Low-cost wave characterization modules for oil spill response

Marine oil spills can be remediated by mechanical skimmers in calm waters, but performance degrades with increased wave height. We have developed and demonstrated a system that quantifies local wave characteristics with an uncertainty of four inches of heave. Our system is intended for the measurement of wave characteristics during oil spill recovery. It conveys this information to coordinators and responders in real time via WiFi and remote reporting through a satellite network. This information will allow for enhanced situational awareness during an oil spill response, assisting stakeholders and optimizing mechanical skimming operations. Our wave characterization module (WCM) uses accelerometer outputs from a very small inertial measurement unit (IMU) to generate wave statistics and calculate wave characteristics. It is configured such that a WCM can either be attached to a skimmer float or incorporated into a microbuoy. Wave height and period are transmitted via WiFi and/or a satellite-enabled mesh-grid network to a cloud-hosted geographic information system (GIS). Here, we discuss the bare-bones sensors-plus-algorithm approach we developed by using spring-mass systems to approximate the wave height and period regime of interest. We then describe open water tests carried out using that development system both mounted to a weir skimmer mockup and packaged in a microbuoy. Finally, we present controlled tests in the wave tank at Ohmsett, the National Oil Spill Response Test Facility in New Jersey, with the WCMs communicating the wave characteristics via WiFi to tankside laptops and via satellite to the cloud-based GIS. Snapshot determinations of wave height calculated using the scalar magnitude of the three-axis accelerometer in the IMU were within four inches of the benchmark wave measurement system at Ohmsett. (C) 2018 Shanghai Jiaotong University. This is an open access article under the CC BY-NC-ND license

The POLST program: a retrospective review of the demographics of use and outcomes in one community where advance directives are prevalent

OBJECTIVES: Determine the use and utility of the Physician Orders for Life-Sustaining Treatment (POLST) program in a community where powers of attorney for health care (POAHCs) are prevalent. METHODS: A retrospective review of medical record and death certificate data of 400 adults who died between September 1, 2007, and March 31, 2008, in the La Crosse County, Wisconsin community. Demographic and cause-of-death data were collected from death certificates. Information about POAHC, POLST forms, and medical treatments provided in the last 30 days of life were abstracted from decedents' medical records. RESULTS: Sixty-seven percent of decedents had a POLST form, whereas 22% had POAHC alone. In comparison with decedents with POAHC alone, decedents with a POLST form were significantly older (83 versus 77 years, p<0.001), more likely to die in a nursing home than in a hospital (p<0.001), and more likely to die from a terminal or chronic illnesses (97%). Decedents with POLST orders for higher levels of medical treatment received more treatment, and in only two cases was there evidence that treatment was discrepant with POLST orders. In 31% of all POLST forms, the person appointed in the POAHC consented to the POLST orders. CONCLUSIONS: POLST can be a highly effective program to ensure that patient preferences are known and honored in all settings. POAHCs are valuable because they identify appropriate surrogates when patients are incapacitated

Glycemic excursions and subclinical cardiac damage in adults with type 2 diabetes: Results from the ADVANCE Trial

We found that 1,5-anhydroglucitol—a marker of glucose excursions—was not independently associated with subclinical cardiac damage, nor with vascular outcomes, in the ADVANCE Trial. High-sensitivity cardiac troponin T and N-terminal pro-b-type natriuretic peptide provided better prognostic information regarding vascular risk in diabetes than 1,5-anhydroglucitol

Finding a way: long-term care homes to support dementia

An ageing demographic has increased the number of people with dementia. Although dementia is commonly associated with memory loss, other early symptoms include difficulty with wayfinding. Dementia alters visuo-spatial perception and the processes used to interpret the physical environment. The role of the design of the physical environment for people with dementia has gained increased recognition. Despite this, design for dementia is often overlooked, focusing on issues relating to physical impairment. This paper presents the results of a PhD study and aims to examine the role of the design of the physical environment in supporting wayfinding for people with dementia living in long-term care settings in Northern Ireland. Mixed methods combined the observation of wayfinding walks and conversational style interviews to elicit perspectives and experiences of residents with dementia. The findings aim to promote well-being for those with dementia living in long-term care settings

Decellularization of human donor aortic and pulmonary valved conduits using low concentration sodium dodecyl sulfate

The clinical use of decellularised cardiac valve allografts is increasing. Long term data will be required to determine whether they outperform conventional cryopreserved allografts. Valves decellularised using different processes may show varied long-term outcomes. It is therefore important to understand the effects of specific decellularisation technologies on the characteristics of donor heart valves. Human cryopreserved aortic and pulmonary valved conduits were decellularised using hypotonic buffer, 0.1% (w/v) SDS and nuclease digestion. The decellularised tissues were compared to cellular cryopreserved valve tissues using histology, immunohistochemistry, quantitation of total DNA, collagen and glycosaminoglycan content, in vitro cytotoxicity assays, uniaxial tensile testing and subcutaneous implantation in mice. The decellularised tissues showed no histological evidence of cells or cell remnants and over 97% DNA removal in all regions (arterial wall, muscle, leaflet and junction). The decellularised tissues retained collagen IV and von Willebrand factor staining with some loss of fibronectin, laminin and chondroitin sulphate staining. There was an absence of MHC Class I staining in decellularised pulmonary valve tissues, with only residual staining in isolated areas of decellularised aortic valve tissues. The collagen content of the tissues was not decreased following decellularisation however the glycosaminoglycan content was reduced. Only moderate changes in the maximum load to failure of the tissues were recorded post-decellularisation. The decellularised tissues were non-cytotoxic in vitro, and were biocompatible in vivo in a mouse subcutaneous implant model. The decellularisation process will now be translated into a GMP compatible process for donor cryopreserved valves with a view to future clinical use

Canine Visceral Leishmaniasis, United States and Canada, 2000–2003

Foxhounds infected with Leishmania spp. were found in 18 states and 2 Canadian provinces