EMPLOYING MARKOV MODELS TO FORECAST THE END STRENGTH OF THE US NAVY SUPPLY CORPS’ FINANCIAL MANAGEMENT (3111) COMMUNITY

The Navy Supply Corps has a wide array of Subspecialties (SSP) and Additional Qualification Designations (AQD) that define an officer’s skillset/experience and billet requirements. Current planning by the Supply Corps’ Office of Personnel (OP) assumes identical retention rates across all SSP/AQD combinations. This strategy may lead to unanticipated effects when changes to policy occur. Our research applies the Markov model to manpower data obtained from OP to analyze the current and forecasted end strength of the Supply Corps’ Financial Management (FM) community. This research addresses the following questions: 1) What are the forecasted end strengths for Navy Supply Corps Officers with FM experience and qualifications? 2) Does the FM community’s current billet structure create enough FM officers to achieve OP’s inventory goal of 2.5 times the number of qualified FM officers per FM billet at the O5-O6 level? We find that if the Supply Corps’ FM community continues along its current manpower trajectory, OP will likely never achieve its inventory goal for the community. However, our models provide multiple ways through which OP can achieve its O5-O6 inventory goals over time.Lieutenant Commander, United States NavyLieutenant Commander, United States NavyLieutenant Commander, United States NavyApproved for public release. Distribution is unlimited

Using Nanoparticle X-ray Spectroscopy to Probe the Formation of Reactive Chemical Gradients in Diffusion-Limited Aerosols.

For aerosol particles that exist in highly viscous, diffusion-limited states, steep chemical gradients are expected to form during photochemical aging in the atmosphere. Under these conditions, species at the aerosol surface are more rapidly transformed than molecules residing in the particle interior. To examine the formation and evolution of chemical gradients at aerosol interfaces, the heterogeneous reaction of hydroxyl radicals (OH) on ∼200 nm particles of pure squalane (a branched, liquid hydrocarbon) and octacosane (a linear, solid hydrocarbon) and binary mixtures of the two are used to understand how diffusion limitations and phase separation impact the particle reactivity. Aerosol mass spectrometry is used to measure the effective heterogeneous OH uptake coefficient (γeff) and oxidation kinetics in the bulk, which are compared with the elemental composition of the surface obtained using X-ray photoemission. When diffusion rates are fast relative to the reaction frequency, as is the case for squalane and low-viscosity squalane-octacosane mixtures, the reaction is efficient (γeff ∼ 0.3) and only limited by the arrival of OH to the interface. However, for cases, where the diffusion rates are slower than reaction rates, as in pure octacosane and higher-viscosity squalane-octacosane mixtures, the heterogeneous reaction occurs in a mixing-limited regime and is ∼10× slower (γeff ∼ 0.03). This is in contrast to carbon and oxygen K edge X-ray absorption measurements that show that the octacosane interface is oxidized much more rapidly than that of pure squalane particles. The O/C ratio of the surface (estimated to be the top 6-8 nm of the interface) is measured to change with rate constants of (3.0 ± 0.9) × 10-13 and (8.6 ± 1.2) × 10-13 cm3 molecule-1 s-1 for squalane and octacosane particles, respectively. The differences in surface oxidation rates are analyzed using a previously published reaction-diffusion model, which suggests that a 1-2 nm highly oxidized crust forms on octacosane particles, whereas in pure squalane, the reaction products are homogeneously mixed within the aerosol. This work illustrates how diffusion limitations can form particles with highly oxidized surfaces even at relatively low oxidant exposures, which is in turn expected to influence their microphysics in the atmosphere

Clinical significance of antimicrobial resistance in Streptococcus pneumoniae

Despite increasing resistance in the pneumococcus over the past 30 years, there are few cases of treatment failure of nonmeningeal infections with high dose parenteral penicillin G, which still remains highly effective for many pneumococcal diseases. This is reflected by the new 2008 CLSI breakpoints for parenteral penicillin G of susceptible, ≤2 g/mL, intermediate, 4 g/mL, and resistant, ≥8 µg/mL for nonmeningeal infections. For meningitis and oral penicillin V use, the old penicillin breakpoints of susceptible, ≤0.06 g/mL, intermediate, 0.12-1 g/mL, and resistant, ≥2 µg/mL will remain in place. Clinically relevant susceptibility breakpoints have also been developed for virtually all relevant antimicrobial agents used to treat pneumococcal diseases, based on clinical studies and pharmacokinetic and pharmacodynamic parameters. Although pneumococcal resistance to -lactams, macrolides and cotrimoxazole is now common worldwide, we are still able to treat almost all pneumococcal infections adequately. An exception is the oral treatment of multidrug resistant serotype 19A strains in children in the USA as these are resistant to amoxicillin, oral cephalosporins and cotrimoxazole. While there is a need to develop new agents, judicious use of antimicrobial agents is the best long-term approach. Empiric treatment guidelines should reflect the emerging threats from increased drug resistance and the possibility of increased virulence in replacement serotypes following vaccine use. Compliance with guidelines by physicians and patients is important to prevent further development of resistance

Protection by Inhaled Hydrogen Therapy in a Rat Model of Acute Lung Injury can be Tracked \u3cem\u3ein vivo\u3c/em\u3e Using Molecular Imaging

Inhaled hydrogen gas (H2) provides protection in rat models of human acute lung injury (ALI). We previously reported that biomarker imaging can detect oxidative stress and endothelial cell death in vivo in a rat model of ALI. Our objective was to evaluate the ability of 99mTc-hexamethylpropyleneamineoxime (HMPAO) and 99mTc-duramycin to track the effectiveness of H2 therapy in vivo in the hyperoxia rat model of ALI. Rats were exposed to room air (normoxia), 98% O2 + 2% N2 (hyperoxia) or 98% O2 + 2% H2 (hyperoxia+H2) for up to 60 h. In vivo scintigraphy images were acquired following injection of 99mTc-HMPAO or 99mTc-duramycin. For hyperoxiarats, 99mTc-HMPAO and 99mTc-duramycin lung uptake increased in a time-dependent manner, reaching a maximum increase of 270% and 150% at 60 h, respectively. These increases were reduced to 120% and 70%, respectively, in hyperoxia+H2 rats. Hyperoxia exposure increased glutathione content in lung homogenate (36%) more than hyperoxia+H2 (21%), consistent with increases measured in 99mTc-HMPAO lung uptake. In 60-h hyperoxia rats, pleural effusion, which was undetectable in normoxia rats, averaged 9.3 gram/rat, and lung tissue 3-nitrotyrosine expression increased by 790%. Increases were reduced by 69% and 59%, respectively, in 60-h hyperoxia+H2 rats. This study detects and tracks the anti-oxidant and anti-apoptotic properties of H2 therapy in vivo after as early as 24 h of hyperoxia exposure. The results suggest the potential utility of these SPECT biomarkers for in vivo assessment of key cellular pathways in the pathogenesis of ALI and for monitoring responses to therapies

Public Deliberations, Discursive Participation and Citizen Engagement: A Review of the Empirical Literature

Many theorists have long extolled the virtues of public deliberation as a crucial component of a responsive and responsible democracy. Building on these theories, in recent years practitioners - from government officials to citizen groups, nonprofits, and foundations - have increasingly devoted time and resources to strengthening citizen engagement through deliberative forums. Although empirical research has lagged behind theory and practice, a body of literature has emerged that tests the presumed individual and collective benefits of public discourse on citizen engagement. We begin our review of this research by defining public deliberation ; we place it in the context of other forms of what we call discursive participation while distinguishing it from other ways in which citizens can voice their individual and collective views on public issues.We then discuss the expectations, drawn from deliberative democratic theory, regarding the benefits (and, for some, pitfalls) assumed to derive from public deliberation. The next section reviews empirical research as it relates to these theoretical expectations.We conclude with recommendations on future directions for research in this area

Associations of body composition measures and C2, a marker for small artery elasticity: The MESA.

ObjectiveLower C2, a continuous blood pressure waveform characteristic asserted to represent small artery elasticity, predicts future cardiovascular disease events. It is hypothesized that the paradoxical positive association between body mass index (BMI) and C2 may reflect muscle instead of excess fat.MethodsIn a multi-ethnic, community-living cohort of 1,960 participants, computed tomography scans of the abdomen were used to measure visceral adipose tissue (VAT) and total abdominal muscle tissue (TAMT), and applanation tonometry of the radial arteries was used to assess C2. The period cross-sectional associations between BMI, TAMT, and VAT with C2 were ascertained.ResultsThe mean age was 62 ± 9 years and 51% were male. After adjustments for age, gender, ethnicity, pack years smoking cigarettes, diabetes, hypertension, and total and HDL cholesterol, higher BMI (standardized beta = 0.09, P-value < 0.01) and more TAMT (standardized beta = 0.12, P-value < 0.01) were significantly associated with higher C2. In contrast, more VAT (standardized beta = -0.09, P-value < 0.01) was associated with lower C2.ConclusionsIn multivariable analysis, VAT, in contrast to TAMT and BMI, was associated with less compliant small arteries. Visceral fat may be a better marker for detrimental excess body fat than BMI

Enhancing the Transfer of Life Skills from Sport-based Youth Development Programs to School, Family, and Community Settings

When designed intentionally, sport-based youth development programs engage youth in physical activity, sport, and exercise as a way to concurrently pursue goals related to socioemotional and physical development (Holt et al., 2017). One such application of this is the Teaching Personal and Social Responsibility (TPSR) model (Hellison, 2011) which has the ultimate goal of students transferring lessons learned within the sport setting to other areas of their life, including family, community, and school. However, once youth leave the program setting, they become vulnerable to challenges from external systems working to support or hinder their transfer of life skills (Martinek & Lee, 2012). Therefore, we propose that (in)congruence among family, school, community and program systems influence the extent to which lessons learned can transfer to other areas of their lives. Specifically drawing from the frameworks of Collective Parental Engagement (Alameda-Lawson & Lawson, 2016) and Students Multiple Worlds’ model (Phelan, Davidson, & Cao, 1991), we argue that skills and competency transfer is best facilitated when social settings which comprise youth’s social systems share similar values and expectations for desired behavior. Practical strategies for enhancing the transferability of lessons learned in TPSR programs through the congruence approach are shared

Closing the gap : development of an analytical methodology using volumetric absorptive microsampling of finger prick blood followed by LC-HRMS/MS for adherence monitoring of antihypertensive drugs

Volumetric absorptive microsampling (VAMS), an emerging microsampling technique, is a promising tool for adherence monitoring. This study focused on development of an analytical methodology to improve VAMS-based strategies for adherence assessment by analyzing angiotensin-converting-enzyme (ACE) inhibitors, loop diuretics, a potassium-sparing diuretic, and a thiazide diuretic. Development included sample preparation, chromatographic conditions, mass spectrometry settings, validation, and demonstrating proof of concept. Quantifcation of analytes, by name furosemide, hydrochlorothiazide, lisinopril, torasemide, and the active metabolites, canrenone, enalaprilat, and ramiprilat in fnger prick blood (FPB), was validated based on international guidelines. Selectivity, carryover, and within/between-run accuracy and precision were in accordance with the recommendations. The matrix efect was evaluated at three diferent hematocrit levels (HT: 20%, 40%, 60%) and the coefcients of variation did not exceed 15%. Dilution integrity (1:10 and 1:20) was given for all analytes except lisinopril, yet for lisinopril, the therapeutic range was already covered by the calibration range. Long-term stability in VAMS tips was tested for 2 weeks at 24 °C in the dark and revealed no degradation of analytes. The proof of concept was performed by analyzing 35 intakes of ACE-inhibitors and diuretics in 18 VAMS and matched plasma samples. Hereby, determined concentration in FPB and plasma cannot be used interchangeably, and thus specifc reference ranges for whole blood must be established. Nevertheless, the VAMS-based strategy was shown to be suitable for assessing adherence of all classes of antihypertensive drugs used in the guidelines to manage hypertension