Delta nitrogen tetroxide fueling operations

The development of the Delta second stage nitrogen tetroxide fueling system is briefly summarized. The nitrogen tetroxide fueling system and the equipment used to protect the spacecraft environment from the toxic nitrogen tetroxide fumes are described. Topics covered include: the nitrogen tetroxide transfer system; loading operations; safety precautions; and chemical treatment of all toxic vapors

Information Optimization in Coupled Audio-Visual Cortical Maps

Barn owls hunt in the dark by using cues from both sight and sound to locate their prey. This task is facilitated by topographic maps of the external space formed by neurons (e.g., in the optic tectum) that respond to visual or aural signals from a specific direction. Plasticity of these maps has been studied in owls forced to wear prismatic spectacles that shift their visual field. Adaptive behavior in young owls is accompanied by a compensating shift in the response of (mapped) neurons to auditory signals. We model the receptive fields of such neurons by linear filters that sample correlated audio-visual signals, and search for filters that maximize the gathered information, while subject to the costs of rewiring neurons. Assuming a higher fidelity of visual information, we find that the corresponding receptive fields are robust and unchanged by artificial shifts. The shape of the aural receptive field, however, is controlled by correlations between sight and sound. In response to prismatic glasses, the aural receptive fields shift in the compensating direction, although their shape is modified due to the costs of rewiring.Comment: 7 pages, 1 figur

Validity and reliability of the Structured Clinical Interview for Depersonalization-Derealization Spectrum (SCI-DER).

This study evaluates the validity and reliability of a new instrument developed to assess symptoms of depresonalization: the Structured Clinical Interview for the Depersonalization-Derealization Spectrum (SCI-DER). The instrument is based on a spectrum model that emphasizes soft-signs, sub-threshold syndromes as well as clinical and subsyndromal manifestations. Items of the interview include, in addition to DSM-IV criteria for depersonalization, a number of features derived from clinical experience and from a review of phenomenological descriptions. Study participants included 258 consecutive patients with mood and anxiety disorders, 16.7% bipolar I disorder, 18.6% bipolar II disorder, 32.9% major depression, 22.1% panic disorder, 4.7% obsessive compulsive disorder, and 1.5% generalized anxiety disorder; 2.7% patients were also diagnosed with depersonalization disorder. A comparison group of 42 unselected controls was enrolled at the same site. The SCI-DER showed excellent reliability and good concurrent validity with the Dissociative Experiences Scale. It significantly discriminated subjects with any diagnosis of mood and anxiety disorders from controls and subjects with depersonalization disorder from controls. The hypothesized structure of the instrument was confirmed empirically

Blockchain for the Healthcare Supply Chain: A Systematic Literature Review

A supply chain (SC) is a network of interests, information, and materials involved in processes that produce value for customers. The implementation of blockchain technology in SC management in healthcare has had results. This review aims to summarize how blockchain technology has been used to address SC challenges in healthcare, specifically for drugs, medical devices (DMDs), and blood, organs, and tissues (BOTs). A systematic review was conducted by following the PRISMA guidelines and searching the PubMed and Proquest databases. English-language studies were included, while non-primary studies, as well as surveys, were excluded. After full-text assessment, 28 articles met the criteria for inclusion. Of these, 15 (54%) were classified as simulation studies, 12 (43%) were classified as theoretical, and only one was classified as a real case study. Most of the articles (n = 23, 82%) included the adoption of smart contracts. The findings of this systematic review indicated a significant but immature interest in the topic, with diverse ideas and methodologies, but without effective real-life applications

Male factor infertility and assisted reproductive technologies. indications, minimum access criteria and outcomes

BackgroundInfertility, which is defined as the inability to conceive after at least 12 months of regular unprotected sexual intercourses, affects about 15-20% of couples worldwide and a male factor is involved in about half of the cases. The development of assisted reproductive technology (ART) made it possible to conceive also to individuals affected from severe oligospermia or azoospermia. However, the impact of the male factor on embryo development, implantation, prevalence of chromosomal abnormalities, genetic and epigenetic alterations, and clinical and obstetric outcomes is still controversial.PurposeThis narrative review examines the indications, minimum access criteria, and outcomes by individual ART technique in relation to the male factor

Patient-reported outcome measures (PROMs) after elective hip, knee and shoulder arthroplasty: Protocol for a prospective cohort study

Background The number of hip, knee and shoulder arthroplasties continues to rise worldwide. The Organization for Economic Cooperation and Development has launched an initiative (called PaRIS Initiative) for the systematic collection of Patient Reported Outcome Measures (PROMs) in patients undergoing elective hip and knee arthroplasty. The Rizzoli Orthopedic Institute (IOR) was selected as a pilot center for the launch of the Initiative in Italy given that IOR hosts the Registry of Orthopedic Prosthetic Implants (RIPO), a region-wide registry which collects joint implant data from all the hospitals in the Emilia-Romagna Region. In this specific geographic area information related to PROMs after joint replacement is unknown. This paper describes the protocol of a study (PaRIS-IOR) that aims to implement the collection of a set of PROMs within an existing implant registry in Italy. The study will also investigate the temporal trend of PROMs in relation to the type of prosthesis and the type of surgical intervention. Methods The PaRIS-IOR study is a prospective, single site, cohort study that consists of the administration of PROMs questionnaires to patients on the list for elective arthroplasty. The questionnaires will be administered to the study population within 30 days before surgery, and then at 6 and 12 months following surgery. The study population will consist of consecutive adult patients undergoing either hip, knee or shoulder arthroplasty. The collected data will be linked with those routinely collected by the RIPO in order to assess the temporal trend of PROMs in relation to the type of prosthesis and the type of surgical intervention. Discussion The PaRIS-IOR study could have important implications in targeting the factors influencing functional outcomes and quality of life reported by patients after hip, knee and shoulder arthroplasty, and will also represent the first systematic collection of PROMs related to arthroplasty in Italy

Risk adjustment for inter-hospital comparison of caesarean delivery rates in low-risk deliveries

BACKGROUND: Caesarean delivery (CD) rates have been frequently used as quality measures for maternity service comparisons. More recently, primary CD rates (CD in women without previous CD) or CD rates within selected categories such as nulliparous, term, cephalic singleton deliveries (NTCS) have been used. The objective of this study is to determine the extent to which risk adjustment for clinical and socio-demographic variables is needed for inter-hospital comparisons of CD rates in women without previous CD and in NTCS deliveries. METHODS: Hospital discharge records of women who delivered in Emilia-Romagna Region (Italy) from January, 2007 to June 2009 and in Tuscany Region for year 2009 were linked with birth certificates. Adjusted RRs of CD in women without a previous Caesarean and NTCS were estimated using Poisson regression. Percentage differences in RR before and after adjustment were calculated and hospital rankings, based on crude and adjusted RRs, were examined. RESULTS: Adjusted RR differed substantially from crude RR in women without a previous Caesarean and only marginally in NTCS group. Hospital ranking was markedly affected by adjustment in women without a previous CD, but less in NTCS. CONCLUSION: Risk adjustment is warranted for inter-hospital comparisons of primary CD rates but not for NTCS CD rates. Crude NTCS CD rates are a reliable estimate of adjusted NTCS CD

Measuring costs of community mental health care in Italy: A prevalence-based study

AbstractBackground:Information on individual mental healthcare costs and utilization patterns in Italy is scant. We analysed the use and the annual costs of community mental health services (MHS) in an Italian local health authority (LHA). Our aims are to compare the characteristics of patients in the top decile of costs with those of the remaining 90%, and to investigate the demographic and clinical determinants of costs.Methods:This retrospective study is based on administrative data of adult patients with at least one contact with MHS in 2013. Costs of services were estimated using a microcosting method. We defined as high cost (HC) those patients whose community mental health services costs place them in the top decile of the cost distribution. The predictors of costs were investigated using multiple linear regression.Results:The overall costs borne for 7601 patients were 17 million €, with HC accounting for 87% of costs and 73% of services. Compared with the rest of the patients, HC were younger, more likely to be male, to have a diagnosis of psychosis, and longer and more intensive MHS utilization. In multiple linear regression, younger age, longer duration of contact with MHS, psychosis, bipolar disorder, personality disorder, depression, dementia and Italian citizenship accounted for 20.7% of cost variance.Conclusion:Direct mental health costs are concentrated among a small fraction of patients who receive intensive socio-rehabilitation in community services. One limitation includes the unavailability of hospital costs. Our methodology is replicable and useful for national and cross-national benchmarking

TRIM5α associates with proteasomal subunits in cells while in complex with HIV-1 virions

<p>Abstract</p> <p>Background</p> <p>The TRIM5 proteins are cellular restriction factors that prevent retroviral infection in a species-specific manner. Multiple experiments indicate that restriction activity requires accessory host factors, including E2-enzymes. To better understand the mechanism of restriction, we conducted yeast-two hybrid screens to identify proteins that bind to two TRIM5 orthologues.</p> <p>Results</p> <p>The only cDNAs that scored on repeat testing with both TRIM5 orthologues were the proteasome subunit PSMC2 and ubiquitin. Using co-immunoprecipitation assays, we demonstrated an interaction between TRIM5α and PSMC2, as well as numerous other proteasome subunits. Fluorescence microscopy revealed co-localization of proteasomes and TRIM5α cytoplasmic bodies. Forster resonance energy transfer (FRET) analysis indicated that the interaction between TRIM5 and PSMC2 was direct. Previous imaging experiments demonstrated that, when cells are challenged with fluorescently-labeled HIV-1 virions, restrictive TRIM5α orthologues assemble cytoplasmic bodies around incoming virion particles. Following virus challenge, we observed localization of proteasome subunits to rhTRIM5α cytoplasmic bodies that contained fluorescently labeled HIV-1 virions.</p> <p>Conclusions</p> <p>Taken together, the results presented here suggest that localization of the proteasome to TRIM5α cytoplasmic bodies makes an important contribution to TRIM5α-mediated restriction.</p