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Negative associations of prenatal tobacco and alcohol exposure (PTE and PAE) on birth outcomes and childhood development have been well documented, but less is known about underlying mechanisms. A possible pathway for the adverse fetal outcomes associated with PTE and PAE is the alteration of fetal autonomic nervous system development. This study assessed PTE and PAE effects on measures of fetal autonomic regulation, as quantified by heart rate (HR), heart rate variability (SD-HR), movement, and HR-movement coupling in a population of fetuses at ≥ 34 weeks gestational age. Participants are a subset of the Safe Passage Study, a prospective cohort study that enrolled pregnant women from clinical sites in Cape Town, South Africa, and the Northern Plains region, United States. PAE was defined by six levels: no alcohol, low quit early, high quit early, low continuous, moderate continuous, and high continuous; while PTE by 4 levels: no smoking, quit early, low continuous, and moderate/high continuous. Linear regression analyses of autonomic measures were employed controlling for fetal sex, gestational age at assessment, site, maternal education, household crowding, and depression. Analyses were also stratified by sleep state (1F and 2F) and site (South Africa,N= 4025, Northern Plains,N= 2466). The final sample included 6491 maternal-fetal-dyad assessed in the third trimester [35.21 ± 1.26 (mean ± SD) weeks gestation]. PTE was associated with a decrease in mean HR in state 2F, in a dose dependent fashion, only for fetuses of mothers who continued smoking after the first trimester. In state 1F, there was a significant increase in mean HR in fetuses whose mother quit during the first trimester. This effect was driven by the Norther Plains cohort. PTE was also associated with a significant reduction in fetal movement in the most highly exposed group. In South Africa a significant increase in mean HR both for the high quit early and the high continuous group was observed. In conclusion, this investigation addresses a critical knowledge gap regarding the relationship between PTE and PAE and fetal autonomic regulation. We believe these results can contribute to elucidating mechanisms underlying risk for adverse outcomes.

HIGHLIGHTS • Nutrition-based interventions to reduce COVID-19 morbidity/mortality are needed. • The Omega-3 Index (O3I) was measured in banked blood from 100 COVID-19 patients. • Risk for death was analyzed as a function of quartiles (Q) of the O3I. • Patients in Q4 (O3I ≥ 5.7%) vs. Q1-3 were 75% less likely to die (p=0.07). • These pilot data suggest that a higher O3I may lower risk for death from COVID-19., Very-long chain omega-3 fatty acids (EPA and DHA) have anti-inflammatory properties that may help reduce morbidity and mortality from COVID-19 infection. We conducted a pilot study in 100 patients to test the hypothesis that RBC EPA+DHA levels (the Omega-3 Index, O3I) would be inversely associated with risk for death by analyzing the O3I in banked blood samples drawn at hospital admission. Fourteen patients died, one of 25 in quartile 4 (Q4) (O3I ≥5.7%) and 13 of 75 in Q1-3. After adjusting for age and sex, the odds ratio for death in patients with an O3I in Q4 vs Q1-3 was 0.25, p=0.07. Although not meeting the classical criteria for statistical significance, this strong trend suggests that a relationship may indeed exist, but more well-powered studies are clearly needed.

Precise identification of drinking and smoking patterns during pregnancy is crucial to better understand the risk to the fetus. The purpose of this manuscript is to describe the methodological approach used to define prenatal drinking and smoking trajectories from a large prospective pregnancy cohort, and to describe maternal characteristics associated with different exposure patterns. In the Safe Passage Study, detailed information regarding quantity, frequency, and timing of exposure was self-reported up to four times during pregnancy and at 1 month post-delivery. Exposure trajectories were developed using data from 11,692 pregnancies (9,912 women) where pregnancy outcome was known. Women were from three diverse populations: white (23%) and American Indian (17%) in the Northern Plains, US, and mixed ancestry (59%) in South Africa (other/not specified [1%]). Group-based trajectory modeling was used to identify 5 unique drinking trajectories (1 none/minimal, 2 quitting groups, 2 continuous groups) and 7 smoking trajectories (1 none/minimal, 2 quitting groups, 4 continuous groups). Women with pregnancies assigned to the low- or high-continuous drinking groups were less likely to have completed high school and were more likely to have enrolled in the study in the third trimester, be of mixed ancestry, or be depressed than those assigned to the none/minimal or quit-drinking groups. Results were similar when comparing continuous smokers to none/minimal and quit-smoking groups. Further, women classified as high- or low-continuous drinkers were more likely to smoke at moderate-, high-, and very high-continuous levels, as compared to women classified as non-drinkers and quitters. This is the first study of this size to utilize group-based trajectory modeling to identify unique prenatal drinking and smoking trajectories. These trajectories will be used in future analyses to determine which specific exposure patterns subsequently manifest as poor peri- and postnatal outcomes.

Advances in ICT have changed, and continue to change, interactions between service providers and customers. Service industries like health care or consulting traditionally relied on interpersonal “high touch, low tech” (Bitner, Brown, and Meuter 2000: 138) exchanges. Today, however, service providers and customers increasingly interact through virtual, rather than physical interfaces (Breidbach, Kolb, and Srinivasan 2013a). But, service research to date has focused predominantly on face-to-face settings (e.g., Froehle and Roth 2004), while technology-enabled value co-creation processes remain largely unexplored and misunderstood (Breidbach and Maglio 2015). Consequently, the understanding of ICT-enabled service is incomplete, and exploring the broader role and implications of ICT in service represents a key research priority for service science (e.g., Srinivasan, Breidbach, and Kolb 2015) and IS scholars alike (Maglio and Breidbach 2014).

The focus of the health sector in most countries remains almost exclusively on health care services, and the potential of multisectoral collaboration remains untapped in many low- and middle-income countries.Different sectors have different contributions to make towards solving specific health problems. In each case, the profile, interests, incentives, and relationships of key individuals and sectors must be mapped and analysed to inform the design of approaches and systems to tackle a shared problem.Collaborative and distributed leadership is key for effective governance of multisectoral action, with a need to build leadership capacity across sectors and levels of government and cultivate champions in different sectors who can agree on common objectives.Important ways forward to support countries to take a multisectoral approach for health include ensuring that the universal health coverage agenda addresses the capacity of the health sector to work with other sectors, learning from multisectoral efforts that do not involve the health sector, improving the capacity of global institutions to support countries in undertaking multisectoral action, and developing a clear implementation research agenda for multisectoral action for health.

Monoclonal antibodies targeting PD- 1 (nivolumab and pembrolizumab) and PD-L1 (avelumab, atezolizumab, and durvalumab) are FDA approved for the treatment of metastatic cancers. Immune-related adverse events (irAEs) are autoimmune diseases which occur following treatment with PD-1 and PD-L1 inhibitors. Neurological irAEs following PD-L1 blockade are rarely reported, and mainly consist of Myasthenia Gravis (MG) and myositis. MG induced by avelumab has not been previously reported. We present a 74-year-old female with stage IV ovarian adenocarcinoma who entered a clinical trial involving avelumab and entinostat after disease progression following extensive resection, chemotherapy with doxorubicin, then docetaxol and cisplatin. She developed progressive generalized weakness and fatigue two months after entering the trial, leading to respiratory weakness and hypoventilation, and resulting in intubation and mechanical ventilation. Exam showed head-drop, diplopia, and proximal > distal upper and lower limb weakness. Antibodies to acetylcholine receptors, muscle specific tyrosine kinase, and voltage-gated calcium channels (P/Q and N type) were negative, and serum creatine kinase was normal. Repetitive nerve stimulation showed significant decrement in the left spinal accessory nerve motor response with recording at trapezius. She was diagnosed with seronegative MG and was treated with IVIG, 2 grams/kg divided over 4 days, prednisone 60 mg daily, and pyridostigmine, which resulted in successful extubation, followed by gradual resolution of MG symptoms over a period of 3 months. At approximately 2 year follow-up, she remains on maintenance IVIG at 0.5 grams/kg every 3 weeks, as she develops proximal lower limb and neck extension weakness at the end of each IVIG cycle. We conclude that MG is a potentially life threatening but treatable irAE associated with avelumab. Our case also adds to the accumulating literature of the role of PD-1 signaling in the pathogenesis of autoimmune diseases of the muscles and neuromuscular junctions.

The fragility of health systems has never been of greater interest—or importance—than at this moment, in the aftermath of the worst Ebola virus disease epidemic to date. The loss of life, massive social disruption, and collapse of even the most basic health-care services shows what happens when a crisis hits and health systems are not prepared. This did not happen only in west Africa— we saw it in Texas too: the struggle to provide a coherent response and manage public sentiment (which often manifests as fear) in a way that ensures that disease does not spread while also allowing day-to-day life to continue. In other words, we saw an absence of resilience. This Viewpoint puts forth a proposed framework for resilient health systems and the characteristics that defi ne them, informed by insights from other fi elds that have embraced resilience as a practice. Health system resilience can be defi ned as the capacity of health actors, institutions, and populations to prepare for and eff ectively respond to crises; maintain core functions when a crisis hits; and, informed by lessons learned during the crisis, reorganise if conditions require it. Health systems are resilient if they protect human life and produce good health outcomes for all during a crisis and in its aftermath. Resilient health systems can also deliver everyday benefi ts and positive health outcomes. This double benefi t—improved performance in both bad times and good—is what has been called “the resilience dividend”. Response to a crisis, be it a disease outbreak or other disruption resulting in a surge of demand for health care (eg, a natural disaster or a mass casualty event) needs both a vigorous public health response and a highly proactive and functioning health-care delivery system. These two systems must work in concert during a crisis—and indeed long before crisis strikes. Health-care systems are complex adaptive systems and resilience is an emergent property of the health system as a whole rather than a single dimension. Building resilience is thus context-dependent and iterative, needing advance assessments of system capacities and weaknesses, investments in vulnerable components of the system before a crisis, reinforcements during the emergency, and review of performance after a crisis. Resilience is not a static construct—for example, the rapid pace of recovery from crisis is a cardinal measure of success. The Ebola epidemic has illustrated that several preconditions for resilience were lacking. The fi rst of these preconditions is recognition of the global nature of severe health crises and clarity about the roles of actors at all levels of the global health system. Although national governments are fundamentally responsible for their health systems, they need the capacity to mobilise the full range of local actors and to rapidly draw on external resources if necessary. The need for a global resilience network is both a moral imperative and a recognition of the fact that pathogens do not respect borders. Shocks to the health system of one country can reverberate across regions and the world. Health system resilience is thus a global public good and needs a collective response from the global community. Funding for this response can come from traditional domestic and donor sources or, as recently suggested, a new international health systems fund to which all countries contribute. A second precondition is a legal and policy foundation to guide the response and establish accountability. The implementation of International Health Regulations, which call on countries to build core public health capacities and establish a means of coordinating a response to health emergencies with regional and global partners, is a prerequisite for eff ective emergency response. Additionally, legislation that clarifi es the authority of public health agencies and the roles and responsibilities of private and public health actors is needed as are policies for involving the private and voluntary sector in the response and allowing fl exibility in sharing and reallocating resources across the health system. Third, there is a need for a strong and committed health workforce, characterised by health personnel who show up for work that might be diffi cult and dangerous. Establishing such a workforce begins with training and deployment of a suffi cient number of doctors, nurses, managers, and outreach workers—a colossal task in a country such as Liberia with a population of 3·5 million people and fewer than 100 doctors—but also building and banking a stock of social capital in the health system before crisis strikes. Just as strong social capital in communities promotes individual psychological resilience after mass trauma, social capital in the health system promotes system-wide recovery from crisis. In the health system context, social capital has two dimensions: a sense of worth, community, and responsibility among health actors (clinicians, managers, engineers, outreach workers) and an inclusive and robust community engagement with the health system. Health systems that earn the trust and support of the population and local political leaders by reliably providing high-quality services before crisis have a powerful resilience advantage. Strong management of district level health systems is key to gaining that trust. Diverse fi elds such as ecology, engineering, complex adaptive systems, psychology, and public health have produced resilience frameworks. The Rockefeller Foundation has developed substantial data about resilient Lancet 2015; 385: 1910–12

Summary Background The prodrug tenofovir alafenamide is associated with improved renal and bone safety compared with tenofovir disoproxil fumarate. We aimed to assess safety, pharmacokinetics, and efficacy of this single-tablet, fixed-dose combination of elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide in HIV-infected, treatment-naive adolescents. Methods We did a 48 week, single-arm, open-label trial in treatment-naive adolescents with HIV from ten hospital clinics in South Africa, Thailand, Uganda, and the USA. Eligible participants were aged 12–18 years, with plasma HIV-1 RNA of at least 1000 copies per mL, a CD4 count of at least 100 cells per μL, and estimated glomerular filtration rate of at least 90 mL/min per 1·73 m 2 by the Schwartz formula, bodyweight of at least 35 kg, and an HIV-1 genotype with sensitivity to elvitegravir, emtricitabine, and tenofovir. Participants received a single-tablet regimen once per day with food (administered by their parent or carer) containing 150 mg elvitegravir, 150 mg cobicistat, 200 mg emtricitabine, and 10 mg tenofovir alafenamide. Study visits to the clinic occurred at weeks 1, 2, 4, 8, 12, 16, 24, 32, 40, and 48. The coprimary endpoints were the pharmacokinetic parameters of area under the curve (AUC) concentration at the end of the dosing interval (AUC tau ) for elvitegravir and the AUC from time zero to the last quantifiable concentration (AUC last ) for tenofovir alafenamide, incidence of treatment-emergent serious adverse events, and all adverse events that emerged after treatment started (including data for bone mineral density). All participants who received one dose of study drug were included in the primary and safety analyses. This trial is registered with ClinicalTrials.gov, number NCT01854775. Findings Between May 22, 2013, and July 22, 2014, we enrolled 50 participants, and all 50 received the assigned treatment; 24 participated in the intensive pharmacokinetic assessment. 48 patients completed the 48 weeks of treatment; two discontinued (one withdrew consent at week 8, one was lost to follow-up at week 12). The regimen was well tolerated and no discontinuations related to adverse events occurred. The mean AUC tau for elvitegravir was 23 840 ng × h per mL (coefficient of variation [CV] 25·5%), and the mean AUC last for tenofovir alafenamide was 189 ng × h per mL (CV 55·8%). Four participants (8%) had a serious adverse event, one of which (intermediate uveitis) was deemed related to the study regimen but resolved without treatment interruption. The most common study drug-related adverse events were nausea (in ten participants), abdominal pain (in six), and vomiting (in five). Exposures to the elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide regimen were similar to those previously noted in adults. Interpretation The elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide regimen was well tolerated and achieved component plasma pharmacokinetic exposures similar to those in adults. Although non-comparative with a small sample size, these data support the use of this regimen in HIV-infected adolescents and its timely assessment in younger children. Funding Gilead Sciences.

Cancer Treatment Centers of America® (CTCA®), where the spirit of “the patient comes first” has never been a cliche, was founded on the principle that only a standard of care suitable for one's own mother would suffice. To build on this mission, the organization added Lean Six Sigma—a manufacturing industry-driven combination of waste reduction and defect-free process improvement. This approach created a patient-driven cultural imperative that has changed both the behavioral experience and financial landscape throughout its hospital network for patients and their families, providers, payers, and administrators alike. Today, continuous improvement permeates every corner of the organization and serves as an omnipresent roadmap for never being satisfied with the status quo. The result has been unprecedented patient satisfaction, a top-down and bottom-up collaborative spirit among all stakeholders, and a trend of cost savings and revenue generation that has competitors taking note. © 2011 Wiley Periodicals, Inc.

We compared the performance of an automated method for obtaining RBC and WBC counts and WBC differential counts in cerebrospinal fluid (CSF) samples with the reference manual method. Results from 325 samples from 10 worldwide clinical sites were used to demonstrate the accuracy, precision, and linearity of the method. Accuracy statistics for absolute cell counts showed a high correlation between methods, with correlation coefficients for all reportable absolute counts greater than 0.9. Linearity results demonstrated that the method provides accurate results throughout the reportable ranges, including clinical decision points for WBCs of 0 to 10/μL. Interassay precision and intra-assay precision for the ADVIA 120 (Bayer HealthCare, Tarrytown, NY) method were acceptable at all levels. The ADVIA 120 CSF Assay enumerates and differentiates cells via flow cytometry in a minimally diluted sample, improving the analysis of typically hypocellular CSF samples. Study results demonstrate that the automated ADVIA 120 CSF Assay is an acceptable alternative to the labor-intensive manual method.

Health system resilience begins with measurement of critical capacities ahead of crisis say Margaret E Kruk and colleagues The 2014 west African Ebola epidemic shone a harsh light on the health systems of Guinea, Liberia, and Sierra Leone. While decades of domestic and international investment had contributed to substantial progress on the Millennium Development Goals,12 national health systems remained weak and were unable to cope with the epidemic. Routine care of the population also deteriorated during the outbreak.1234 Surveillance systems did not function effectively, allowing Ebola to spread within and between the countries. Global institutions were slow to respond to the crisis, squandering an opportunity to stem its course.567 Since then, diverse panels of experts have pointed to political and technical deficiencies in multilateral organisations in tackling health crises.891011 These reports have noted that the first line of defence against future pandemics is an effective national health system. They have also called for better measurement of public health capacity, and investment to build resilient health systems—systems that can withstand health shocks while maintaining routine functions.10 The issue of how global bodies can support countries in withstanding future health shocks is playing out now in the election of the new director general of WHO, with several candidates making health system resilience part of their election planks. Based on recent literature, this paper defines health system resilience as “the capacity of health actors, institutions, and populations to prepare for and effectively respond to crises; maintain core functions when a crisis hits; and, informed by lessons learnt during the crisis, reorganise if conditions require it.”12 Health system resilience is relevant in all countries facing health shocks—whether sudden (Ebola, earthquakes, terror attacks, refugees), slower moving (new pathogens such as …

© The Author(s) 2013. This qualitative study examines the experiences of four nonprofit human service organizations engaging in performance measurement processes to satisfy accountability requirements and increase organizational and program effectiveness. Nonprofits are increasingly required to respond to performance measurement mandates issuing from multiple sources. However, many of the recommended strategies have been developed in the for-profit and public sectors, and are less appropriate or feasible for nonprofit organizations. Three central findings emerged from interviews, focus groups, and review of archival data. First, the complexity of human change processes and the variation among individual clients complicate efforts to define client outcomes. Second, staff skills play a critical role in effective utilization of data systems. Third, organizational strategies to support performance measurement include incorporating user perspectives into system design and providing adequate staff access to data.

A person with tetraplegia has lost the ability to willfully control his/her arms and legs, usually due to a severe spinal cord injury. Existing technologies using head motion or puffs of breath to control device movement promise increased mobility and the possibility of expanding recreational activities in a variety of forms to this population. Lack of access to rehabilitative services and engaging recreational activity fosters inactivity. This often creates an environment that causes individuals with physical disabilities to experience reduced function and mobility beyond the cause of their disability, and further disengages them from society1. Adaptive sports are increasing in popularity and provide many benefits to participants.Copyright © 2013 by ASME

Purpose: To quantify inter- and intrafractional variations of tumor position and analyze the relationship between these changes and respiratory motion amplitude, volume changes and tumor location, in frameless stereotactic body radiotherapy (SBRT) of lung tumors. Materials and methods: Tumor volumes and bony landmarks were contoured manually by a single physician on 174 pre- and under treatment cone-beam computed tomographies (CBCTs) of 17 patients. The interfraction variation of the tumor position was measured by comparing the centroid position of the tumor relative to bony anatomy of each fraction to the pretreatment CBCT scans. The intrafraction variation was measured by comparing the pretreatment tumor location to under treatment CBCTs for every fraction. Respiratory motion was analyzed on planning 4D fan beam CTs for all patients. The change in tumor volume was determined by comparing the contoured tumor volumes on sequential pretreatment CBCTs. Results: The average interfraction/intrafraction tumor displacementrelative to bony landmark in mm was 0.6 (SD 2.3) /-0.3 (SD 0.7) in mediolateral, -0.7 (SD 3.8) /0.0 (SD 2.1) in anteroposterior, and -0.6 (SD 5.9) /-0.2 (SD 2.3) in craniocaudal direction. Inter-/intrafraction tumor-to-bone variations >3 mm were observed in 60%/14% of scans respectively. On the initial CBCT, the average tumor volume was 9 cm3 (range 1-37 cm3) with a mean volume reduction over the treatment course of 12% (range, +14% to -54%). Patients with a pretreatment motion amplitude > 9 mm (p=0.002), peripheral tumor location (p=0.04), and volume change >12% (p=0.009) had larger interfraction displacement in lateral direction. Conclusions: Frameless set up is comparable to patient positioning with more elaborate fixation devices. Tumor position variations relative to bony anatomy are an important source of geometric uncertainty providing a rationale for repeated soft tissue-based image guidance, particularly in patients identified in this study to be at higher risk for variations.

The Australian Government and industry groups have been discussing the projected “skills shortage” for a number of years. This concern for the future is mirrored in many countries including the USA and the UK where the risk is not having sufficient skilled people to realise the projects being proposed. Growing tertiary qualified practicing engineers takes time and commitment but without the excitement of the possibility of such a career being seeded in the youth of the world, school leavers won’t be attracted to engineering in sufficient numbers. In response, one successful model for exciting school children about engineering and science careers is the international F1inSchools Technology Challenge which was created in the UK in 2002 and implemented in Australia in 2003. It is now run in over 300 Australian Schools and 33 countries. In the Australian context, the program is managed and promoted by the Reengineering Australia Foundation. It is supported and fostered through a range of regional hubs, individual schools and some exceptional teachers. Presented in this paper are some perspectives drawn particularly from the Australian experience with the program over 10 years — which by any measure has been outstanding. The F1inSchools model has been designed specifically through its association with Formula One racing to attract the intrinsic interests of students. It is based on the fundamentals of action learning. Role models and industry involvement are utilised as motivation modifiers in students from Years 5 to 12. While immersing children in project based learning, the program explicitly encourages them to engage with practicing mentors taking them on a journey outside their normal classroom experience. In this program, students have the opportunity to use the design and analysis tools that are implemented in high technology industries. Their experience is one of reaching into industry and creative exploration rather than industry reaching down to them to play in a constrained and artificial school based environment. Anecdotally F1inSchools has been very successful in positively influencing career choices. With the aim of objectively assessing the impact of the program, doctoral research has been completed. Some key findings from this work are summarized and reported in this paper. The children involved truly become excited as they utilise a vehicle for integration of learning outcomes across a range of educational disciplines with a creative design focus. This enthusiasm flows to reflective thought and informed action in their career choice. As a result of F1inSchools, students are electing to follow engineering pathways and they will shape tomorrow’s world.

Recent advances in InGaAs camera technology has stimulated interest in the short wave infra-red (SWIR) band in the spectral region 0.84 – 1.7 μm. Located between the visible and thermal infra-red, the SWIR band shows interesting properties of both. Images tends to have the look of the visible and are less affected by scattering from aerosol haze, however the solar irradiance is dropping rapidly with wavelength in the SWIR. Spectral signatures, particularly of paints and dyes, may be different in the SWIR band compared to the visible. For these reasons we have chosen to investigate hyper-spectral measurements in this band using the NovaSol μHSI SWIR hyper-spectral imager system.

Laser aided detection and ranging (LADAR) imaging systems are usually corrupted by several pathologic noises. Speckle noise is due to the coherent nature of the laser illuminator. Scintillation noise is introduced by atmospheric turbulence over the outgoing illumination path and manifests itself as a multiplicative noise in the imagery. These noises can be mitigated by a simple recursive averaging algorithm when looking at fixed targets in staring mode. However if the target under observation is moving with respect to the imaging platform, the averaging will cause the target image to smear. In such a case, a maximum a-posteriori (MAP) approach can be used to estimate localized statistics of the scene under observation as well as the scintillation. The parameter estimates can then be incorporated into a spatially and temporally adaptive averaging approach which mitigates the noise while at the same time preserving motion in the scene.

The Standoff Intelligence Detection (SID) program is an Air Force Research Laboratory (AFRL) quick reaction program, tasked with providing the warfighter ready-now technologies related to directed energy, optics, and photonics. The first variant of these aircraft was started in 2008 utilizing two Cessna 182Q aircraft retrofitted with a wing mounted imaging systems and mission equipment. The 3rd generation of these imaging aircraft is equipped on a Cessna T-206H, Turbo Stationair. The aircraft is a 6-seat, single-engine aircraft, retrofitted with an MX-15HDi sensor system and supporting equipment. The SID Program has produced the aircraft to provide an ISR platform to support tests, exercises, search and rescue, and real-world needs.

Laser Aided Detection and Ranging (LADAR) imaging systems can be used to provide high resolution imaging and tracking of moving targets at night. Central to the tracking system is a high speed correlation algorithm to determine target motion between sensor image frames. Several issues complicate the correlation calculations. These include coherent speckle noise and atmosphere induced scintillation of the illuminator beam. The Fitts correlation algorithm is commonly used because of its simplicity and speed. However it is only optimal when the shift between sensor frames is less than a pixel. In addition it can be sensitive to certain types of noise. Projection based phase only (PBPO) is another type of correlation algorithm that is also high speed and in many cases less sensitive to noise. In this paper we compare the Fitts algorithm with PBPO in terms of number of computations and noise immunity when used in a LADAR tracker.

Recent advances in InGaAs camera technology has stimulated interest in the short wave infra-red (SWIR) band in the spectral region 0.9 - 1.7 μm. Located between the visible and thermal infra-red, the SWIR band shows interesting properties of both. Images tends to have the look of the visible and are less affected by scattering from aerosol haze, however the solar irradiance is dropping rapidly with wavelength in the SWIR. Spectral signatures, particularly of paints and dyes, may be different in the SWIR band compared to the visible. For these reasons we have chosen to investigate hyper-spectral measurements in this band using the NovaSol μHSI SWIR hyper-spectral imager system.

Intensity interferometery holds tremendous potential for remote sensing of space objects. Whereas spatial resolution of imagery obtained from earth-based observatories is typically limited by both the size of the primary mirror and atmospheric effects, intensity interferometers (IIs) are relatively unaffected by atmospheric distortions and their effective apertures can be substantially larger than is practical for traditional observatories. Most intensity interferometer measurements have been performed in the visible region due to well-known issues of poor signal to noise ratios and the performance of detectors in the visible spectral bands. In fact the short-wave infrared (SWIR) spectral band is relatively unexplored for II applications. In this paper we investigate the measurement signal to noise terms for a notional SWIR intensity interferometer. Our study goes beyond the most basic SNR equations of II, and analyzes atmospheric effects, sky backgrounds, and detector characteristics, considering the current state-of-the-art for experiments in the short-wave infrared spectral region.

Most non-conventional approaches to image restoration of scenes observed over long atmospheric slant paths require multiple frames of short exposure images taken with low noise focal plane arrays. The individual pixels in these arrays often exhibit spatial non-uniformity in their response. In addition base motion jitter in the observing platform introduces a frame-to-frame linear shift that must be compensated for in order for the multi-frame restoration to be successful. In this paper we describe a maximum aposteriori parameter estimation approach to the simultaneous estimation of the frame-to-frame shifts and the array non-uniformity. This approach can be incorporated into an iterative algorithm and implemented in real time as the image data is being collected. We can not only estimate the scene, but also the angle dependent point spread function. We present a brief derivation of the algorithm as well as its application to actual image data collected from an airborne platform.

Purpose A Phase I/II protocol was conducted to examine the toxicity and efficacy of the combination of intensity-modulated radiation therapy (IMRT) with a single-fraction high-dose-rate (HDR) brachytherapy implant. Methods and Materials From 2001 through 2006, 26 consecutive patients were treated on the trial. The primary objective was to demonstrate a high rate of completion without experiencing a treatment-limiting toxicity. Eligibility was limited to patients with T stage ≤2b, prostate-specific antigen (PSA) ≤20, and Gleason score ≤7. Treatment began with a single HDR fraction of 6 Gy to the entire prostate and 9 Gy to the peripheral zone, followed by IMRT optimized to deliver in 28 fractions with a normalized total dose of 70 Gy. Patients received 50.4 Gy to the pelvic lymph node. The prostate dose (IMRT and HDR) resulted in an average biologic equivalent dose >128 Gy (α/β = 3). Patients whose pretreatment PSA was ≥10 ng/mL, Gleason score 7, or stage ≥T2b received short-term androgen ablation. Results Median followup was 53 months (9–68 months). There were no biochemical failures by either the American Society of Therapeutic Radiology and Oncology or the Phoenix definitions. The median nadir PSA was 0.32 ng/mL. All the 26 patients completed the treatment as prescribed. The rate of Grade 3 late genitourinary toxicity was 3.8% consisting of a urethral stricture. There was no other Grade 3 or 4 genitourinary or gastrointestinal toxicities. Conclusions Single-fraction HDR-boosted IMRT is a safe effective method of dose escalation for localized prostate cancer.

It is well known that luminance from photo-chemical reactions of hydroxyl ions in the upper atmosphere (~85 km altitude) produces a significant amount of night time radiation in the short wave infra-red (SWIR) band between 0.9 and 1.7 μm wave length. This has been demonstrated as an effective illumination source for night time imaging applications. It addition it has been shown that observation of the spatial and temporal variations of the illumination can be used to characterize atmospheric tidal wave actions in the sky glow region. These spatiotemporal variations manifest themselves as traveling wave patterns whose period and velocity are related to the wind velocity at 85 km as well as the turbulence induced by atmospheric vertical instabilities. Ground to space observation systems especially those employing adaptive optics are adversely affected by high altitude turbulence and winds. In this paper we propose the use of sky glow observations to predict and characterize image system degradation due to upper atmosphere turbulence.

We are developing antenna‐coupled TES bolometers for CMB polarimetry that receive both linear polarizations over nearly two octaves of bandwidth. This ultra‐wide bandwidth is achieved with a novel adaptation of the sinuous antenna that integrates microstrip feed‐lines onto the arms of the antenna and uses a contacting extended hemispherical lens to focus the beam. It is challenging to achieve desirable antenna performance over such a wide band and our version of the sinuous antenna offers a unique solution. We have integrated this antenna with TES‐bolometers and report on a series of optical tests that demonstrate the antenna beams’s high symmetry, cross‐polarization rejection, gain, and optical efficiency over the operating band.

This paper presents a practical structural scaling method as applied to the Terrestrial Planet Finder (TPF) Structurally Connected Interferometer Testbed (SCIT). A hybrid scaling law was chosen to scale a strawman on-orbit TPF SCI design down to two smaller test articles for ground operations. Manufacturing and test facility constraints were considered while maintaining scalability and traceability to the flight design.

Discourse is critical to organizations as well as to information technology in a variety of ways, as the literature attests (Alvesson and Karreman 2000; Beech 2000; Benders et al. 1998; Button and Sharrock 1995; Oswick et al. 2000; Rachel and Woolgar 1994). But there is an interesting new catch: the ways we talk about technology, and the content of the technology itself, are increasingly multimodal,involving graphical as well as textual elements (Kress et al. 1997).

PURPOSE: To determine the maximum-tolerated dose and characterize the pharmacokinetic behavior of LU79553, a novel bisnaphthalimide antineoplastic agent, when administered as a daily intravenous infusion for 5 days every 3 weeks. PATIENTS AND METHODS: Patients with advanced solid malignancies received escalating doses of LU79553. Plasma sampling and urine collections were performed on both days 1 and 5 of the first course. RESULTS: Thirty patients received 105 courses of LU79553 at doses ranging from 2 to 24 mg/m2/d. Proximal myopathy, erectile dysfunction, and myelosuppression precluded the administration of multiple courses at doses above 18 mg/m2/d. These toxicities were intolerable in two of six patients after receiving three courses at the 24-mg/m2/d dose level. At the 18-mg/m2/d dose, one of six patients developed febrile neutropenia and grade 2 proximal myopathy after three courses of LU79553. The results of electrophysiologic, histopathologic, and ultrastructural studies supported a drug-induced primary myopathic process. A patient with a platinum- and taxane-resistant papillary serous carcinoma of the peritoneum experienced a partial response lasting 22 months. Pharmacokinetics were dose-independent, optimally described by a three-compartment model, and there was modest drug accumulation over the 5 days of treatment. CONCLUSION: Although no dose-limiting events were noted in the first two courses of LU79553, cumulative muscular toxicity precluded repetitive treatment with LU79553 at doses above 18 mg/m2/d, which is the recommended dose for subsequent disease-directed evaluations. The preliminary antitumor activity noted is encouraging, but the qualitative and cumulative nature of the principal toxicities, as well as the relatively small number of patients treated repetitively, mandate that rigorous and long-term toxicologic monitoring be performed in subsequent evaluations of this unique agent.

Public keys can be trusted if they are digitally signed by a trusted third party. This trust is most commonly conveyed by use of a digital certificate. However, having once established trust in a public key, means must exist to terminate that trust should circumstances dictate. The most common means to do so is through revocation of the corresponding digital certificate. This paper identifies and discusses options that may be considered by those undertaking to address the revocation of digital certificates.