Maritime threat response

This report was prepared by Systems Engineering and Analysis Cohort Nine (SEA-9) Maritime Threat Response, (MTR) team members.Background: The 2006 Naval Postgraduate School (NPS) Cross-Campus Integrated Study, titled “Maritime Threat Response” involved the combined effort of 7 NPS Systems Engineering students, 7 Singaporean Temasek Defense Systems Institute (TDSI) students, 12 students from the Total Ship Systems Engineering (TSSE) curriculum, and numerous NPS faculty members from different NPS departments. After receiving tasking provided by the Wayne E. Meyer Institute of Systems Engineering at NPS in support of the Office of the Assistant Secretary of Defense for Homeland Defense, the study examined ways to validate intelligence and respond to maritime terrorist attacks against United States coastal harbors and ports. Through assessment of likely harbors and waterways to base the study upon, the San Francisco Bay was selected as a representative test-bed for the integrated study. The NPS Systems Engineering and Analysis Cohort 9 (SEA-9) Maritime Threat Response (MTR) team, in conjunction with the TDSI students, used the Systems Engineering Lifecycle Process (SELP) [shown in Figure ES-1, p. xxiii ] as a systems engineering framework to conduct the multi-disciplinary study. While not actually fabricating any hardware, such a process was well-suited for tailoring to the team’s research efforts and project focus. The SELP was an iterative process used to bound and scope the MTR problem, determine needs, requirements, functions, and to design architecture alternatives to satisfy stakeholder needs and desires. The SoS approach taken [shown in Figure ES-2, p. xxiv ]enabled the team to apply a systematic approach to problem definition, needs analysis, requirements, analysis, functional analysis, and then architecture development and assessment.In the twenty-first century, the threat of asymmetric warfare in the form of terrorism is one of the most likely direct threats to the United States homeland. It has been recognized that perhaps the key element in protecting the continental United States from terrorist threats is obtaining intelligence of impending attacks in advance. Enormous amounts of resources are currently allocated to obtaining and parsing such intelligence. However, it remains a difficult problem to deal with such attacks once intelligence is obtained. In this context, the Maritime Threat Response Project has applied Systems Engineering processes to propose different cost-effective System of Systems (SoS) architecture solutions to surface-based terrorist threats emanating from the maritime domain. The project applied a five-year time horizon to provide near-term solutions to the prospective decision makers and take maximum advantage of commercial off-the-shelf (COTS) solutions and emphasize new Concepts of Operations (CONOPS) for existing systems. Results provided insight into requirements for interagency interactions in support of Maritime Security and demonstrated the criticality of timely and accurate intelligence in support of counterterror operations.This report was prepared for the Office of the Assistant Secretary of Defense for Homeland DefenseApproved for public release; distribution is unlimited

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

An efficient march (5n) FSM-based Memory Built-in Self-Test (MBIST) architecture with diagnosis capabilities

In deep submicron Systems-on-Chip, embedded memories are consuming a growing part of the die area. The manufacturing test of embedded memory is a critical stage in the SoC production process that screens out faulty chips and speeds up the volume production of new manufacturing technology. Memory Build-In Self-Test or MBIST is a standard mechanism to test the memory arrays and potentially detect all of the faults that may be present inside memory cells using an effective collection of algorithms. However, a massive number of memory cells wrapped by BIST logic can result in substantial overhead in wiring and gate area, and also a detrimental influence on memory performance. Therefore, new MBIST designs for advanced SoCs that address the challenges must be explored to reduce the overall cost of manufacturing tests. It is important to choose the appropriate level of algorithmic coverage and diagnosis for a range of array sizes. The March 5n algorithm proven the alternative form of March-based algorithm with better test length has achieved shorter test time than conventional MATS++ algorithms without penalizing the fault coverage. This memory testing algorithm and architecture suit the needs for fast array testing to get the products to market in the quickest fashion. However, the previous work is extendable for inversion coupling fault detection and repair support. Therefore, the March 5n architecture is utilized as the foundation in this project. An improved March 5n architecture is proposed to extend its properties in terms of fault coverage and diagnosis capabilities to allow memory failure analysis. Block of March algorithms, an address generator, data generator, diagnosis module, and redundancy logic are the components of the targeted BIST architecture. Extensive circuitry from the previous architecture will be implemented to achieve the goals. The additional logic will accumulate the fault information and its corresponding diagnosis results will report during the memory testing. Synopsys Electronic Design Automation tools (VCS, Design Compiler and Verdi) are utilized in synthesising and evaluating the performance in terms of speed, area, power and fault coverage. Several reports and waveforms are generated and simulated for evaluation. The outcome of this project has demonstrated that adding more logic can enhance the capability for diagnosis and enable redundant programming to replace the defective cell. Besides, the inversion coupling fault coverage using the March 5n is verified to be functioning as intended. Speed up of the redundant memory space allocation in a repair mechanism is achieved with the proposed architecture due to the ability to keep track of each failure signature of memory when tested. In comparison to earlier work, the improved architecture has generally enhanced maximum clock speeds by almost 8% and decreased power dissipation by about 6%. However, higher speed and functionality are obtained at the cost of 4% of the area overhead

An investigation of the mechanical behavior of a microswitch beam under thermal and electrostatic loading including cryogenic effect

Three dimensional multiphysics finite element analysis (FEA) was performed to investigate the static and dynamic responses of a micro-switch in harsh temperature environment. The temperature range for the analysis was from -60°C to 100°C. The investigated microswitch consists of a clamped-clamped beam actuated by a bottom electrode coated with dielectric film. Coupled field simulations between the thermal, structural and electrostatic fields were performed by using the multifield solver in ANSYS. The static responses of the beam under the temperature effects were obtained from this analysis. The analysis shows that the natural frequencies were decreased with the increasing of temperature and increasing in the cryogenic range. This study will provide the designers with a tool to optimize the geometry and performance of the microswitches operated under harsh temperature environment

Pediatric melioidosis in Pahang, Malaysia

Melioidosis is much less common in children than in adults. This study investigated the incidence, demographic characteristics, presenting symptoms and outcome of pediatric melioidosis in Pahang, Malaysia. This retrospective study included patients < or =18 years old with positive body fluid cultures for Burkholderia pseudomallei from January 2000 to June 2003. Data on culture results were obtained from 2 referral hospitals. The incidence of pediatric melioidosis was 0.68/100,000 population per year. Of the 13 patients identified during the study period, 10 were male; 9 were Malays, 2 were Indians and 2 were aborigines. The mean age of these patients was 9.5 +/- 5.4 years. None of the patients had a previous history of confirmed melioidosis or predisposing factors for infection. Localized melioidosis was the most common presentation (46.2%) followed by melioidosis with septic shock (38.4%). Among patients with localized melioidosis, head and neck involvement (83.3%) was the most common presentation (2 patients with cervical abscesses, 1 with submandibular abscesses and 2 with acute suppurative parotitis) and another patient had right axillary abscess. All of the patients with septic shock had pneumonia and 2 of them had multi-organ involvement. The mortality among patients with septic shock was 80% and death occurred within 24 h of admission in all cases. In contrast, no complications or death occurred among patients with localized melioidosis. Melioidosis with septic shock is less common than localized melioidosis in pediatric patients, but is associated with very high mortality

A case study on the transparency of Singapore banks

This study addresses that issue by examining the transparency level of local banks. A transparency model comprising of both quantitative and qualitative financial information disclosed in annual reports of local and foreign full licence banks is used in this study toderive a Transparency Score (TSCORE), which indicates the transparency level of a bank. This study also discusses factors contributing to confidence in local banks despite the regional financial crisis

A March 5n FSM-based memory built-in self-test (MBIST) architecture with diagnosis capabilities

MBIST is a standard mechanism to test memory arrays and potentially detect all of the faults that may be present inside the memory cells using an effective collection of algorithms. However, a massive number of memory cells wrapped by BIST logic can result in substantial overhead in wiring, gate area and also be detrimental to memory performance. Therefore, new MBIST designs for advanced SoCs that address the challenges must be explored to reduce the overall cost of manufacturing tests. It is important to choose the appropriate BIST architecture and algorithmic coverage for a range of array sizes to get the products to market in the quickest fashion. March 5n algorithm in previous is proven to achieve shorter test time than conventional MATS++ algorithms without penalizing the fault coverage. Moreover, the algorithm is capable of covering inversion coupling faults. The fault coverage of the previous March 5n algorithm is extended and proved in this work. An improved March 5n architecture is proposed to extend its properties in terms of repair capabilities while incurring minimal area overhead expenses. The proposed work improved the March 5n MBIST architecture by nearly 8% of maximum operating frequency and repair capabilities with the trade-off of area overhead increment by about 4%

Enhancing student participation in a design-centric mechatronics class

10.1016/j.mechatronics.2013.02.009Mechatronics238918-925MECH