Development and evaluation of a mechanical ventilator-sharing system

BackgroundDuring the COVID-19 pandemic surge in the hospitalization of critically ill patients and the global demand for mechanical ventilators, alternative strategies for device sharing were explored. We developed and assessed the performance of a system for shared ventilation that uses clinically available components to individualize tidal volumes under a variety of clinically relevant conditions. The feasibility of remote monitoring of ventilators was also assessed.MethodsBy using existing resources and off-the-shelf components, a ventilator-sharing system (VSS) that ventilates 2 patients simultaneously with a single device, and a ventilator monitoring system (VMS) that remotely monitors pulmonary mechanics were developed. The feasibility and effectiveness of VSS and VMS were evaluated in benchtop testing using 2 test lungs on a single ventilator, and then performance was assessed in translational swine models of normal and impaired lung function.ResultsIn benchtop testing, VSS and VMS delivered the set individualized parameters with minimal % errors in test lungs under pressure- and volume-regulated ventilation modes, suggesting the highest precision and accuracy. In animal studies, the VSS and VMS successfully delivered the individualized mechanical ventilation parameters within clinically acceptable limits. Further, we found no statistically significant difference between the target and measured values.ConclusionThe VSS adequately ventilated 2 test lungs or animals with variable lung conditions. The VMS accurately displayed mechanical ventilation settings, parameters, and alarms. Both of these systems could be rapidly assembled for scaling up to ventilate several critically ill patients in a pandemic or mass casualty disaster situations by leveraging off-the-shelf and custom 3D printed components

Weaving The Threads of Multiculturalism Throughout Medical Education

How do medical students learn about the healthcare impact of essential multiculturalism issues in an increasingly diverse population? This study gauges student participation in a variety of multiculturalism curricula and student assessment of curriculum time devoted to multiculturalism at school versus national levels

The First Decommissioning of a Fusion Reactor Fueled by Deuterium-Tritium

The Tokamak Fusion Test Reactor (TFTR) at the Plasma Physics Laboratory of Princeton University (PPPL) was the first fusion reactor fueled by a mixture of deuterium and tritium (D-T) to be decommissioned in the world. The decommissioning was performed over a period of three years and was completed safely, on schedule, and under budget. Provided is an overview of the project and detail of various factors which led to the success of the project. Discussion will cover management of the project, engineering planning before the project started and during the field work as it was being performed, training of workers in the field, the novel adaptation of tools from other industry, and the development of an innovative process for the use of diamond wire to segment the activated/contaminated vacuum vessel. The success of the TFTR decommissioning provides a viable model for the decommissioning of D-T burning fusion devices in the future

North Korean Decisionmaking

Discerning the decisionmaking of Kim Jong-Un and the North Korean regime on issues of peaceful engagement and warlike actions endures as a mighty challenge for U.S. intelligence analysts and policymakers. In this report, we seek to inform analysis of Democratic People’s Republic of Korea (DPRK) leadership decisionmaking. To do so, we use three discussion papers that were written to facilitate discussion of an interagency working group. The three papers are assembled here in a single report. The first discussion paper describes decisionmaking among different authoritarian regimes, including North Korea, and the opening up of those economies to outside engagement. The second paper outlines two different scenarios that might occur when conventional deterrence on the Korean Peninsula breaks down and the resulting decisions that North Korea’s leadership could face. The third paper assesses DPRK decisionmaking about nuclear weapon use. The report concludes with some observations, drawn from the issues covered in these three discussion papers, about DPRK decisionmaking and stability on the Korean Peninsula

Nucleation of quark matter bubbles in neutron stars

The thermal nucleation of quark matter bubbles inside neutron stars is examined for various temperatures which the star may realistically encounter during its lifetime. It is found that for a bag constant less than a critical value, a very large part of the star will be converted into the quark phase within a fraction of a second. Depending on the equation of state for neutron star matter and strange quark matter, all or some of the outer parts of the star may subsequently be converted by a slower burning or a detonation.Comment: 13 pages, REVTeX, Phys.Rev.D (in press), IFA 93-32. 5 figures (not included) available upon request from [email protected]

Impaired decisional impulsivity in pathological videogamers

Abstract Background Pathological gaming is an emerging and poorly understood problem. Impulsivity is commonly impaired in disorders of behavioural and substance addiction, hence we sought to systematically investigate the different subtypes of decisional and motor impulsivity in a well-defined pathological gaming cohort. Methods Fifty-two pathological gaming subjects and age-, gender- and IQ-matched healthy volunteers were tested on decisional impulsivity (Information Sampling Task testing reflection impulsivity and delay discounting questionnaire testing impulsive choice), and motor impulsivity (Stop Signal Task testing motor response inhibition, and the premature responding task). We used stringent diagnostic criteria highlighting functional impairment. Results In the Information Sampling Task, pathological gaming participants sampled less evidence prior to making a decision and scored fewer points compared with healthy volunteers. Gaming severity was also negatively correlated with evidence gathered and positively correlated with sampling error and points acquired. In the delay discounting task, pathological gamers made more impulsive choices, preferring smaller immediate over larger delayed rewards. Pathological gamers made more premature responses related to comorbid nicotine use. Greater number of hours played also correlated with a Motivational Index. Greater frequency of role playing games was associated with impaired motor response inhibition and strategy games with faster Go reaction time. Conclusions We show that pathological gaming is associated with impaired decisional impulsivity with negative consequences in task performance. Decisional impulsivity may be a potential target in therapeutic management

Challenging Disciplinary Boundaries in the First Year: A New Introductory Integrated Science Course for STEM Majors

To help undergraduates make connections among disciplines so they are able to approach, evaluate, and contribute to the solutions of important global problems, our campus has been focused on interdisciplinary research and education opportunities across the science, technology, engineering, and mathematics (STEM) disciplines. This paper describes the mobilization, planning, and implementation of a first-year interdisciplinary course for STEM majors that integrates key concepts found in traditional first-semester biology, chemistry, computer science, mathematics, and physics courses. This team-taught course, Integrated Quantitative Science (IQS), is half of a first-year student’s schedule in both semesters and is composed of a double lecture and a weekly lab and workshop. Features of this first-year course, including themes and concepts covered each semester, some of the materials developed, lessons learned, challenges, and preliminary measures of success are described

Challenging Disciplinary Boundaries in the First Year: A New Introductory Integrated Science Course for STEM Majors

To help undergraduates make connections among disciplines so they are able to approach, evaluate, and contribute to the solutions of important global problems, our campus has been focused on interdisciplinary research and education opportunities across the science, technology, engineering, and mathematics (STEM) disciplines. This paper describes the mobilization, planning, and implementation of a first-year interdisciplinary course for STEM majors that integrates key concepts found in traditional first-semester biology, chemistry, computer science, mathematics, and physics courses. This team-taught course, Integrated Quantitative Science (IQS), is half of a first-year student’s schedule in both semesters and is composed of a double lecture and a weekly lab and workshop. Features of this first-year course, including themes and concepts covered each semester, some of the materials developed, lessons learned, challenges, and preliminary measures of success are described