NASA/USRA high altitude research aircraft. Gryphon: Soar like an eagle with the roar of a lion

At the equator, the ozone layer ranges from 65,000 to 130,000+ feet. This is beyond the capabilities of the ER-2, which is NASA's current high altitude reconnaissance aircraft. The Universities Space Research Association, in cooperation with NASA, is sponsoring an undergraduate program which is geared to designing an aircraft that can study the ozoned layer at the equator. This aircraft must be able to satisfy four mission profiles. Mission one is a polar mission which ranges from Chile to the South Pole and back to Chile, a total range of 6000 n. mi. at 100,000 feet with a 2500 lb. payload. The second mission is also a polar mission with a decreased altitude of 70,000 feet and an increased payload of 4000 lb. For the third mission, the aircraft will take-off at NASA Ames, cruise at 100,000 feet carrying a 2500 lb. payload, and land in Puerto Montt, Chile. The final mission requires the aircraft to take-off at NASA Ames, cruise at 100,000 feet with a 1000 lb. payload, make an excursion to 120,000 feet, and land at Howard AFB, Panama. All three missions require that a subsonic Mach number be maintained due to constraints imposed by the air sampling equipment. The aircraft need not be manned for all four missions. Three aircraft configurations were determined to be the most suitable for meeting the above requirements. The performance of each configuration is analyzed to investigate the feasibility of the project requirements. In the event that a requirement can not be obtained within the given constraints, recommendations for proposal modifications are given

Public Performance Metrics: Driving Physician Motivation and Performance

Introduction: As providers transition from “fee-for-service” to “pay-for-performance” models, focus has shifted to improving performance. This trend extends to the emergency department (ED) where visits continue to increase across the United States. Our objective was to determine whether displaying public performance metrics of physician triage data could drive intangible motivators and improve triage performance in the ED.Methods: This is a single institution, time-series performance study on a physician-in-triage system. Individual physician baseline metrics—number of patients triaged and dispositioned per shift—were obtained and prominently displayed with identifiable labels during each quarterly physician group meeting. Physicians were informed that metrics would be collected and displayed quarterly and that there would be no bonuses, punishments, or required training; physicians were essentially free to do as they wished. It was made explicit that the goal was to increase the number triaged, and while the number dispositioned would also be displayed, it would not be a focus, thereby acting as this study’s control. At the end of one year, we analyzed metrics.Results: The group’s average number of patients triaged per shift were as follows: Q1-29.2; Q2-31.9; Q3-34.4; Q4-36.5 (Q1 vs Q4, p < 0.00001). The average numbers of patients dispositioned per shift were Q1-16.4; Q2-17.8; Q3-16.9; Q4-15.3 (Q1 vs Q4, p = 0.14). The top 25% of Q1 performers increased their average numbers triaged from Q1-36.5 to Q4-40.3 (ie, a statistically insignificant increase of 3.8 patients per shift [p = 0.07]). The bottom 25% of Q1 performers, on the other hand, increased their averages from Q1-22.4 to Q4-34.5 (ie, a statistically significant increase of 12.2 patients per shift [p = 0.0013]).Conclusion: Public performance metrics can drive intangible motivators (eg, purpose, mastery, and peer pressure), which can be an effective, low-cost strategy to improve individual performance, achieve institutional goals, and thrive in the pay-for-performance era

Enzyme microarrays assembled by acoustic dispensing technology

Miniaturizing bioassays to the nanoliter scale for high-throughput screening reduces the consumption of reagents that are expensive or difficult to handle. Through the use of acoustic dispensing technology, nanodroplets containing 10 μM ATP (3 μCi/μL 32P) and reaction buffer in 10% glycerol were positionally dispensed to the surface of glass slides to form 40-nL compartments (100 droplets/slide) for Pim1 (proviral integration site 1) kinase reactions. The reactions were activated by dispensing 4 nL of various levels of a pyridocarbazolo-cyclopentadienyl ruthenium complex Pim1 inhibitor, followed by dispensing 4 nL of a Pim1 kinase and peptide substrate solution to achieve final concentrations of 150 nM enzyme and 10 μM substrate. The microarray was incubated at 30 °C (97% Rh) for 1.5 h. The spots were then blotted to phosphocellulose membranes to capture phosphorylated substrate. With phosphor imaging to quantify the washed membranes, the assay showed that, for doses of inhibitor from 0.75 to 3 μM, Pim1 was increasingly inhibited. Signal-to-background ratios were as high as 165, and average coefficients of variation for the assay were not, vert, ∼20%. Coefficients of variation for dispensing typical working buffers were under 5%. Thus, microarrays assembled by acoustic dispensing are promising as cost-effective tools that can be used in protein assay development

COVID-19 Risk for Individuals with Intellectual and/or Developmental Disabilities Varies by Type of Residential Setting

COVID-19 case and fatality rates are higher for people with IDD who are living in Skilled Nursing Facilities compared with those living in other types of facilities or those living in individual residences or their family home

Using the Five Ps: Conceptualizing COVID-19-Related Mental Health Concerns

The COVID-19 pandemic has resulted in rising mental health concerns. As individuals experience loneliness, anxiety, and depression related to the pandemic, counselors-in-training navigate their treatment of clients while also living through the pandemic and its polarization. The authors present the Five Ps, a case conceptualization model that supervisors can use to help beginning counselors consider the history and context of the presenting concerns of clients, in addition to utilizing clients’ strengths in treatment. The authors provide a case illustration using the Five Ps in a supervision setting and discuss implications for supervision and future research

Using an Idiographic Approach to Clients with Health Anxiety

Worries about one’s health, while ubiquitous, can for some become quite distressing. Health anxiety occurs when one becomes focused on symptoms and fears they may become ill or die. This often overtakes their life due to continued worry. They often spend an inordinate amount of time and effort to seek answers. Other aspects of their life are placed in the periphery or abandoned. Traditional approaches are aimed at symptom relief. While effective for some, others continue to struggle. A more novel approach that aims to look at the client both holistically and individualistically can address much more than symptom amelioration

Success rates of re-excision after positive margins for invasive lobular carcinoma of the breast.

Rates of positive margins after surgical resection of invasive lobular carcinoma (ILC) are high (ranging from 18 to 60%), yet the efficacy of re-excision lumpReceptor subtypeectomy for clearing positive margins is unknown. Concerns about the diffuse nature of ILC may drive increased rates of completion mastectomy to treat positive margins, thus lowering breast conservation rates. We therefore determined the success rate of re-excision lumpectomy in women with ILC and positive margins after surgical resection. We identified 314 cases of stage I-III ILC treated with breast conserving surgery (BCS) at the University of California, San Francisco. Surgical procedures, pathology reports, and outcomes were analyzed using univariate and multivariate statistics and Cox-proportional hazards models. We evaluated outcomes before and after the year 2014, when new margin management consensus guidelines were published. Positive initial margins occurred in 118 (37.6%) cases. Of these, 62 (52.5%) underwent re-excision lumpectomy, which cleared the margin in 74.2%. On multivariate analysis, node negativity was significantly associated with successful re-excision (odds ratio [OR] 3.99, 95% CI 1.15-13.81, p = 0.029). After 2014, we saw fewer initial positive margins (42.7% versus 25.5%, p = 0.009), second surgeries (54.6% versus 20.2%, p < 0.001), and completion mastectomies (27.7% versus 4.5%, p < 0.001). In this large cohort of women with ILC, re-excision lumpectomy was highly successful at clearing positive margins. Additionally, positive margins and completion mastectomy rates significantly decreased over time. These findings highlight improvements in management of ILC, and suggest that completion mastectomy may not be required for those with positive margins after initial BCS

NASA Glenn Research Center Support of the Advanced Stirling Radioisotope Generator Project

A high-efficiency radioisotope power system was being developed for long-duration NASA space science missions. The U.S. Department of Energy (DOE) managed a flight contract with Lockheed Martin Space Systems Company to build Advanced Stirling Radioisotope Generators (ASRGs), with support from NASA Glenn Research Center. DOE initiated termination of that contract in late 2013, primarily due to budget constraints. Sunpower, Inc., held two parallel contracts to produce Advanced Stirling Convertors (ASCs), one with Lockheed Martin to produce ASC-F flight units, and one with Glenn for the production of ASC-E3 engineering unit "pathfinders" that are built to the flight design. In support of those contracts, Glenn provided testing, materials expertise, Government-furnished equipment, inspection capabilities, and related data products to Lockheed Martin and Sunpower. The technical support included material evaluations, component tests, convertor characterization, and technology transfer. Material evaluations and component tests were performed on various ASC components in order to assess potential life-limiting mechanisms and provide data for reliability models. Convertor level tests were conducted to characterize performance under operating conditions that are representative of various mission conditions. Despite termination of the ASRG flight development contract, NASA continues to recognize the importance of high-efficiency ASC power conversion for Radioisotope Power Systems (RPS) and continues investment in the technology, including the continuation of the ASC-E3 contract. This paper describes key Government support for the ASRG project and future tests to be used to provide data for ongoing reliability assessments