A participant observer's view of the role of field work in planning education.

Massachusetts Institute of Technology. Dept. of Urban Studies and Planning. Thesis. 1973. M.C.P.Bibliography: leaves 313-315.M.C.P

X-Ray Diffraction Powder Data for Steroids: Supplement IX

This supplement continues a series of publications which began with a separate section, in the December, 1958 issue. All supplements are listed in the references

The National Rural Cable TV Development Task Force : a case study of a "coordinative approach" to federal policy and program implementation

Thesis (Ph.D.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1981.MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH.Includes bibliographies.by William Gaston Polk, Jr.Ph.D

Optoelectronic System for Measuring Heights Above a Floor

An optoelectronic system has been developed for measuring heights, above a floor, of designated points on a large object. In the original application for which the system was conceived, the large object is a space shuttle and the designated points are two front and two rear points for the attachment of jacks for positioning the shuttle at the height and horizontal pitch specified for maintenance operations. The front and rear jacking points are required to be raised to heights of 198 1/4 in. (502.9 0.6 cm) and 120.6 1/4 in. (306.4 0.6 cm), respectively

Cigarette Smoke-induced Ca 2+ Release Leads to Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Dysfunction

Chronic obstructive pulmonary disease affects 64 million people and is currently the fourth leading cause of death worldwide. Chronic obstructive pulmonary disease includes both emphysema and chronic bronchitis, and in the case of chronic bronchitis represents an inflammatory response of the airways that is associated with mucus hypersecretion and obstruction of small airways. Recently, it has emerged that exposure to cigarette smoke (CS) leads to an inhibition of the cystic fibrosis transmembrane conductance regulator (CFTR) Cl− channel, causing airway surface liquid dehydration, which may play a role in the development of chronic bronchitis. CS rapidly clears CFTR from the plasma membrane and causes it to be deposited into aggresome-like compartments. However, little is known about the mechanism(s) responsible for the internalization of CFTR following CS exposure. Our studies revealed that CS triggered a rise in cytoplasmic Ca2+ that may have emanated from lysosomes. Furthermore, chelation of cytoplasmic Ca2+, but not inhibition of protein kinases/phosphatases, prevented CS-induced CFTR internalization. The macrolide antibiotic bafilomycin A1 inhibited CS-induced Ca2+ release and prevented CFTR clearance from the plasma membrane, further linking cytoplasmic Ca2+ and CFTR internalization. We hypothesize that CS-induced Ca2+ release prevents normal sorting/degradation of CFTR and causes internalized CFTR to reroute to aggresomes. Our data provide mechanistic insight into the potentially deleterious effects of CS on airway epithelia and outline a hitherto unrecognized signaling event triggered by CS that may affect the long term transition of the lung into a hyper-inflammatory/dehydrated environment

Significant regional differences in antibiotic use across 576 US hospitals and 11 701 326 adult admissions, 2016-2017

BACKGROUND: Quantifying the amount and diversity of antibiotic use in United States hospitals assists antibiotic stewardship efforts but is hampered by limited national surveillance. Our study aimed to address this knowledge gap by examining adult antibiotic use across 576 hospitals and nearly 12 million encounters in 2016-2017. METHODS: We conducted a retrospective study of patients aged ≥ 18 years discharged from hospitals in the Premier Healthcare Database between 1 January 2016 and 31 December 2017. Using daily antibiotic charge data, we mapped antibiotics to mutually exclusive classes and to spectrum of activity categories. We evaluated relationships between facility and case-mix characteristics and antibiotic use in negative binomial regression models. RESULTS: The study included 11 701 326 admissions, totaling 64 064 632 patient-days, across 576 hospitals. Overall, patients received antibiotics in 65% of hospitalizations, at a crude rate of 870 days of therapy (DOT) per 1000 patient-days. By class, use was highest among β-lactam/β-lactamase inhibitor combinations, third- and fourth-generation cephalosporins, and glycopeptides. Teaching hospitals averaged lower rates of total antibiotic use than nonteaching hospitals (834 vs 957 DOT per 1000 patient-days; P \u3c .001). In adjusted models, teaching hospitals remained associated with lower use of third- and fourth-generation cephalosporins and antipseudomonal agents (adjusted incidence rate ratio [95% confidence interval], 0.92 [.86-.97] and 0.91 [.85-.98], respectively). Significant regional differences in total and class-specific antibiotic use also persisted in adjusted models. CONCLUSIONS: Adult inpatient antibiotic use remains high, driven predominantly by broad-spectrum agents. Better understanding reasons for interhospital usage differences, including by region and teaching status, may inform efforts to reduce inappropriate antibiotic prescribing

Keeper Wear Mechanisms in the XIPS © 25-cm Neutralizer Cathode Assembly

Abstract: The 25-cm Xenon Ion Propulsion System (XIPS © ) thruster has been life tested for over 16,000 hours for communication satellite station keeping applications. The neutralizer cathode assembly (NCA) was observed to experience a significant amount of erosion by the end of the life test. While the NCA competed the test successfully and the life exceeds the requirement for the Boeing 702 satellite orbit-raising and station-keeping mission, erosion of the NCA keeper is a concern for longer duration NASA missions. The performance of a 25-cm neutralizer cathode has been investigated in the JPL cathode test facilities to determine the mechanisms responsible for the observed erosion in the thruster life test. Experiments with fast scanning emissive probes showed that the thruster life test started in the 4.5 kW high power mode with the neutralizer cathode operating normally in the quiescent "spot mode" where low erosion rates are observed. After 2880 hours of operation in the high power mode, the thruster operation was changed to the 2 kW low power station-keeping mode and continued in that mode for remaining 13,370 hours of the test. The emissive probe measurements indicate that the neutralizer cathode started out in the low power mode with significant plasma oscillations in the near cathode region. This behavior is indicative of "plume-mode" operation, which produces energetic ions and is well correlated to high keeper and cathode electrode erosion rates. A reduction in the neutralizer cathode orifice diameter was effective in re-establishing the spot-mode operation and eliminating the oscillations responsible for energetic ion production. Additional wear reduction can be achieved using alternative materials with lower sputtering yields. A wear test is now underway of a modified version of this neutralizer cathode that incorporates the smaller orifice diameter and a replacement of the standard molybdenum keeper material by tantalum. The wear test, combined with JPL's validated neutralizer cathode life models, is intended to show that the erosion rate of the present keeper and of the smaller cathode-plate orifice is insignificant thereby demonstrating sufficient neutralizer life for deep space missions

Electronically available patient claims data improve models for comparing antibiotic use across hospitals: Results from 576 US facilities

BACKGROUND: The Centers for Disease Control and Prevention (CDC) uses standardized antimicrobial administration ratios (SAARs)-that is, observed-to-predicted ratios-to compare antibiotic use across facilities. CDC models adjust for facility characteristics when predicting antibiotic use but do not include patient diagnoses and comorbidities that may also affect utilization. This study aimed to identify comorbidities causally related to appropriate antibiotic use and to compare models that include these comorbidities and other patient-level claims variables to a facility model for risk-adjusting inpatient antibiotic utilization. METHODS: The study included adults discharged from Premier Database hospitals in 2016-2017. For each admission, we extracted facility, claims, and antibiotic data. We evaluated 7 models to predict an admission\u27s antibiotic days of therapy (DOTs): a CDC facility model, models that added patient clinical constructs in varying layers of complexity, and an external validation of a published patient-variable model. We calculated hospital-specific SAARs to quantify effects on hospital rankings. Separately, we used Delphi Consensus methodology to identify Elixhauser comorbidities associated with appropriate antibiotic use. RESULTS: The study included 11 701 326 admissions across 576 hospitals. Compared to a CDC-facility model, a model that added Delphi-selected comorbidities and a bacterial infection indicator was more accurate for all antibiotic outcomes. For total antibiotic use, it was 24% more accurate (respective mean absolute errors: 3.11 vs 2.35 DOTs), resulting in 31-33% more hospitals moving into bottom or top usage quartiles postadjustment. CONCLUSIONS: Adding electronically available patient claims data to facility models consistently improved antibiotic utilization predictions and yielded substantial movement in hospitals\u27 utilization rankings

The contribution of open extremity fractures to infection in multiply injured patients

We sought to determine whether a contaminated open fracture was a reliable component for calculating the Outcome Predictive Score in patients with multiple injuries. We studied 41 patients whose primary source of contamination was open extremity fractures. Only one of the 41 patients developed osteomyelitis. The rate of infection from an open fracture is minimal in the multiply injured patient. Inclusion of patients with open fractures in studies that assess the likelihood of infection and the value of anti-infective agents incorrectly identified patients for clinical trials and results in an overestimation of survival based on the Outcome Predictive Score. These findings suggest that open fractures should be excluded as an entry criterion in future clinical trials.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31658/1/0000592.pd

Expert consensus on an in vitro approach to assess pulmonary fibrogenic potential of aerosolized nanomaterials

The increasing use of multi-walled carbon nanotubes (MWCNTs) in consumer products and their potential to induce adverse lung effects following inhalation has lead to much interest in better understanding the hazard associated with these nanomaterials (NMs). While the current regulatory requirement for substances of concern, such as MWCNTs, in many jurisdictions is a 90-day rodent inhalation test, the monetary, ethical, and scientific concerns associated with this test led an international expert group to convene in Washington, DC, USA, to discuss alternative approaches to evaluate the inhalation toxicity of MWCNTs. Pulmonary fibrosis was identified as a key adverse outcome linked to MWCNT exposure, and recommendations were made on the design of an in vitro assay that is predictive of the fibrotic potential of MWCNTs. While fibrosis takes weeks or months to develop in vivo, an in vitro test system may more rapidly predict fibrogenic potential by monitoring pro-fibrotic mediators (e.g., cytokines and growth factors). Therefore, the workshop discussions focused on the necessary specifications related to the development and evaluation of such an in vitro system. Recommendations were made for designing a system using lung-relevant cells co-cultured at the air–liquid interface to assess the pro-fibrogenic potential of aerosolized MWCNTs, while considering human-relevant dosimetry and NM life cycle transformations. The workshop discussions provided the fundamental design components of an air–liquid interface in vitro test system that will be subsequently expanded to the development of an alternative testing strategy to predict pulmonary toxicity and to generate data that will enable effective risk assessment of NMs