System analysis approach to deriving design criteria (loads) for Space Shuttle and its payloads. Volume 1: General statement of approach

Space shuttle, the most complex transportation system designed to date, illustrates the requirement for an analysis approach that considers all major disciplines simultaneously. Its unique cross coupling and high sensitivity to aerodynamic uncertainties and high performance requirements dictated a less conservative approach than those taken in programs. Analyses performed for the space shuttle and certain payloads, Space Telescope and Spacelab, are used a examples. These illustrate the requirements for system analysis approaches and criteria, including dynamic modeling requirements, test requirements control requirements and the resulting design verification approaches. A survey of the problem, potential approaches available as solutions, implications for future systems, and projected technology development areas are addressed

System analysis approach to deriving design criteria (Loads) for Space Shuttle and its payloads. Volume 2: Typical examples

The achievement of an optimized design from the system standpoint under the low cost, high risk constraints of the present day environment was analyzed. Space Shuttle illustrates the requirement for an analysis approach that considers all major disciplines (coupling between structures control, propulsion, thermal, aeroelastic, and performance), simultaneously. The Space Shuttle and certain payloads, Space Telescope and Spacelab, are examined. The requirements for system analysis approaches and criteria, including dynamic modeling requirements, test requirements, control requirements, and the resulting design verification approaches are illustrated. A survey of the problem, potential approaches available as solutions, implications for future systems, and projected technology development areas are addressed

Estimating the Effect of Palliative Care Interventions and Advance Care Planning on ICU Utilization: A Systematic Review

OBJECTIVE: We conducted a systematic review to answer three questions: 1) Do advance care planning and palliative care interventions lead to a reduction in ICU admissions for adult patients with life-limiting illnesses? 2) Do these interventions reduce ICU length of stay? and 3) Is it possible to provide estimates of the magnitude of these effects? DATA SOURCES: We searched MEDLINE, EMBASE, Cochrane Controlled Clinical Trials, and Cumulative Index to Nursing and Allied Health Literature databases from 1995 through March 2014. STUDY SELECTION: We included studies that reported controlled trials (randomized and nonrandomized) assessing the impact of advance care planning and both primary and specialty palliative care interventions on ICU admissions and ICU length of stay for critically ill adult patients. DATA EXTRACTION: Nine randomized controlled trials and 13 nonrandomized controlled trials were selected from 216 references. DATA SYNTHESIS: Nineteen of these studies were used to provide estimates of the magnitude of effect of palliative care interventions and advance care planning on ICU admission and length of stay. Three studies reporting on ICU admissions suggest that advance care planning interventions reduce the relative risk of ICU admission for patients at high risk of death by 37% (SD, 23%). For trials evaluating palliative care interventions in the ICU setting, we found a 26% (SD, 23%) relative risk reduction in length of stay with these interventions. CONCLUSIONS: Despite wide variation in study type and quality, patients who received advance care planning or palliative care interventions consistently showed a pattern toward decreased ICU admissions and reduced ICU length of stay. Although SDs are wide and study quality varied, the magnitude of the effect is possible to estimate and provides a basis for modeling impact on healthcare costs

Inhibition of Angiogenesis by Treatment with Cold Atmospheric Plasma as a Promising Therapeutic Approach in Oncology

Background: Cold atmospheric plasma (CAP) is increasingly used in the field of oncology. Many of the mechanisms of action of CAP, such as inhibiting proliferation, DNA breakage, or the destruction of cell membrane integrity, have been investigated in many different types of tumors. In this regard, data are available from both in vivo and in vitro studies. Not only the direct treatment of a tumor but also the influence on its blood supply play a decisive role in the success of the therapy and the patient’s further prognosis. Whether the CAP influences this process is unknown, and the first indications in this regard are addressed in this study. Methods: Two different devices, kINPen and MiniJet, were used as CAP sources. Human endothelial cell line HDMEC were treated directly and indirectly with CAP, and growth kinetics were performed. To indicate apoptotic processes, caspase-3/7 assay and TUNEL assay were used. The influence of CAP on cellular metabolism was examined using the MTT and glucose assay. After CAP exposure, tube formation assay was performed to examine the capillary tube formation abilities of HDMEC and their migration was messured in separate assays. To investigate in a possible mutagenic effect of CAP treatment, a hypoxanthine-guanine-phosphoribosyl-transferase assay with non malignant cell (CCL-93) line was performed. Results: The direct CAP treatment of the HDMEC showed a robust growth-inhibiting effect, but the indirect one did not. The MMT assay showed an apparent reduction in cell metabolism in the first 24 h after CAP treatment, which appeared to normalize 48 h and 72 h after CAP application. These results were also confirmed by the glucose assay. The caspase 3/7 assay and TUNEL assay showed a significant increase in apoptotic processes in the HDMEC after CAP treatment. These results were independent of the CAP device. Both the migration and tube formation of HDMEC were significant inhibited after CAP-treatment. No malignant effects could be demonstrated by the CAP treatment on a non-malignant cell line. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Out of the Mouths of Babes: Links Between Linguistic Structure of Loss Narratives and Psychosocial Functioning in Parentally Bereaved Children

This study examined links between the language bereaved children use to describe the death of their caregiver and children’s psychological/behavioral functioning and coping strategies. Participants included 44 children (54.5% male) aged 7 to 12 (M = 9.05) years who were bereaved by the death of a caregiver. Children were assessed via self‐ and caregiver‐report measures and an in‐person interview regarding the loss of their caregiver. Children’s loss narratives gathered through in‐person interviews were transcribed and subjected to textual analysis. Linguistic categories included pronouns and verb tense. Drawing from linguistic and self‐distancing theories, we hypothesized that children’s use of language reflecting self‐distancing (third‐person pronouns and past tense) or social connectedness (first‐person plural pronouns) would be negatively associated with psychological/behavioral distress and avoidant coping. Similarly, we expected that children’s use of self‐focused language (first‐person singular pronouns and present tense) would be positively associated with psychological/behavioral distress and avoidant coping. As hypothesized, preliminary findings suggest that children who employed more self‐distancing language and used more social connectedness words reported less avoidant coping, rs = .40–.42. Also as hypothesized, children who employed more self‐focused language had higher levels of self‐reported posttraumatic stress symptoms, r = .54, and avoidant coping, r = .54, and higher parent‐reported psychological/behavioral distress, r = .43. Implications for theory‐building, risk screening, and directions for future research with bereaved youth are discussed.ResumenSpanish Abstracts by the Asociación Chilena de Estrés Traumático (ACET)Fuera de la boca de los bebes: vínculos entre la estructura lingüística de las narrativas de pérdida y el funcionamiento psicosocial en los niños con duelo parentalNARRATIVAS DE PÉRDIDA Y FUNCIONAMIENTO EN NIÑOSEste estudio examinó los vínculos entre el lenguaje usado por los niños en duelo para describir la muerte de su cuidador y el funcionamiento psicológico / conductual y las estrategias de afrontamiento de los niños. Los participantes incluyeron 44 niños (54,5% hombres) de 7 a 12 años (M = 9,05) en duelo por la muerte de un cuidador. Los niños fueron evaluados a través de medidas de autoreporte y reporte del cuidador y una entrevista en persona con respecto a la pérdida de su cuidador. Las narrativas de pérdida de los niños recopiladas a través de entrevistas en persona fueron transcritas y se sometieron a un análisis textual. Las categorías lingüísticas incluyen pronombres y tiempo verbal. Partiendo de teorías lingüísticas y de autodistanciamiento, hipotetizamos que el uso de lenguaje por parte de los niños que refleje autodistanciamiento (pronombres en tercera persona y tiempo pasado) o conectividad social (pronombres en primera persona en plural) estaría negativamente asociado con angustia psicológica o conductual y el afrontamiento evitativo. De manera similar, esperábamos que el uso de lenguaje enfocado en sí mismo (pronombres en primera persona singular y tiempo presente) se asociara positivamente con la angustia psicológica / conductual y el afrontamiento evitativo. Como se hipotetizó, los hallazgos preliminares sugieren que los niños que emplearon más lenguaje autodistanciado y un mayor uso de palabras de conectividad social reportaron menos afrontamiento evitativo, rs = .40‐.42. También según la hipótesis, los niños que empleaban más lenguaje enfocado en sí mismos tenían niveles más altos de síntomas de estrés postraumático autoreportados, r = .54, afrontamiento evitativo, r = .54 y mayor angustia psicológica / conductual informada por los padres, r = . 43. Se discuten las implicaciones para el desarrollo de la teoría, el tamizaje de riesgos y direcciones para futuras investigaciones con jóvenes en duelo.抽象Traditional and Simplified Chinese Abstracts by AsianSTSSOut of the Mouths of Babes: Links between Linguistic Structure of Loss Narratives and Psychosocial Functioning in Parentally‐Bereaved ChildrenTraditional Chinese標題: 喪失監護人的兒童其喪親敘述的語言結構與心理社會運作的關連撮要: 本研究檢視喪親兒童用以描述監護人去世的語言、兒童的心理/行為運作及應對策略。樣本為44名經歷了監護人去世的兒童(54.5%男性), 年齡介乎7 至 12歲 (M = 9.05)。自評報告和監護人報告用以測量兒童的狀況, 並有親身面談評估監護人過身的經歷。我們從親身面談取得兒童對喪親的敘述記錄, 並進行文本分析, 檢視的語言學範疇包括代名詞和動詞時態。我們基於語言學和自我疏遠理論, 假設兒童反映自我疏遠(第三人稱代名詞及過去式)或社交連繫(第一人稱複數代名詞)的語言, 會跟心理/行為悲痛及迴避式的應對方法有負向關連;而反映專注於自我的語言(第一人稱單數代名詞及現在式), 會跟心理/行為悲痛及迴避式的應對方法有正向關連。初步結果反映, 一如假設, 用較多自我疏遠和社交連繫語言的兒童, 有較低水平的迴避式應對(rs = .40–.42);而用較多專注於自我語言的兒童, 有較高水平的自評創傷後壓力症狀(r = .54)、迴避式應對(r = .54), 及根據家長評核有較高水平的心理/行為悲痛(r = .43)。我們亦討論到是次有關喪親青少年的發現, 對建立理論和風險篩查的幫助, 及日後的研究方向。Simplified Chinese标题: 丧失监护人的儿童其丧亲叙述的语言结构与心理社会运作的关连撮要: 本研究检视丧亲儿童用以描述监护人去世的语言、儿童的心理/行为运作及应对策略。样本为44名经历了监护人去世的儿童(54.5%男性), 年龄介乎7 至 12岁 (M = 9.05)。自评报告和监护人报告用以测量儿童的状况, 并有亲身面谈评估监护人过身的经历。我们从亲身面谈取得儿童对丧亲的叙述记录, 并进行文本分析, 检视的语言学范畴包括代名词和动词时态。我们基于语言学和自我疏远理论, 假设儿童反映自我疏远(第三人称代名词及过去式)或社交连系(第一人称复数代名词)的语言, 会跟心理/行为悲痛及回避式的应对方法有负向关连;而反映专注于自我的语言(第一人称单数代名词及现在式), 会跟心理/行为悲痛及回避式的应对方法有正向关连。初步结果反映, 一如假设, 用较多自我疏远和社交连系语言的儿童, 有较低水平的回避式应对(rs = .40–.42);而用较多专注于自我语言的儿童, 有较高水平的自评创伤后压力症状(r = .54)、回避式应对(r = .54), 及根据家长评核有较高水平的心理/行为悲痛(r = .43)。我们亦讨论到是次有关丧亲青少年的发现, 对建立理论和风险筛查的帮助, 及日后的研究方向。Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144623/1/jts22293.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144623/2/jts22293_am.pd

Stimulated monocyte IL-6 secretion predicts survival of patients with head and neck squamous cell carcinoma

<p>Abstract</p> <p>Background</p> <p>This study was performed in order to determine whether monocyte <it>in vitro </it>function is associated with presence, stage and prognosis of head and neck squamous cell carcinoma (HNSCC) disease.</p> <p>Methods</p> <p>Prospective study describing outcome, after at least five years observation, of patients treated for HNSCC disease in relation to their monocyte function. Sixty-five patients with newly diagnosed HNSCC and eighteen control patients were studied. Monocyte responsiveness was assessed by measuring levels of monocyte <it>in vitro </it>interleukin (IL)-6 and monocyte chemotactic peptide (MCP)-1 secretion after 24 hours of endotoxin stimulation in cultures supplied either with 20% autologous serum (AS) or serum free medium (SFM). Survival, and if relevant, cause of death, was determined at least 5 years following primary diagnosis.</p> <p>Results</p> <p>All patients, as a group, had higher <it>in vitro </it>monocyte responsiveness in terms of IL-6 (AS) (<it>t </it>= 2.03; <it>p </it>< 0.05) and MCP-1 (SFM) (<it>t </it>= 2.49; <it>p </it>< 0.05) compared to controls. Increased <it>in vitro </it>monocyte IL-6 endotoxin responsiveness under the SFM condition was associated with decreased survival rate (Hazard ratio (HR) = 2.27; Confidence interval (CI) = 1.05–4.88; <it>p </it>< 0.05). The predictive value of monocyte responsiveness, as measured by IL-6, was also retained when adjusted for age, gender and disease stage of patients (HR = 2.67; CI = 1.03–6.92; <it>p </it>< 0.05). With respect to MCP-1, low endotoxin-stimulated responsiveness (AS), analysed by Kaplan-Meier method, predicted decreased survival (χ = 4.0; <it>p </it>< 0.05).</p> <p>Conclusion</p> <p>In HNSCC patients, changed monocyte <it>in vitro </it>response to endotoxin, as measured by increased IL-6 (SFM) and decreased MCP-1 (AS) responsiveness, are negative prognostic factors.</p

Laryngeal tuberculosis presenting as a supraglottic carcinoma: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Laryngeal tuberculosis used to be a common complication in advanced pulmonary tuberculosis. However, it has become a rare occurrence in developed countries since the introduction of antituberculous agents. Moreover, the pattern of the disease has changed over the years. Nowadays, it more closely resembles a laryngeal carcinoma than any other laryngeal illness.</p> <p>Case presentation</p> <p>We describe the case of a 50-year-old Caucasian man who presented with the clinical picture of laryngeal cancer, but which turned out to be tuberculosis. We illustrate the difficulty of recognizing laryngeal tuberculosis both clinically and even with radiological examination.</p> <p>Conclusion</p> <p>Although laryngeal tuberculosis is uncommon, especially in developed countries, it still occurs and should be considered as a differential diagnosis in any laryngeal disease, in particular in the case of a laryngeal carcinoma.</p