Balloon tank skin strain measurements at liquid-hydrogen temperature on centaur flight vehicle

Balloon tank skin strain measurements at liquid hydrogen temperature on Centaur flight vehicl

Air conditioning, comfort and energy in india's commercial building sector

Before India's building sector can fulfil its CO2 abatement potential, it is imperative for new build projects, especially those which provide for commercial and public functions, to eschew the energy-intensive designs that characterized western commercial buildings of the 20th century. In the absence of an adaptive thermal comfort standard specifically for India's climatic and cultural context, the current trend is simply to design airconditioned buildings to meet the stringent ASHRAE and ISO "Class A" comfort specifications. This paper proposes a holistic Post Occupancy Evaluation (POE) study of a cross section of Indian office buildings purposively stratified across a range of energy intensities with diverse environmental control systems and design approach in different climatic zones to develop an adaptive thermal comfort standard. By climatically adapting indoor design temperatures, the standard will offer India a low-carbon development pathway for its commercial building sector without compromising overall comfort or productivity

Evaluation of Ovarian Lesions Inducing Endometrial Hyperplasia or Carcinoma in a Tertiary Care Hospital in Southern India

Background: Excessive and prolonged estrogenic stimulation results in endometrial hyperplasias or endometrioid adenocarcinomas. One of the major reasons for an excess endogenous estrogen production is estrogen secreting ovarian lesions which could either be neoplastic or non-neoplastic.Aims: This was a study done to evaluate and correlate presence of ovarian lesions in uterus harboring endometrial hyperplasia or endometrial carcinoma.Materials and Methods: This was a retrospective study conducted at a referral hospital in South India over a 16-year period. Histology of ovaries were studied in panhysterectomy cases with a tissue diagnosis of endometrial hyperplasia or endometrial carcinoma. The data was evaluated as only percentage. Results: A total of 118 specimens revealed pathological proliferative lesion of the endometrium with endometrial hyperplasias occurring in 78 (66.1%) and endometrioid adenocarcinoma in the remaining 40 (33.9%) cases. Fifty-two cases showed lesions in ovary/ovaries. Forty-two (35.6%) of them revealed estrogen-secreting lesions in ovaries. The rest showed non-estrogen producing lesions. Follicular cyst was the predominant estrogen elaborating lesions in the ovary with 23 cases (44.2%). In 21.1% of cases, ovaries featured stromal hyperplasia and 7.7% showed granulosa cell tumor. Only one (1.9%) case of thecoma was identifi ed. Two cases showed twin lesions with follicular cyst and stromal hyperplasia. All patients except for one were in post-menopausal age group.Conclusion: Follicular cyst was the predominant lesion associated with endometrial hyperplasia and endometrioid adenocarcinoma of endometrium in post-menopausal age group. In addition, hyperplastic lesions in endometrium can occur in non-hormonal secreting ovarian epithelial tumors possibly due to functioning stromal cells. Keywords: Carcinoma, endometrium, estrogen, hyperplasia, ovar

A Tree-Ring-Based Reconstruction of Delaware River Basin Streamflow Using Hierarchical Bayesian Regression

A hierarchical Bayesian regression model is presented for reconstructing the average summer streamflow at five gauges in the Delaware River basin using eight regional tree-ring chronologies. The model provides estimates of the posterior probability distribution of each reconstructed streamflow series considering parameter uncertainty. The vectors of regression coefficients are modeled as draws from a common multivariate normal distribution with unknown parameters estimated as part of the analysis. This leads to a multilevel structure. The covariance structure of the streamflow residuals across sites is explicitly modeled. The resulting partial pooling of information across multiple stations leads to a reduction in parameter uncertainty. The effect of no pooling and full pooling of station information, as end points of the method, is explored. The no-pooling model considers independent estimation of the regression coefficients for each streamflow gauge with respect to each tree-ring chronology. The full-pooling model considers that the same regression coefficients apply across all streamflow sites for a particular tree-ring chronology. The cross-site correlation of residuals is modeled in all cases. Performance on metrics typically used by tree-ring reconstruction experts, such as reduction of error, coefficient of efficiency, and coverage rates under credible intervals is comparable to, or better, for the partial-pooling model relative to the no-pooling model, and streamflow estimation uncertainty is reduced. Long record simulations from reconstructions are used to develop estimates of the probability of duration and severity of droughts in the region. Analysis of monotonic trends in the reconstructed drought events do not reject the null hypothesis of no trend at the 90% significance over 1754–2000

Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip

Background: Labral reconstruction has been advocated as an alternative to debridement for the treatment of irreparable labral tears, showing favorable short-term results. However, literature is scarce regarding outcomes and return to sport in the nonelite athletic population. Purpose: To report minimum 1-year clinical outcomes and the rate of return to sport in athletic patients who underwent primary hip arthroscopy with labral reconstruction in the setting of femoroacetabular impingement syndrome and irreparable labral tears. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected and retrospectively analyzed for patients who underwent an arthroscopic labral reconstruction between August 2012 and December 2017. Patients were included if they identified as an athlete (high school, college, recreational, or amateur); had follow-up on the following patient-reported outcomes (PROs): modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS); and completed a return-to-sport survey at 1 year postoperatively. Patients were excluded if they underwent any previous ipsilateral hip surgery, had dysplasia, or had prior hip conditions. The proportions of patients who achieved the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for mHHS and HOS-SSS were calculated. Statistical significance was set at P =.05. Results: There were 32 (14 females) athletes who underwent primary arthroscopic labral reconstruction during the study period. The mean age and body mass index of the group were 40.3 years (range, 15.5-58.7 years) and 27.9 kg/m2 (range, 19.6-40.1 kg/m2), respectively. The mean follow-up was 26.4 months (range, 12-64.2 months). All patients demonstrated significant improvement in mHHS, NAHS, HOS-SSS, and VAS (P \u3c.001) at latest follow-up. Additionally, 84.4% achieved MCID and 81.3% achieved PASS for mHHS, and 87.5% achieved MCID and 75% achieved PASS for HOS-SSS. VAS pain scores decreased from 4.4 to 1.8, and the satisfaction with surgery was 7.9 out of 10. The rate of return to sport was 78%. Conclusion: At minimum 1-year follow-up, primary arthroscopic labral reconstruction, in the setting of femoroacetabular impingement syndrome and irreparable labral tears, was associated with significant improvement in PROs in athletic populations. Return to sport within 1 year of surgery was 78%

Is an Epic Pluvial Masking the Water Insecurity of the Greater New York City Region?

Six water emergencies have occurred since 1981 for the New York City (NYC) region despite the following: 1) its perhumid climate, 2) substantial conservation of water since 1979, and 3) meteorological data showing little severe or extreme drought since 1970. This study reconstructs 472 years of moisture availability for the NYC watershed to place these emergencies in long-term hydroclimatic context. Using nested reconstruction techniques, 32 tree-ring chronologies comprised of 12 species account for up to 66.2% of the average May–August Palmer drought severity index. Verification statistics indicate good statistical skill from 1531 to 2003. The use of multiple tree species, including rarely used species that can sometimes occur on mesic sites like Liriodendron tulipifera, Betula lenta, and Carya spp., seems to aid reconstruction skill. Importantly, the reconstruction captures pluvial events in the instrumental record nearly as well as drought events and is significantly correlated to precipitation over much of the northeastern United States. While the mid-1960s drought is a severe drought in the context of the new reconstruction, the region experienced repeated droughts of similar intensity, but greater duration during the sixteenth and seventeenth centuries. The full record reveals a trend toward more pluvial conditions since ca. 1800 that is accentuated by an unprecedented 43-yr pluvial event that continues through 2011. In the context of the current pluvial, decreasing water usage, but increasing extra-urban pressures, it appears that the water supply system for the greater NYC region could be severely stressed if the current water boom shifts toward hydroclimatic regimes like the sixteenth and seventeenth centuries

Ideas to Action: Using Curriculum Design to Develop a “Roadmap to Wellness” Curriculum

Introduction: Physician burnout, well-being, and professional fulfillment are deeply intertwined topics that are increasingly recognized as affecting the lives of physicians, health care workers, and patients alike. The Accreditation Council for Graduate Medical Education (ACGME) mandates that all residencies address wellness within the context of residency training without providing much guidance on how to do so. Emergency Medicine organizations such as the American College of Emergency Physicians, the American Academy of Emergency Physicians, the Society for Academic Emergency Medicine, and the Council of Residency Directors of Emergency Medicine (CORD) suggest that one method to address wellness is in the form of a curriculum. Successfully developing or modifying a curriculum to work for individual residency programs can be a difficult task. Methods: The CORD Resilience Committee Wellness Curriculum Subcommittee comprised of experts in physician wellness and medical education started by conducted literature searches on terms related to burnout and wellness and searching the internet for documented wellness curricula, models and resources. Using this information and a standard curriculum development process, they created a roadmap for developing (or modifying), initiating, and evaluating a wellness curriculum. Conclusion: Wellness curricula are not a one-size-fits-all situation. Using the checklist and guidelines in this white paper, readers can individualize existing wellness curricula to help foster physician well-being