Modeling the Impact of RFID Technology on the Healthcare Supply Chain

Due to increasing competition in the healthcare industry, healthcare providers must find ways to reduce their costs of operation or potentially lose customers to more affordable options. For many years, the healthcare supply chain has significantly lagged behind the retail supply chain in terms of supply chain efficiency. Certain disruptive technologies that have become widespread in the retail supply chain have yet to be integrated by a significant number of healthcare providers, and as a result, there are large opportunities for improvements in the healthcare supply chain that could lead to both cost and time savings. Radio Frequency Identification (RFID) technology is a disruptive technology in the retail supply chain that utilizes readers to automatically identify and track tags attached to objects. This paper leverages modeling and simulation techniques to explore the impact that RFID technology could have on the healthcare supply chain. Keywords Healthcare Supply Chain, Retail Supply Chain, Disruptive Technology, RFID Technology, Simulation, Modelin

Intraspecific variability modulates interspecific variability in animal organismal stoichiometry.

Interspecific differences in organismal stoichiometry (OS) have been documented in a wide range of animal taxa and are of significant interest for understanding evolutionary patterns in OS. In contrast, intraspecific variation in animal OS has generally been treated as analytical noise or random variation, even though available data suggest intraspecific variability in OS is widespread. Here, we assess how intraspecific variation in OS affects inferences about interspecific OS differences using two co-occurring Neotropical fishes: Poecilia reticulata and Rivulus hartii. A wide range of OS has been observed within both species and has been attributed to environmental differences among stream systems. We assess the contributions of species identity, stream system, and the interactions between stream and species to variability in N:P, C:P, and C:N. Because predation pressure can impact the foraging ecology and life-history traits of fishes, we compare predictors of OS between communities that include predators, and communities where predators are absent. We find that species identity is the strongest predictor of N:P, while stream or the interaction of stream and species contribute more to the overall variation in C:P and C:N. Interspecific differences in N:P, C:P, and C:N are therefore not consistent among streams. The relative contribution of stream or species to OS qualitatively changes between the two predation communities, but these differences do not have appreciable effects in interspecific patterns. We conclude that although species identity is a significant predictor of OS, intraspecific OS is sometimes sufficient to overwhelm or obfuscate interspecific differences in OS

Phase-Dependent Properties of Extrasolar Planet Atmospheres

Recently the Spitzer Space Telescope observed the transiting extrasolar planets, TrES-1 and HD209458b. These observations have provided the first estimates of the day side thermal flux from two extrasolar planets orbiting Sun-like stars. In this paper, synthetic spectra from atmospheric models are compared to these observations. The day-night temperature difference is explored and phase-dependent flux densities are predicted for both planets. For HD209458b and TrES-1, models with significant day-to-night energy redistribution are required to reproduce the observations. However, the observational error bars are large and a range of models remains viable.Comment: 8 pages, 7 figures, accepted for publication in the Astrophysical Journa

Perspectives of Dermatology Program Directors on the Impact of Step 1 Pass/Fail.

INTRODUCTION: The shift of Step 1 to Pass/Fail has generated several questions and concerns about obtaining residency positions among allopathic and osteopathic students alike. Determining the perspectives of Dermatology Program Directors in regards to post-Step 1 Pass/Fail is critical for students to better prepare for matching into dermatology. METHODS: After receiving Institutional Review Board (IRB) exemption status, the program directors were chosen from 144 Accreditation Council for Graduate Medical Education (ACGME) and 27 American Osteopathic Association (AOA) Dermatology programs using contact information from their respective online website databases. An eight-item survey was constructed on a three-point Likert scale, one free text response, and four demographic questions. The anonymous survey was sent out over the course of three weeks with weekly individualized reminder requests for participation. RESULTS: A total of 54.54% of responders had Letters of Recommendation in their top 3. Forty-five percent of responders had Completed Audition Rotation at Program in their top 3. And, 38.09% of responders had USMLE Step 2 CK Scores in their top 3. CONCLUSION: Approximately 50% of responders agreed that all medical students will have more difficulty matching dermatology. Based on the survey study, Dermatology program directors want to focus more on letters of recommendation, audition rotations, and Step 2 CK scores. Because each field seems to prioritize different aspects of an application, students should attempt to gain as much exposure to different fields such as through research and shadowing to narrow down their ideal specialties. Consequently, the student will have more time to tailor their applications to what residency admissions are looking for

Myiasis-induced sepsis: a rare case report of: Wohlfahrtiimonas chitiniclastica: and: Ignatzschineria indica: bacteremia in the continental United States

Rationale: The presentation of sepsis and bacteremia in cutaneous and cavitary myiasis is uncommon. We present a patient, residing in a temperate region of the United States, with myiasis and sepsis from the emerging human pathogens Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica. Patient concerns: A 37-year-old male patient with an 8-month history of chronic lymphedema and ulcers of the lower left extremity presented with myiasis of the left foot and leg. The patient was initially seen by his family practitioner many times and was prescribed antibiotics which he could not afford. Debridement of the myiasis was not conducted by the family practitioner due to the belief that the patient's current state of myiasis would effectively debride and eventually heal the chronic ulcers along with multiple antibiotic regimens. Over the 8-month period, the patient developed a progressive, painful, necrotizing infection of his lower left extremity. Diagnoses: Physical examination clearly showed myiasis of the patient's lower left extremity, believed to be caused by Lucilia sericata (green bottle fly). Blood cultures revealed the presence of Providencia stuartii, W chitiniclastica, and I indica to be the underlying cause of sepsis and bacteremia. Interventions: All visible maggots were extracted, debridement of devitalized tissue was performed, and the leg ulcers were wrapped in pH neutral bleach. The patient was initially treated with a broad-spectrum antibiotic regimen of vancomycin, clindamycin, piperacillin, and tazobactam which, following clinical improvement, was de-escalated to cefepime. Outcomes: The fly larvae and maggots were removed from the extremity by scrubbing, pulse lavage, and filing away the callused tissue. Additionally, the patient's sepsis and bacteremia, caused by W chitiniclastica and I indica, were successfully treated through antibiotic intervention. Amputation was avoided. Lessons: The use of pulse lavage and chlorhexidine-soaked brushes for the removal of cavitary myiasis is an effective and minimally invasive procedure which does not cause additional damage to surrounding tissue. W chitiniclastica and I indica are emerging bacteria that have known association to parasitic fly myiasis in humans and are capable of causing sepsis and/or bacteremia if not accurately identified and treated promptly

Stand-off Molecular Composition Analysis

Composition of distant stars can be explored by observing absorption spectra. Stars produce nearly blackbody radiation that passes through the cloud of vaporized material surrounding the star. Characteristic absorption lines are discernible with a spectrometer, and atomic composition is investigated by comparing spectral observations with known material profiles. Most objects in the solar system—asteroids, comets, planets, moons—are too cold to be interrogated in this manner. Material clouds around cold objects consist primarily of volatiles, so bulk composition cannot be probed. Additionally, low volatile density does not produce discernible absorption lines in the faint signal generated by cold objects. We propose a system for probing the molecular composition of cold solar system targets from a distant vantage. The concept utilizes a directed energy beam to melt and vaporize a spot on a distant target, such as from a spacecraft orbiting the object. With sufficient flux (~10 MW/m2) on a rocky asteroid, the spot temperature rises rapidly to ~2500 K, and evaporation of all materials on the surface occurs. The melted spot creates a high-temperature blackbody source, and ejected material creates a molecular plume in front of the spot. Bulk composition is investigated by using a spectrometer to view the heated spot through the ejected material. Spatial composition maps could be created by scanning the surface. Applying the beam to a single spot continuously produces a borehole, and shallow sub-surface composition profiling is possible. Initial simulations of absorption profiles with laser heating show great promise for molecular composition analysis

Financing essential HIV services: a new economic agenda.

Anna Vassall and colleagues discuss the need for, and challenges facing, innovative and sustainable financing of the HIV response. Please see later in the article for the Editors' Summary

A fast high-precision six-degree-of-freedom relative position sensor

Lasers are commonly used in high-precision measurement and profiling systems. Some laser measurement systems are based on interferometry principles, and others are based on active triangulation, depending on requirements of the application. This paper describes an active triangulation laser measurement system for a specific application wherein the relative position of two fixed, rigid mechanical components is to be measured dynamically with high precision in six degrees of freedom (DOF). Potential applications include optical systems with feedback to control for mechanical vibration, such as target acquisition devices with multiple focal planes. The method uses an array of several laser emitters mounted on one component. The lasers are directed at a reflective surface on the second component. The reflective surface consists of a piecewise-planar pattern such as a pyramid, or more generally a curved reflective surface such as a hyperbolic paraboloid. The reflected spots are sensed at 2-dimensional photodiode arrays on the emitter component. Changes in the relative position of the emitter component and reflective surface will shift the location of the reflected spots within photodiode arrays. Relative motion in any degree of freedom produces independent shifts in the reflected spot locations, allowing full six-DOF relative position determination between the two component positions. Response time of the sensor is limited by the read-out rate of the photodiode arrays. Algorithms are given for position determination with limits on uncertainty and sensitivity, based on laser and spot-sensor characteristics, and assuming regular surfaces. Additional uncertainty analysis is achievable for surface irregularities based on calibration data

Surfactant protein D increases fusion of Mycobacterium tuberculosis- containing phagosomes with lysosomes in human macrophages

Lung surfactant protein D (SP-D) binds to Mycobacterium tuberculosis surface lipoarabinomannan and results in bacterial agglutination, reduced uptake, and inhibition of growth in human macrophages. Here we show that SP-D limits the intracellular growth of bacilli in macrophages by increasing phagosome-lysosome fusion but not by generating a respiratory burst

Simulations of Directed Energy Thrust on Rotating Asteroids

Asteroids that threaten Earth could be deflected from their orbits using directed energy to vaporize the surface, as the ejected plume creates a reaction thrust that alters the asteroid’s trajectory. In this situation, a critical issue is the rotation of the asteroid relative to the directed energy beam, as this will reduce the average thrust magnitude and modify the thrust direction. Flux levels required to evaporate surface material depend on the surface material composition, rotation rate, albedo, and thermal and bulk mechanical properties of the asteroid. The observed distribution of asteroid rotation rates is used, along with an estimated range of material and mechanical properties, as input to a 4D thermalphysical model to calculate the resultant thrust vector. The model uses a directed energy beam, striking the surface of a rotating sphere with specified material properties, beam profile, and rotation rate. The model calculates thermal changes in the sphere, including vaporization and mass ejection of the target material. The amount of vaporization integrated over the target is used to determine the thrust magnitude and the phase shift relative to the non-rotating case. As the object rotates beneath the beam, the energy spreads out, decreasing temperature and vaporization causing both a phase shift and magnitude decrease in the average thrust vector. This produces a 4D analytical model of the expected thrust profile for rotating objects