Ridge Orientations of the Ridge-Forming Unit, Sinus Meridiani, Mars-A Fluvial Explanation

Imagery and MOLA data were used in an analysis of the ridge-forming rock unit (RFU) exposed in Sinus Meridiani (SM). This unit shows parallels at different scales with fluvial sedimentary bodies. We propose the terrestrial megafan as the prime analog for the RFU, and likely for other members of the layered units. Megafans are partial cones of fluvial sediment, with radii up to hundreds of km. Although recent reviews of hypotheses for the RFU units exclude fluvial hypotheses [1], inverted ridges in the deserts of Oman have been suggested as putative analogs for some ridges [2], apparently without appreciating The wider context in which these ridges have formed is a series of megafans [3], a relatively unappreciated geomorphic feature. It has been argued that these units conform to the megafan model at the regional, subregional and local scales [4]. At the regional scale suites of terrestrial megafans are known to cover large areas at the foot of uplands on all continents - a close parallel with the setting of the Meridiani sediments at the foot of the southern uplands of Mars, with its incised fluvial systems leading down the regional NW slope [2, 3] towards the sedimentary units. At the subregional scale the layering and internal discontinuities of the Meridiani rocks are consistent, inter alia, with stacked fluvial units [4]. Although poorly recognized as such, the prime geomorphic environment in which stream channel networks cover large areas, without intervening hillslopes, is the megafan [see e.g. 4]. Single megafans can reach 200,000 km2 [5]. Megafans thus supply an analog for areas where channel-like ridges (as a palimpsest of a prior landscape) cover the intercrater plains of Meridiani [6]. At the local, or river-reach scale, the numerous sinuous features of the RFU are suggestive of fluvial channels. Cross-cutting relationships, a common feature of channels on terrestrial megafans, are ubiquitous. Desert megafans show cemented paleo-channels as inverted topography [4] with all these characteristics

AMTV headway sensor and safety design

A headway sensing system for an automated mixed traffic vehicle (AMTV) employing an array of optical proximity sensor elements is described, and its performance is presented in terms of object detection profiles. The problem of sensing in turns is explored experimentally and requirements for future turn sensors are discussed. A recommended headway sensor configuration, employing multiple source elements in the focal plane of one lens operating together with a similar detector unit, is described. Alternative concepts including laser radar, ultrasonic sensing, imaging techniques, and radar are compared to the present proximity sensor approach. Design concepts for an AMTV body which will minimize the probability of injury to pedestrians or passengers in the event of a collision are presented

Education and support needs during recovery in acute respiratory distress syndrome survivors

Abstract Introduction There is a limited understanding of the long-term needs of survivors of the acute respiratory distress syndrome (ARDS) as they recover from their episode of critical illness. The Timing it Right (TIR) framework, which emphasizes ARDS survivors' journey from the ICU through to community re-integration, may provide a valuable construct to explore the support needs of ARDS survivors during their recovery. Methods Twenty-five ARDS survivors participated in qualitative interviews examining their needs for educational, emotional and tangible support for each phase of the TIR framework. Transcripts were analyzed using framework methodology. Results ARDS survivors' support needs varied across the illness trajectory. During the ICU stay, survivors were generally too ill to require information. The transfer to the general ward was characterized by anxiety surrounding decreased surveillance and concern for future health and treatment. Information needs focused on the events surrounding the acute illness, while physical and emotional needs revolved around physical therapy and psychological support for depression and anxiety. As patients were preparing for hospital discharge, they expressed a desire for specific information about the recovery and rehabilitation process following an episode of ARDS (e.g., outpatient physiotherapy, long-term sequela of the illness). Once in the community, survivors wanted guidance on home care, secondary prevention, and ARDS support groups. Conclusions Our findings support the need for future educational and support interventions to meet the changing needs of ARDS survivors during their recovery

Clinicians' perceptions of rationales for rehabilitative exercise in a critical care setting: A cross-sectional study

Australian College of Critical Care Nurses Ltd. Background: Rehabilitative exercise for critically ill patients may have many benefits; however, it is unknown what intensive care unit (ICU) clinicians perceive to be important rationale for the implementation of rehabilitative exercise in critical care settings. Objective: To identify which rationales for rehabilitative exercise interventions were perceived by ICU clinicians to be important and determine whether perceptions were consistent across nursing, medical and physiotherapy clinicians. Methods: A cross-sectional study was undertaken among clinicians (nursing, medical, physiotherapy) working in a mixed medical surgical ICU in an Australian metropolitan tertiary hospital. Participants completed a customised web-based questionnaire developed by a clinician working-group. The questionnaire consisted of 11 plausible rationales for commencing rehabilitative exercise in ICUs based on prior literature and their own clinical experiences grouped into 4 over-arching categories (musculoskeletal, respiratory, psychological and facilitation of discharge). Participants rated their perceived importance for each potential rationale on a 5-point Likert scale. Results: Participants (n = 76) with a median (interquartile range) 4.8 (1.5, 15.5) years of experience working in ICUs completed the questionnaire. Responses were consistent across professional disciplines. Clinicians rated rehabilitative exercise as either 'very much' or 'somewhat' important for facilitating discharge (n = 76, 100%), reducing muscle atrophy (n = 76, 100%), increasing muscle strength (n = 76, 100%), prevention of contractures (n = 73, 96%), reducing the incidence of ICU acquired weakness (n = 62, 82%), increasing oxygenation (n = 71, 93%), facilitating weaning (n = 72, 97%), reducing anxiety (n = 60, 80%), reducing depression (n = 64, 84%), reducing delirium (n = 53, 70%), and increasing mental alertness (n = 65, 87%). Conclusions: Any shortcoming in implementation of rehabilitation exercise is unlikely attributable to a lack of perceived importance by nursing, medical or physiotherapy clinicians who are the most likely clinicians to influence rehabilitation practices in ICUs. It is noteworthy that this study examined self-reported perceptions, not physiological or scientific legitimacy of rationales, or clinician behaviours in practice

A retrospective cohort pilot study to evaluate a triage tool for use in a pandemic

Abstract Introduction The objective of this pilot study was to assess the usability of the draft Ontario triage protocol, to estimate its potential impact on patient outcomes, and ability to increase resource availability based on a retrospective cohort of critically ill patients cared for during a non-pandemic period. Methods Triage officers applied the protocol prospectively to 2 retrospective cohorts of patients admitted to 2 academic medical/surgical ICUs during an 8 week period of peak occupancy. Each patient was assigned a treatment priority (red -- 'highest', yellow -- 'intermediate', green -- 'discharge to ward', or blue/black -- 'expectant') by the triage officers at 3 separate time points (at the time of admission to the ICU, 48, and 120 hours post admission). Results Overall, triage officers were either confident or very confident in 68.4% of their scores; arbitration was required in 54.9% of cases. Application of the triage protocol would potentially decrease the number of required ventilator days by 49.3% (568 days) and decrease the total ICU days by 52.6% (895 days). On the triage protocol at ICU admission the survival rate in the red (93.7%) and yellow (62.5%) categories were significantly higher then that of the blue category (24.6%) with associated P values of < 0.0001 and 0.0003 respectively. Further, the survival rate of the red group was significantly higher than the overall survival rate of 70.9% observed in the cohort (P < 0.0001). At 48 and 120 hours, survival rates in the blue group increased but remained lower then the red or yellow groups. Conclusions Refinement of the triage protocol and implementation is required prior to future study, including improved training of triage officers, and protocol modification to minimize the exclusion from critical care of patients who may in fact benefit. However, our results suggest that the triage protocol can help to direct resources to patients who are most likely to benefit, and help to decrease the demands on critical care resources, thereby making available more resources to treat other critically ill patients

Impact Assessment of the Village Seed Bank (VSB) program for chickpea, groundnut and pigeonpea in the Central Dry Zone of Myanmar, focusing on the production, distribution, productivity and profitability of seed of improved cultivars, Research Report No 76

A major objective of the Australian Centre for International Agricultural Research (ACIAR)-funded MyPulses project in Myanmar was the development of improved, high-yielding varieties of pigeonpea, groundnut and chickpea through breeding and selection and their widespread adoption by farmers of the Central Dry Zone (CDZ). The village seed bank (VSB) model was implemented by the Department of Agriculture (DoA) with backstopping from MyPulses partner International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) in the 2015–16 season, then expanded during 2016–17 and 2017–18. During the three years of the program, a total of 1,343 VSB farmers from 495 villages associated with 104 townships across the CDZ obtained good quality, improved cultivar seeds directly from the DoA. This impact assessment survey was commissioned to examine the extent to which the VSB program was successful in facilitating the spread and adoption of new, improved legume cultivars as well as the productivity and economic benefits of those cultivars. Since it would have been impossible to get feedback about the program from all the VSB farmers, 182 of them from 41 villages were selected at random for the survey..

Hydroxymethylglutaryl-CoA reductase inhibition with simvastatin in acute lung injury to reduce pulmonary dysfunction (HARP-2) trial : study protocol for a randomized controlled trial

Acute lung injury (ALI) is a common devastating clinical syndrome characterized by life-threatening respiratory failure requiring mechanical ventilation and multiple organ failure. There are in vitro, animal studies and pre-clinical data suggesting that statins may be beneficial in ALI. The Hydroxymethylglutaryl-CoA reductase inhibition with simvastatin in Acute lung injury to Reduce Pulmonary dysfunction (HARP-2) trial is a multicenter, prospective, randomized, allocation concealed, double-blind, placebo-controlled clinical trial which aims to test the hypothesis that treatment with simvastatin will improve clinical outcomes in patients with ALI

A Probabilistic Approach to the Spatial Variability of Ground Properties in the Design of Urban Deep Excavation

Uncertainty in ground datasets often stems from spatial variability of soil parameters and changing groundwater regimes. In urban settings and where engineering ground interventions need to have minimum and well-anticipated ground movements, uncertainty in ground data leads to uncertain analysis, with substantial unwelcomed economical and safety implications. A probabilistic random set finite element modelling (RSFEM) approach is used to revisit the stability and serviceability of a 27 m deep submerged soil nailed excavation built into a cemented soil profile, using a variable water level and soil shear strength. Variation of a suite of index parameters, including mobilized working loads and moments in facing and soil inclusion elements, as well as stability and serviceability of facing and the integrated support system, are derived and contrasted with field monitoring data and deterministic FE modelling outputs. The validated model is then deployed to test the viability of using independent hydraulic actions as stochastic variables as an alternative to dependent hydraulic actions and soil shear strength. The achieved results suggest that utilizing cohesion as a stochastic variable alongside the water level predicts system uncertainty reasonably well for both actions and material response; substituting the hydraulic gradient produces a conservative probability range for the action response only

Study protocol: The Improving Care of Acute Lung Injury Patients (ICAP) study

INTRODUCTION: The short-term mortality benefit of lower tidal volume ventilation (LTVV) for patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) has been demonstrated in a large, multi-center randomized trial. However, the impact of LTVV and other critical care therapies on the longer-term outcomes of ALI/ARDS survivors remains uncertain. The Improving Care of ALI Patients (ICAP) study is a multi-site, prospective cohort study that aims to evaluate the longer-term outcomes of ALI/ARDS survivors with a particular focus on the effect of LTVV and other critical care therapies. METHODS: Consecutive mechanically ventilated ALI/ARDS patients from 11 intensive care units (ICUs) at four hospitals in the city of Baltimore, MD, USA, will be enrolled in a prospective cohort study. Exposures (patient-based, clinical management, and ICU organizational) will be comprehensively collected both at baseline and throughout patients' ICU stay. Outcomes, including mortality, organ impairment, functional status, and quality of life, will be assessed with the use of standardized surveys and testing at 3, 6, 12, and 24 months after ALI/ARDS diagnosis. A multi-faceted retention strategy will be used to minimize participant loss to follow-up. RESULTS: On the basis of the historical incidence of ALI/ARDS at the study sites, we expect to enroll 520 patients over two years. This projected sample size is more than double that of any published study of long-term outcomes in ALI/ARDS survivors, providing 86% power to detect a relative mortality hazard of 0.70 in patients receiving higher versus lower exposure to LTVV. The projected sample size also provides sufficient power to evaluate the association between a variety of other exposure and outcome variables, including quality of life. CONCLUSION: The ICAP study is a novel, prospective cohort study that will build on previous critical care research to improve our understanding of the longer-term impact of ALI/ARDS, LTVV and other aspects of critical care management. Given the paucity of information about the impact of interventions on long-term outcomes for survivors of critical illness, this study can provide important information to inform clinical practice