Manipulator technology for the space shuttle

A shuttle-attached manipulator is currently proposed as the payload-handling device for the space shuttle. Basic requirements for the manipulator involve length, force, compliance, and control. Approaches for studying control methods are presented and simulation methods are discussed. Basic details about the two earthbased manipulators selected for simulation experiments are related to the test methods. Preliminary data from one test are shown as an example of the direction of the testing. A computer-generated simulation is explained, and the relationship of the three simulations to the design problems is discussed

A Local Health Department’s Use of CLAS to Advance Health Equity

Health Equity is the idea that everyone has the opportunity to achieve optimal health regardless of race/ethnicity, educational attainment, sexual orientation, income, religious affiliation, residence, or ability. In 2014, the Florida Department of Health in Orange County (DOH-Orange) deemed health equity one of its three agency priorities. Though there are a number of determinants that influence health outcomes, such as genetics, individual behavior choices, and access to health services, the social determinants tend to be the most complex and influential on quality of life and well-being. The DOH-Orange has implemented the Culturally Linguistically and Appropriate Services standards for Healthcare (CLAS) which offer a framework for healthcare providers to advance health equity by addressing the cultural and linguistic needs of populations that traditionally have received unequal access to healthcare services. Achieving health equity is a challenging process that will likely take at least a generation. However, only by achieving healthy equity can we ensure that health disparities are eliminated and the influence of social determinants of health are negligible

The Royal Free Hospital score: a calibrated prognostic model for patients with cirrhosis admitted to intensive care unit. Comparison with current models and CLIF-SOFA score

Prognosis for patients with cirrhosis admitted to intensive care unit (ICU) is poor. ICU prognostic models are more accurate than liver-specific models. We identified predictors of mortality, developed a novel prognostic score (Royal Free Hospital (RFH) score), and tested it against established prognostic models and the yet unvalidated Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) model

Thing Theory

This article is an extended review of Graham Harman's Heidegger Explained: From Phenomenon to Thing. The paper explains Harman's argument that Heidegger's famous broken tool incident - the account that introduces a critique of presence based on the withdrawn dimensions of things - has a much greater relevance than is usually imagined. It explores Harman's extrapolations from Heidegger to rethink the very nature of objects - or things in themselves, their relations to each other, and their own unfathomable inner being. The paper goes on to note the implications of this argument for thinking more generally about relationality, space, and the more-than-human

A randomized, controlled trial comparing ganciclovir to ganciclovir plus foscarnet (each at half dose) for preemptive therapy of cytomegalovirus infection in transplant recipients

Forty-eight patients who provided 2 consecutive blood samples that tested positive for cytomegalovirus DNA by polymerase chain reaction (PCR) were randomized to receive either full-dose ganciclovir ( 5 mg/kg intravenously [iv] twice daily) or half-dose ganciclovir (5 mg/kg iv once daily) plus half-dose foscarnet (90 mg/kg iv once daily) for 14 days. In the ganciclovir arm, 17 (71%) of 24 patients reached the primary end point of being CMV negative by PCR within 14 days of initiation of therapy, compared with 12 (50%) of 24 patients in the ganciclovir-plus-foscarnet arm (P = .12). Toxicity was greater in the combination-therapy arm. In patients who failed to reach the primary end point, baseline virus load was 0.77 log(10) higher, the replication rate before therapy was faster (1.5 vs. 2.7 days), and the viral decay rate was slower (2.9 vs. 1.1 days) after therapy. Bivariable logistic regression models identified baseline virus load, bone-marrow transplantation, and doubling time and half-life of decay as the major factors affecting response to therapy within 14 days. This study did not support a synergistic effect of ganciclovir plus foscarnet in vivo

Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis.

BACKGROUND: Nonselective beta-adrenergic blockers decrease portal pressure and prevent variceal hemorrhage. Their effectiveness in preventing varices is unknown. METHODS: We randomly assigned 213 patients with cirrhosis and portal hypertension (minimal hepatic venous pressure gradient [HVPG] of 6 mm Hg) to receive timolol, a nonselective beta-blocker (108 patients), or placebo (105 patients). The primary end point was the development of gastroesophageal varices or variceal hemorrhage. Endoscopy and HVPG measurements were repeated yearly. RESULTS: During a median follow-up of 54.9 months, the rate of the primary end point did not differ significantly between the timolol group and the placebo group (39 percent and 40 percent, respectively; P=0.89), nor were there significant differences in the rates of ascites, encephalopathy, liver transplantation, or death. Serious adverse events were more common among patients in the timolol group than among those in the placebo group (18 percent vs. 6 percent, P=0.006). Varices developed less frequently among patients with a baseline HVPG of less than 10 mm Hg and among those in whom the HVPG decreased by more than 10 percent at one year and more frequently among those in whom the HVPG increased by more than 10 percent at one year. CONCLUSIONS: Nonselective beta-blockers are ineffective in preventing varices in unselected patients with cirrhosis and portal hypertension and are associated with an increased number of adverse events. (ClinicalTrials.gov number, NCT00006398.

Differences of Pathophysiology in Experimental Meningitis Caused by Three Strains of Streptococcus Pneumoniae

Differences in cytochemical and pathophysiologic abnormalities in experimental meningitis caused by pneumococcal strains A, B, and C were determined. Strain C produced the most severe abnormalities of cerebrospinal fluid (CSF) concentrations of lactate (P < .01), protein (P < .02), and glucose (P < .01), CSF white blood cell count (P < .04), cerebral blood flow (P < .02), and clinical signs (P < .05). Brain edema occurred only with strains A and C, with no association with disease severity; intracranial hypertension was also independent of disease severity. Strain B, not C, achieved the highest bacterial titers in the CSF (P < .005). The widely different abilities of strains of Streptococcus pneumoniae to induce intracranial abnormalities suggest that virulence determinants affect not only evasion of defense during colonization and invasion, as shown in other models, but also determine the course of disease once infection has been established. Differences of cell-wall metabolism among pneumococcal strains may playa role in this latter phase of the development of meningiti

Solitons from Dressing in an Algebraic Approach to the Constrained KP Hierarchy

The algebraic matrix hierarchy approach based on affine Lie $sl (n)$ algebras leads to a variety of 1+1 soliton equations. By varying the rank of the underlying $sl (n)$ algebra as well as its gradation in the affine setting, one encompasses the set of the soliton equations of the constrained KP hierarchy. The soliton solutions are then obtained as elements of the orbits of the dressing transformations constructed in terms of representations of the vertex operators of the affine $sl (n)$ algebras realized in the unconventional gradations. Such soliton solutions exhibit non-trivial dependence on the KdV (odd) time flows and KP (odd and even) time flows which distinguishes them from the conventional structure of the Darboux-B\"{a}cklund Wronskian solutions of the constrained KP hierarchy.Comment: LaTeX, 13pg