SAO/NASA joint investigation of astronomical viewing quality at Mount Hopkins Observatory: 1969-1971

Quantitative measurements of the astronomical seeing conditions have been made with a stellar-image monitor system at the Mt. Hopkins Observatory in Arizona. The results of this joint SAO-NASA experiment indicate that for a 15-cm-diameter telescope, image motion is typically 1 arcsec or less and that intensity fluctuations due to scintillation have a coefficient of irradiance variance of less than 0.12 on the average. Correlations between seeing quality and local meteorological conditions were investigated. Local temperature fluctuations and temperature gradients were found to be indicators of image-motion conditions, while high-altitude-wind conditions were shown to be somewhat correlated with scintillation-spectrum bandwidth. The theoretical basis for the relationship of atmospheric turbulence to optical effects is discussed in some detail, along with a description of the equipment used in the experiment. General site-testing comments and applications of the seeing-test results are also included

The effect of levonorgestrel intrauterine device placement on serum CA‐125 levels in healthy premenopausal women

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135190/1/ijgo179.pd

Zinc and manganese chelation by neutrophil S100A8/A9 (Calprotectin) limits extracellular aspergillus fumigatus hyphal growth and corneal infection

PMCID: PMC4684987.-- et al.Calprotectin, a heterodimer of S100A8 and S100A9, is an abundant neutrophil protein that possesses antimicrobial activity primarily because of its ability to chelate zinc and manganese. In the current study, we showed that neutrophils from calprotectindeficient S100A9 mice have an impaired ability to inhibit Aspergillus fumigatus hyphal growth in vitro and in infected corneas in a murine model of fungal keratitis; however, the ability to inhibit hyphal growth was restored in S100A9 mice by injecting recombinant calprotectin. Furthermore, using recombinant calprotectin with mutations in either the Zn and Mn binding sites or the Mn binding site alone, we show that both zinc and manganese binding are necessary for calprotectin's antihyphal activity. In contrast to hyphæ, we found no role for neutrophil calprotectin in uptake or killing of intracellular A. fumigatus conidia either in vitro or in a murine model of pulmonary aspergillosis. We also found that an A. fumigatus δzafA mutant, which demonstrates deficient zinc transport, exhibits impaired growth in infected corneas and following incubation with neutrophils or calprotectin in vitro as compared with wild-type. Collectively, these studies demonstrate a novel stage-specific susceptibility of A. fumigatus to zinc and manganese chelation by neutrophil-derived calprotectin.This work was supported by National Eye Institute Grant R01 EY18612 (to E.P.), Visual Science Research Center Core Grant P30EY011373 (to Case Western Reserve University), National Institute of Allergy and Infectious Diseases Grant R01 AI101171 (to E.P.S. and W.J.C.), National Institute of Allergy and Infectious Diseases Immunology Training Grant 5T32AI089474 (to H.L.C.), National Eye Institute Visual Science Training Grant T32 EY007157 (to H.L.C.), and National Eye Institute National Research Service Award Grant 1F30EY025548-01 (to H.L.C.). T.M.H. and A.J. received Lucille Castori Center for Microbes, Inflammation, and Cancer Grants and National Institute of Allergy and Infectious Diseases Grants R01 AI093808 and R21 AI105617 (to T.M.H.). T.M.H. is an investigator in the Pathogenesis of Infectious Diseases supported by the Burroughs Wellcome Fund. J.A.C. was supported by the Spanish Ministry of Economy and Competitiveness through Grant SAF2013-48382-R.Peer Reviewe

Hemodynamic progression of aortic stenosis in adults assessed by doppler echocardiography

AbstractDoppler echocardiography was used to follow the hemodynamic severity of aortic stenosis. First, the reproducibility of repeat recordings (mean interval 28 ± 36 days) of aortic jet velocity, made by two independent observers, was tested in 38 adults with aortic stenosis and unchanged clinical status. The two recordings of maximal velocity correlated well (r = 0.96, y = 0.88x + 0.46m/s, SEE = 0.21 m/s) with a mean coefficient of variation of 3.2%. Repeat recording of left ventricular outflow tract velocity by two independent observers in 10 other patients with aortic stenosis also correlated well (r = 0.94, y = 1.06x + 0.0 m/s, SEE = 0.06 m/s) with a mean coefficient of variation of 4.6%.Next, Doppler echocardiography was used to study 42 patients with aortic stenosis (mean age 66 years) over a follow-up interval of 6 to 43 months (mean 20). Maximal aortic jet velocity increased by 0.36 m/s per year (range −0.3 to +1.0 m/s per year). Mean transaortic pressure gradient changed by −7 to +23 (mean 8) mm Hg/year. Aortic valve area by the continuity equation (n = 25) decreased by 0 to 0.5 cm2/year (mean decrease 0.1 cm2/year). year patients had a worsening of stenosis (decrease in valve area) even though they had no change or a decrease in pressure gradient, because of concurrent decreases in transaortic volume flow.Twenty-one patients (50%) developed new or progressive symptoms of aortic stenosis necessitating valve replacement. These patients had a higher maximal aortic jet velocity at follow-up (4.5 versus 3.9 m/s, p < 0.01) and a greater rate of increase in mean pressure gradient (15 versus 7 mm Hg/year, p < 0.01) than did those who remained asymptomatic; however, there were no significant differences in age, follow-up interval or maximal aortic jet velocity at entry.It is concluded that Doppler echocardiographic measures of aortic stenosis severity are reproducible. The rate of change of transaortic pressure gradient varies among patients and the gradient may not increase even when stenosis severity worsens. Although stenosis severity progresses more rapidly in patients who develop symptoms requiring valve replacement, these patients cannot be identified at the initial study

Retrospective Study of Midazolam Protocol for Prehospital Behavioral Emergencies

Introduction: Agitated patients in the prehospital setting pose challenges for both patient care and emergency medical services (EMS) provider safety. Midazolam is frequently used to control agitation in the emergency department setting; however, limited data exist in the prehospital setting. We describe our experience treating patients with midazolam for behavioral emergencies in a large urban EMS system. We hypothesized that using midazolam for acute agitation leads to improved clinical conditions without causing significant clinical deterioration.Methods: We performed a retrospective review of EMS patient care reports following implementation of a behavioral emergencies protocol in a large urban EMS system from February 2014–June 2016. For acute agitation, paramedics administered midazolam 1 milligram (mg) intravenous (IV), 5 mg intramuscular (IM), or 5 mg intranasal (IN). Results were analyzed using descriptive statistics, Levene’s test for assessing variance among study groups, and t-test to evaluate effectiveness based on route.Results: In total, midazolam was administered 294 times to 257 patients. Median age was 30 (interquartile range 24–42) years, and 66.5% were male. Doses administered were 1 mg (7.1%) and 5 mg (92.9%). Routes were IM (52.0%), IN (40.8%), and IV (7.1%). A second dose was administered to 37 patients. In the majority of administrations, midazolam improved the patient’s condition (73.5%) with infrequent adverse events (3.4%). There was no significant difference between the effectiveness of IM and IN midazolam (71.0% vs 75.4%; p = 0.24).Conclusion: A midazolam protocol for prehospital agitation was associated with reduced agitation and a low rate of adverse events

Enhancing patient experience by training local trainers in fundamental communication skills

Medical centers have a vested interest in improving patient experience through enhancing communication skills. The American Academy on Communication in Healthcare has helped institutions across the country establish internal expertise through delivering train-the-trainer programs. The phases of the program include preparing for implementation of the program, having program participants undergo a fundamental communication skills workshop and then understanding the theoretical and practical rationales underlying the workshop, setting up practice sessions for participants to achieve mastery, and ensuring long-term viability of a communication skills improvement initiative. Outcomes for participants include increased self-assessed personal communication skill, optimism about rolling out a communication skills program, and enhanced communication and hopefulness in working with colleagues. Train-the-trainer programs are a viable way to create enduring communities of local experts who can implement and support institutions’ commitments to excellence in the communication skills of their providers