Understanding Differences in Medical Versus Surgical Patients Alerted by the Modified Early Warning Score (MEWS) at Jefferson Hospital

An Early Warning Score (EWS) is a risk-management tool to identify patients experiencing clinical deterioration early, therefore allowing timely treatment to occur. Although EWS scores are recommended for all in-patients, more data is available for patients under general medical services compared to surgical services. This study aims to understand differences between medical versus surgical in-patients who receive a red alert from the Modified Early Warning Score (MEWS) at Jefferson hospital. Patients who received a red MEWS alert during admission and discharged between June 2017 to March 2018 (N=812) were categorized as medical or surgical patients. Patient characteristics were compared using an independent samples t-test (age, alert count) or chi-square test (sex, race, admission source, insurance). Patient outcomes were compared using a binary logistic regression (in-hospital mortality, RRT, sepsis diagnosis, ICU transfer, intubation, discharge to hospice) or a Cox regression model (length of stay), controlling for age, sex, and race. Compared to medical patients, surgical patients were younger by 2.7 years (p=0.026) and more likely to have a Commercial and/or Medicare category of insurance (OR=1.568, p=0.005). Surgical patients were more likely to have ICU transfer (OR=1.487, p=0.013) and intubation post-alert (OR=2.470, p=0.006), while less likely to be discharged early (HR=0.675,

Three Gravitationally Lensed Supernovae behind CLASH Galaxy Clusters

We report observations of three gravitationally lensed supernovae (SNe) in the Cluster Lensing And Supernova survey with Hubble (CLASH) Multi-Cycle Treasury program. These objects, SN CLO12Car (z = 1.28), SN CLN12Did (z = 0.85), and SN CLA11Tib (z = 1.14), are located behind three different clusters, MACSJ1720.2+3536 (z = 0.391), RXJ1532.9+3021 (z = 0.345), and A383 (z = 0.187), respectively. Each SN was detected in Hubble Space Telescope optical and infrared images. Based on photometric classification, we find that SNe CLO12Car and CLN12Did are likely to be Type Ia supernovae (SNe Ia), while the classification of SN CLA11Tib is inconclusive. Using multi-color light-curve fits to determine a standardized SN Ia luminosity distance, we infer that SN CLO12Car was ~1.0 ± 0.2 mag brighter than field SNe Ia at a similar redshift and ascribe this to gravitational lens magnification. Similarly, SN CLN12Did is ~0.2 ± 0.2 mag brighter than field SNe Ia. We derive independent estimates of the predicted magnification from CLASH strong+weak-lensing maps of the clusters (in magnitude units, 2.5 log_(10)μ): 0.83 ± 0.16 mag for SN CLO12Car, 0.28 ± 0.08 mag for SN CLN12Did, and 0.43 ± 0.11 mag for SN CLA11Tib. The two SNe Ia provide a new test of the cluster lens model predictions: we find that the magnifications based on the SN Ia brightness and those predicted by the lens maps are consistent. Our results herald the promise of future observations of samples of cluster-lensed SNe Ia (from the ground or space) to help illuminate the dark-matter distribution in clusters of galaxies, through the direct determination of absolute magnifications

A GUD Toolbox: Implementation of Giving-Up Densities with Mammals

Giving-up densities are the density of food remaining within an artificial foraging patch over a specified time and are an indicator of how an organism perceives its environment. The GUD method is particularly useful to study the foraging behavior of an organism relative to predation risk and interactions with other environmental variables (e.g., cover, conspecifics, and food quantity and quality) to address larger ecological and evolutionary questions. The GUD methodology is commonly used with the mammalian taxonomic group due to their general size, detectability, and abundance in comparison to other taxa. However, development of protocols that maximize the potential for success of GUDs in the field can be a barrier to the implementation of GUD methodologies to address ecological and evolutionary questions. Thus, we will synthesize protocol information from mammalian studies that implemented GUDs to act as a resource for scientists planning to implement GUDs in their research and/or teaching. By increasing access to the GUD methodology, we hope to further research in ecology and evolution and implementation of these tools in teaching. Keywords: Giving-up density, predation risk, food availability, methodology, mammals, foraging behavio

Yamato: Bringing the Moon to the Earth ... Again

The Yamato mission to the lunar South Pole-Aitken Basin returns samples that enable dating of lunar formation and the lunar bombardment period. The design of the Yamato mission is based on a systems engineering process which takes an advanced consideration of cost and mission risk to give the mission a high probability of success

Flying Blind: Exploring the Visual Cues Used by Helicopter Pilots in Degraded Visual Environments

Helicopter pilots rely on visual cues from the environment and instrument displays during critical phases of flight – particularly final approach and landing – to safely land. However, the specific visual cues pilots rely on and how they integrate those cues to make anticipatory inceptor inputs or corrections are not well understood. Importantly, those cues may be degraded under nighttime and brownout/whiteout conditions where the downwash of a helicopter’s rotors cause loose dirt/snow to be projected into the air, resulting in the obfuscation of the pilot’s vision outside the aircraft. The lack of visual cues in these conditions means that pilots are often ‘flying blind’ and must transition from using visual scene-based cues and motion-based cues to alphanumeric or pictographic information on displays. This transition of in-flight rules involves changes in perceptual and cognitive processing during a time of increased cognitive and physical workload. Pilots must shift their visual and attentional focus from the external scene to head-down displays. Additionally, cognitive processing shifts from natural visual cues to detection and response. This shift is not instantaneous. Delays in recognizing and understanding the alphanumeric information increases the risk of spatial disorientation. Therefore, it becomes imperative to identify what cues pilots may rely on to inform the design of displays that may be more effective under degraded viewing conditions. To address this issue, we reviewed the literature on the visual cues used to process forward motion (i.e., speed, heading), altitude, position in space, and collision detection (specifically during the landing flare). Analyses conclude that (a) optical flow supports awareness of linear motion, (b) lines of splay and depression promote altitude regulation, (c) accretion and deletion of environmental features outside the aircraft allow for roll, yaw, and heave detection, (d) motion parallax is crucial for motion detection when an aircraft is hovering, and (e) a successful landing flare may rely on a combination of time-to-contact and time-to-passage cues. These results suggest that visual cues can be incorporated in an artificial visual environment. Providing information on the visual cues processed during landing can assist designers and developers alike to design a synthetic display that facilitates spatial awareness

Recent Progress in Biopolymer-Based Hydrogel Materials for Biomedical Applications.

Hydrogels from biopolymers are readily synthesized, can possess various characteristics for different applications, and have been widely used in biomedicine to help with patient treatments and outcomes. Polysaccharides, polypeptides, and nucleic acids can be produced into hydrogels, each for unique purposes depending on their qualities. Examples of polypeptide hydrogels include collagen, gelatin, and elastin, and polysaccharide hydrogels include alginate, cellulose, and glycosaminoglycan. Many different theories have been formulated to research hydrogels, which include Flory-Rehner theory, Rubber Elasticity Theory, and the calculation of porosity and pore size. All these theories take into consideration enthalpy, entropy, and other thermodynamic variables so that the structure and pore sizes of hydrogels can be formulated. Hydrogels can be fabricated in a straightforward process using a homogeneous mixture of different chemicals, depending on the intended purpose of the gel. Different types of hydrogels exist which include pH-sensitive gels, thermogels, electro-sensitive gels, and light-sensitive gels and each has its unique biomedical applications including structural capabilities, regenerative repair, or drug delivery. Major biopolymer-based hydrogels used for cell delivery include encapsulated skeletal muscle cells, osteochondral muscle cells, and stem cells being delivered to desired locations for tissue regeneration. Some examples of hydrogels used for drug and biomolecule delivery include insulin encapsulated hydrogels and hydrogels that encompass cancer drugs for desired controlled release. This review summarizes these newly developed biopolymer-based hydrogel materials that have been mainly made since 2015 and have shown to work and present more avenues for advanced medical applications

Direct Measurement of the Quantum Wavefunction

Central to quantum theory, the wavefunction is the complex distribution used to completely describe a quantum system. Despite its fundamental role, it is typically introduced as an abstract element of the theory with no explicit definition. Rather, physicists come to a working understanding of the wavefunction through its use to calculate measurement outcome probabilities via the Born Rule. Presently, scientists determine the wavefunction through tomographic methods, which estimate the wavefunction that is most consistent with a diverse collection of measurements. The indirectness of these methods compounds the problem of defining the wavefunction. Here we show that the wavefunction can be measured directly by the sequential measurement of two complementary variables of the system. The crux of our method is that the first measurement is performed in a gentle way (i.e. weak measurement) so as not to invalidate the second. The result is that the real and imaginary components of the wavefunction appear directly on our measurement apparatus. We give an experimental example by directly measuring the transverse spatial wavefunction of a single photon, a task not previously realized by any method. We show that the concept is universal, being applicable both to other degrees of freedom of the photon (e.g. polarization, frequency, etc.) and to other quantum systems (e.g. electron spin-z quantum state, SQUIDs, trapped ions, etc.). Consequently, this method gives the wavefunction a straightforward and general definition in terms of a specific set of experimental operations. We expect it to expand the range of quantum systems scientists are able to characterize and initiate new avenues to understand fundamental quantum theory

Whole Body Cryotherapy as a Novel Treatment for Long COVID Syndrome Associated Brain Fog

SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19), was first discovered in December 2019 in Wuhan, China when adults began presenting with severe pneumonia of an unknown cause. SARS-CoV-2 can cause a wide range of clinical manifestations. SARS-CoV-2 can penetrate the olfactory mucosa and may enter the brain through the cribriform plate along the olfactory tract, through vagal or trigeminal pathways, or pass through the blood-brain barrier. Once inside the brain, levels of inflammatory cytokines are increased and can lead to altered learning, memory, neuroplasticity, hallucinations, nightmares, cognitive and attention deficits, new-onset anxiety and depression, and psychosis. A theoretical treatment for long COVID syndrome, whole body cryotherapy, involves exposing the entire body, including the head, to ultra-low temperatures for a brief time using an enclosed space referred to as a whole-body cryochamber. This literature review evaluates the efficacy of whole body cryotherapy on long COVID syndrome and its current clinical uses