A cross-sectional survey of a dermatology outpatient service in Malta

A survey of the outpatient service provided by a consultant dermatologist at the national dermatology department in Malta was carried out. The aims of this study were to identify the main conditions being treated and to analyze management and referral practices. Possible implications for future training of primary care physicians were also investigated. The survey was carried out for one week every season over a 12-month period, giving a total study period of four weeks. Data was collected on a total of 662 patients (401 new patients and 261 follow-ups). The average waiting time for a routine clinic appointment for new cases was 4 weeks, but 18% of patients were seen within 48 hours of referral and 7% were seen within one week. Age-specific attendance rates were highest for females over 50 years and males over 60. Overall, the commonest conditions seen were chronic leg ulcers, psoriasis, skin infections and seborrhoeic keratoses. Skin biopsy was the most frequent investigation performed and topical treatment was the commonest form of therapy. Private general practitioners and government doctors based in health centres accounted for 51% and 29% of all referrals respectively. A diagnosis was offered in 65% of referral notes. Of these, 44% had a diagnosis matching that given by the dermatologist at the patient's first visit. Treatment was attempted prior to referral in 64% of patients with acne but in only 15% of patients with viral warts.peer-reviewe

Mindful

Intangible discoveries can be obtained through the thought provoking frequencies of rhythm and poetry. Once melodic dynamics and subtle elements arise, there exists an infinite force in the eyes of the beholder. Mindful by Amato PM is a conscious hip-hop/rap album that has a clear and concise focus: to elicit inner greatness. The various layers to this concept are expressed both lyrically and sonically throughout the long playing. The intention is for the record to be played throughout, while each track blends to form a larger movement. Each stands on it’s own two feet, but the full listen through generally brings forth a more transparent version of the artist’s vision. It is our daily actions that define who we are as a person. The jagged slope of life, with ups and downs, allow for us to discover new concepts, practices, and habits. These days then make up the time we spend in the world have. Chance is quite a powerful concept, which makes an appearance in Mindful through the compositional structure and generative tactics. Other topics, such as astronomy, philosophy, and mathematics, also state cases in several tracks. It seems as if the topics each play their role in the larger matter or in better expression the motivation as a whole. It is as if you can sense the ocean’s waves flowing in your veins, when the light bleeds through and you change your ways. Dream. For a dream is never false, unless you deem it so.https://remix.berklee.edu/graduate-studies-production-technology/1093/thumbnail.jp

Public Involvement in Long-Term Stewardship Sites of the Superfund Program

Active public involvement can support effective long-term stewardship (LTS) programs, which protect public health and the environment during the operation of long-term remedies. Although public involvement is important for the success of LTS programs, much of literature about public involvement focuses more on the whole cleanup process and less on the LTS phase. Therefore, our project attempted to provide more information about public involvement at LTS sites. To accomplish this, we identified LTS sites with high public involvement and interviewed associated EPA officials. Based on our findings from interviews, and review of site reports and five-year reviews, we provided a set of conclusions, as well as recommendations for EPA to increase public involvement

Relationships between tree stand density and burn severity as measured by the Composite Burn Index following a ponderosa pine forest wildfire in the American Southwest

The Trigo fire burned 5548 ha of the Manzano Mountains in central New Mexico in 2008. The fire burned with mixed severity through ponderosa pine (Pinus ponderosa) stands on the Cibola National Forest and private lands. The burned area exhibited a range of stand densities enabling this research to quantify the relationship between variation in tree density and burn severity using the Composite Burn Index (CBI) severity classification. Across 90 CBI plots, high tree density was strongly associated with high burn severity. The CBI method allowed classification of burn severity to a range of forest vertical fuels strata. Tree mortality and duff consumption are two attributes that recorded higher severity in plots with higher tree densities. The CBI approach is designed for rapid on-the-ground assessments; to compliment this procedure a rapid visual classification of stand density was tested to determine its accuracy for land managers. This visual assessment correlated well with quantitative measurements of tree density. Since density classes were also highly correlated with CBI scores they may therefore be a good predictor of burn severity in a stand. This is a more rapid way for land managers to categorize stand density than traditional density measurements. These findings demonstrate that reducing tree density in southwestern ponderosa pine stands may significantly lower burn severity resulting from wildfire

Mount Protects Thin-Walled Glass or Ceramic Tubes from Large Thermal and Vibration Loads

The design allows for the low-stress mounting of fragile objects, like thin walled glass, by using particular ways of compensating, isolating, or releasing the coefficient of thermal expansion (CTE) differences between the mounted object and the mount itself. This mount profile is lower than true full kinematic mounting. Also, this approach enables accurate positioning of the component for electrical and optical interfaces. It avoids the higher and unpredictable stress issues that often result from potting the object. The mount has been built and tested to space-flight specifications, and has been used for fiber-optic, optical, and electrical interfaces for a spaceflight mission. This mount design is often metal and is slightly larger than the object to be mounted. The objects are optical or optical/electrical, and optical and/or electrical interfaces are required from the top and bottom. This requires the mount to be open at both ends, and for the object s position to be controlled. Thin inside inserts at the top and bottom contact the housing at defined lips, or edges, and hold the fragile object in the mount. The inserts can be customized to mimic the outer surface of the object, which further reduces stress. The inserts have the opposite CTE of the housing material, partially compensating for the CTE difference that causes thermal stress. A spring washer is inserted at one end to compensate for more CTE difference and to hold the object against the location edge of the mount for any optical position requirements. The spring also ensures that any fiber-optic or optic interface, which often requires some pressure to ensure a good interface, does not overstress the fragile object. The insert thickness, material, and spring washer size can be traded against each other to optimize the mount and stresses for various thermal and vibration load ranges and other mounting requirements. The alternate design uses two separate, unique features to reduce stress and hold the object. A release agent is applied to the inside surface of the mount just before the binding potting material is injected in the mount. This prevents the potting material from bonding to the mount, and thus prevents stress from being applied, at very low temperatures, to the fragile object being mounted. The potting material mixing and curing is temperature- and humidity-controlled. The mount has radial grooves cut in it that the potting material fills, thus controlling the vertical position of the mounted object. The design can easily be used for long and thin objects, short and wide objects, and any shape in between. The design s advantages are amplified for long and thin fragile objects. The general testing range was 45 to +45 C, but multiple mounts were successfully tested down to 60 and up to 50 C and the design can be adjusted for larger ranges

Terrapin technologies manned Mars mission proposal

A Manned Mars Mission (M3) design study is proposed. The purpose of M3 is to transport 10 personnel and a habitat with all required support systems and supplies from low Earth orbit (LEO) to the surface of Mars and, after an eight-man surface expedition of 3 months, to return the personnel safely to LEO. The proposed hardware design is based on systems and components of demonstrated high capability and reliability. The mission design builds on past mission experience, but incorporates innovative design approaches to achieve mission priorities. Those priorities, in decreasing order of importance, are safety, reliability, minimum personnel transfer time, minimum weight, and minimum cost. The design demonstrates the feasibility and flexibility of a Waverider transfer module

Mission Concept for the Single Aperture Far-Infrared (SAFIR) Observatory

The Single Aperture Far-InfraRed (SAFIR) Observatory's science goals are driven by the fact that the earliest stages of almost all phenomena in the universe are shrouded in absorption by and emission from cool dust and gas that emits strongly in the far-infrared and submillimeter. Over the past several years, there has been an increasing recognition of the critical importance of this spectral region to addressing fundamental astrophysical problems, ranging from cosmological questions to understanding how our own Solar System came into being. The development of large, far-infrared telescopes in space has become more feasible with the combination of developments for the James Webb Space Telescope and of enabling breakthroughs in detector technology. We have developed a preliminary but comprehensive mission concept for SAFIR, as a 10 m-class far-infrared and submillimeter observatory that would begin development later in this decade to meet the needs outlined above. Its operating temperature (<4K) and instrument complement would be optimized to reach the natural sky confusion limit in the far-infrared with diffraction-limited peformance down to at least 40 microns. This would provide a point source sensitivity improvement of several orders of magnitude over that of Spitzer or Herschel, with finer angular resolution, enabling imaging and spectroscopic studies of individual galaxies in the early universe. We have considered many aspects of the SAFIR mission, including the telescope technology, detector needs and technologies, cooling method and required technology developments, attitude and pointing, power systems, launch vehicle, and mission operations. The most challenging requirements for this mission are operating temperature and aperture size of the telescope, and the development of detector arrays.Comment: 36 page

Teak Efficiency and Environmental Education Methods for Batipa

We have addressed three issues in this project regarding the Batipa Peninsula and the surrounding areas: solutions for teak by-products, reconnecting wildlife corridors, and the sustainability of the Chiriquí Province through education. Our mission was to create effective and attainable solutions for these issues. We conducted primary research, via interviews and on-site visits, to find low-cost, low-risk solutions for these problems. Our recommendations included new equipment for better teak efficiency, construction of permanent structures for wildlife, planned future projects, proposed classes, critiqued Oteima’s online presence, and generated new tourism itineraries for Batipa

GREEN, EQUITABLE AND LIVABLE TRANSFORMING THE CORE OF MASON SQUARE IN SPRINGFIELD, MA

GREEN, EQUITABLE AND LIVABLE - TRANSFORMING THE CORE OF MASON SQUARE takes a focused look at the Mason Square Planning District in Springfield, Ma and provides strategies for urban design and landscape architecture to support a community’s vision for the future. The students engaged through various community meetings for the larger Mason Square district in the spring of 2023 and enthusiastically supported the ideas and thoughts that were expressed. brownfield at Wilbraham Avenue. The larger goal is to shape a district for everybody to create safe and beautiful streets, provide better connectivity to public urban green, enhance arts, culture and dining, and catalyze equitable housing and business opportunities. Core Recommendations: Ben Swan Way is a space that should be used more for temporary community events. More usable for people as a small-scale neighborhood hub for curbside dining, cultural events, markets, performances. Measures range from complete closing down for regular traffic to modest alteration of parking layout and introduction of pedestrian-friendly surfaces to slow down traffic. Reduction of traffic speed along State Street and Wilbraham Road through reduction of lane widths and/or number of lanes, elevated pedestrian crossings, planting of big street trees, establishment of bike lanes and on-street parking. Implementation through phasing and testing. Safe ways to walk back and forth from residential areas to the Rebecca Johnson and the DeBerry Swan School. Primary street corridors need more pedestrian-scale lighting, benches, and covered bus stops. Former MCDI area should be developed with a diverse strategy that encompasses opportunities for small businesses and manufacturing including work/live/art, adult education, mix of affordable and market rate housing, hospitality industry and community services as a hub for the Mason Square community. Food is an topic in the district that needs to be addressed at multiple scales and levels. Offering spaces for community gardens on vacant or underutilized lots can be a great opportunity to educate about food and create community. Local markets should cater to diverse income levels to provide food security. Food should be part of the local economy and display the ethnic diversity. The neighborhood needs more and various restaurants and places to eat. Inclusion of art and activities that acknowledge black culture and the diversity of today. Embrace the racial history of the project area through expansion of community-building art events such as Fresh Paint, and commemoration of Nelson Stevens and AfriCOBRA (the African Commune of Bad Relevant Artists). Stronger pedestrian and bicycle connections from east to west. Underutilized land along the former railroad corridor should be used as a green spine for the community. The proposed trail “McKnight Rail Trail” should be implemented in phases to regain traction and credibility of the more than 30-year old planning proposals The area of Springfield Water and Sewer Commission should be repurposed for recreation and housing to glue the neighborhoods together. Illumination, color scheme, friendly appearance of storefronts is necessary that people feel safe 24/7. Plantings with big trees can minimize heat island effects in the core area of Mason Square. Green roofs for new buildings, green facades and stormwater swales are recommended. Editor: Chandana Palika Copy Editor: Frank Sleeger