An analytical approach to solution of two- point boundary condition problems in optimal guidance Summary report, May 1965 - Apr. 1966

Analytical approaches to path-adaptive guidance functions, circular orbit trajectories, and use of Fortran-compiled program

Scenarios for optimizing potato productivity in a lunar CELSS

The use of controlled ecological life support system (CELSS) in the development and growth of large-scale bases on the Moon will reduce the expense of supplying life support materials from Earth. Such systems would use plants to produce food and oxygen, remove carbon dioxide, and recycle water and minerals. In a lunar CELSS, several factors are likely to be limiting to plant productivity, including the availability of growing area, electrical power, and lamp/ballast weight for lighting systems. Several management scenarios are outlined in this discussion for the production of potatoes based on their response to irradiance, photoperiod, and carbon dioxide concentration. Management scenarios that use 12-hr photoperiods, high carbon dioxide concentrations, and movable lamp banks to alternately irradiate halves of the growing area appear to be the most efficient in terms of growing area, electrical power, and lamp weights. However, the optimal scenario will be dependent upon the relative 'costs' of each factor

Imaging geometry through dynamics: the observable representation

For many stochastic processes there is an underlying coordinate space, $V$, with the process moving from point to point in $V$ or on variables (such as spin configurations) defined with respect to $V$. There is a matrix of transition probabilities (whether between points in $V$ or between variables defined on $V$) and we focus on its ``slow'' eigenvectors, those with eigenvalues closest to that of the stationary eigenvector. These eigenvectors are the ``observables,'' and they can be used to recover geometrical features of $V$

Paediatric nonbronchoscopic bronchoalveolar lavage: Overview and recommendations for clinical practice

NB-BAL is an effective procedure for the diagnosis of pulmonary disease processes in ventilated infants and children. This procedure is, however, not without risks to both patients and staff. Numerous complications of NB-BAL exist, with hypoxia being the most common. As a result, care should be taken in performing NB-BAL on haemodynamically unstable patients; patients with coagulation defects; and patients with cardiac or brain abnormalities. This paper presents an overview of paediatric nonbronchoscopic bronchoalveolar lavage (NB-BAL) including: the rationale for NB-BAL; the complications associated with the procedure; indications and contraindications. It also recommends an evidence-based clinical guideline for performing the procedure in the paediatric intensive care unit. By following the NB-BAL guidelines presented in this paper, one can ensure that an effective specimen is obtained from the lower respiratory tract, whilst minimising the risk to the patient

User perceptions of multi-source feedback tools for junior doctors

Context:  The effectiveness of multi-source feedback (MSF) tools, which are increasingly important in medical careers, will be influenced by their users’ attitudes. This study compared perceptions of two tools for giving MSF to UK junior doctors, of which one provides mainly textual feedback and one provides mainly numerical feedback. We then compared the perceptions of three groups, including: trainees; raters giving feedback, and supervisors delivering feedback. Methods:  Postal questionnaires about the usability, usefulness and validity of a feedback system were distributed to trainees, raters and supervisors across the north of England. Results:  Questionnaire responses were analysed to compare opinions of the two tools and among the different user groups. Overall there were few differences. Attitudes towards MSF in principle were positive and the tools were felt to be usable, but there was little agreement that they could effectively identify doctors in difficulty or provide developmental feedback. The text-oriented tool was rated as more useful for giving feedback on communication and attitude, and as more useful for identifying a doctor in difficulty. Raters were more positive than other users about the usefulness of numerical feedback, but, overall, text was felt to be more useful. Some trainees expressed concern that feedback was based on insufficient knowledge of their work. This was not supported by raters’ responses, although many did use indirect information. Trainees selected raters mainly for the perceived value of their feedback, but also based on personal relationships and the simple pragmatics of getting a tool completed. Discussion:  Despite positive attitudes to MSF, the perceived effectiveness of the tools was low. There are small but significant preferences for textual feedback, although raters may prefer numerical scales. Concerns about validity imply that greater awareness of contextual and psychological influences on feedback generation is necessary to allow the formative benefits of MSF to be optimised and to negate the risk of misuse in high-stakes contexts

Whole-genome sequencing and the clinician: a tale of two cities

Clinicians are faced with unprecedented opportunities to identify the genetic aetiologies of hitherto molecularly uncharacterised conditions via the use of high-throughput sequencing. Access to genomic technology and resultant data is no longer limited to clinicians, geneticists and bioinformaticians, however; ongoing commercialisation gives patients themselves ever greater access to sequencing services. We report an increasingly common medical scenario by describing two neuromuscular patients-a mother and adult son-whose consumer access to whole-genome sequencing affected their diagnostic journey