Purple Medicine

In response to a broad set of complex national security challenges of the twenty-first century, the Quadrennial Defense Review (QDR) report of Febru- ary 2006 advised that all the organizations, processes, and practices within the Department of Defense be given a high degree of agility, flexibility, responsive- ness, and ultimately effectiveness in supporting the joint war fighter and future national defense goals

Nutrition Research: Basis for Station Requirements

Prior to the Shuttle program, all understanding of nutritional needs in space came from Skylab metabolic research. Because Shuttle flights were short, most less than 14 days, research focused on major nutritional issues: energy (calories), protein and amino acids, water and electrotypes, with some more general physiology studies that related to iron and calcium. Using stable isotope tracer studies and diet intake records, we found that astronauts typically did not consume adequate calories to meet energy expenditure. To monitor energy and nutrient intake status and provide feedback to the flight surgeon and the astronauts, the International Space Station (ISS) program implemented a weekly food frequency questionnaire and routine body mass measurements. Other Shuttle investigations found that protein turnover was higher during flight, suggesting there was increased protein degradation and probably concurrent increase in protein synthesis, and this occurred even in cases of adequate protein and caloric intake. These results may partially explain some of the loss of leg muscle mass. Fluid and electrolyte flight studies demonstrated that water intake, like energy intake, was lower than required. However, sodium intakes were elevated during flight and likely related to other concerns such as calcium turnover and other health-related issues. NASA is making efforts to have tasty foods with much lower salt levels to reduce sodium intake and to promote fluid intake on orbit. Red blood cell studies conducted on the Shuttle found decreased erythrogenesis and increased serum ferritin levels. Given that the diet is high in iron there may be iron storage health concerns, especially related to the role of iron in oxidative damage, complicated by the stress and radiation. The Shuttle nutrition research lead to new monitoring and research on ISS. These data will be valuable for future NASA and commercial crewed missions

From the Empire State to the North Star State: Voter Engagement in the 2016 Election

Voter engagement has the potential to be a fundamental part of social work practice and key to the professional socialization of social work students. This article describes a classroom-based voter engagement project conducted in two undergraduate social work programs in different U.S. states with significantly different voting laws. We describe the rationale, process of implementing the project, evaluation, and review the results in the context of the 2016 election. We suggest future research that can help develop best practices and methods for implementation of voter engagement in social work practice and education in the future

Gastric Tube Placement in Children 1-215 Months Old

poster abstractFeeding by a nasogastric/orogastric (NG/OG) tube is preferred when the gastrointestinal system is functional and the need for assisted feeding is expected to be short-term. Preliminary studies in children show that between 21% and 44% of these tubes are placed incorrectly. When tubes are out of place, children can be seriously harmed, causing increased morbidity and occasionally death. The aims of this study were to determine the best method to predict the insertion distance for placing NG/OG tubes and to determine the best clinical methods of testing the location of NG/OG tubes once they were inserted. A randomized clinical trial was conducted. The three insertion-distance prediction methods tested were nose-ear-xiphoid (NEX); nose-ear-mid-umbilicus (NEMU); and age-related, height-based (ARHB). An abdominal radiograph was obtained immediately following tube insertion to determine the internal location of the tube tip and orifice(s). Based on data from 95 children age 1-220 months (M = 51.8, SD = 54.9, median = 33.4), both the ARHB and NEMU methods were superior to NEX in placing the tube in the stomach (p = .0064). ARHB and NEMU were not significantly different from each other. NEX was frequently too short (41.93% of tube insertions) leaving the tube tip and/or orifices in the esophagus. The three clinical methods of testing tube location were CO2 monitoring and measuring pH and bilirubin in tube aspirate. Measuring pH of tube aspirate was the superior clinical method of determining tube location. Aspirate was available for testing in 84 children (88.42%). Based on a pH cutoff of 5 (recommended by Metheny in fasting adults), the sensitivity was 26.67 (low), specificity was 80.60 (high), positive predictive value was 23.53 (low), and negative predictive value was 83.08 (high). Measuring the NEX distance is the method most commonly used by nurses in practice; therefore, based on the results of this study and studies of other researchers, a practice change to either ARHB or NEMU should improve the safety of enteral feeding in children. Because of the low sensitivity in predicting misplaced tubes using pH, the superior clinical method, obtaining an abdominal x-ray to ensure placement in the stomach at the time of tube insertion is recommended

Masses, Luminosities, and Orbital Coplanarities of the mu Orionis Quadruple Star System from PHASES Differential Astrometry

mu Orionis was identified by spectroscopic studies as a quadruple star system. Seventeen high precision differential astrometry measurements of mu Ori have been collected by the Palomar High-precision Astrometric Search for Exoplanet Systems (PHASES). These show both the motion of the long period binary orbit and short period perturbations superimposed on that caused by each of the components in the long period system being themselves binaries. The new measurements enable the orientations of the long period binary and short period subsystems to be determined. Recent theoretical work predicts the distribution of relative inclinations between inner and outer orbits of hierarchical systems to peak near 40 and 140 degrees. The degree of coplanarity of this complex system is determined, and the angle between the planes of the A-B and Aa-Ab orbits is found to be 136.7 +/- 8.3 degrees, near the predicted distribution peak at 140 degrees; this result is discussed in the context of the handful of systems with established mutual inclinations. The system distance and masses for each component are obtained from a combined fit of the PHASES astrometry and archival radial velocity observations. The component masses have relative precisions of 5% (component Aa), 15% (Ab), and 1.4% (each of Ba and Bb). The median size of the minor axes of the uncertainty ellipses for the new measurements is 20 micro-arcseconds. Updated orbits for delta Equulei, kappa Pegasi, and V819 Herculis are also presented.Comment: 12 Pages, Accepted for publication in A

What Will it Take to Make Solar Panels Cool?

With the predicted results of climate change looming, humanity must do all it can to limit greenhouse gas emissions. Maintaining a habitable environment along with the high quality of living associated with developed nations requires investment in renewable energy. Because national governments often fail to make responsible decisions for their country\u27s future, this burden falls to institutions like UMass Amherst. Although costly investments like solar panels substantially improve the sustainability of campus, some innovative improvements of existing solar energy infrastructure can go a long way. For example, when solar panels heat up they lose photovoltaic efficiency. We propose that UMass institute cooling systems on current and future solar panel structures. This may sound extravagant, but in this paper we outline a plan for a simple and affordable cooling system that can be constructed from supplies bought at a local hardware store. The University spent approximately $1.5 million dollars on the new solar canopy atop the Robsham’s Visitor Center. This structure generates an estimated$40,000 worth of electricity each year, with a 38 year return on investment. We expect a cooling system for each canopy to cost around $500 and to improve power output by more than 10 percent. This means that by the most conservative estimate, a$500 investment will generate an additional $4,000 worth of electricity, reducing the return on investment time by 4 years. Compared with the initial solar canopy investment, this magnitude of electricity generation would have cost$150,000. By comparison, $500 is peanuts. Read on to see how a little ingenuity can go a long way to save money and the environment

The peripheral blood transcriptome in septic cardiomyopathy: an observational, pilot study.

BACKGROUND:Septic cardiomyopathy (SCM) is common in sepsis and associated with increased morbidity and mortality. Left ventricular global longitudinal strain (LV GLS), measured by speckle tracking echocardiography, allows improved identification of impaired cardiac contractility. The peripheral blood transcriptome may be an important window into SCM pathophysiology. We therefore studied the peripheral blood transcriptome and LV GLS in a prospective cohort of patients with sepsis. RESULTS:In this single-center observational pilot study, we enrolled adult patients (age > 18) with sepsis within 48 h of admission to the ICU. SCM was defined as LV GLS > - 17% based on echocardiograms performed within 72 h of admission. We enrolled 27 patients, 24 of whom had high-quality RNA results; 18 (75%) of 24 had SCM. The group was 50% female and had a median (IQR) age of 59.5 (48.5-67.0) years and admission APACHE II score of 21.0 (16.0-32.3). Forty-six percent had septic shock. After filtering for low-expression and non-coding genes, 15,418 protein coding genes were expressed and 73 had significantly different expression between patients with vs. without SCM. In patients with SCM, 43 genes were upregulated and 30 were downregulated. Pathway analysis identified enrichment in type 1 interferon signaling (adjusted p < 10-5). CONCLUSIONS:In this hypothesis-generating study, SCM was associated with upregulation of genes in the type 1 interferon signaling pathway. Interferons are cytokines that stimulate the innate and adaptive immune response and are implicated in the early proinflammatory and delayed immunosuppression phases of sepsis. While type 1 interferons have not been implicated previously in SCM, interferon therapy (for viral hepatitis and Kaposi sarcoma) has been associated with reversible cardiomyopathy, perhaps suggesting a role for interferon signaling in SCM

Dissemination and Systemic Colonization of Uropathogenic Escherichia coli in a Murine Model of Bacteremia

Infection with uropathogenic Escherichia coli (UPEC), the causative agent of most uncomplicated urinary tract infections, proceeds in an ascending manner and, if left untreated, may result in bacteremia and urosepsis. To examine the fate of UPEC after its entry into the bloodstream, we developed a murine model of sublethal bacteremia. CBA/J mice were inoculated intravenously with 1 × 106 CFU of pyelonephritis strain E. coli CFT073 carrying a bioluminescent reporter. Biophotonic imaging, used to monitor the infection over 48 h, demonstrated that the bacteria disseminated systemically and appeared to localize at discrete sites. UPEC was recovered from the spleen, liver, kidneys, lungs, heart, brain, and intestines as early as 20 min postinoculation, peaking at 24 h postinoculation. A nonpathogenic E. coli K-12 strain, however, disseminated at significantly lower levels (P < 0.01) and was cleared from the liver and cecum by 24 h postinoculation. Isogenic mutants lacking type 1 fimbriae, P fimbriae, capsule, TonB, the heme receptors Hma and ChuA, or particularly the sialic acid catabolism enzyme NanA were significantly outcompeted by wild-type CFT073 during bacteremia (P < 0.05), while flagellin and hemolysin mutants were not