Prediction of carbon nanotubes reinforced interphase properties in fuzzy fibre reinforced polymer via inverse analysis and optimisation

This paper presents the parameter identification procedure of carbon nanotubes (CNTs) reinforced interphase in fuzzy fibre reinforced polymer (FFRP). The procedure was completed with ANSYS Workbench 19.2 software by combining Mechanical ADPL and Goal-Driven Optimisation. Firstly, a three-phase representative volume element (RVE) containing carbon fibre, CNTs reinforced interphase and epoxy resin was developed as a collection of Mechanical APDL commands. This RVE model was simulated to evaluate the elastic constants of FFRP lamina. CNTs reinforced interphase was characterised by transversely isotropic model. Interphase properties were parametrised and became input parameters in the Goal-Driven Optimisation. FFRP lamina elastic constants were set as the output parameters. Multi-objective Genetic Algorithm (MOGA) was used to identify the interphase properties, so that the output FFRP lamina elastic constants match the objective and constraints. The optimisation algorithm converged after 585 evaluations. Five potential candidate point, which met required objectives and constraints, were found. The identified interphase properties agreed well with the literature (an average percentage error of around 2%). This inverse procedure shows the potential to identify the interphase properties in nano-engineered composites, which are extremely difficult to measure experimentall

Variability and spectral classification of LMC giants: results from DENIS and EROS

We present the first cross-identifications of sources in the near-infrared DENIS survey and in the micro-lensing EROS survey in a field of about 0.5 square degrees around the optical center (OC) of the Large Magellanic Cloud. We analyze the photometric history of these stars in the EROS data base and obtain light-curves for about 800 variables. Most of the stars are long period variables (Miras and Semi-Regulars), a few Cepheids are also present. We also present new spectroscopic data on 126 asymptotic giant branch stars in the OC field, 30 previously known and 96 newly discovered by the DENIS survey. The visible spectra are used to assign a carbon- (C-) or oxygen-rich (O-rich) nature to the observed stars on the basis of the presence of molecular bands of TiO, VO, CN, C2. For the remaining of the stars we used the (J-Ks) color to determine whether they are O-rich or C-rich. Plotting Log(period) versus Ks we find three very distinct period-luminosity relations, mainly populated by Semi-Regular of type a (SRa), b (SRb) and Mira variables. Carbon-rich stars occupy mostly the upper part of these relations. We find that 65% of the asymptotic giant branch population are long period variables (LPVs).Comment: 9 pages, 7 figures, 4 tables (2 via CDS), accepted by A&A journa

Recombinant alpha-interferon as salvage therapy in multiple myeloma

Ten patients with end-stage multiple myeloma refractory to conventional chemotherapy and hemibody irradiation received recombinant α-interferon as salvage therapy. The median duration of treatment was 8 weeks. One patient had an objective response and survived 8 months, whereas in the remaining 9 patients the disease progressed and median survival was 11,5 weeks. Side-effects were substantial and included confusion with extreme weakness, resulting in 5 patients refusing further therapy. The low response rate and the morbidity in this pilot study resulted in its discontinuation and the conclusion that recombinant α-interferon as singleagent therapy used for salvage in patients with refractory myeloma is of no value.S Afr Med J 1989; 76: 100-10

Metadata Deep Dive: Results from a Detailed Quality Assessment of NASA's Earth Observation Metadata

No abstract availabl

I’ll make a “Patient” out of you: An Update to “Physicians as ‘Patients’”- Design, Implementation, and Challenges of Novel Immersive Simulated Patient Experiences to Foster Physician Empathy and Compassion

Title: I’ll make a “Patient” out of you: An Update to “Physicians as ‘Patients’”- Design, Implementation, and Challenges of Novel Immersive Simulated Patient Experiences to Foster Physician Empathy and Compassion Author: Aaron M. Lee, DO, MS (Internal Medicine, Chief Resident) Co-Authors and Specialty Program Affiliations:  Khanh Hoang Nicholas Le, MD (Internal Medicine, PGY-1), Preetham Suresh, MD (Anesthesia, faculty), Ricardo Wood (UCSD Simulation Center), Sean Kenmore, MD (Internal Medicine, faculty)  Issues Addressed/ Background The importance of fostering physician empathy and compassion has become increasingly recognized as a critical aspect of physician training, with the ACGME and AAMC both acknowledging empathy as a key component of professionalism, with recommendations to incorporate empathy education into core medical education goals. The challenge remains how best to teach physician empathy and compassion in medical education, and to create long term effective educational interventions. Empathy curriculum in graduate medical education remains limited, as there are few standardized methodologies for teaching empathy.  Herein lies an opportunity for growth and development of novel and new methodologies to deliver patient-centered and empathy/compassion education to physicians in training. We hypothesize that lack of appreciation or understanding of the patient experience is much to blame in the deficits in teaching physician empathy and compassion. To address this void, we propose a set of novel immersive simulation exercises to place resident physicians in the role of a patient with space for guided reflection. We propose that a standardized longitudinal curriculum based on high-fidelity immersive simulation exercises throughout medical training will improve physician empathy and compassion, and the delivery of this form of education can be effective, easily disseminated, cost effective, and enjoyable to the learner, ultimately leading to better patient-centered and high-value care.This project was previously presented at PSQI 2022 in an earlier iteration, wherein the simulations were less immersive and in smaller sample size. The updated model presented here utilizes the UCSD patient room simulation labs to create high-fidelity fully immersive role-reversal simulation experiences.  Description of project/protocol/innovation Study design and measuring empathyThis project was funded via a generous seed grant award from the Sanford Institute for Empathy and Compassion, Center for Empathy and Compassion Training in Medical Education. This study is being performed in the UCSD Internal Medicine residency program, which consists of 143 resident physicians at varying training levels. Simulations are based off national VA patient survey data and reflect aspects of the patient experience that are painful or common. Our first simulation session, which will occur April 14, 2023, will encompass 20 residents in several high-fidelity immersive simulations at the UC San Diego simulation labs, with the help of the UCSD Simulation team. We also have plans to have a separate simulation session to include another 10-20 residents in early May 2023.This study utilizes standardized survey data (Jefferson Scale of Empathy) to evaluate the effectiveness of role-reversal simulation didactics in fostering physician empathy. Baseline survey data has been collected from the entire residency, and additional survey data will be collected after interventions have been complete. An intervention group will include those residents who are randomly assigned to the simulation group, while the remainder of the cohort will make up the control group. Statistical analysis will be performed by the Jefferson Scale of Empathy team comparing the two cohorts. All results and responses are de-identified to the primary researchers.The intervention/simulationsSeveral original simulations have been designed, each representing several aspects of the patient experience. Each resident is intended to rotate through each of the simulations in the role of the patient, which in total equals 30-40 minutes of simulation time. A debrief exercise is held afterwards for 30 minutes as well. During this debrief time, participants also will experience several forms of patient’s foods supplied by UCSD Health Dining, which will add another sensory component to the patient experience. Simulation A: a patient on the commode in a shared room is unable to reach their nurse to help them get back to bedSimulation B: ED patient boarding in a busy hallway is given bad news, physician leaves partway through without finishing the newsSimulation C: patient undergoing central line procedure, being done by a novice resident who is visibly nervous, and accosted by a circulating nurseSimulation D:  patient interacts with a physician who speaks only a foreign language, who brokenly obtains consent for a procedure  Lessons Learned/expected outcomes These novel simulations will be performed on April 14, 2023 over a 2 hour session, and an additional session in May 2023. Preliminary results from a prior iteration of this simulation idea suggested a positive signal between role-reversal simulations leading to increased empathy and compassion. We anticipate that these higher fidelity simulations and sensory immersion are powerful tools towards fostering greater appreciation of the inpatient patient experience, and will be effective towards increasing physician empathy and compassion.We recognize several challenges with building this form of curriculum. These simulations require resources, including equipment and simulation space, actors who can play roles of physicians (which most standardized actors are not trained to do), and dedicated educational time, all of which can prove challenging to obtain.    Recommendations/ Next steps While the development and implementation of these simulation activities is not without its own challenges, we believe these exercises may truly revolutionize how we approach empathy education in medical training. Current versions of standardized encounters do not take into consideration the patient experience, which we feel to be a crucial aspect of building empathy. These simulations are relatively easy to reproduce, and in a world where simulation has become more commonplace, should be easily adopted into curricula. As such, we feel that the next steps for this exercise are to build more robust simulations and disseminate this information to other academic institutions. We have produced an educational packet for these simulation exercises, which will serve as a distribution tool so that other academic institutions may adopt this novel teaching modality. Within this educational packet includes the background and evidence supporting these interventions, a toolkit which includes a supplies list, the simulations and scripts, and generally provides the overall structure to recreate these simulations

Near-IR variability properties of a selected sample of AGB stars

We present the results of a near-infrared monitoring programme of a selected sample of stars, initially suspected to be Mira variables and OH/IR stars, covering more than a decade of observations. The objects monitored cover the typical range of IRAS colours shown by O-rich stars on the Asymptotic Giant Branch and show a surprisingly large diversity of variability properties. 16 objects are confirmed as large-amplitude variables. Periods between 360 and 1800 days and typical amplitudes from 1 to 2 magnitudes could be determined for nine of them. In three light curves we find a systematic decrease of the mean brightness, two light curves show pronounced asymmetry. One source, IRAS 07222-2005, shows infrared colours typical of Mira variables but pulsates with a much longer period (approx. 1200 days) than a normal Mira. Two objects are ither close to (IRAS 03293+6010) or probably in (IRAS 18299-1705) the post-AGB phase. In IRAS 16029-3041 we found a systematic increase of the H-K colour of approximately 1 magnitude, which we interpret as evidence of a recent episode of enhanced mass loss. IRAS 18576+0341, a heavily obscured Luminous Blue Variable was also monitored. The star showed a continued decrease of brightness over a period of 7 years (1995 - 2002).Comment: 9 pages + 3 appendix, 36 figures, photometry table, accepted in Astronomy & Astrophysic

The global gas and dust budget of the Large Magellanic Cloud: AGB stars and supernovae and the impact on the ISM evolution

‘The definitive version is available at: www3.interscience.wiley.com '. Copyright Blackwell / Royal Astronomical Society. DOI: 10.1111/j.1365-2966.2009.14743.xWe report on an analysis of the gas and dust budget in the interstellar medium (ISM) of the Large Magellanic Cloud (LMC). Recent observations from the Spitzer Space Telescope enable us to study the mid-infrared dust excess of asymptotic giant branch (AGB) stars in the LMC. This is the first time we can quantitatively assess the gas and dust input from AGB stars over a complete galaxy, fully based on observations. The integrated mass-loss rate over all intermediate and high mass-loss rate carbon-rich AGB candidates in the LMC is 8.5 × 10−3 M⊙ yr−1 , up to 2.1 × 10−2 M⊙ yr−1 . This number could be increased up to 2.7 × 10−2 M⊙ yr−1 if oxygen-rich stars are included. This is overall consistent with theoretical expectations, considering the star formation rate (SFR) when these low- and intermediate-mass stars where formed, and the initial mass functions. AGB stars are one of the most important gas sources in the LMC, with supernovae (SNe), which produces about 2–4 × 10−2 M⊙ yr−1 . At the moment, the SFR exceeds the gas feedback from AGB stars and SNe in the LMC, and the current star formation depends on gas already present in the ISM. This suggests that as the gas in the ISM is exhausted, the SFR will eventually decline in the LMC, unless gas is supplied externally. Our estimates suggest 'a missing dust-mass problem' in the LMC, which is similarly found in high-z galaxies: the accumulated dust mass from AGB stars and possibly SNe over the dust lifetime (400–800 Myr) is significant less than the dust mass in the ISM. Another dust source is required, possibly related to star-forming regions.Peer reviewe

A toolkit for the collection of thrombosis-related data elements in COVID-19 clinical studies

Thrombosis has emerged as an important complication of coronavirus disease 2019 (COVID-19), particularly among individuals with severe illness. However, the precise incidence of thrombotic events remains uncertain due to differences in study design, patient populations, outcome ascertainment, event definitions, and reporting. In an effort to overcome some of these challenges and promote standardized data collection and reporting in clinical studies, the American Society of Hematology Research Collaborative COVID-19 Non-Malignant Hematology Task Force, in collaboration with the International Society on Thrombosis and Haemostasis COVID-19 Task Force, developed sets of data elements in the following domains: venous thromboembolism, myocardial infarction, stroke/transient ischemic attack, peripheral arterial thrombosis, bleeding, laboratory investigations, and antithrombotic therapy. Data elements in each of these domains were developed with 3 levels of detail to facilitate their incorporation into studies evaluating a range of interventions and outcomes. Previously published data elements were included where possible. The use of standardized variables in a range of clinical studies can enhance the quality of data collection, create efficiency, enhance comparison of results across studies, and facilitate future pooling of data sets