causes ion current blocking, presumably due to localised hydroxide-induced precipitation processes. Aqueous NBu 4 + is shown to ‘invert’ the diode effect (from cationic to anionic diode). Potential for applications in desalination and/or ion sensing are discussed. [Figure not available: see fulltext.]. </p

Erratum: Author Correction: Identification of genes required for eye development by high-throughput screening of mouse knockouts.

[This corrects the article DOI: 10.1038/s42003-018-0226-0.]