Small business consulting : making it work

https://egrove.olemiss.edu/aicpa_guides/1223/thumbnail.jp

Identification of Hibernating Myocardium: Comparative Accuracy of Myocardial Contrast Echocardiography, Rest-Redistribution Thallium-201 Tomography and Dobutamine Echocardiography

AbstractObjectives. We sought to evaluate the comparative accuracy of myocardial contrast echocardiography (MCE), quantitative rest-redistribution thallium-201 (Tl-201) tomography and low and high dose (up to 40 μg/kg body weight per min) dobutamine echocardiography (DE) in identifying myocardial hibernation.Background. Myocardial contrast echocardiography can assess myocardial perfusion and may therefore be useful in predicting myocardial hibernation. However, its accuracy in comparison to myocardial perfusion scintigraphy and to that of high dose DE remains to be investigated.Methods. Eighteen patients (aged [±SD] 57 ± 10 years) with stable coronary artery disease and ventricular dysfunction underwent the above three modalities before coronary revascularization. Myocardial contrast echocardiography was achieved with intracoronary Albunex. Rest echocardiographic and Tl-201 studies were repeated ≥6 weeks after revascularization.Results. Of 109 revascularized segments with severe dysfunction, 46 (42%) improved. Left ventricular ejection fraction increased from 38 ± 14% to 45 ± 13% at follow-up (p = 0.003). Rest Tl-201 uptake and the ratio of peak contrast intensity of dysfunctional to normal segments with MCE were higher (p < 0.01) in segments that recovered function compared with those that did not. Myocardial contrast echocardiography, thallium scintigraphy and any contractile reserve during DE had a similar sensitivity (89% to 91%) with a lower specificity (43% to 66%) for recovery of function. A biphasic response during DE was the most specific (83%) and the least sensitive (68%) (p < 0.01). The best concordance with MCE was Tl-201 (80%, kappa 0.57). Changes in ejection fraction after revascularization related significantly to the number of viable dysfunctional segments by all modalities (r = 0.54 to 0.65).Conclusions. In myocardial hibernation, methods evaluating rest perfusion (MCE, Tl-201) or any contractile reserve have a similar high sensitivity but a low specificity for predicting recovery of function. A limited contractile reserve (biphasic response) increases the specificity of DE. Importantly, the three techniques identified all patients who had significant improvement in global ventricular function.(J Am Coll Cardiol 1997;29:985–93)© 1997 by the American College of Cardiolog

Communicating the Threat of a Tropical Cyclone to the Eastern Range

The 45th Weather Squadron (45 WS) has developed a tool to help visualize the Wind Speed Probability product from the National Hurricane Center (NHC) and to help communicate that information to space launch customers and decision makers at the 45th Space Wing (45 SW) and Kennedy Space Center (KSC) located in east central Florida. This paper reviews previous work and presents the new visualization tool, including initial feedback as well as the pros and cons. The NHC began issuing their Wind Speed Probability product for tropical cyclones publicly in 2006. The 45 WS uses this product to provide a threat assessment to 45 SW and KSC leadership for risk evaluations with an approaching tropical cyclone. Although the wind speed probabilities convey the uncertainty of a tropical cyclone well, communicating this information to customers is a challenge. The 45 WS continually strives to provide the wind speed probability information to customers in a context which clearly communicates the threat of a tropical cyclone. First, an intern from the Florida Institute of Technology (FIT) Atmospheric Sciences department, sponsored by Scitor Corporation, independently evaluated the NHC wind speed probability product. This work was later extended into a M.S. thesis at FIT, partially funded by Scitor Corporation and KSC. A second thesis at FIT further extended the evaluation partially funded by KSC. Using this analysis, the 45 WS categorized the probabilities into five probability interpretation categories: Very Low, Low, Moderate, High, and Very High. These probability interpretation categories convert the forecast probability and forecast interval into easily understood categories that are consistent across all ranges of probabilities and forecast intervals. As a follow-on project, KSC funded a summer intern to evaluate the human factors of the probability interpretation categories, which ultimately refined some of the thresholds. The 45 WS created a visualization tool to express the timing and risk for multiple locations in a single graphic. Preliminary results on an on-going project by FIT will be included in this paper. This project is developing a new method of assigning the probability interpretation categories and updating the evaluation of the performance of the NHC wind speed probability analysis

Lightning Reporting at 45th Weather Squadron: Recent Improvements

The 45th Weather Squadron (45 WS) provides daily lightning reports to space launch customers at CCAFS/KSC. These reports are provided to assess the need to inspect the electronics of satellite payloads, space launch vehicles, and ground support equipment for induced current damage from nearby lightning strokes. The 45 WS has made several improvements to the lightning reports during 2008-2009. The 4DLSS, implemented in April 2008, provides all lightning strokes as opposed to just one stroke per flash as done by the previous system. The 45 WS discovered that the peak current was being truncated to the nearest kilo amp in the database used to generate the daily lightning reports, which led to an up to 4% underestimate in the peak current for average lightning. This error was corrected and led to elimination of this underestimate. The 45 WS and their mission partners developed lightning location error ellipses for 99% and 95% location accuracies tailored to each individual stroke and began providing them in the spring of 2009. The new procedure provides the distance from the point of interest to the best location of the stroke (the center of the error ellipse) and the distance to the closest edge of the ellipse. This information is now included in the lightning reports, along with the peak current of the stroke. The initial method of calculating the error ellipses could only be used during normal duty hours, i.e. not during nights, weekends, or holidays. This method was improved later to provide lightning reports in near real-time, 24/7. The calculation of the distance to the closest point on the ellipse was also significantly improved later. Other improvements were also implemented. A new method to calculate the probability of any nearby lightning stroke. being within any radius of any point of interest was developed and is being implemented. This may supersede the use of location error ellipses. The 45 WS is pursuing adding data from nine NLDN sensors into 4DLSS in real-time. This will overcome the problem of 4DLSS missing some of the strong local strokes. This will also improve the location accuracy, reduce the size and eccentricity of the location error ellipses, and reduce the probability of nearby strokes being inside the areas of interest when few of the 4DLSS sensors are used in the stroke solution. This will not reduce 4DLSS performance when most of the 4DLSS sensors are used in the stroke solution. Finally, several possible future improvements were discussed, especially for improving the peak current estimate and the error estimate for peak current, and upgrading the 4DLSS. Some possible approaches for both of these goals were discussed

Female ornaments: is red skin color attractive to males and related to condition in rhesus macaques?

Sexual selection produces extravagant male traits, such as colorful ornaments, via female mate choice. More rarely, in mating systems in which males allocate mating effort between multiple females, female ornaments may evolve via male mate choice. Females of many anthropoid primates exhibit ornaments that indicate intraindividual cyclical fertility, but which have also been proposed to function as interindividual quality signals. Rhesus macaque females are one such species, exhibiting cyclical facial color variation that indicates ovulatory status, but in which the function of interindividual variation is unknown. We collected digital images of the faces of 32 rhesus macaque adult females. We assessed mating rates, and consortship by males, according to female face coloration. We also assessed whether female coloration was linked to physical (skinfold fat, body mass index) or physiological (fecal glucocorticoid metabolite [fGCM], urinary C-peptide concentrations) condition. We found that redder-faced females were mated more frequently, and consorted for longer periods by top-ranked males. Redder females had higher fGCM concentrations, perhaps related to their increased mating activity and consequent energy mobilization, and blood flow. Prior analyses have shown that female facial redness is a heritable trait, and that redderfaced females have higher annual fecundity, while other evidence suggests that color expression is likely to be a signal rather than a cue. Collectively, the available evidence suggests that female coloration has evolved at least in part via male mate choice. Its evolution as a sexually selected ornament attractive to males is probably attributable to the high female reproductive synchrony found in this species

End-diastolic wall thickness as a predictor of recovery of function in myocardial hibernation Relation to rest-redistribution Tl-201 tomography and dobutamine stress echocardiography

AbstractOBJECTIVESThe study assessed whether end-diastolic wall thickness (EDWT), measured with echocardiography, is an important marker of myocardial viability in patients with suspected myocardial hibernation, and it compared this index to currently established diagnostic modalities of dobutamine stress echocardiography (DSE) and rest-redistribution thallium-201 (Tl-201) scintigraphy.BACKGROUNDBecause myocardial necrosis is associated with myocardial thinning, preserved EDWT may provide a simple index of myocardial viability that is readily available from the resting echocardiogram.METHODSAccordingly, 45 patients with stable coronary artery disease and ventricular dysfunction underwent rest 2D echocardiograms, DSE and rest-redistribution Tl-201 tomography before revascularization and a repeat resting echocardiogram ≥2 months later.RESULTSGlobal wall motion score index decreased from 2.38 ± 0.73 to 1.94 ± 0.82 after revascularization (p < 0.001). Thirty-eight percent of severely dysfunctional segments recovered resting function. Compared to segments without recovery of resting function, those with recovery had greater EDWT (0.94 ± 0.18 cm vs. 0.67 ± 0.22 cm, p ≤ 0.0001) and a higher Tl-201 uptake (78 ± 13% vs. 59 ± 21%; p < 0.0001). An EDWT >0.6 cm had a sensitivity of 94% and specificity of 48% for recovery of function. Similarly, a Tl-201 maximal uptake of ≥60% had a sensitivity of 91% and specificity of 50%. Receiver operating characteristic curves for prediction of recovery of regional and global function were similar for EDWT and maximum Tl-201 uptake. Combination of EDWT and any contractile reserve during DSE for recovery of regional function improved the specificity to 77% without a significant loss in sensitivity (88%).CONCLUSIONSEnd-diastolic wall thickness is an important marker of myocardial viability in patients with suspected hibernation, and it can predict recovery of function similar to Tl-201 scintigraphy. Importantly, a simple measurement of EDWT ≤0.6 cm virtually excludes the potential for recovery of function and is a valuable adjunct to DSE in the assessment of myocardial viability

Climatological Study of the Short-Term Variation of the 0 C, -10 C, and -20 C Altitude Levels over the Florida Spaceport

For evaluation of the potential of cloud electrification, it is necessary to know the altitude of the 0, -10 and -20 degree Celsius levels. Cape Canaveral Air Force Station has recorded balloon launch data back to 1989. In support of rocket launches, often multiple balloons are launched within minutes of each other in the 4-6 hours leading up to launch. In the past, temperature data from sondes was typically available every hour or so through the launch countdown, allowing for frequent updates of these critical temperature thresholds. Recently, launch customers are relying on Jimsphere and wind profiler data that do not have a thermodynamic component in the latter 4-6 hours of a countdown. This study compares the altitude differences of the 0, -10 and -20 degree Celsius levels from consecutive balloon pairs not to exceed 6 hours apart. The analysis uses 9685 soundings from 1989 to 2013. Approximately 5 of the time the altitude of the temperature level in question (0, -10, -20 degrees C), varies by more than 500 feet (operationally significant threshold) within 6 hours. This study analyzes the altitude variability as a function of several meteorological parameters, such as change in sonde type, dew point depression, and solar zenith angle. Additionally, the study concludes with impacts to launch operations