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BACKGROUND Electronic paper (E-paper) screens use electrophoretic ink to provide paper-like low-power displays with advanced networking capabilities that may potentially serve as an alternative to traditional whiteboards and television display screens in hospital settings. E-paper may be leveraged in the emergency department (ED) to facilitate communication. Providing ED patient status updates on E-paper screens could improve patient satisfaction and overall experience and provide more equitable access to their health information. OBJECTIVE We aimed to pilot a patient-facing digital whiteboard using E-paper to display relevant orienting and clinical information in real time to ED patients. We also sought to assess patients’ satisfaction after our intervention and understand our patients’ overall perception of the impact of the digital whiteboards on their stay. METHODS We deployed a 41-inch E-paper digital whiteboard in 4 rooms in an urban, tertiary care, and academic ED and enrolled 110 patients to understand and evaluate their experience. Participants completed a modified Hospital Consumer Assessment of Health Care Provider and Systems satisfaction questionnaire about their ED stay. We compared responses to a matched control group of patients triaged to ED rooms without digital whiteboards. We designed the digital whiteboard based on iterative feedback from various departmental stakeholders. After establishing IT infrastructure to support the project, we enrolled patients on a convenience basis into a control and an intervention (digital whiteboard) group. Enrollees were given a baseline survey to evaluate their comfort with technology and an exit survey to evaluate their opinions of the digital whiteboard and overall ED satisfaction. Statistical analysis was performed to compare baseline characteristics as well as satisfaction. RESULTS After the successful prototyping and implementation of 4 digital whiteboards, we screened 471 patients for inclusion. We enrolled 110 patients, and 50 patients in each group (control and intervention) completed the study protocol. Age, gender, and racial and ethnic composition were similar between groups. We saw significant increases in satisfaction on postvisit surveys when patients were asked about communication regarding delays (P=.03) and what to do after discharge (P=.02). We found that patients in the intervention group were more likely to recommend the facility to family and friends (P=.04). Additionally, 96% (48/50) stated that they preferred a room with a digital whiteboard, and 70% (35/50) found the intervention “quite a bit” or “extremely” helpful in understanding their ED stay. CONCLUSIONS Digital whiteboards are a feasible and acceptable method of displaying patient-facing data in the ED. Our pilot suggested that E-paper screens coupled with relevant, real-time clinical data and packaged together as a digital whiteboard may positively impact patient satisfaction and the perception of the facility during ED visits. Further study is needed to fully understand the impact on patient satisfaction and experience. CLINICALTRIAL ClinicalTrials.gov NCT04497922; https://clinicaltrials.gov/ct2/show/NCT04497922

Sufficient folate intake confers positive health benefits, while deficiency is linked with many health problems. Although the US policy of dietary folic acid fortification has reduced the incidence of these deficiency-related health problems, recent evidence has demonstrated an association between folic acid supplementation and increased colorectal cancer incidence. Few studies have explored the possibility that folate affects other slowly developing cancers. This study sought to determine whether folic acid supplementation is sufficient to alter the growth and development of existing oral cancers. A series of in vitro growth, viability, and adhesion assays were performed using the well-characterized human oral squamous cell carcinoma cell lines, CAL27 and SCC25, to determine the effects of folic acid supplementation. Folic acid administration significantly stimulated CAL27 and SCC25 proliferation in a dose-dependent manner, but it was not sufficient to increase proliferation at any concentration tested in the normal control cell line, HGF-1. Neither oral cancer cell line harbored the common C677T DNA polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene, which might reduce folate bioavailability. Overexpression of p53 mRNA was observed in both cancerous cell lines, but it was differentially altered by folic acid administration in only SCC25 cells. These findings suggest folic acid administration may significantly alter growth of oral cancers in vitro via p53-dependent and p53-independent pathways. As oral cancer rates continue to rise in specific geographic areas, and among specific subsets of the US population, understanding environmental mediators, such as folic acid supplementation, becomes increasingly important for nutrition and public health scientists.

The Morningstar Energy Box is a derivative of both the Searl device and a variant of the Russian Scientists Godin and Roschin. Laminated rollers and a main ring with ferromagnetic fluid are used to enhance electrical and magnetic properties. The device is constrained by a mechanical cage to hold the rollers. An operational theory for the Energy Box uses rotating electromagnetic fields different from either Searl or the Russians. Moreover, the Russians made several serious claims that produced self-acceleration to generate electricity, created a large weight loss when spun in one direction and weight gain when spun in the opposite direction. They also claimed their device generated discrete magnetic walls. To date, no one has validated these outrageous Russian claims. However, the Energy Box found similar phenomenon regarding the discrete magnetic walls with both weight gain and loss, although not at the same magnitude. Where they claimed to lose as much as 35% of the weight of a 375 kg armature, the Energy Box in an early test only lost 2 to 5 pounds of its 190 pounds at steady-state. During transient rotation changes, the weight change dropped as much as 20 to 40 pounds. However, a last test series recorded a weight lost of 14 pounds with a 7.3% change during steady-state. We can state that we saw similar phenomena as the Russian claims as well as lost weight and the device may represent an advanced propulsion scheme for space travel. Nomenclature B = Magnetic field E = Electric field J = Current S = Poynting vector t = Time

Proanthocyanidins, compounds highly concentrated in dietary fruits, such as cranberries and grapes, demonstrate significant cancer prevention potential against many types of cancer. The objective of this study was to evaluate cranberry and grape seed extracts to quantitate and compare their anti-proliferative effects on the most common type of oral cancer, oral squamous cell carcinoma. Using two well-characterized oral squamous cell carcinoma cell lines, CAL27 and SCC25, assays were performed to evaluate the effects of cranberry and grape seed extract on phenotypic behaviors of these oral cancers. The proliferation of both oral cancer cell lines was significantly inhibited by the administration of cranberry and grape seed extracts, in a dose-dependent manner. In addition, key regulators of apoptosis, caspase-2 and caspase-8, were concomitantly up-regulated by these treatments. However, cranberry and grape seed extracts elicited differential effects on cell adhesion, cell morphology, and cell cycle regulatory pathways. This study represents one of the first comparative investigations of cranberry and grape seed extracts and their anti-proliferative effects on oral cancers. Previous findings using purified proanthocyanidin from grape seed extract demonstrated more prominent growth inhibition, as well as apoptosis-inducing, properties on CAL27 cells. These observations provide evidence that cranberry and grape seed extracts not only inhibit oral cancer proliferation but also that the mechanism of this inhibition may function by triggering key apoptotic regulators in these cell lines. This information will be of benefit to researchers interested in elucidating which dietary components are central to mechanisms involved in the mediation of oral carcinogenesis and progression.

This paper presents the results of a set of impinging jet gel spray experiments and the tools used to analyze the results. The use of gelled propellants in combustion chambers has offered storage and safety benefits, but the spray characteristics of non-Newtonian fluids at high shear rates is poorly understood. This is due to the complex stresses inside these fluids as well as the difficulty of measuring and characterizing the spray properties. Current analysis techniques commonly focus on droplet diameter or SMD. When working with gelled liquids, the large variety of shapes and structures present invalidates such a representation. An algorithm for analyzing spray images is presented here which approximates the surface area and volume of arbitrarily shaped distinct objects in a spray image. For more dense sprays another analysis method is described which makes no geometric assumptions. This method is based on modal decomposition and frequency analysis to quantify trends in a set of images. Applying these two procedures to experimental data, several trends were identified. Among these it was found that the addition of gel makes spray feature sizes less sensitive to shear rate. Higher gel concentrations produce larger drops even though they require higher spray velocities to break up. It is anticipated that the techniques presented here may be used to put numbers to properties which have formerly only been qualitative, and provide numerical trends to predict gel spray results.

Thermoelastic stress analysis measures temperature variations in loaded solids and relates these to associated stresses. For orthotropic materials, the measured signal is proportional to a linear combination of the normal stress changes in the directions of material symmetry, and K1 and K2 are thermo-mechanical coefficients. Quantitative thermoelastic stress analysis of orthotropic composites necessitates (i) determination of the above two thermo-mechanical coefficients (i.e. calibration), and (ii) separation of the stresses. Although calibration procedures can take different forms, K1 and K2 can be experimentally determined most reliably and easily from calibration specimens of the same material, paint coating, loading frequency and ambient conditions as the test structure. Such calibration specimens typically employ a geometry and loading for which the state of stress or strain is known theoretically, or independently determined. Loaded beams, a diametrically-compressed disk, or uniaxial tensile coupons have been used for isotropic materials. Orthotropic materials usually necessitate testing two calibration specimens, with their principal material directions interchanged respectively. The present paper demonstrates the ability to determine both K1 and K2 from a single diametrally-loaded orthotropic composite (graphite/epoxy) disk. To be able to determine both coefficients from a single calibration specimen is advantageous. Disks are also easy to machine and load, rendering them very convenient for calibration.Copyright © 2006 by ASME

The skin of 41 patients including 16 blacks, 15 Caucasiatis, and 10 Hispanics, was observed using a fluorescent microscope. Three patterns of autofluorescence were observed: intercellular, cytoplasmic, and a combination of inter cellular and cytoplasmic. The hair of 75 subjects, including 18 Negroes and 55 Caucasians, was observed. Two patterns were found: medullar and at the cortex. Skin from black patients was associated with the cytoplasmic pattern of autofluorescence. Compared to lighter skin, black skin was also significantly associated with increased intensity of autofluorescence indicating that autoflorescence of the epidermis parallels the link al degree of pigmentation. In the hair of 75 subjects, similar results were obtained: Negro hair exhibited more fluorescnce than Caucasian hair, and darker hair (brown to black) exhibited more fluorescence than lighter hair(blond). This may be related to melanin and its breakdown products.

To the Editor.— Fifteen patients with herpes gestationis have been studied with immunofluorescence, and the findings reported, 1,2 since Provost and Tomasi, 3 have demonstrated C3 at the basement membrane zone in two cases in 1973. In all 17 cases, C3 was found at the basement membrane zone, while 11 showed IgG at the basement membrane zone by direct test, and only two showed circulating serum antibodies to the basement membrane zone (Table). These findings show herpes gestationis has distinct immunofluorescent characteristics, closer to bullous pemphigoid than it is to dermatitis herpetiformis, a concept that was previously based on clinical descriptions. Interesting atypical fluorescent findings have recently been reported in the bullous diseases. 4-6 We now describe a unique case that was diagnosed as herpes gestationis on clinical grounds but with features of pemphigus and herpes gestationis on immunofluorescence testing. Report of a Case.— A maculopapular pruritic eruption developed on

• Previous reports showed that cyclophosphamide used late in the treatment of patients with pemphigus vulgaris reduced the complications due to steroids. In this study, cyclophosphamide was used in the initial treatment of five patients with pemphigus vulgaris in combination with prednisone to avoid side-effects of prednisone. Two patients had no prior treatment with steroids for pemphigus. Results indicate that the initial combined program may be a highly effective treatment method for pemphigus vulgaris. Followup from one to four years after treatment shows all five patients in remission; four require no medication. ( Arch Dermatol 114:889-894, 1978)