Development of a Collaborative Design Tool for Structural Analysis in an Immersive Virtual Environment

This paper contains the results of an on-going collaborative research effort by the departments of Architecture and Computer Science of Virginia Polytechnic Institute and State University, U.S.A., to develop a computer visualization application for the structural analysis of building structures. The VIRTUAL-SAP computer program is being developed by linking PC-SAP4 (Structural Analysis Program), and virtual environment software developed using the SVE (Simple Virtual Environment) library. VIRTUAL-SAP is intended for use as a collaborative design tool to facilitate the interaction between the architect, engineer, and contractor by providing an environment that they can walk-through and observe the consequences of design alterations. Therefore, this software can be used as an interactive computer-aided analysis of building systems

Acceleration feedback control of human-induced floor vibrations

Active vibration control (AVC) via a proof-mass actuator is considered to be a suitable technique for the mitigation of vibrations caused by human motions in floor structures. It has been observed that actuator dynamics strongly influence structure dynamics despite considering collocated actuator/sensor control. The well-known property of the interlacing of poles and zeros of a collocated control system is no longer accomplished. Therefore, velocity-based feedback control, which has been previously used by other researchers, might not be a good solution. This work presents a design process for a control scheme based on acceleration feedback control with a phase-lag compensator, which will generally be different from an integrator circuit. This first-order compensator is applied to the output (acceleration) in such a way that the relative stability and potential damping to be introduced are significantly increased accounting for the interaction between floor and actuator dynamics. Additionally, a high-pass filter designed to avoid stroke saturation is applied to the control signal. The AVC system designed according to this procedure has been assessed in simulation and successfully implemented in an in-service open-plan office floor. The actual vibration reductions achieved have been approximately 60% for walking tests and over 90% for a whole-day vibration monitoring. (C) 2009 Elsevier Ltd. All rights reserved

In vitro Cortical Network Firing is Homeostatically Regulated: A Model for Sleep Regulation.

Prolonged wakefulness leads to a homeostatic response manifested in increased amplitude and number of electroencephalogram (EEG) slow waves during recovery sleep. Cortical networks show a slow oscillation when the excitatory inputs are reduced (during slow wave sleep, anesthesia), or absent (in vitro preparations). It was recently shown that a homeostatic response to electrical stimulation can be induced in cortical cultures. Here we used cortical cultures grown on microelectrode arrays and stimulated them with a cocktail of waking neuromodulators. We found that recovery from stimulation resulted in a dose-dependent homeostatic response. Specifically, the inter-burst intervals decreased, the burst duration increased, the network showed higher cross-correlation and strong phasic synchronized burst activity. Spectral power below <1.75 Hz significantly increased and the increase was related to steeper slopes of bursts. Computer simulation suggested that a small number of clustered neurons could potently drive the behavior of the network both at baseline and during recovery. Thus, this in vitro model appears valuable for dissecting network mechanisms of sleep homeostasis

Infant Serum and Maternal Milk Vitamin B-12 Are Positively Correlated in Kenyan Infant-Mother Dyads at 1-6 Months Postpartum, Irrespective of Infant Feeding Practice.

BackgroundVitamin B-12 is an essential nutrient required for many functions including DNA synthesis, erythropoiesis, and brain development. If maternal milk vitamin B-12 concentrations are low, infants may face elevated risks of deficiency when exclusively breastfed.ObjectiveWe evaluated cross-sectional associations between infant serum vitamin B-12 concentrations and maternal milk vitamin B-12 concentrations at 1-6 mo postpartum among an unsupplemented population in rural western Kenya, and assessed biological demographic, and dietary characteristics associated with adequate infant serum vitamin B-12.MethodsWe modeled 1) infant serum vitamin B-12 using maternal milk vitamin B-12 concentration with linear regression; and 2) adequate (>220 pmol/L) infant serum vitamin B-12 using hypothesized biological, demographic, and dietary predictors with logistic regression. In both models, we used generalized estimating equations to account for correlated observations at the cluster-level.ResultsThe median (quartile 1, quartile 3) infant serum vitamin B-12 concentration was 276 pmol/L (193, 399 pmol/L) and approximately one-third of infants had serum vitamin B-12 ≤220 pmol/L, indicating that they were vitamin B-12 depleted or deficient. There was a positive correlation between maternal milk and infant serum vitamin B-12 (r = 0.36, P < 0.001) and in multivariable analyses, maternal milk vitamin B-12 concentration was significantly associated with infant serum vitamin B-12 adequacy (P-trend = 0.03).ConclusionsDespite a high prevalence (90%) of maternal milk vitamin B-12 concentrations below the level used to establish the Adequate Intake (<310 pmol/L), there was a low prevalence of infant vitamin B-12 deficiency. We found few factors that were associated with infant vitamin B-12 adequacy in this population, including infant feeding practices, although maternal vitamin B-12 status was not measured. The contribution of maternal milk to infant vitamin B-12 status remains important to quantify across populations, given that maternal milk vitamin B-12 concentration is modifiable with supplementation. This trial was registered at clinicaltrials.gov as NCT01704105

Demographic Factors, Duration and Costs of Hospitalization, and Causes of Death in Patients Intoxicated with Opioids and Amphetamines

Background: Intoxications are medical emergencies and among the significant causes of morbidity and mortality worldwide. In recent years, prevalence of intoxication with opioids and stimulants, such as amphetamines, is increasing particularly among young people. In this study, we investigated demographic factors, duration of hospitalization, costs of hospitalization, and cause of death in patients intoxicated with amphetamines and opioids.Materials and Methods: This study was a prospective descriptive–analytic study. Sampling method was census, and Subjects were patients intoxicated with amphetamines and opioids, alone or combined, who referred to toxicology ward of Ali-Asghar hospital in Isfahan, from October 2009 to April 2010.Results: During 6 months, among 2325 subjects, 419 patients used opioids, 98 patients used amphetamines, and 25 patients used both of them. The mean age of patients in the three groups was not significantly different. Most patients were male in all groups. The most common route of intoxication was orally in opioid group and inhalation in amphetamine group. The most common cause of intoxication was intentional attempt. Vital signs at admission were normal in three groups, but the average of heart rate, body temperature, respiratory rate and blood pressure, was slightly higher in the amphetamine group than the opioid group. Duration and cost of hospitalization were not significantly different between groups. Four patients were died totally and the outcome was not significantly different between groups. The mean age and duration of hospitalization were significantly higher in died compared to living patients.Conclusion: Opioids and amphetamines accounted for high percentages of intoxication, especially in young single men with self-employed job. Therefore, control and prevention of opioids and amphetamines consumption are important ways to reduce this kind of intoxication in this group

Telemedicine in the Emergency Department in the Era of COVID-19: Front-Line Experiences from 2 Institutions

During the COVID-19 pandemic, one of the major changes that has occurred in emergency medicine is the evolution of telemedicine. With relaxation of regulatory and administrative barriers, the use of this already available technology has rapidly expanded. Telemedicine provides opportunity to markedly decrease personal protective equipment (PPE) and reduce healthcare worker exposures. Moreover, with the convenience and availability of access to medical care via telemedicine, a more fundamental change in healthcare delivery in the United States is likely. The implementation of telemedicine in the emergency department (ED) in particular has great potential to prevent the iatrogenic spread of COVID-19 and protect health care workers. Challenges to widespread adoption of telemedicine include privacy concerns, limitation of physical examination, and concerns of patient experience. In this clinical review, we discuss ED telemedicine applications, logistics, and challenges in the COVID-19 era as well as recent regulatory and legal changes. In addition, examples of telemedicine use are described from 2 institutions. Examples of future applications of telemedicine within the realm of emergency medicine are also discussed

Diabetes mellitus type 2 is associated with increased tumor expression of programmed death-ligand 1 (PD-L1) in surgically resected non-small cell lung cancer - A matched case-control study

OBJECTIVES: Programmed death-ligand 1 (PD-L1) expression is a biomarker for cancer immunotherapy. Diabetes mellitus type-2 is a comorbid disease associated with adverse outcomes in Non-Small Cell Lung Cancer (NSCLC). We aimed to investigate the differences in PD-L1 expression in diabetics. METHODS: A matched case-control cohort of surgically-resected NSCLC was assembled from an early multicenter study (PMID: 19152440). PD-L1 immunohistochemistry (Clone 22C3) was graded by a tumor positive score (TPS) system (TPS0: no staining; TPS1: \u3c 1%; TPS2: 1-49%; TPS3: \u3e /=50%). Variables showing significance at univariate survival analysis were fit in a Cox regression survival model. RESULTS: Diabetics (n=40) and nondiabetics (n=39) showed no differences in age, gender, cancer stage, and follow-up. NSCLCs were more likely PD-L1 positive in diabetics but with tumor positivity \u3c 50% (TPS0: 7.5 vs. 20.5%, TPS1: 35 vs. 25.6%, TPS2: 45 vs.23.1%, TPS3: 12.5 vs. 30.8%, respectively; P \u3c 0.05). In diabetics, squamous cell carcinomas (SCC) and adenocarcinomas were mainly TPS2 (65% vs. 20%) and TPS1 (50% vs. 26%), respectively. Peritumoral inflammation correlated with TPS (r=0.228), a relationship accentuated in diabetics (r=0.377, P \u3c 0.05) but diminished and non-significant in nondiabetics (r=0.136, P \u3e /=0.05). This association was stronger in SCC (r=0.424). Diabetes was associated with increased tumor recurrence (HR: 3.08; 95%CI: 1.027-9.23). CONCLUSION: Diabetes is associated with an increase in peritumoral inflammation, PD-L1 positivity, and recurrence in NSCLC, more pronounced in SCC, suggesting the possibility of metabolic reprogramming and upregulation of PD-L1 by inducible pathways. reserved