Validation of a Contour Method Single-Measurement Uncertainty Estimator

This work validates an analytical single-measurement uncertainty estimator for contour method measurement by comparing it with a first-order uncertainty estimate provided by a repeatability study. The validation was performed on five different specimen types. The specimen types cover a range of geometries, materials, and stress conditions that represent typical structural applications. The specimen types include: an aluminum T-section, a stainless steel plate with a dissimilar metal slot-filled weld, a stainless steel forging, a titanium plate with an electron beam slot-filled weld, and a nickel disk forging. For each specimen, the residual stress was measured using the contour method on replicate specimens to assess measurement precision. The uncertainty associated with each contour method measurement was also calculated using a recently published single-measurement uncertainty estimator. Comparisons were then made between the estimated uncertainty and the demonstrated measurement precision. These results show that the single-measurement analytical uncertainty estimate has good correlation with the demonstrated repeatability. The spatial distributions of estimated uncertainty were found to be similar among the conditions evaluated, with the uncertainty relatively constant in the interior and larger along the boundaries of the measurement plane

An Uncertainty Estimator for Slitting Method Residual Stress Measurements Including the Influence of Regularization

This paper describes the development of a new uncertainty estimator for slitting method residual stress measurements. The new uncertainty estimator accounts for uncertainty in the regularization-based smoothing included in the residual stress calculation procedure, which is called regularization uncertainty. The work describes a means to quantify regularization uncertainty and then, in the context of a numerical experiment, compares estimated uncertainty to known errors. The paper further compares a first-order uncertainty estimate, established by a repeatability experiment, to the new uncertainty estimator and finds good correlation between the two estimates of precision. Furthermore, the work establishes a procedure for automated determination of the regularization parameter value that minimizes total uncertainty. In summary, the work shows that uncertainty in the regularization parameter is a significant contributor to the total uncertainty in slitting method measurements and that the new uncertainty estimator provides a reasonable estimate of single measurement uncertainty

Doc2b Protects β-Cells Against Inflammatory Damage and Enhances Function

Loss of functional β-cell mass is an early feature of type 1 diabetes. To release insulin, β-cells require soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) complexes, as well as SNARE complex regulatory proteins like double C2 domain-containing protein β (Doc2b). We hypothesized that Doc2b deficiency or overabundance may confer susceptibility or protection, respectively, to the functional β-cell mass. Indeed, Doc2b+/- knockout mice show an unusually severe response to multiple-low-dose streptozotocin (MLD-STZ), resulting in more apoptotic β-cells and a smaller β-cell mass. In addition, inducible β-cell-specific Doc2b-overexpressing transgenic (βDoc2b-dTg) mice show improved glucose tolerance and resist MLD-STZ-induced disruption of glucose tolerance, fasting hyperglycemia, β-cell apoptosis, and loss of β-cell mass. Mechanistically, Doc2b enrichment enhances glucose-stimulated insulin secretion (GSIS) and SNARE activation and prevents the appearance of apoptotic markers in response to cytokine stress and thapsigargin. Furthermore, expression of a peptide containing the Doc2b tandem C2A and C2B domains is sufficient to confer the beneficial effects of Doc2b enrichment on GSIS, SNARE activation, and apoptosis. These studies demonstrate that Doc2b enrichment in the β-cell protects against diabetogenic and proapoptotic stress. Furthermore, they identify a Doc2b peptide that confers the beneficial effects of Doc2b and may be a therapeutic candidate for protecting functional β-cell mass

Emergency Medicine In-Training Examination Scores are Not Associated with Burnout and Not Affected by the Introduction of a Wellness Curriculum

Introduction: There is little research examining the relationship between burnout and medical knowledge. Study Objectives: The authors sought to determine if emergency medicine (EM) resident performance on the In-Training Examination (EM-ITE) is associated with burnout and if EM-ITE scores are affected by the implementation of a wellness curriculum. Methods: As part of a multi-institution prospective education intervention trial, the Maslach Burnout Inventory, a valuable tool in the assessment of physician burnout, was administered at 10 EM residencies in February 2017. Then, five intervention sites introduced a year-long wellness curriculum. The MBI was re-administered at all sites in August 2017 and February 2018. The EM-ITE, an instrument for medical knowledge assessment, was administered in February 2017 and February 2018 at all sites. Results: 285/382 (75%) residents participated in the February 2017 data collection; 247/386 (64%) participated in August 2017; and 228/386 (59%) participated in February 2018. EM-ITE scores were reported for 296/383 (77.5%) residents for 2017 and 304/386 (78.8%) residents for 2018. There was no association between change in mean EM-ITE scores at the intervention sites compared to the control sites. In the subset of 172 residents who completed the 2017 and 2018 MBI, there was no correlation between burnout and changes in EM-ITE scores. Conclusion: In this study of EM residents, burnout was not associated with resident medical knowledge acquisition and change in EM resident medical knowledge was not affected by the introduction of a wellness curriculum

Development of Interdisciplinary Communication Tools to Improve Handoffs for Emergent Airway Management

Project goal Improve response time from airway alert to intubation while ensuring pertinent critical patient information is communicated to the airway team to reduce negative patient outcomes and better mobilize anesthesia resources

Life\u27s Simple 7 and Health Care Utilization among the Framingham Generation III Cohort

Abstract Objective: To evaluate associations of cardiovascular health status with utilization of healthcare services. Methods: Our study included 3,786 participants from the Framingham Third Generation Cohort (enrollment: May 2008 – February 2011). LS7 0-14 point summary scores were categorized as “suboptimal” (score of 0-7) and “optimal” (score of 8-14). Participants were stratified into two utilization groups. Those with 0-1 utilizations were compared to those with 2 or more visits ( Super Users”). Logistic regression was used to estimate associations of the two LS7 categories with the odds of Super User utilization (models adjusted for age, sex, race, and education). Results: Compared to those with “suboptimal” LS7 scores, participants with “optimal” LS7 scores had a 40.5% lower odds (95% confidence interval: 28-51%) of being a “Super User” of health care services (p\u3c0.005). Conclusions: In a younger population, higher LS7 cardiovascular health metric scores were associated with lower utilization of costly health care services. Public Health Implications: These results may have implications for primary care physicians and other health professionals to help identify patients at risk for over-utilization of higher-cost health care services

A phase II study of temozolomide vs. procarbazine in patients with glioblastoma multiforme at first relapse.

A randomized, multicentre, open-label, phase II study compared temozolomide (TMZ), an oral second-generation alkylating agent, and procarbazine (PCB) in 225 patients with glioblastoma multiforme at first relapse. Primary objectives were to determine progression-free survival (PFS) at 6 months and safety for TMZ and PCB in adult patients who failed conventional treatment. Secondary objectives were to assess overall survival and health-related quality of life (HRQL). TMZ was given orally at 200 mg/m(2)/day or 150 mg/m(2)/day (prior chemotherapy) for 5 days, repeated every 28 days. PCB was given orally at 150 mg/m(2)/day or 125 mg/m(2)/day (prior chemotherapy) for 28 days, repeated every 56 days. HRQL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30 [+3]) and the Brain Cancer Module 20 (BCM20). The 6-month PFS rate for patients who received TMZ was 21%, which met the protocol objective. The 6-month PFS rate for those who received PCB was 8% (P = 0.008, for the comparison). Overall PFS significantly improved with TMZ, with a median PFS of 12.4 weeks in the TMZ group and 8.32 weeks in the PCB group (P = 0.0063). The 6-month overall survival rate for TMZ patients was 60% vs. 44% for PCB patients (P = 0.019). Freedom from disease progression was associated with maintenance of HRQL, regardless of treatment received. TMZ had an acceptable safety profile; most adverse events were mild or moderate in severity

Long-term outcomes after haploidentical stem cell transplantation (haplo-SCT) for hematologic malignancies

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