LARCMACS: A TEX macro set for typesetting NASA reports

This LARCMACS user's manual describes the February 1988 version of LARCMACS, the TEX macro set used by the Technical Editing Branch (TEB) at NASA Langley Research Center. These macros were developed by the authors to facilitate the typesetting of NASA formal reports. They are also useful, however, for informal NASA reports and other technical documents such as meeting papers. LARCMACS are distributed by TEB for the convenience of the Langley TEX user community. LARCMACS contain macros for obtaining the standard double-column format for NASA reports, for typesetting tables in the ruled format traditional in NASA reports, and for typesetting difficult mathematical expressions. Each macro is described and numerous examples are included. Definitions of the LARCMACS macros are also included

Bacterial and Sediment Transport in an Artificial Sand Bed Stream During Unsteady Flow

Storms cause a substantial increase in the fecal indicator bacteria (FIB) concentrations in stream water. Causes for this concentration increase include FIB-laden stormwater runoff and the release of bacteria from stream-bottom sediments. Studies were carried out to quantify this second cause of water quality impairment. Coliform bacteria are a group of FIB, indicate the presence of pathogenic microorganisms, and have been shown to be transported in streams far from their source areas, especially during storms. FIB transport is dependent on several factors including water velocity, size and transport rates of bed sediments, and the FIB concentration in bed sediment. The objective of this work is to determine the effect of varying flow rates on the transport of bed-dwelling coliforms in sand bed streams. Artificial stream experiments were run with field-induced storm hydrographs to determine resuspension rates of coliforms and their association with the movement of bed material. Six artificial storm events were created by varying discharge in a 0.63-m wide stainless steel flume with 2.5 m of the 8-m-long channel bed covered with 0.26 to 0.375-mm sand. Peak flow rates varied from 0.04 to 0.074 m3/s, peak velocities were 0.3 to 0.65 m/s, and event durations were either 60 min or 90 min. Water samples were collected upstream and downstream of the sand bed at selected intervals throughout each event, and bed sediment samples were collected before and after each event. Average FIB concentrations in water up- and downstream of the sand bed were statistically similar for events with peak velocities less than 0.58 m/s. Peak concentrations of total coliform and suspended sediments occurred in the downstream samples during the rising limb of hydrographs, due to resuspension of coliforms and sand from the bed. However, after the initial surge, there was no noticeable effect of the water flows on resuspension. To simulate downstream concentrations due to resuspension, we modeled the system using a 1-D advection-dispersion equation with added source/sink terms to account for sediment settling and resuspension. This experiment and its analysis may provide a methodology for determining coliform and suspended sediment inputs into total maximum daily load (TMDL) calculations

The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: prospective cohort study of 15 781 febrile illnesses

Objectives To evaluate current processes by which young children presenting with a febrile illness but suspected of having serious bacterial infection are diagnosed and treated, and to develop and test a multivariable model to distinguish serious bacterial infections from self limiting non-bacterial illnesses

A Strategy for Electronic Dissemination of NASA Langley Technical Publications

To demonstrate NASA Langley Research Center\u27s relevance and to transfer technology to external customers in a timely and efficient manner, Langley has formed a working group to study and recommend a course of action for the electronic dissemination of technical reports (EDTR). The working group identified electronic report requirements (e.g., accessibility, file format, search requirements) of customers in U.S. industry through numerous site visits and personal contacts. Internal surveys were also used to determine commonalities in document preparation methods. From these surveys, a set of requirements for an electronic dissemination system was developed. Two candidate systems were identified and evaluated against the set of requirements: the Full-Text Electronic Documents System (FEDS), which is a full-text retrieval system based on the commercial document management package Interleaf, and the Langley Technical Report Server (LTRS), which is a Langley-developed system based on the publicly available World Wide Web (WWW) software system. Factors that led to the selection of LTRS as the vehicle for electronic dissemination included searching and viewing capability, current system operability, and client software availability for multiple platforms at no cost to industry. This report includes the survey results, evaluations, a description of the LTRS architecture, recommended policy statement, and suggestions for future implementations

Impact of Opioid-Free Anesthesia Versus Opioid-Based Anesthesia on Time to Extubation: A Scoping Review

Purpose/Background Opioids during surgery have been clinically proven to lengthen the time between intubation and post-op extubation. Increased time to extubation is associated with negative patient outcomes. This scoping review aims to evaluate the use of ketamine with opioid free analgesia (OFA) versus traditional opioid usage and its outcomes on extubation times. Methods From September 2021 to November 2021, we conducted a literature search using the University of Tennessee Health Science Center’s (UTHSC) online library. Through the PubMed, CINAHL, Medline, and Cochrane databases, we identified seventy-one articles that matched our criteria. Of those articles, we selected twenty-five to undergo rapid critical appraisal (RCA). We then chose ten articles that were critically appraised and were from peer-reviewed sources. Finally, we constructed an outcome synthesis table and level of evidence table to synthesize the results of those ten articles. Results Ten articles were chosen for this scoping review. Nine articles show that the use of ketamine decreases the time to extubation, with five proving to be statistically significant. Four articles demonstrated a decrease in ICU length of stay in days with the ketamine-based anesthesia group. Five articles found a significant decrease in postoperative opioid consumption in the ketamine-based anesthesia group. The results demonstrate that there is evidence favoring the use of ketamine and opioid free anesthesia to decrease extubation times, decrease ICU lengths of stay, and decrease postoperative opioid consumption. Implications for Nursing Practice This scoping review has demonstrated that ketamine, when used as a perioperative adjunct for pain control, will reduce opioid usage and times to extubation. Implementation of routine ketamine administration should be considered in populations that may have prolonged intubation times

The COVID-19 System Shock Framework: Capturing Health System Innovation During the COVID-19 Pandemic.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has resulted in over 2 million deaths globally. The experience in Australia presents an opportunity to study contrasting responses to the COVID-19 health system shock. We adapted the Hanefeld et al framework for health systems shocks to create the COVID-19 System Shock Framework (CSSF). This framework enabled us to assess innovations and changes created through COVID-19 at the Sydney Children's Hospitals Network (SCHN), the largest provider of children's health services in the Southern hemisphere. METHODS: We used ethnographic methods, guided by the CSSF, to map innovations and initiatives implemented across SCHN during the pandemic. An embedded field researcher shadowed members of the emergency operations centre (EOC) for nine months. We also reviewed clinic and policy documents pertinent to SCHN's response to COVID-19 and conducted interviews and focus groups with stakeholders, including clinical directors, project managers, frontline clinicians, and other personnel involved in implementing innovations across SCHN. RESULTS: The CSSF captured SCHN's complex response to the pandemic. Responses included a COVID-19 assessment clinic, inpatient and infectious disease management services, redeploying and managing a workforce working from home, cohesive communication initiatives, and remote delivery of care, all enabled by a dedicated COVID-19 fund. The health system values that shaped SCHN's response to the pandemic included principles of equity of healthcare delivery, holistic and integrated models of care, and supporting workforce wellbeing. SCHN's resilience was enabled by innovation fostered through a non-hierarchical governance structure and responsiveness to emerging challenges balanced with a singular vision. CONCLUSION: Using the CSSF, we found that SCHN's ability to innovate was key to ensuring its resilience during the pandemic

Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study

© 2017 Elsevier Ltd Background Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. Methods In this prospective observational study, we included children and adolescents (age

Comparing the use of, and considering the need for, lumbar puncture in children with influenza or other respiratory virus infections

Background The clinical presentation of influenza in infancy may be similar to serious bacterial infection and be investigated with invasive procedures like lumbar puncture (LP), despite very limited evidence that influenza occurs concomitantly with bacterial meningitis, perhaps because the diagnosis of influenza is very often not established when the decision to perform LP is being considered. Methods A retrospective medical record review was undertaken in all children presenting to the Children's Hospital at Westmead, Sydney, Australia, in one winter season with laboratory-confirmed influenza or other respiratory virus infections (ORVIs) but excluding respiratory syncytial virus, to compare the use of, and reflect on the need for, the performance of invasive diagnostic procedures, principally LP, but also blood culture, in influenza and non-influenza cases. We also determined the rate of concomitant bacterial meningitis or bacteraemia. Findings Of 294 children, 51% had laboratory-confirmed influenza and 49% had ORVIs such as parainfluenza viruses (34%) and adenoviruses (15%). Of those with influenza, 18% had a LP and 71% had a blood culture performed compared with 6·3% and 55·5% in the ORVI group (for both

Alien Registration- Mccaskill, Mary (Fairfield, Somerset County)

https://digitalmaine.com/alien_docs/9438/thumbnail.jp

Alien Registration- Mccaskill, Mary (Fairfield, Somerset County)

https://digitalmaine.com/alien_docs/9438/thumbnail.jp