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Health challenges in the Sahrawi refugee camps in the Algerian desert are faced by both human and animal populations, and therefore responses must function for the benefit of both.

A tenant sets himself on fire in Sophie Calle’s childhood bed, which is tossed out and left in her building’s courtyard. A spiteful colleague assaults Calle with a stiletto, bringing her career as ...

The integration of distributed energy generation systems has begun to impact the operation of distribution feeders within the balancing areas of numerous electrical utilities. Battery energy storage systems may be used to facilitate greater integration of renewable energy generation. This paper describes a method for determining the power and energy capacities a battery energy storage system would need in order to accommodate a particular photovoltaic penetration level within a distribution feeder, or conversely, the amount of photovoltaic that could be installed on a feeder with a minimal investment in power and energy battery energy storage system (BESS) capacities. This method determines the BESS capacities required to compensate both intra-hour and inter-hour load and photovoltaic fluctuations to achieve a flat feeder power profile. By managing the feeder power, the voltage drop along the length of feeder may be managed, thereby mitigating the voltage fluctuation induced by the stochastic nature of both renewables generation and load. Doing so facilitates system benefits, such as conservation voltage reduction, fewer operations of load tap changers, and voltage regulators, and allows for deferment of capital expenditures.

Wind turbine blades are subjected to dynamic loadings during operation and the certification process that result in dynamic stresses and strains that are important to understand. Generally, only a small number of strain gages are used in the certification process and even fewer, if any at all, are installed for operational measurements. Recent advances in digital image correlation (DIC) and digital photogrammetry (DP) have allowed for new opportunities for blade inspection and structural health monitoring. This paper presents two different methods for determining the dynamic stresses and strains using (1) DIC techniques and, (2) a newly developed expansion process in conjunction with the finite element model to predict stresses and strains from limited measurement locations. The limited set of measurement data was provided by placing few optical targets on the test structure and using three dimensional point tracking approach to measure their displacements. The two approaches are discussed and used in the evaluation of a Southwest Wind Power turbine blade subjected to static loading and dynamic loading that are typical of the certification process. The advantages of each of the techniques are described and discussed in the paper.

Objectives Calcium channel blockers are highly protein-bound medications frequently used in the management of hypertension. Overdose results in severe hypotension and is the fourth most common cause of toxicity-related deaths in the United States. Management is mostly supportive, with currently no standard role for targeted drug removal. The protein-bound nature of these medications presents the option of utilizing albumin dialysis for their removal and for the reversal of associated shock. Design and subjects We present two cases of life-threatening intentional amlodipine overdoses successfully treated with albumin dialysis. Both patients experienced profound distributive shock in the setting of preserved cardiac contractility that was refractory to maximal vasoactive agent support. Interventions and results After initiation of albumin dialysis, the patients showed rapid hemodynamic improvement and were able to be weaned off vasopressor support. Conclusions These cases demonstrate the safety and efficacy of albumin dialysis in the management of near-fatal calcium channel blocker overdoses related to amlodipine and offer an additional therapeutic option apart from conventional supportive care. Importantly, these cases were not associated with impaired cardiac contractility, thereby making venoarterial extracorporeal membrane oxygenation a less preferable option. Furthermore, this therapeutic benefit of albumin dialysis can potentially be extended to the management of toxicity related to other highly protein-bound drugs and toxins.

In premature neonates, hyperoxic exposure contributes to lung injury characterized by simplified alveolarization and arrested vascularization. These are the hallmarks of bronchopulmonary dysplasia, a disease with long-term consequences on pulmonary and neurodevelopmental function. Lung vascular development and endothelial cell signals are synergistically important for normal alveolarization. It has been shown that metabolism of nutrients such as glucose, fatty acid, and glutamine is key in controlling proliferation, differentiation, apoptosis, autophagy, senescence, and inflammatory responses, which contribute to the pathogenesis of chronic lung diseases, including bronchopulmonary dysplasia. Recent studies show that metabolic reprogramming occurs in vitro in cells and in vivo in animal models and more importantly in patients with bronchopulmonary dysplasia, suggesting that metabolic dysregulation may participate in the pathogenesis and progression of these diseases. Although endothelial cells rely mainly on glycolysis for bioenergetics, they have the metabolic flexibility to maintain cell function under stress or nutrient deprivation. Others have shown that hyperoxia decreases glycolysis and oxidative phosphorylation in epithelial cells. Nevertheless, endothelial cells show enhanced mitochondrial fatty acid use after exposure to hyperoxia. This may serve to preserve endothelial cell proliferation and alveolarization, and thereby mitigate neonatal hyperoxic lung injury.

Kratzer semantics for modals and conditionals generates the prediction that sentences of the form if p, ought p are trivially true. As Frank and Zvolenszky show, for certain flavors of modality, like deontic modality, this prediction is false. I explain some conservative solutions to the problem, and then argue that they are inadequate to account for puzzle cases involving self-frustrating oughts. These cases illustrate a general problem: there are two forms of information-sensitivity in deontic modals. Even generalizations of Kratzer semantics that predict these two roles for information, e.g. Kolodny and MacFarlane, predict that they vary together. I propose a generalization of Kratzer semantics that allows the two roles for information to vary independently of each other.

We performed a first-in-disease trial of in vivo CD28:CD80/86 costimulation blockade with abatacept for acute graft-versus-host disease (aGVHD) prevention during unrelated-donor hematopoietic cell transplantation (HCT). All patients received cyclosporine/methotrexate plus 4 doses of abatacept (10 mg/kg/dose) on days −1, +5, +14, +28 post-HCT. The feasibility of adding abatacept, its pharmacokinetics, pharmacodynamics, and its impact on aGVHD, infection, relapse, and transplantation-related mortality (TRM) were assessed. All patients received the planned abatacept doses, and no infusion reactions were noted. Compared with a cohort of patients not receiving abatacept (the StdRx cohort), patients enrolled in the study (the ABA cohort) demonstrated significant inhibition of early CD4+ T cell proliferation and activation, affecting predominantly the effector memory (Tem) subpopulation, with 7- and 10-fold fewer proliferating and activated CD4+ Tem cells, respectively, at day+28 in the ABA cohort compared with the StdRx cohort (P

The clinical ethics literature on extracorporeal membrane oxygenation (ECMO) has been focused primarily on identifying hypothetical ethical dilemmas that may arise with the use of this technology. Little has been written on the actual experience with ECMO-related ethical questions.To describe the role of an ethics consultation service during the expansion of a single-center ECMO program in a cardiothoracic surgery intensive care unit (CSICU) and to identify common ethical themes surrounding the use of ECMO.We conducted a retrospective, descriptive cohort study of all ECMO ethics consultation cases in the CSICU at a large academic hospital between 2013 and 2015.During the study period, 113 patients were placed on ECMO in the CSICU, 45 (39.5%) of whom were seen by the ethics committee. In 2013, 10 of 46 (21.7%) patients received ethics consults. By 2015, 28 of 30 (93.3%) of patients were seen by ethics consultants. Initial consultation occurred at a median of 2 days (interquartile range, 1-6 d) following initiation of ECMO. The most common ethical issue involved disagreement about the ongoing use of ECMO, which included multiple axes: Disagreement among health care providers, disagreement among surrogates, and disagreement between health care providers and surrogates over stopping or continuing ECMO.In our experience with integrating ethics consultation into the routine care of ECMO patients, most of the ethical questions more closely resembled traditional concerns about the appropriate use of any life-sustaining treatment rather than the novel dilemmas imagined in the current literature.

Spousal caregivers of persons with dementia often have difficulty engaging persons with dementia in leisure activities. This qualitative descriptive study identifies how caregivers perceive their spouses’ participation in leisure activities since dementia onset and the professional guidance caregivers require to increase persons with dementia participation in shared leisure activities. Nine spousal caregivers from a hospital-based caregiver intervention attended one of three focus groups. Using symbolic interactionism and selective optimization with compensation theory as guiding frameworks, thematic content analysis was performed. Three major themes were identified: Recognizing and acknowledging changes, Making sense of changes and conflicts, and Embracing changes and forging ahead. Findings can be used by healthcare providers to better understand caregivers’ needs for engaging persons with dementia in shared leisure activities, and inform development of feedback protocols to enhance caregiver interventions.

A common perception is that detailed project execution planning (PEP) is not necessary for pipeline projects. In particular, project teams argue that it is not worth the time and effort for an owner to develop a detailed execution plan because the contractor will provide one before construction begins. In addition, project teams will also argue that developing a detailed, resource-loaded schedule is overkill for a pipeline project. This study was undertaken to test the importance of good PEP to pipeline project results.Copyright © 2014 by ASME

Approximately 20 types of venomous snakes areendemictotheUS.Allbutthecoralsnake(familyElapidae)are North American pit vipers (family Viperidae). TheViperidae subfamily Crotalidae, which includes the rattle-snake, copperhead, and cottonmouth (water moccasin),account for the majority of snake bites and envenomationsthatoccurintheUS.

Current design analysis for wind turbine blade applications is based on an estimation of the forces that drive the system during operation. Much effort has been expended in the estimation of these forces from fluid structure interaction models as well as from measured operating responses. However, the existing approaches can only provide an approximate estimate of the forces for the structural modeling of the blades, primarily because of a lack of distributed sensing capability and because the assumed boundary conditions are not always accurate. Two relatively new techniques are currently under investigation that enable a much better overall prediction of the response of the system. Full-field optical measuring techniques and real time data expansion approaches have the potential to greatly improve these required predictions. Three-dimensional digital image correlation (DIC) and dynamic point tracking (3DPT) have recently been explored as possible approaches to collect data on various types of structures using noncontacting measurement while the system is operating (rotating). A basic discussion on these imaging techniques is provided to show their usefulness in making structural dynamic measurements. The sets of limited surface data that are collected can be used in conjunction with an expansion algorithm to obtain fullfield information. The finite element model mass and stiffness matrices are used to obtain the normal constitutive relations as well as the modal characteristics. This information is used to develop the expansion algorithm and for the stress recovery during the back substitution process typically employed in the finite element approach. A basic discussion of the process used is presented along with several different test cases to demonstrate the optical measurement process and the ability to achieve full-field results. Some thoughts on the exploitation of these new tools and the vision forward are also presented.

Wind turbine blades are often subjected to static and dynamic testing to identify the performance levels of the blades. In general, strain gages are employed to capture strain data at discrete points. Recent advances in digital image correlation (DIC) and digital photogrammetry have allowed for new opportunities for blade inspection and structural health monitoring. DIC allows for imaging techniques to measure displacement values at various points on the structure. This displacement data is then used in conjunction with a finite element model to apply modal expansion techniques to obtain displacement values at each finite element degree of freedom for each time step of dynamic transient data. This technique is used to predict strain values at any point on the structure. This paper presents results obtained from dynamic testing at limited measurement locations to predict the full field dynamic strain for two structures evaluated. A major benefit to this approach is that strain values can be found at locations that are not in the measurement field of view, including on surfaces that are contained within the structure.

Digital image correlation (DIC) has been becoming increasingly popular as a means to perform structural health monitoring because of its full-field, non-contacting measurement ability. In this paper, 3D DIC techniques are used to identify the mode shapes of a wind turbine blade. The blade containing a handful of optical targets is excited at different frequencies using a shaker as well as a pluck test. The response is recorded using two PHOTRON™ high speed cameras. Time domain data is transferred to the frequency domain to extract mode shapes and natural frequencies using an Operational Modal Approach. A finite element model of the blade is also used to compare the mode shapes. Furthermore, a modal hammer impact test is performed using a more conventional approach with an accelerometer. A comparison of mode shapes from the photogrammetric, finite element, and impact test approaches are presented to show the accuracy of the DIC measurement approach.

Modal testing is performed on wind turbine blades to provide information that is necessary for model updating and validation. In this work, a finite element model of a small wind turbine blade is developed and is used to perform dynamic stress–strain prediction using digital image correlation techniques. In order to assure that the model is appropriate for this work, a modal test is performed and correlated to the finite element model. Several blades are tested to identify the variability expected in the as-built configuration. This paper presents the test, analysis and correlation for this wind turbine blade.

This exploratory pilot study was conducted to evaluate outcome differences between traditional individualized sensory integration treatment and integrated sensorimotor activities for preschool children with autism spectrum disorders. Pre- and post test measures of play were evaluated for two small groups of children who met criteria for exhibiting sensory processing issues. Results indicated positive differences in play behavior for both groups of children. Overall, further research is indicated to better understand the impact of various treatment approaches on participation in preschool occupations.

Often times, wind turbine blades are subjected to static and dynamic testing to identify the performance levels that can be achieved for a particular configuration. These tests are a necessary part of the validation process. Typically, a variety of different static and dynamic measurements are made using a variety of different transducers. Typically, only a handful of strain gages are deployed to capture strain information. Recent advances in digital image correlation (DIC) and dynamic photogrammetry (DP) have allowed new opportunities for blade inspection, structural health monitoring, and full-field vibration testing. The primary benefit to using DIC is that the measurement approach is not limited to identifying the displacement or strain at only a few discrete measurement locations, but instead makes full-field surface measurements possible. These techniques are currently being explored on several wind turbine blade applications and can provide a wealth of additional information that was previously unobtainable. This paper, which is the first part of a two part paper, presents the static strain measurements and calibration of the system overall. The strain distribution along the length of the structure is compared to the finite element model. The data analysis is used to assure that the model is calibrated for the dynamic testing results; dynamic testing results are presented in the second part of this paper.

Often times, wind turbine blades are subjected to static and dynamic testing to identify the performance levels that can be achieved for a particular configuration. Many times only a handful of strain gages are deployed to capture that information.

We characterized endocytosis of iron-saturated (holo) and iron-depleted (apo) 125I-labeled bovine lactoferrin (Lf) by isolated rat hepatocytes. Hepatocytes ingested both Lf forms--determined by EGTA/dextran sulfate removal of surface-bound Lf--at maximal endocytic rates of 1.85 and 1.52 fmol cell-1 min-1 for 125I-apo-Lf and 125I-holo-Lf, respectively. First-order endocytic rate constants (37 degrees C) for 125I-apo-Lf and 125I-holo-Lf were 0.276 and 0.292 min-1, respectively. Regardless of Lf's iron content, hyperosmotic media (approximately 500 mmol/kg) inhibited Lf uptake by approximately 90%, indicating endocytosis of both Lf forms was primarily clathrin-dependent. Endocytosis of both Lf forms was not altered significantly in the presence of excess iron chelator desferrioxamine or rat holo-transferrin, or by cycloheximide treatment. Fluorescein isothiocyanate- and cyclohexanedione-modified Lf competed fully with native Lf for binding and endocytosis, indicating that, unlike human Lf, modification of lysine or arginine residues does not block the interaction of bovine Lf with cells. After binding Lf at 4 degrees C, cells at 37 degrees C internalized approximately 90% of Lf bound to Ca(2+)-dependent sites but not Lf bound to Ca(2+)-independent sites. Following uptake, hepatocytes released acid-soluble (degraded) products of 125I-Lf biphasically at 37 degrees C, an initial rapid phase within the first 20 min--more pronounced with 125I-holo-Lf--followed by a sustained linear release of 298 and 355 molecule equiv cell-1 min-1 for 125I-apo-Lf and 125I-holo-Lf, respectively. At 4 degrees C, both digitonin-permeabilized and intact cells bound approximately 1.1 x 10(6) 125I-Lf molecules to Ca(2+)-dependent sites per cell, indicating that hepatocytes do not contain a sizeable intracellular pool of these sites. Moreover, cells retained > 70% of Ca(2+)-dependent sites on the surface during sustained Lf endocytosis. Thus, these Lf binding sites recycle during endocytosis at an estimated 4-5 min/circuit.

When combined with the scores from a clinical assessment, the test was able to predict individuals with prodromal symptoms of schizophrenia who later developed the disorder with 90 percent accuracy.

Understanding why women with perimenopausal depression respond differently to hormone withdrawal may one day offer new insights into the biology of depression and alternative treatments for the disease.