MATLAB Model to Predict Liquid Hydrogen Spill Characteristics and Safety

The potential of using liquid hydrogen for propulsion is often undermined due to its perilous nature. Hydrogen has a wide flammability range when mixed with air (4.0 - 75.0% hydrogen) and a low ignition energy (0.019 mJ). Liquid hydrogen adds to this high risk as a cryogenic fluid that is to be maintained below -22 K. A liquid hydrogen model has been created in MATLAB that can model various spill scenarios from cryogenic liquid hydrogen vessels. This model takes into consideration the spill rate, spill temperature, air temperature, duration of spill, and air flow conditions to calculate the mass accumulation, pool temperature, pool radius, pool height, and evaporation rate over time. The model can also predict a safe radius for users to abide by if a spill is occurring. This model is verified through an in-depth analysis of each variable and comparison to known trends of cryogenic liquid spills and leaks. The liquid hydrogen safety model can be used with standard operating procedures for hydrogen liquefaction systems to ensure safe practices. This model provides safety advantages to better prepare those operating hydrogen liquefaction systems and vessels that are used in line with hydrogen fuel cells and other hydrogen technologies

Lost Art and Lost Lives: Nazi Art Looting and Art Restitution

During the Nazi Regime, Adolf Hitler and the Nazis seized an estimated one fifth of all art in Europe and more than 5 million cultural objects before 1945. The Nazis established control over the regime and furthered their racist ambitions through stealing art of any cultural or monetary value to them. They stole “degenerate” art in an attempt to annihilate “racially inferior” races, and “racially pure” art for the glorification of the “Aryan” race. Since the end of WWII, the return of Nazi-looted art to its original owners or their heirs has been an important avenue for remembrance of and belated justice for Holocaust victims and their families. Some have suggested a parallel between lost art and lost lives, where art restitution provides a form of justice. However, the path to justice is not an easy one. Many heirs do not know they have a claim to their family’s stolen art or do not know it still exists, and the claims that go to trial often do not go soundly in favor of the victim or his or her heir. Many museums, galleries, art dealers, and collectors have failed to do proper provenance research, or know the jaded history of their artworks and argue that they received the looted artwork in good faith. In order to highlight the importance of Nazi-looted art restitution and justice for Holocaust victims and their families, this paper focuses on the way art was used by the Nazis as a means of control, the structure of the looting system, and the systems of art restitution. Three artworks seized from Jewish art collectors are used to exemplify “degenerate” and “pure” art, discuss the impact of the legal system on restitution, and emphasize provenance as a means of honoring Holocaust victims. Gustav Klimt’s Portrait of Adele Bloch-Bauer, Camille Pissarro’s Shepherdess Bringing in Sheep, and the pair of paintings, Adam and Eve, by Lucas Cranach the Elder illustrate why art collectors, museums, and galleries must confront the vicious Nazi history of such beautiful works of art. Though it will never be possible to return all that was stolen from Nazi victims, the art world can provide justice by doing more thorough provenance research and displaying the provenance information for viewers

Residence Restrictions on Custodial Parents: Sex-Based Discrimination?

Residence restrictions are frequently imposed on the custodial, but not the noncustodial, parent. These restrictions come into play when the custodial parent wishes to move with the child, the noncustodial parent opposes the move, and a court is called upon to resolve the dispute. The court will do so based upon a determination of what it judges to be in the best interests of the child. The best interests inquiry ultimately resolves itself into a question of whether the custodial parent\u27s reasons for making the move are sufficiently substantial to outweigh the noncustodial parent\u27s interest in existing visitation privileges. A custodial parent who violates the residence restrictions may lose custody of the child, forfeit child support, or be subjected to contempt proceedings. This Article will demonstrate that residence restrictions are not consistent with concepts of custody and general rules on change of custody. And, it will show that residence restrictions are sex-based in their application, justification, and effect because they exist to protect only the interests of the noncustodial father. If most custodial parents were men, residence restrictions would cease to exist or would be analyzed differently; the focus would finally be on the real interests at stake for all involved

Initiatives in Anesthesia Workspace Hygiene During COVID-19: The Gray Airway Basin and the Epic Hand Hygiene Event

What’s the Problem? The COVID-19 Pandemic has highlighted the need for anesthesia providers to decrease workspace contamination, particularly during and after airway management. Delineation of “clean” and “dirty” spaces in the anesthesia workplace has been historically challenging, but the heightened awareness of microbial contamination presents a new opportunity to effect behavioral change among staff

Development and Implementation of a COVID-19 Specific Peri-Operative Workflow for Anesthesia Providers

What\u27s the Problem? Needed to develop and clarify the use of PPE in the COVID-19 era New considerations for infection control in OR Unique airway equipment and filter placement considerations Potential shortages of equipment and medications, need for conservation Need to incorporate human factors principles into protocol release and procedural compliance We realized that there was no standard protocol for these functions existing in a visually compelling graphic form for wide distribution throughout anesthesia care areas, and sought to create one

Morphology of the canine omentum, part 1: arterial landmarks that define the omentum

Although the omentum remains an enigmatic organ, research during the last decades has revealed its fascinating functions including fat storage, fluid drainage, immune activity, angiogenesis and adhesion. While clinicians both in human and veterinary medicine are continuously exploring new potential omental applications, detailed anatomical data on the canine omentum are currently lacking, and information is often retrieved from human medicine. In this study, the topographic anatomy of the canine greater and lesser omentum is explored in depth. Current nomenclature is challenged, and a more detailed terminology is proposed. Consistent arteries that are contained within folds of the superficial omental wall are documented, described and named, as they can provide the anatomical landmarks that are necessary for unambiguous scientific communication on the canine omentum. In an included dissection video, the conclusions and in situ findings described in this study are demonstrated

Economic Assessment of High-Dose Versus Adjuvanted Influenza Vaccine:An Evaluation of Hospitalization Costs Based on a Cohort Study

Two influenza vaccines are licensed in the U.S. exclusively for the 65 years and older population: a trivalent inactivated high-dose influenza vaccine (HD-IIV3) and a trivalent inactivated adjuvanted influenza vaccine (aIIV3). In a recent publication, we estimated a relative vaccine effectiveness (rVE) of HD-IIV3 vs. aIIV3 of 12% (95% CI: 3.3–20%) for influenza-related hospitalizations using a retrospective study design, but did not report the number of prevented hospitalizations nor the associated avoided cost. In this paper we report estimations for both. Methods: Leveraging the rVE of a cohort study over two influenza seasons (2016/17 and 2017/18), we collected cost data for healthcare provided to the same study population. Vaccine costs were obtained from the Medicare pricing schedule. Our economic assessment compared cost of vaccination and hospital care for patients experiencing acute respiratory or cardiovascular illness. Results: We analyzed 1.9 million HD-IIV3 and 223,793 aIIV3 recipients. Average vaccine list prices were $46.23 for HD-IIV3 and$48.26 for aIIV3. The hospitalization rates for respiratory disease in HD-IIV3 and aIIV3 recipients were 187 (95% CI: 185–189) and 212 (195–231) per 10,000 persons-years, respectively. Attributing the average cost per hospitalization of $12,652 ($12,214–$13,090) to the difference in hospitalization rates, we estimate net savings of HD-IIV3 to be$34 ($10–$62) per recipient. Conclusion: Pooled over two predominantly A/H3N2 respiratory seasons, vaccination with HD-IIV3 was associated with lower hospitalization rates and associated costs compared to aIIV3 in senior members of a large national managed health care company in the U.S. Reduced hospitalizations affect healthcare utilization overall, and therefore other costly health outcomes

Comparative effectiveness of high dose versus adjuvanted influenza vaccine:A retrospective cohort study

Background: Adults 65 years and older (seniors) experience more complications following influenza infection than younger adults. We estimated the relative vaccine effectiveness (rVE) of a trivalent high dose (HD-IIV3) versus an adjuvanted trivalent influenza vaccine (aIIV3) in seniors for respiratory-related hospitalizations. Methods: We conducted a retrospective cohort study using claims data from Optum's Clinformatics® Data Mart to compare outcome rates between seniors who received HD-IIV3 versus aIIV3 during the 2016/17 and 2017/18, predominantly A/H3N2 respiratory seasons. Rates were adjusted for demographic characteristics, comorbid conditions, previous influenza vaccination, and geography. We used the previous event rate ratio (PERR) approach to address bias by time-fixed unmeasured confounders. Results: We identified 842,282 HD-IIV3 and 34,157 aIIV3 recipients for the 2016/17 season and 1,058,638 HD-IIV3 and 189,636 aIIV3 recipients for the 2017/18 season. The pooled rVE of HD-IIV3 versus aIIV3 for respiratory-related hospitalizations over both seasons was 12% (95% confidence interval: 3.3%–20%); 13% (−6.4% to 32%) for the 2016/17 season and 12% (2.1%–21%) for the 2017/18 season. Conclusions: Pooled over two predominantly A/H3N2 respiratory seasons, HD-IIV3 was associated with fewer respiratory hospital admissions than aIIV3 in senior members of large national managed health care company in the U.S

Risk factors for pneumonia and influenza hospitalizations in long-term care facility residents:a retrospective cohort study

Abstract Background Older adults who reside in long-term care facilities (LTCFs) are at particularly high risk for infection, morbidity and mortality from pneumonia and influenza (P&I) compared to individuals of younger age and those living outside institutional settings. The risk factors for P&I hospitalizations that are specific to LTCFs remain poorly understood. Our objective was to evaluate the incidence of P&I hospitalization and associated person- and facility-level factors among post-acute (short-stay) and long-term (long-stay) care residents residing in LTCFs from 2013 to 2015. Methods In this retrospective cohort study, we used Medicare administrative claims linked to Minimum Data Set and LTCF-level data to identify short-stay (< 100 days, index = admission date) and long-stay (100+ days, index = day 100) residents who were followed from the index date until the first of hospitalization, LTCF discharge, Medicare disenrollment, or death. We measured incidence rates (IRs) for P&I hospitalization per 100,000 person-days, and estimated associations with baseline demographics, geriatric syndromes, clinical characteristics, and medication use using Cox regression models. Results We analyzed data from 1,118,054 short-stay and 593,443 long-stay residents. The crude 30-day IRs (95% CI) of hospitalizations with P&I in the principal position were 26.0 (25.4, 26.6) and 34.5 (33.6, 35.4) among short- and long-stay residents, respectively. The variables associated with P&I varied between short and long-stay residents, and common risk factors included: advanced age (85+ years), admission from an acute hospital, select cardiovascular and respiratory conditions, impaired functional status, and receipt of antibiotics or Beers criteria medications. Facility staffing and care quality measures were important risk factors among long-stay residents but not in short-stay residents. Conclusions Short-stay residents had lower crude 30- and 90-day incidence rates of P&I hospitalizations than long-stay LTCF residents. Differences in risk factors for P&I between short- and long-stay populations suggest the importance of considering distinct profiles of post-acute and long-term care residents in infection prevention and control strategies in LTCFs. These findings can help clinicians target interventions to subgroups of LTCF residents at highest P&I risk