Variable Force Dynamic Stabber

The Projectile Professionals were tasked with designing a testing apparatus to test the effectiveness of stab resistant material. The requirements and standards for this were provided by the NIJ and distinguished university professor, Dr. Nassersharif. Design specifications were established for the problem and research was done on the existing testing method via patent and literature searches. Each member of the Projectile Professionals was responsible for creating thirty design concepts. The proposed designs were then evaluated to make sure that the NIJ standards were being achieved. Engineering analysis using a popular method developed in Japan called QFD (Quality Function Deployment) was performed to transform the design specifications of the customer into engineering characteristics for the product in order to compare each concept. The Projectile Professionals’ testing device will be compressed air powered which is prefilled to a specific pressure reading allowing adequate energy levels to be generated. A PVC barrel which houses the projectile is attached to the compressed air tank. A trigger operated solenoid valve is to release the air built up behind the projectile sending it down the barrel striking the armor at the opened end. This system is mounted onto a test bench that can have easy mobility as well as support the apparatus. The projectile behaves as a dual-mass system coupled with dampening foam so that the impact energy is delivered to more accurately mimic the action of a human hand stab. Another target that must be achieved is striking the armor at 90 degrees as well as 45 degrees using an adjustable padded backstop. Overall after the concept generations were completed, the Projectile Professionals were able to pick an optimal design to move forward with. A proof of concept was generated and presented to faculty and engineering students. The new and improved design was discussed and settled upon. The team went to work right away putting together the new apparatus to begin gathering data. With the apparatus being complete the team used a high-speed camera to calculate the velocity right before impact which in turn a correlation between energy and pressure was created. These findings were presented to faculty and students for the final build and test review. Overall, the team did achieve solving the problem statement given

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Predicting medical school and internship success: Does the quality of the research and clinical experience matter?

© Association of Military Surgeons of the U.S. All rights reserved. Objectives: This article explores specific aspects of self-reported clinical and research experience and their relationship to performance in medical training. Methods: This is a retrospective cohort study conducted at the Uniformed Services University. The American Medical College Application Service application was used to discern students’ self-reported clinical and research experience. Two authors applied a classification scheme for clinical and research experience to the self-reported experiences. Study outcomes included medical school grade point average (GPA), U.S. Medical Licensing Examination (USMLE) scores, and intern expertise and professionalism scores. A linear regression analysis was conducted for each outcome while controlling for prematriculation GPA. Results: Data were retrieved on 1,020 matriculants. There were several statistically significant but small differences across outcomes when comparing the various categories of clinical experience with no clinical experience. The technician-level experience group had a decrease of 0.1 in cumulative GPA in comparison to students without self-reported clinical experience (p = 0.004). This group also performed 5 points lower on the USMLE Step 2 than students who did not report clinical experience (p = 0.013). The various levels of self-reported research experience were unrelated to success in medical school and graduate medical education. Discussion: These findings indicate that self-reported technician-level clinical experience is related to a small reduction in typically reported outcomes in medical school

Basal cell carcinoma in post-traumatic scar successfully treated with thulium laser and photodynamic therapy

Basal cell carcinoma (BCC) is the most common form of skin cancer. Ultraviolet radiation (UV) is one major risk factor for BCC. Other less common risk factors are ionizing radiation, arsenic exposure, genetic alterations, skin trauma and skin scars. Several therapies could be used to manage BCC, including conventional surgery, Mohs’ surgery, cryosurgery, photodynamic therapy (PDT), and CO2 laser. In this report, PDT was performed after local pretreatment with thulium 1927 nm laser, enhancing the aminolevulinic acid (MAL) absorption and increasing the penetration depth of irradiation