Technology for the Future: In-Space Technology Experiments Program, part 2

The purpose of the Office of Aeronautics and Space Technology (OAST) In-Space Technology Experiments Program In-STEP 1988 Workshop was to identify and prioritize technologies that are critical for future national space programs and require validation in the space environment, and review current NASA (In-Reach) and industry/ university (Out-Reach) experiments. A prioritized list of the critical technology needs was developed for the following eight disciplines: structures; environmental effects; power systems and thermal management; fluid management and propulsion systems; automation and robotics; sensors and information systems; in-space systems; and humans in space. This is part two of two parts and contains the critical technology presentations for the eight theme elements and a summary listing of critical space technology needs for each theme

Technology for the Future: In-Space Technology Experiments Program, part 1

The purpose of the Office of Aeronautics and Space Technology (OAST) In-Space Technology Experiment Program (In-STEP) 1988 Workshop was to identify and prioritize technologies that are critical for future national space programs and require validation in the space environment, and review current NASA (In-Reach) and industry/university (Out-Reach) experiments. A prioritized list of the critical technology needs was developed for the following eight disciplines: structures; environmental effects; power systems and thermal management; fluid management and propulsion systems; automation and robotics; sensors and information systems; in-space systems; and humans in space. This is part one of two parts and is the executive summary and experiment description. The executive summary portion contains keynote addresses, strategic planning information, and the critical technology needs summaries for each theme. The experiment description portion contains brief overviews of the objectives, technology needs and backgrounds, descriptions, and development schedules for current industry, university, and NASA space flight technology experiments

The High Cost of Opioid Use in Pregnancy

Background: Numerous investigators have highlighted the need to integrate opioid use disorder (OUD) treatment with maternity care. Since data first became available in 2014, Montgomery County (Ohio) has experienced the highest rates of OUD and unintended opioid overdose deaths in the state. This paper examines the demographics and costs of medical treatment for pregnant women with OUD and their newborns with prenatal exposure to opioids (PEO). Methods: The study involved a retrospective records review of all newborns born between May 1, 2016, and April 30, 2017, at a large, urban medical center. Newborns with PEO were matched with a control group by mother's type of insurance, race/ethnicity, method of birth, and maternal parity. Results: Establishing which of the pregnant women should be diagnosed with OUD and be included in the study group was inordinately challenging. Ultimately, of the 3841 infants birthed during the study period, 131 (3.4%) were iden-tified as being born to mothers with OUD. Significantly more mothers with OUD were White and on Medicaid. Only 25 (19.2%) mothers with OUD engaged in treatment for substance use. Compared to the control group, newborns with PEO were much more likely (71.4% versus 25.4%) to be admitted to the NICU and had much longer lengths of stay in both the NICU (mean of 14.4 versus 4.1 days) and hospital (16.9 versus 5.8 days), resulting in dramatic increases in health care cost. Conclusion: These data underscore the need for a comprehensive, systematic approach to OUD and PEO and affirm the government as a major stakeholder in the care of infants born to these women

A study of concept options for the evolution of Space Station Freedom

Two conceptual evolution configurations for Space Station Freedom, a research and development configuration, and a transportation node configuration are described and analyzed. Results of pertinent analyses of mass properties, attitude control, microgravity, orbit lifetime, and reboost requirements are provided along with a description of these analyses. Also provided are brief descriptions of the elements and systems that comprise these conceptual configurations

Evidence that two phenotypically distinct mouse PKD mutations, bpk and jcpk, are allelic

Evidence that two phenotypically distinct mouse PKD mutations, bpk and jcpk, are allelic. Numerous mouse models of polycystic kidney disease (PKD) have been described. All of these diseases are transmitted as single recessive traits and in most, the phenotypic severity is influenced by the genetic background. However, based on their genetic map positions, none of these loci appears to be allelic and none are candidate modifier loci for any other mouse PKD mutation. Previously, we have described the mouse bpk mutation, a model that closely resembles human autosomal recessive polycystic kidney disease. We now report that the bpk mutation maps to a 1.6 CM interval on mouse Chromosome 10, and that the renal cystic disease severity in our intersubspecific intercross progeny is influenced by the genetic background. Interestingly, bpk co-localizes with jcpk, a phenotyp-ically-distinct PKD mutation, and complementation testing indicates that the bpk and jcpk mutations are allelic. These data imply that distinct PKD phenotypes can result from different mutations within a single gene. In addition, based on its map position, the bpk locus is a candidate genetic modifier for jck, a third phenotypically-distinct PKD mutation

The extraordinary linear polarisation structure of the southern Centaurus A lobe revealed by ASKAP

We present observations of linear polarisation in the southern radio lobe of Centaurus A, conducted during commissioning of the Australian Square Kilometre Array Pathfinder (ASKAP) telescope. We used 16 antennas to observe a 30 square degree region in a single 12 hour pointing over a 240 MHz band centred on 913 MHz. Our observations achieve an angular resolution of $26\times33$ arcseconds (480 parsecs), a maximum recoverable angular scale of 30 arcminutes, and a full-band sensitivity of 85 \muupJy beam$^{-1}$. The resulting maps of polarisation and Faraday rotation are amongst the most detailed ever made for radio lobes, with of order 10$^5$ resolution elements covering the source. We describe several as-yet unreported observational features of the lobe, including its detailed peak Faraday depth structure, and intricate networks of depolarised filaments. These results demonstrate the exciting capabilities of ASKAP for widefield radio polarimetry.Comment: 10 pages, 6 figures. Accepted in "The Power of Faraday Tomography" special issue of Galaxie

Randomised controlled trials for evaluating the prescribing impact of information meetings led by pharmacists and of new information formats, in General Practice in Italy

<p>Abstract</p> <p>Background</p> <p>Suboptimal translation of valid and relevant information in clinical practice is a problem for all health systems. Lack of information independent from commercial influences, limited efforts to actively implement evidence-based information and its limited comprehensibility are important determinants of this gap and may influence an excessive variability in physicians' prescriptions. This is quite noticeable in Italy, where the philosophy and methods of Evidence-Based Medicine still enjoy limited diffusion among practitioners. Academic detailing and pharmacist outreach visits are interventions of proven efficacy to make independent and evidence-based information available to physicians; this approach and its feasibility have not yet been tested on a large scale and, moreover, they have never been formally tested in Italy.</p> <p>Methods/Design</p> <p>Two RCTs are planned:</p> <p>1) a two-arm cluster RCT, carried out in Emilia-Romagna and Friuli Venezia Giulia, will evaluate the effectiveness of small group meetings, randomising about 150 Primary Care Groups (corresponding to about 2000 GPs) to pharmacist outreach visits on two different topics. Physicians' prescriptions (expressed as DDD per 1000 inhabitants/day), knowledge and attitudes (evaluated through the answers to a specific questionnaire) will be compared for target drugs in the two groups (receiving/not receiving each topic).</p> <p>2) A three-arm RCT, carried out in Sardinia, will evaluate both the effectiveness of one-to-one meetings (one pharmacist visiting one physician per time) and of a 'new' information format (compared to information already available) on changing physicians' prescription of specific drugs. About 900 single GPs will be randomised into three groups: physicians receiving a visit supported by "traditional" information material, those receiving a visit with "new" information material on the same topic and those not receiving any visit/material.</p> <p>Discussion</p> <p>The two proposed RCTs aim to evaluate the organisational feasibility and barriers to the implementation of independent information programs led by NHS pharmacists. The objective to assess a 10 or 15% decreases in the prescription of the targeted drugs is quite ambitious in such 'natural' settings, which will be minimally altered by the interventions themselves; this in spite of the quite large sample sizes used comparing to other studies of these kind. Complex interventions like these are not easy to evaluate, given the many different variables into play. Anyway, the pragmatic nature of the two RCTs appears to be also one of their major strengths, helping to provide a deeper insight on what is possible to achieve – in terms of independent information – in a National Health System, with special reference to Italy.</p> <p>Trial registration</p> <p>ISRCTN05866587 (cluster RCT) and ISRCTN28525676 (single GPs RCT)</p

CD4 count at presentation for HIV care in the United States and Canada: Are those over 50 years more likely to have a delayed presentation?

We assessed CD4 count at initial presentation for HIV care among ≥50-year-olds from 1997-2007 in 13 US and Canadian clinical cohorts and compared to <50-year-olds. 44,491 HIV-infected individuals in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) were included in our study. Trends in mean CD4 count (measured as cells/mm3) and 95% confidence intervals ([,]) were determined using linear regression stratified by age category and adjusted for gender, race/ethnicity, HIV transmission risk and cohort. From 1997-2007, the proportion of individuals presenting for HIV care who were ≥50-years-old increased from 17% to 27% (p-value < 0.01). The median CD4 count among ≥50 year-olds was consistently lower than younger adults. The interaction of age group and calendar year was significant (p-value <0.01) with both age groups experiencing modest annual improvements over time (< 50-year-olds: 5 [4 , 6] cells/mm3; ≥50-year-olds: 7 [5 , 9] cells/mm3), after adjusting for sex, race/ethnicity, HIV transmission risk group and cohort; however, increases in the two groups were similar after 2000. A greater proportion of older individuals had an AIDS-defining diagnosis at, or within three months prior to, first presentation for HIV care compared to younger individuals (13% vs. 10%, respectively). Due to the increasing proportion, consistently lower CD4 counts, and more advanced HIV disease in adults ≥50-year-old at first presentation for HIV care, renewed HIV testing efforts are needed

High-resolution record reveals climate-driven environmental and sedimentary changes in an active rift

Young rifts are shaped by combined tectonic and surface processes and climate, yet few records exist to evaluate the interplay of these processes over an extended period of early rift-basin development. Here, we present the longest and highest resolution record of sediment flux and paleoenvironmental changes when a young rift connects to the global oceans. New results from International Ocean Discovery Program (IODP) Expedition 381 in the Corinth Rift show 10s–100s of kyr cyclic variations in basin paleoenvironment as eustatic sea level fluctuated with respect to sills bounding this semi-isolated basin, and reveal substantial corresponding changes in the volume and character of sediment delivered into the rift. During interglacials, when the basin was marine, sedimentation rates were lower (excepting the Holocene), and bioturbation and organic carbon concentration higher. During glacials, the basin was isolated from the ocean, and sedimentation rates were higher (~2–7 times those in interglacials). We infer that reduced vegetation cover during glacials drove higher sediment flux from the rift flanks. These orbital-timescale changes in rate and type of basin infill will likely influence early rift sedimentary and faulting processes, potentially including syn-rift stratigraphy, sediment burial rates, and organic carbon flux and preservation on deep continental margins worldwide