Communication system features dual mode range acquisition plus time delay measurement

Communication system combines range acquisition system and time measurement system for tracking high velocity aircraft and spacecraft. The range acquisition system uses a pseudonoise code to determine range and the time measurement system reduces uncontrolled phase variations in the demodulated signal

Urine metabolomic analysis to detect metabolites associated with the development of contrast induced nephropathy.

ObjectiveContrast induced nephropathy (CIN) is a result of injury to the proximal tubules. The incidence of CIN is around 11% for imaging done in the acute care setting. We aim to analyze the metabolic patterns in the urine, before and after dosing with intravenous contrast for computed tomography (CT) imaging of the chest, to determine if metabolomic changes exist in patients who develop CIN.MethodsA convenience sample of high risk patients undergoing a chest CT with intravenous contrast were eligible for enrollment. Urine samples were collected prior to imaging and 4 to 6 hours post imaging. Samples underwent gas chromatography/mass spectrometry profiling. Peak metabolite values were measured and data was log transformed. Significance analysis of microarrays and partial least squares was used to determine the most significant metabolites prior to CT imaging and within subject. Analysis of variance was used to rank metabolites associated with temporal change and CIN. CIN was defined as an increase in serum creatinine level of ≥ 0.5 mg/dL or ≥ 25% above baseline within 48 hours after contrast administration.ResultsWe sampled paired urine samples from 63 subjects. The incidence of CIN was 6/63 (9.5%). Patients without CIN had elevated urinary citric acid and taurine concentrations in the pre-CT urine. Xylulose increased in the post CT sample in patients who developed CIN.ConclusionDifferences in metabolomics patterns in patients who do and do not develop CIN exist. Metabolites may be potential early identifiers of CIN and identify patients at high-risk for developing this condition prior to imaging

Age - Not Marbling - Indicates Tenderness

Test panels and shearing machine measurements agree: Tenderness of steak is related to animal\u27s age. Marbling appears unrelated to tenderness, flavor or juiciness. More research on beef tenderness planned

Coming in Warm: Qualitative Study and Concept Map to Cultivate Patient‐Centered Empathy in Emergency Care

Background Increased empathy may improve patient perceptions and outcomes. No training tool has been derived to teach empathy to emergency care providers. Accordingly, we engaged patients to assist in creating a concept map to teach empathy to emergency care providers. Methods We recruited patients, patient caretakers and patient advocates with emergency department experience to participate in three separate focus groups (n = 18 participants). Facilitators guided discussion about behaviors that physicians should demonstrate in order to rapidly create trust, enhance patient perception that the physician understood the patient's point of view, needs, concerns, fears, and optimize patient/caregiver understanding of their experience. Verbatim transcripts from the three focus groups were read by the authors and by consensus, 5 major themes with 10 minor themes were identified. After creating a codebook with thematic definitions, one author reviewed all transcripts to a library of verbatim excerpts coded by theme. To test for inter‐rater reliability, two other authors similarly coded a random sample of 40% of the transcripts. Authors independently chose excerpts that represented consensus and strong emotional responses from participants. Results Approximately 90% of opinions and preferences fell within 15 themes, with five central themes: Provider transparency, Acknowledgement of patient's emotions, Provider disposition, Trust in physician, and Listening. Participants also highlighted the need for authenticity, context and individuality to enhance empathic communication. For empathy map content, patients offered example behaviors that promote perceptions of physician warmth, respect, physical touch, knowledge of medical history, explanation of tests, transparency, and treating patients as partners. The resulting concept map was named the “Empathy Circle”. Conclusions Focus group participants emphasized themes and tangible behaviors to improve empathy in emergency care. These were incorporated into the “Empathy Circle”, a novel concept map that can serve as the framework to teach empathy to emergency care providers

The geometry of manifolds and the perception of space

This essay discusses the development of key geometric ideas in the 19th century which led to the formulation of the concept of an abstract manifold (which was not necessarily tied to an ambient Euclidean space) by Hermann Weyl in 1913. This notion of manifold and the geometric ideas which could be formulated and utilized in such a setting (measuring a distance between points, curvature and other geometric concepts) was an essential ingredient in Einstein's gravitational theory of space-time from 1916 and has played important roles in numerous other theories of nature ever since.Comment: arXiv admin note: substantial text overlap with arXiv:1301.064

Review of End-of-Life Thermal Control Coating Performance

White thermal control coatings capable of long term performance are needed for Fission Surface Power (FSP) where heat from a nuclear reactor placed on the surface of the Moon must be rejected to the environment. The threats to thermal control coating durability on the lunar surface are electrons, protons, and ultraviolet radiation. The anticipated damage to the coating is a gradual darkening over time. The increase in solar absorptance would, in essence, add a cyclic heat load to the radiator. The greater the darkening, the greater the added heat load. The cyclic heat load could ultimately impart a cyclic influence on FSP system performance. No significant change in emittance is anticipated. Optical properties degradation data were found in the open literature for the Z-93 series of thermal control paints. Additional optical properties degradation data were found from the Lunar Orbiter V mission, the Optical Properties Monitor, and the Materials International Space Station Experiment. Anticipated end-of-life thermal control coating performance for a FSP installation is postulated. With the FSP installation located away from landing and launching areas, and out of line-of-sight, lunar dust from human activity may not be a threat. The benefits of investing in next generation thermal control paint chemistry are explored

Stochastic Model for Modulus of Elasticity of Lumber

A model was developed for generating the lengthwise variability in modulus of elasticity (MOE) of lumber. A limited grade selection of southern pine visual and machine stress-rated (MSR) grades formed the basic data base, A second-order Markov model was used to generate serially correlated MOE's along 30-inch segments for a piece of lumber. Modulus of elasticity indexes were obtained by dividing each correlated MOE by the average MOE of the piece of lumber. The MOE of each segment was obtained by multiplying the MOE indexes by a single random observation from a distribution of MOE. The distribution characteristics of the generated MOE values are preserved, and the first- and second-order lengthwise serial correlations are preserved

Performance of the Mortality in emergency department Sepsis score for predicting hospital mortality among patients with severe sepsis and septic shock

Objective The aim of the study was to test if the Mortality in Emergency Department Sepsis (MEDS) score accurately predicts death among emergency department (ED) patients with severe sepsis and septic shock. Methods This study was a preplanned secondary analysis of a before-and-after interventional study conducted at a large urban ED. Inclusion criteria were suspected infection, 2 or more criteria for systemic inflammation, and either systolic blood pressure of less than 90 mm Hg after a fluid bolus or lactate 4 mmol/L or higher. Exclusion criteria were: age of less than 18 years, no aggressive care desired, or need for immediate surgery. Clinical and outcomes data were prospectively collected on consecutive eligible patients for 1 year before and 1 year after implementing early goal-directed therapy (EGDT). The MEDS scores and probabilities of in-hospital death were calculated. The main outcome was in-hospital mortality. The area under the receiver operating characteristic curve was used to evaluate score performance. Results One hundred forty-three patients, 79 pre-EGDT and 64 post-EGDT, were included. The mean age was 58 ± 17 years, and pneumonia was the source of infection in 37%. The in-hospital mortality rate was 23%. The area under the receiver operating characteristic curve for MEDS to predict mortality was 0.61 (95% confidence interval [CI], 0.50-0.72) overall, 0.69 (95% CI, 0.56-0.82) in pre-EGDT patients, and 0.53 (95% CI, 0.33-0.74) in post-EGDT patients. Conclusions The MEDS score performed with poor accuracy for predicting mortality in ED patients with sepsis. These results suggest the need for further validation of the MEDS score before widespread clinical use

The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation

Objectives Organ failure worsens outcome in sepsis. The Sequential Organ Failure Assessment (SOFA) score numerically quantifies the number and severity of failed organs. We examined the utility of the SOFA score for assessing outcome of patients with severe sepsis with evidence of hypoperfusion at the time of emergency department (ED) presentation. Design Prospective observational study. Setting Urban, tertiary ED with an annual census of >110,000. Patients ED patients with severe sepsis with evidence of hypoperfusion. Inclusion criteria: suspected infection, two or more criteria of systemic inflammation, and either systolic blood pressure 4 mmol/L. Exclusion criteria age <18 years or need for immediate surgery. Interventions SOFA scores were calculated at ED recognition (T0) and 72 hours after intensive care unit admission (T72). The primary outcome was in-hospital mortality. The area under the receiver operating characteristic curve was used to evaluate the predictive ability of SOFA scores at each time point. The relationship between Δ SOFA (change in SOFA from T0 to T72) was examined for linearity. Results A total of 248 subjects aged 57 ± 16 years, 48% men, were enrolled over 2 years. All patients were treated with a standardized quantitative resuscitation protocol; the in-hospital mortality rate was 21%. The mean SOFA score at T0 was 7.1 ± 3.6 points and at T72 was 7.4 ± 4.9 points. The area under the receiver operating characteristic curve of SOFA for predicting in-hospital mortality at T0 was 0.75 (95% confidence interval 0.68 - 0.83) and at T72 was 0.84 (95% confidence interval 0.77-0.90). The Δ SOFA was found to have a positive relationship with in-hospital mortality. Conclusions The SOFA score provides potentially valuable prognostic information on in-hospital survival when applied to patients with severe sepsis with evidence of hypoperfusion at the time of ED presentation