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Improving the readiness and lethality of the U.S. fighting forces has always been a key priority, and it received renewed emphasis in the National Defense Authorization Act of 2017. A major rearrangement of the Defense Health Agency and the Military Health System is ongoing with this emphasis. Although revising features to improve our military health service is essential, the health, well-being, and readiness of our people will also rely on the culture created at the Command level where soldiers, sailors, airmen and civilians operate daily. In alignment with our military health care community and in support of our renewed emphasis on warfighting readiness, USS Missouri began a journey to address foundational mindset that drives the core behaviors, training, and procedures of the submarine force and Naval Nuclear Propulsion Principles leading to enhanced readiness, resilience, and accountability.

JEEP is a high-energy (50–150 keV) multi-purpose beamline offering polychromatic and monochromatic modes. It can accommodate large samples and experimental rigs, enabling in situ studies using radiography, tomography, energy-dispersive diffraction, monochromatic and white-beam two-dimensional diffraction/scattering and small-angle X-ray scattering., I12 is the Joint Engineering, Environmental and Processing (JEEP) beamline, constructed during Phase II of the Diamond Light Source. I12 is located on a short (5 m) straight section of the Diamond storage ring and uses a 4.2 T superconducting wiggler to provide polychromatic and monochromatic X-rays in the energy range 50–150 keV. The beam energy enables good penetration through large or dense samples, combined with a large beam size (1 mrad horizontally × 0.3 mrad vertically). The beam characteristics permit the study of materials and processes inside environmental chambers without unacceptable attenuation of the beam and without the need to use sample sizes which are atypically small for the process under study. X-ray techniques available to users are radiography, tomography, energy-dispersive diffraction, monochromatic and white-beam two-dimensional diffraction/scattering and small-angle X-ray scattering. Since commencing operations in November 2009, I12 has established a broad user community in materials science and processing, chemical processing, biomedical engineering, civil engineering, environmental science, palaeontology and physics.

Background and Purpose— On the basis of phase II trials, we considered that transcranial laser therapy could have neuroprotective effects in patients with acute ischemic stroke. Methods— We studied transcranial laser therapy in a double-blind, sham-controlled randomized clinical trial intended to enroll 1000 patients with acute ischemic stroke treated ≤24 hours after stroke onset and who did not undergo thrombolytic therapy. The primary efficacy measure was the 90-day functional outcome as assessed by the modified Rankin Scale, with hierarchical Bayesian analysis incorporating relevant previous data. Interim analyses were planned after 300 and 600 patients included. Results— The study was terminated on recommendation by the Data Monitoring Committee after a futility analysis of 566 completed patients found no difference in the primary end point (transcranial laser therapy 140/282 [49.6%] versus sham 140/284 [49.3%] for good functional outcome; modified Rankin Scale, 0–2). The results remained stable after inclusion of all 630 randomized patients (adjusted odds ratio, 1.024; 95% confidence interval, 0.705–1.488). Conclusions— Once the results of the interim futility analysis became available, all study support was immediately withdrawn by the capital firms behind PhotoThera, and the company was dissolved. Proper termination of the trial was difficult but was finally achieved through special efforts by former employees of PhotoThera, the CRO Parexel and members of the steering and the safety committees. We conclude that transcranial laser therapy does not have a measurable neuroprotective effect in patients with acute ischemic stroke when applied within 24 hours after stroke onset. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01120301.

A novel X-ray Beam Position Monitor has been designed and implemented on the Multimode InfraRed Imaging And Microspectroscopy (MIRIAM) beamline at Diamond. Installed in the B22 Front End and using no optical elements except for filters, it provides sub-micrometre position sensitivity and sub-microradiant angular sensitivity to Bending Magnet source vertical movements. By sampling at 100 kHz frequency, Fast Fourier Transform analysis is continuously displayed and any periodic components in the Synchrotron Radiation emission are revealed within the exceptional bandwidth of 50 kHz. Long term source drift in position or angle are monitored and recorded every 0.5 seconds.