Acute chest syndrome: a narrative review to guide inpatient management

ACS is defined as a new infiltrate in a chest radiograph involving at least one broncho-pulmonary segment in an individual with one additional clinical finding. There are multiple causes of ACS which include infections, pulmonary edema, pulmonary infection, hypoxemia and hypoventilation. The goal is to quickly diagnose and treat this condition to prevent irreversible lung damage and mortality. In this narrative review, we discuss why a balanced approach to fluid and pain management will provide better outcome for patients, and the evidence behind using antibiotics, steroids, bronchodilators, nitric oxide, incentive spirometry, as well as the current management of patients with concomitant ACS and SARS-CoV2.Kevin Wang (DO, Department of Internal Medicine, University of Missouri), Monisha Das-Ireland (Department of Pulmonary-Critical Care, University of Missouri -- Kansas City School of Medicine)Includes bibliographical reference

A Comparison of Inverse Simulation-Based Fault Detection in a Simple Robotic Rover with a Traditional Model-Based Method

Robotic rovers which are designed to work in extra-terrestrial environments present a unique challenge in terms of the reliability and availability of systems throughout the mission. Should some fault occur, with the nearest human potentially millions of kilometres away, detection and identification of the fault must be performed solely by the robot and its subsystems. Faults in the system sensors are relatively straightforward to detect, through the residuals produced by comparison of the system output with that of a simple model. However, faults in the input, that is, the actuators of the system, are harder to detect. A step change in the input signal, caused potentially by the loss of an actuator, can propagate through the system, resulting in complex residuals in multiple outputs. These residuals can be difficult to isolate or distinguish from residuals caused by environmental disturbances. While a more complex fault detection method or additional sensors could be used to solve these issues, an alternative is presented here. Using inverse simulation (InvSim), the inputs and outputs of the mathematical model of the rover system are reversed. Thus, for a desired trajectory, the corresponding actuator inputs are obtained. A step fault near the input then manifests itself as a step change in the residual between the system inputs and the input trajectory obtained through inverse simulation. This approach avoids the need for additional hardware on a mass- and power-critical system such as the rover. The InvSim fault detection method is applied to a simple four-wheeled rover in simulation. Additive system faults and an external disturbance force and are applied to the vehicle in turn, such that the dynamic response and sensor output of the rover are impacted. Basic model-based fault detection is then employed to provide output residuals which may be analysed to provide information on the fault/disturbance. InvSim-based fault detection is then employed, similarly providing \textit{input} residuals which provide further information on the fault/disturbance. The input residuals are shown to provide clearer information on the location and magnitude of an input fault than the output residuals. Additionally, they can allow faults to be more clearly discriminated from environmental disturbances

Inverse Simulation as a Tool for Fault Detection and Isolation in Planetary Rovers

With manned expeditions to planetary bodies beyond our own and the Moon currently intractable, the onus falls upon robotic systems to explore and analyse extraterrestrial environments such as Mars. These systems typically take the form of wheeled rovers, designed to navigate the difficult terrain of other worlds. Rovers have been used in this role since Lunokhod 1 landed on the Moon in 1970. While early rovers were remote controlled, communication latency with bodies beyond the Moon and the desire to improve mission effectiveness have resulted in increasing autonomy in planetary rovers. With an increase in autonomy, however, comes an increase in complexity. This can have a negative impact on the reliability of the rover system. With a fault-free system an unlikely prospect and human assistance millions of miles away, the rover must have a robust fault detection, isolation and recovery (FDIR) system. The need for comprehensive FDIR is demonstrated by the recent Chinese lunar rover, Yutu (or “Jade Rabbit”). Yutu was rendered immobile 42 days after landing and remained so for the duration of its operational life: 31 months. While its lifespan far exceeded its expected value, Yutu's inability to move severely impaired its ability to perform its mission. This clearly highlights the need for robust FDIR. A common approach to FDIR is through the generation and analysis of residuals. Output residuals may be obtained by comparing the outputs of the system with predictions of those outputs, obtained from a mathematical model of the system which is supplied with the system inputs. Output residuals allow simple detection and isolation of faults at the output of the system. Faults in earlier stages of the system, however, propagate through the system dynamics and can disperse amongst several of the outputs. This problem is exemplified by faults at the input, which can potentially excite every system state and thus manifest in every output residual. Methods exist for decoupling and analysing output residuals such that input faults may be isolated, however, these methods are complex and require comprehensive development and testing. A conceptually simpler approach is presented in this paper. Inverse simulation (InvSim) is a numerical method by which the inputs of a system are obtained for a desired output. It does so by using a Newton-Raphson algorithm to solve a non-linear model of the system for the input. When supplied with the outputs of a fault-afflicted system, InvSim produces the input required to drive a fault-free system to this output. The fault therefore manifests itself in this generated input signal. The InvSim-generated input may then be compared to the true system input to generate input residuals. Just as a fault at an output manifests itself in the residual for that output alone, a fault at an input similarly manifests itself only in the residual for that input. InvSim may also be used to generate residuals at other locations in the system, by considering distinct subsystems with their own inputs and outputs. This ability is tested comprehensively in this paper. Faults are applied to a simulated rover at a variety of locations within the system structure and residuals generated using both InvSim and conventional forward simulation. Residuals generated using InvSim are shown to facilitate detection and isolation of faults in several locations using simple analyses. By contrast, forward simulation requires the use of complex analytical methods such as structured residuals or adaptive thresholds

The Mass-Radius Relation Of Young Stars. I. Usco 5, An M4.5 Eclipsing Binary In Upper Scorpius Observed By K2

We present the discovery that UScoCTIO 5, a known spectroscopic binary in the Upper Scorpius star-forming region (P = 34 days, M-tot sin(i) = 0.64M(circle dot)), is an eclipsing system with both primary and secondary eclipses apparent in K2 light curves obtained during Campaign 2. We have simultaneously fit the eclipse profiles from the K2 light curves and the existing RV data to demonstrate that UScoCTIO 5 consists of a pair of nearly identical M4.5 stars with M-A = 0.329 +/- 0.002 M-circle dot, R-A = 0.834 +/- 0.006 R-circle dot, M-B = 0.317 +/- 0.002 M-circle dot, and R-B = 0.810 +/- 0.006 R-circle dot. The radii are broadly consistent with pre-main-sequence ages predicted by stellar evolutionary models, but none agree to within the uncertainties. All models predict systematically incorrect masses at the 25%-50% level for the HR diagram position of these mid-M dwarfs, suggesting significant modifications to mass-dependent outcomes of star and planet formation. The form of the discrepancy for most model sets is not that they predict luminosities that are too low, but rather that they predict temperatures that are too high, suggesting that the models do not fully encompass the physics of energy transport (via convection and/or missing opacities) and/or a miscalibration of the SpT-T-eff scale. The simplest modification to the models (changing T-eff to match observations) would yield an older age for this system, in line with the recently proposed older age of Upper Scorpius (tau similar to 11 Myr).NASA Science Mission directorateW. M. Keck FoundationAstronom

Assessing the effectiveness of specially protected areas for conservation of Antarctica's botanical diversity

Vegetation is sparsely distributed over Antarctica's ice-free ground, and distinct plant communities are present in each of the continent's 15 recently identified Antarctic Conservation Biogeographic Regions (ACBRs). With rapidly increasing human activity in Antarctica, terrestrial plant communities are at risk of damage or destruction by trampling, overland transport and infrastructure construction, and the impacts of anthropogenically introduced species, as well as uncontrollable pressures such as fur seal activity and climate change. Under the Protocol on Environmental Protection to the Antarctic Treaty, the conservation of plant communities can be enacted and facilitated through the designation of Antarctic Specially Protected Areas (ASPAs). In this study we examined the distribution within the 15 ACBRs of the 33 ASPAs whose explicit purpose includes protecting macroscopic terrestrial flora. Large omissions in the protection of Antarctic botanical diversity were found, with no protection of plant communities in six ACBRs and, in a further six, less than 0.4% of the ACBR area was included within an ASPA protecting vegetation. We completed the first normalised difference vegetation index (NDVI) satellite remote sensing survey to provide baseline data on the extent of vegetation cover in all ASPAs designated for plant protection in Antarctica. Protected vegetation cover within the 33 ASPAs totalled 16.1 km2 for the entire Antarctic continent, with over half of this within a single protected area. Over 96% of the protected vegetation was contained within two ACBRs, which together contribute only 7.8% of the continent's ice-free ground. We conclude that Antarctic botanical diversity is clearly inadequately protected, and call for systematic designation of ASPAs protecting plant communities across by the Antarctic Treaty Consultative Parties, the members of the governing body of the continen

Motor Competence in Early Childhood Is Positively Associated with Bone Strength in Late Adolescence

The onset of walking in early childhood results in exposure of the lower limb to substantial forces from weight bearing activity that ultimately contribute to adult bone strength. Relationships between gross motor score (GMS), at 18 months and bone outcomes measured at age 17 years were examined in 2327 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Higher GMS indicated greater motor competence in weight‐bearing activities. Total hip bone mineral density (BMD) and hip cross‐sectional moment of inertia (CSMI) were assessed from dual‐energy X‐ray absorptiometry (DXA). Bone measures including cortical bone mineral content (BMC), periosteal circumference (PC), cortical thickness (CT), cortical bone area (CBA), cortical BMD (BMD(C)) and cross‐sectional moment of inertia (CSMI) were assessed by peripheral quantitative computed tomography (pQCT) at 50% distal‐proximal length. Before adjustment, GMS was associated with hip BMD, CSMI, and tibia BMC, PC, CT, CBA and CSMI (all p < 0.001) but not BMD(C) (p > 0.25). Strongest associations (standardized regression coefficients with 95% CI) were between GMS and hip BMD (0.086; 95% CI, 0.067 to 0.105) and tibia BMC (0.105; 95% CI, 0.089 to 0.121). With the exception of hip BMD, larger regression coefficients were observed in males (gender interactions all p < 0.05). Adjustment for lean mass resulted in substantial attenuation of regression coefficients, suggesting associations between impaired motor competence and subsequent bone development are partly mediated by alterations in body composition. In conclusion, impaired motor competence in childhood is associated with lower adolescent bone strength, and may represent a risk factor for subsequent osteoporosis. © 2015 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR)

Confirmation of a gapped primordial disk around LkCa 15

Recently, analysis of near-infrared broad-band photometry and Spitzer IRS spectra has led to the identification of a new "pre-transitional disk" class whose members have an inner optically thick disk separated from an outer optically thick disk by an optically thin gap. This is in contrast to the "transitional disks" which have inner disk holes (i.e. large reductions of small dust from the star out to an outer optically thick wall). In LkCa 15, one of these proposed pre-transitional disks, detailed modeling showed that although the near-infrared fluxes could be understood in terms of optically thick material at the dust sublimation radius, an alternative model of emission from optically thin dust over a wide range of radii could explain the observations as well. To unveil the true nature of LkCa 15's inner disk we obtained a medium-resolution near-infrared spectrum spanning the wavelength range 2-5 microns using SpeX at the NASA Infrared Telescope Facility. We report that the excess near-infrared emission above the photosphere of LkCa 15 is a black-body continuum which can only be due to optically thick material in an inner disk around the star. When this confirmation of a primordial inner disk is combined with earlier observations of an inner edge to LkCa 15's outer disk it reveals a gapped structure. Forming planets emerge as the most likely mechanism for clearing the gap we detect in this evolving disk.Comment: accepted ApJ

A Survey of Computational Tools in Solar Physics

The SunPy Project developed a 13-question survey to understand the software and hardware usage of the solar physics community. 364 members of the solar physics community, across 35 countries, responded to our survey. We found that 99$\pm$0.5% of respondents use software in their research and 66% use the Python scientific software stack. Students are twice as likely as faculty, staff scientists, and researchers to use Python rather than Interactive Data Language (IDL). In this respect, the astrophysics and solar physics communities differ widely: 78% of solar physics faculty, staff scientists, and researchers in our sample uses IDL, compared with 44% of astrophysics faculty and scientists sampled by Momcheva and Tollerud (2015). 63$\pm$4% of respondents have not taken any computer-science courses at an undergraduate or graduate level. We also found that most respondents utilize consumer hardware to run software for solar-physics research. Although 82% of respondents work with data from space-based or ground-based missions, some of which (e.g. the Solar Dynamics Observatory and Daniel K. Inouye Solar Telescope) produce terabytes of data a day, 14% use a regional or national cluster, 5% use a commercial cloud provider, and 29% use exclusively a laptop or desktop. Finally, we found that 73$\pm$4% of respondents cite scientific software in their research, although only 42$\pm$3% do so routinely