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Although widely used as a job title in academia, the role of Program Coordinator (PC) is often not well-defined and rarely matches the job description.The PC is responsible for a wide variety of programmatic tasks, which requires them to “change hats” throughout the day and the role evolves as an academic program progresses.How a program is initially set up tends to be more of a ”road map” but many detours may lie ahead and it may fall on the PC to navigate the new terrain and possibly help forge the new path by considering the needs and feedback of students, faculty and other stakeholders.Although the examples in this paper are from the perspectives of PCs who operate in National Science Foundation Research Traineeship (NRT) programs, the experiences and advice are applicable to any academic or research program, especially interdisciplinary programs.

Improving diversity in the healthcare workforce holds promise in improving the health outcomes of our diverse patient population. Attracting, recruiting, and retaining physicians from races and ethnicities that are historically underrepresented in medicine are vital in this effort. Increasing diversity at the graduate medical education level has the potential to positively reshape our physician personnel. In this editorial, we discuss the current state of diversity-oriented recruitment strategies for residency programs and present opportunities for future efforts.

To determine whether a brief leadership curriculum including high-fidelity simulation can improve leadership skills among resident physicians.This was a double-blind, randomized controlled trial among obstetrics-gynecology and emergency medicine (EM) residents across 5 academic medical centers from different geographic areas of the United States, 2015-2017. Participants were assigned to 1 of 3 study arms: the Leadership Education Advanced During Simulation (LEADS) curriculum, a shortened Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) curriculum, or as active controls (no leadership curriculum). Active controls were recruited from a separate site and not randomized to limit any unintentional introduction of materials from leadership curricula. The LEADS curriculum was developed in partnership with the Council on Resident Education in Obstetrics and Gynecology and Council of Residency Directors in Emergency Medicine as a novel way to provide a leadership toolkit. Both LEADS and the abbreviated TeamSTEPPS were designed as six 10-minute interactive web-based modules.The primary outcome of interest was the leadership performance score from the validated Clinical Teamwork Scale instrument measured during standardized high-fidelity simulation scenarios. Secondary outcomes were 9 key components of leadership from the detailed leadership evaluation measured on 5-point Likert scales. Both outcomes were rated by a blinded clinical video reviewer.One hundred ten obstetrics-gynecology and EM residents participated in this 2-year trial. Participants in both LEADS and TeamSTEPPS had statistically significant improvement in leadership scores from "average" to "good" ranges both immediately and at the 6-month follow-up, while controls remained unchanged in the "average" category throughout the study. There were no differences between LEADS and TeamSTEPPS curricula with respect to the primary outcome.Residents who participated in a brief structured leadership training intervention had improved leadership skills that were maintained at 6-month follow-up.

Organic materials are an attractive choice for structural components due to their light weight and versatility. However, because they decompose at low temperatures relative to traditional materials, they pose a safety risk due to fire and loss of structural integrity. To quantify this risk, analysts use chemical kinetics models to describe the material pyrolysis and oxidation using thermogravimetric analysis (TGA). This process requires the calibration of many model parameters to closely match experimental data. Previous efforts in this field have largely been limited to finding a single best-fit set of parameters even though the experimental data may be very noisy. Furthermore, the chemical kinetics models are often simplified representations of the true decomposition process. The simplification induces model-form errors that the fitting process cannot capture. In this work, we propose a methodology for calibrating decomposition models to TGA data that accounts for uncertainty in the model-form and experimental data simultaneously. The methodology is applied to the decomposition of a carbon fiber epoxy composite with a three-stage reaction network and Arrhenius kinetics. The results show a good overlap between the model predictions and TGA data. Uncertainty bounds capture deviations of the model from the data. The calibrated parameter distributions are also presented. The distributions may be used in forward propagation of uncertainty in models that leverage this material.

Introduction: In the wake of George Floyd’s murder, White faculty in our department began to express the desire to gain a greater understanding of structural racism and racial inequity. To facilitate this learning, support allyship, and mitigate the emotional labor and taxation that frequently falls on faculty of color to respond to these appeals, we developed AWARE (Allies Welcomed to Advance Racial Equity), a faculty seminar series primarily designed for and led by a majority White faculty to tackle the topics of structural racism, Whiteness, and Anti-racist action. Methods: We developed a 6-session seminar series, identifying 5 White faculty as lecturers and a cadre of Black and White volunteer facilitators, to lead 60-minute sessions comprised of lecture, facilitated small group reflection, and large group sharing, that reviewed key topics/texts on structural racism, Whiteness, and Anti-racism. Results: Attendance ranged from 26 to 37 participants at each session. About 80% of faculty participated in at least 1 session of the program. The majority of participants (85%) felt “more empowered to influence their current environment to be more inclusive of others” and were “better equipped to advocate for themselves or others.” Most (81%) felt “more connected to their colleagues following completion of the program.” Ultimately, faculty thought highly of the program upon completion with 26/27 (96%) stating they would recommend the program to a colleague. Discussion: We offer a reproducible model to improve departmental climate by engaging in the shared labor of educating our colleagues and communities about structural racism, Whiteness, and Anti-racism to create a point of entry into reflection, dialogue, and deliberate actions for change.

Schizophrenia risk is associated with increased gene copy number and brain expression of complement component 4 (C4). Because the complement system facilitates synaptic pruning, the C4 association has renewed interest in a hypothesis that excessive pruning contributes to schizophrenia pathogenesis. However, little is known about complement regulation in neural tissues or whether such regulation could be relevant to psychiatric illness. Intriguingly, common variation within CSMD1, which encodes a putative complement inhibitor, has consistently associated with schizophrenia at genome-wide significance. We found that Csmd1 is predominantly expressed in the brain by neurons, and is enriched at synapses; that human stem cell-derived neurons lacking CSMD1 are more vulnerable to complement deposition; and that mice lacking Csmd1 have increased brain complement activity, fewer synapses, aberrant complement-dependent development of a neural circuit, and synaptic elements that are preferentially engulfed by cultured microglia. These data suggest that CSMD1 opposes the complement cascade in neural tissues.Graphic Abstract.Our findings support a model in which CSMD1 opposes actions of the complement cascade in neural tissues (top left). We investigated two models in which Csmd1 was genetically ablated: human cortical neurons derived from embryonic stem cells, and a back-crossed C57bl6-Tac mouse line (top right). Csmd1 is normally expressed by neurons and present at synapses where it can protect them from complement (bottom left); in the absence of Csmd1 (bottom right), we find more deposition of complement (on cultured human cortical neurons and in the mouse visual system), reduced numbers of synapses (in the mouse visual system), and synaptic fractions that are more readily engulfed by microglia (ex vivo). Created with BioRender.com.

Neuronal circuit assembly requires the fine balance between synapse formation and elimination. Microglia, through the elimination of supernumerary synapses, have an established role in this process. While the microglial receptor TREM2 and the soluble complement proteins C1q and C3 are recognized as key players, the neuronal molecular components that specify synapses to be eliminated are still undefined. Here, we show that exposed phosphatidylserine (PS) represents a neuronal “eat‐me” signal involved in microglial‐mediated pruning. In hippocampal neuron and microglia co‐cultures, synapse elimination can be partially prevented by blocking accessibility of exposed PS using Annexin V or through microglial loss of TREM2. In vivo, PS exposure at both hippocampal and retinogeniculate synapses and engulfment of PS‐labeled material by microglia occurs during established developmental periods of microglial‐mediated synapse elimination. Mice deficient in C1q, which fail to properly refine retinogeniculate connections, have elevated presynaptic PS exposure and reduced PS engulfment by microglia. These data provide mechanistic insight into microglial‐mediated synapse pruning and identify a novel role of developmentally regulated neuronal PS exposure that is common among developing brain structures., Exposed phosphatidylserine on pre‐ and postsynaptic membranes functions as an “eat‐me” signal contributing to microglia‐mediated synapse pruning.

Under normal operating conditions, polymer foams protect components from mechanical, electrical, and thermal shocks. However, if the protecting polymer foam is exposed to a heat source such as a fire or an over-heating component, the foam will pyrolyze, changing heat paths by creating voids or dripping onto components. Material properties also change as the virgin material becomes char, gas, or liquid. In a sealed system, the gases created by the pyrolysates can also pressurize the system, leading to breach. Understanding the chemistry, heat transfer, and fluid flow of these materials in a fire is vital for safety assessments. To investigate such a scenario, a 2D finite element model with heat transfer, porous media flow, and a pyrolysis chemistry model was created. The gas velocity is solved using Darcy’s approximation, and the heat transfer and pressurization are determined by solving the continuity, species, and enthalpy equations in both the condensed and gas phases. A vapor–liquid equilibrium (VLE) model is used to determine the phase of the pyrolysates. The model was validated using experimental data that showed that the rate of pressurization and the local temperatures are dependent on orientation with respect to gravity. In addition, at the high temperatures and pressures seen in these experiments, it is expected that the organic pyrolysates will exist in both the liquid and gaseous phases. The model reproduces the orientation dependence of the temperature and pressure, as well as the condensation and evaporation of organic pyrolysates. Model uncertainty is analyzed using a Latin Hypercube approach, and sensitivities are ranked using the Pearson correlation. The inverted orientation shows a larger model uncertainty due the buoyant flow. The model was generally sensitive to the density of the steel, the density of the foam, and the pyrolysis reactions.

Archaeological inquiry into the landscapes produced by free Black Americans has greatly contributed to understandings of how spatial use continued to reflect resistance to racial subjugation during the Reconstruction and Jim Crow eras. In this article, I discuss the community of Antioch Colony, a freedmen’s community located in central Texas, to consider the remaking of Black community in the rural countryside between the years of 1870 and 1954. Using oral histories, historic aerial photography, and historic maps, I examine the ways residents of Antioch Colony adapted their landscape over time to create an empowering environment suitable for their needs in the post-bellum period. Through my analysis, I find that the landscape created reinforced a sense of belonging by allowing people to freely congregate and move through space.

This review addresses two puzzling findings related to mutations in galactocerebrosidase (GALC) that cause Krabbe disease (KD), a severe lysosomal storage disorder characterized by extensive myelin damage in children with mutations in both GALC alleles. First, heterozygous carriers of KD-causing mutations, which include the biological parents of children with KD, exhibit increased risk for developing other diseases. Second, variants in the GALC locus increase the risk of developing multiple sclerosis (MS), another disease characterized by extensive myelin damage. What explains these correlations? In studies on cuprizone-induced myelin damage in heterozygous (GALC+/-) mice carrying one copy of a mutation that causes KD-like disease, the extent of damage was similar in GALC+/- and wild-type (WT) mice. In contrast, GALC+/- mice had striking defects in repair of cuprizone-induced damage. We further found unexpected microglial defects in myelin debris clearance and in the ability to up-regulate the Trem2 microglial protein critical for debris uptake. These defects were rescued by exposure to a lysosomal re-acidifying drug discovered in our studies on KD, and which provides multiple clinically relevant benefits in the twitcher (GALC+/-) mouse model of KD. Thus, heterozygous GALC mutations cause effects on biological function that may help to understand the increased disease risk in heterozygous carriers of such mutations and to understand why GALC variations increase the risk of MS. Our findings indicate that while some genetic risk factors may contribute to complex diseases by increasing the risk of tissue damage, others may do so by compromising tissue repair.

Research involving measurements of sensory perception among the older adult population is complicated by difficulties with traditional testing methods for these individuals. A trend in food sensory testing is the use of rapid profiling techniques. Three rapid profiling techniques – check-all-that-apply (CATA), sorting and projective mapping– were tested in an older adult population (aged 60+) to determine their appropriateness of use with this population. Participants (n = 60) attended three sessions where seven commercially available instant and ready-made puddings along with two duplicate samples were evaluated using each of the three rapid profiling methods. A younger cohort of individuals (n = 60) was used as a control. All three methods appeared to produce valid results in the older population group, however, higher panelist reliability, lower difficulty and higher percentage of correct completions led to the conclusion that CATA is the most appropriate rapid profiling test for older adults.

Genome-wide association studies are identifying multiple genetic risk factors for several diseases, but the functional role of these changes remains mostly unknown. Variants in the galactocerebrosidase (GALC) gene, for example, were identified as a risk factor for Multiple Sclerosis (MS); however, the potential biological relevance of GALC variants to MS remains elusive. We found that heterozygote GALC mutant mice have reduced myelin debris clearance and diminished remyelination after a demyelinating insult. We found no histological or behavioral differences between adult wild-type and GALC +/- animals under normal conditions. Following exposure to the demyelinating agent cuprizone, however, GALC +/- animals had significantly reduced remyelination during recovery. In addition, the microglial phagocytic response and elevation of Trem2, both necessary for clearing damaged myelin, were markedly reduced in GALC +/- animals. These altered responses could be corrected in vitro by treatment with NKH-477, a compound discovered as protective in our previous studies on Krabbe disease, which is caused by mutations in both GALC alleles. Our data are the first to show remyelination defects in individuals with a single mutant GALC allele, suggesting such carriers may have increased vulnerability to myelin damage following injury or disease due to inefficient myelin debris clearance. We thus provide a potential functional link between GALC variants and increased MS susceptibility, particularly due to the failure of remyelination associated with progressive MS. Finally, this work demonstrates that genetic variants identified through genome-wide association studies may contribute significantly to complex diseases, not by driving initial symptoms, but by altering repair mechanisms.

This session will highlight several challenging and complicated cases of anxiety treated in an interdisciplinary geriatric outpatient clinic and nursing home settings. We will share our lessons learned from these clinical encounters with the assistance of Dr. Tawny Smith, a clinical psychiatric pharmacist. Dr. Lara will discuss a case of a patient with major depressive disorder with psychosis which mimicked new onset anxiety disorder. She will review the diagnostic challenges associated with anxiety disorders masking and exacerbating major depressive disorder and the treatment approach for this patient. In addition, Dr. Scott will discuss a case of a patient distressed by anxiety who was found to be most appropriately diagnosed with mixed features of a bipolar II disorder. She will review the overlap between uncomplicated anxiety and mixed features, and clinical pearls for distinguishing between the two. She will also discuss medication choices for treatment of a mixed episode. Dr. Nettles will discuss a case of a patient with Generalized Anxiety Disorder and Panic Disorder who had been managed long term with increasingly high dose benzodiazepines. She will review clinical pearls and challenges of managing this complicated patient and safely tapering high dose benzodiazepines while still managing anxiety. Lastly, Dr. Gonzalez will discuss the pharmacologic management of anxiety in a patient in a nursing home with co-morbid major neurocognitive disorder. Specifically, he will highlight the challenges of utilizing medications that address anxiety and underlying PTSD symptoms, while being mindful of medication side effects that can worsen neurocognitive symptoms. Dr. Smith will review clinical pearls related to the cases presented. In addition, we will share knowledge regarding literature updates, as well as guidelines for treatment of the aging patient with anxiety.

This paper presents a proposed methodology for applying statistical techniques as the basis for validation activities of a computer model of heat transfer. To demonstrate this approach, a case study of a Ruggedized Instrumentation Package subject to heating from battery discharge and electrical resistance during normal operations is considered. First, the uncertainty in the simulation due to the discretization of the governing partial differential equations is quantified. This error is analogous to the measure ment error in an experiment in that it is not representative of actual physical variation, and is necessary to completely characterize the range of simulation outcomes. Secondly, physical uncertainties, such as unknown or variable material properties, are incorporated into the model and propagated through it. To this end, a sensitivity study enables exploration of the output space of the model. Experiments are considered to be a realization of one of these possible outcomes, with the added complication of containing physical processes not included in the model. Statistical tests are proposed to quantitatively compare experimental measurements and simulation results. The problem of discrepancies between the computational model and tests is considered as well.

Within the context of a multiple baseline design, the researchers in this investigation used a constant time delay (CTD) procedure to teach two classroom support personnel (i.e., paraprofessional, peer tutor) to use a simultaneous prompting (SP) procedure when teaching a high school student with a moderate intellectual disability to (a) identify words from science core content, (b) identify words from social studies core content, (c) make Kool-Aid, and (d) alphabetize last names by their first letters. The classroom teacher implemented the CTD procedure with a high degree of fidelity, the paraprofessional and the peer tutor implemented the SP procedure with high levels of fidelity, and the student increased his ability to perform the targeted skills.

Author(s): Scott, Sarah Nicole | Advisor(s): Fernandez-Pello, A C | Abstract: Polymer foam encapsulants provide mechanical, electrical, and thermal isolation in engineered systems. It can be advantageous to surround objects of interest, such as electronics, with foams in a hermetically sealed container to protect the electronics from hostile environments, such as a crash that produces a fire. However, in fire environments, gas pressure from thermal decomposition of foams can cause mechanical failure of the sealed system.In this work, a detailed study of thermally decomposing polymeric methylene diisocyanate (PMDI)-polyether-polyol based polyurethane foam in a sealed container is presented. Both experimental and computational work is discussed. Validation experiments, called Foam in a Can (FIC) are presented. In these experiments, 320 kg/m3 PMDI foam in a 0.2 L sealed steel container is heated to 1073 K at a rate of 150 K/min and 50 K/min. FIC is tested in two orientations, upright and inverted. The experiment ends when the can breaches due to the buildup of pressure from the decomposing foam. The temperature at key locations is monitored as well as the internal pressure of the can. When the foams decompose, organic products are produced. These products can be in the gas, liquid, or solid phase. These experiments show that the results are orientation dependent: the inverted cans pressurize, and thus breach faster than the upright. There are many reasons for this, among them: buoyancy driven flows, the movement of liquid products to the heated surface, and erosive channeling that enhance the foam decomposition. The effort to model this problem begins with Erickson’s No Flow model formulation. In this model, Arrhenius type reactions, derived from Thermogravimetric Analysis (TGA), control the reaction. A three-step reaction is used to decompose the PMDI RPU (rigid polyurethane foam) into CO2, organic gases, and char. Each of these materials has unique properties. The energy equation is used to solve for temperature through the domain. Though gas is created in the reaction mechanism, it does not advect, rather, its properties are taken into account when calculating the material properties, such as the effective conductivity. The pressure is calculated using the ideal gas law. A rigorous uncertainty quantification (UQ) assessment, using the mean value method, along with an analysis of sensitivities, is presented for this model. The model is also compared to experiments. In general, the model works well for predicting temperature, however, due to the lack of gas advection and presence of a liquid phase, the model does not predict pressure well. Porous Media Model is then added to allow for the advection of gases through the foam region, using Darcy’s law to calculate the velocity. Continuity, species, and enthalpy equations are solved for the condensed and gas phases. The same reaction mechanism as in the No Flow model is used, as well as material properties. A mesh resolution study, as well as a calibration of parameters is conducted, and the model is compared to experimental results. This model, due to the advection of gases, produces gravity dependent results that compare well to experiment. However, there were several properties that had to be calibrated, and replacing these calibrated parameters with physically derived values is desired. To that end, Vapor Liquid Equilibrium (VLE) equations are added to the Porous Media model. These equations predict the vapor/liquid split of the organic decomposition products based on temperature and pressure. UQ for the parameters in the model as well as a sensitivity study is presented, in addition to comparison to experiment. The addition of the VLE improved temperature and pressure prediction, both qualitatively and quantitatively.

Wildland and wildland/urban interface fires are a serious problem in many areas of the world. It is expected that with global warming the wildfire and wildland/urban interface fire problem will only intensify. The ignition of natural combustible material by hot metal particles or embers is an important fire ignition pathway by which wildland and urban spot fires are started. There are numerous cases reported of wild fires started by hot metal particles from clashing power lines, or from sparks generated by machines or engines. Similarly there are many cases reported of industrial fires caused by grinding and welding sparks. Despite the importance of the subject, the topic remains relatively unstudied. The senior author of this article and his collaborators have been working for the past few years on this problem. In this article, we provide a comprehensive summary of that work to date. The work includes experimental and theoretical modeling of the ability of hot metal particles and embers to cause the ign...

Polymer foam encapsulants provide mechanical, electrical, and thermal isolation in engineered systems. It can be advantageous to surround objects of interest, such as electronics, with foams in a hermetically sealed container in order to protect them from hostile environments or from accidents such as fire. In fire environments, gas pressure from thermal decomposition of foams can cause mechanical failure of sealed systems. In this work, a detailed uncertainty quantification study of polymeric methylene diisocyanate (PMDI)-polyether-polyol based polyurethane foam is presented and compared to experimental results to assess the validity of a 3-D finite element model of the heat transfer and degradation processes. In this series of experiments, 320 kg/m3 PMDI foam in a 0.2 L sealed steel container is heated to 1,073 K at a rate of 150 K/min. The experiment ends when the can breaches due to the buildup of pressure. The temperature at key location is monitored as well as the internal pressure of the can. Both experimental uncertainty and computational uncertainty are examined and compared. The mean value method (MV) and Latin hypercube sampling (LHS) approach are used to propagate the uncertainty through the model. The results of the both the MV method and the LHS approach show that while the model generally can predict the temperature at given locations in the system, it is less successful at predicting the pressure response. Also, these two approaches for propagating uncertainty agree with each other, the importance of each input parameter on the simulation results is also investigated, showing that for the temperature response the conductivity of the steel container and the effective conductivity of the foam, are the most important parameters. For the pressure response, the activation energy, effective conductivity, and specific heat are most important. The comparison to experiments and the identification of the drivers of uncertainty allow for targeted development of the computational model and for definition of the experiments necessary to improve accuracy.

Study objective. To compare the amount of segmental vertebral motion produced with the lateral recovery position and the HAINES technique when performed on cadavers with destabilized cervical spines. Methods. The cervical spines of 10 cadavers were surgically destabilized at the C5–C6 vertebral segment. Sensors from an electromagnetic tracking device were affixed to the vertebrae in question to monitor the amount of anterior/posterior, medial/lateral, and distraction/compression linear motion produced during the application of the two study techniques. Results. The statistical analysis of linear motion data did not reveal any significant differences between the two recovery positions. Conclusion. At this time, no single version of the recovery position can be endorsed for the spine-injured trauma patient. More research is needed to fully ascertain the safety of commonly used recovery positions.

Neurodegenerative lysosomal storage disorders (LSDs) are severe and untreatable, and mechanisms underlying cellular dysfunction are poorly understood. We found that toxic lipids relevant to three different LSDs disrupt multiple lysosomal and other cellular functions. Unbiased drug discovery revealed several structurally distinct protective compounds, approved for other uses, that prevent lysosomal and cellular toxicities of these lipids. Toxic lipids and protective agents show unexpected convergence on control of lysosomal pH and re-acidification as a critical component of toxicity and protection. In twitcher mice (a model of Krabbe disease [KD]), a central nervous system (CNS)-penetrant protective agent rescued myelin and oligodendrocyte (OL) progenitors, improved motor behavior, and extended lifespan. Our studies reveal shared principles relevant to several LSDs, in which diverse cellular and biochemical disruptions appear to be secondary to disruption of lysosomal pH regulation by specific lipids. These studies also provide novel protective strategies that confer therapeutic benefits in a mouse model of a severe LSD., Different structurally related lipids from three genetically distinct lysosomal storage disorders are sufficient to cause multiple dysfunctions that converge on disruption of lysosomal pH as a core pathogenic mechanism., Author Summary Neurodegenerative lysosomal storage disorders (LSDs) are severe and untreatable recessive genetic disorders that cause devastating damage to the nervous system. These diseases exhibit severe disruption of lysosomes (a cellular organelle that breaks down lipids and proteins) and other aspects of cell function. However, the means by which mutations cause these dysfunctions are poorly understood. By studying different lipids that accumulate in three different LSDs, we found that lipids with specific shared structures are sufficient to cause multiple lysosomal and cellular dysfunctions, including an abnormal alkalization of the lysosomal pH. We prevented all of these dysfunctions by promoting lysosomal re-acidification and discovered several drugs—already approved for other purposes—with unexpected abilities to restore lysosomal pH and rescue cells. In a genetic mouse model of a severe LSD, one of these compounds decreased tissue damage, improved quality of life, and extended survival. In contrast with previous studies on individual disorders, our study provides novel shared principles relevant to several LSDs and uncovers relevant compounds able to provide multiple benefits in a disease-relevant model in vivo.

The American Academy of Pediatrics and the American Academy of Family Physicians believe that infants, children, and adolescents benefit from having a medical home, characterized by accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care. Several studies suggest that patients with asthma benefit from having a medical home. However, no national study has been conducted examining the relationships between having a medical home and asthma control in school-aged children with asthma. The purpose of this study was to examine the hypothesis that having an adequate medical home is protective against uncontrolled asthma in children.To test this hypothesis, cross-sectional data from the 2003-2004 National Survey of Children's Health were analyzed. Analyses entailed creating the variables "medical home" as well as "uncontrolled asthma" from multiple variables. Multivariate analysis was performed using children with uncontrolled asthma as the dependent variable.The logistic regression model performed yielded that school-aged children with uncontrolled asthma were more likely to: speak a primary language other than English (OR, 1.069; 95% CI, 1.045-1.093); live in households with incomes100% of the federal poverty level (FPL) (OR, 1.826; 95% CI, 1.810-1.842); not have health insurance (OR, 2.296; 95% CI, 2.263-2.330); live in rural rather than metropolitan areas (OR, 1.275; 95% CI, 1.262-1.287); and be non-Caucasian (OR, 2.067; 95% CI, 2.050-2.085). Multivariate analysis also yielded that children with uncontrolled asthma were more likely to have a medical home (OR, 1.138; 95% CI, 1.128-1.148).After controlling for possible confounding variables, this study did not detect an association between having a medical home and asthma control for children with asthma aged 5 to 17 years. Additional research should examine the relationship between variables, such as poverty, place of residence, health insurance status, and the medical home, not only in the instance of uncontrolled asthma, but for other childhood health conditions.

Background A patient with a suspected cervical spine injury may be at risk for secondary neurologic injury when initially placed and repositioned to the center of the spine board. Objectives We sought to determine which centering adjustment best limits cervical spine movement and minimizes the chance for secondary injury. Methods Using five lightly embalmed cadaveric specimens with a created global instability at C5–C6, motion sensors were anchored to the anterior surface of the vertebral bodies. Three repositioning methods were used to center the cadavers on the spine board: horizontal slide, diagonal slide, and V-adjustment. An electromagnetic tracking device measured angular (degrees) and translation (millimeters) motions at the C5–C6 level during each of the three centering adjustments. The dependent variables were angular motion (flexion-extension, axial rotation, lateral flexion) and translational displacement (anteroposterior, axial, and medial-lateral). Results The nonuniform condition produced significantly less flexion-extension than the uniform condition ( p = 0.048). The horizontal slide adjustment produced less cervical flexion-extension ( p = 0.015), lateral bending ( p = 0.003), and axial rotation ( p = 0.034) than the V-adjustment. Similarly, translation was significantly less with the horizontal adjustment than with the V-adjustment; medial-lateral ( p = 0.017), axial ( p p = 0.006). Conclusions Of the three adjustments, our team found that horizontal slide was also easier to complete than the other methods. The horizontal slide best limited cervical spine motion and may be the most helpful for minimizing secondary injury based on the study findings.

Polymer foam encapsulants provide mechanical, electrical, and thermal isolation in engineered systems. In fire environments, gas pressure from thermal decomposition of polymers can cause mechanical failure of sealed systems. In this work, a detailed uncertainty quantification study of PMDI-based polyurethane foam is presented to assess the validity of the computational model. Both experimental measurement uncertainty and model prediction uncertainty are examined and compared. Both the mean value method and Latin hypercube sampling approach are used to propagate the uncertainty through the model. In addition to comparing computational and experimental results, the importance of each input parameter on the simulation result is also investigated. These results show that further development in the physics model of the foam and appropriate associated material testing are necessary to improve model accuracy.

This paper details a methodology for quantification of errors and uncertainties of a finite element heat transfer model applied to a Ruggedized Instrumentation Package (RIP). The proposed verification process includes solution verification, which examines the errors associated with the code's solution techniques. The model was subjected to mesh resolution and numerical parameters sensitivity studies to determine reasonable parameter values and to understand how they change the overall model response and performance criteria. To facilitate quantification of the uncertainty associated with the mesh, automatic meshing and mesh refining/coarsening algorithms were created and implemented on the complex geometry of the RIP. Similarly, highly automated software to vary model inputs was also developed for the purpose of assessing the solution's sensitivity to numerical parameters. The model was subjected to mesh resolution and numerical parameters sensitivity studies. This process not only tests the robustness and numerical error with computation time. Agglomeration of these studies provides a bound for the uncertainty due to numerical error for the model. An emphasis is placed on the automation of solution verification to allow a rigorous look at uncertainty to be performed even within a tight design and development schedule.

Although it is essential to maintain a secure airway in a trauma patient, it is also critical to protect the potentially injured cervical spine. It has previously been suggested that the jaw thrust maneuver be used in place of the head tilt-chin lift in the suspected spine-injured patient.We sought to examine whether the jaw thrust was in fact safer to use in the setting of an unstable upper cervical spine injury.Unstable, dissociative C1-C2 injuries were surgically created in nine fresh, lightly embalmed human cadaver specimens. An electromagnetic motion analysis device was used to assess the amount of angular and linear motion with sensors placed above and below the injured segment. Measurements were recorded during execution of the two airway maneuvers. Trials were performed both with and without a cervical immobilization collar in place.There was almost twice as much angular motion in all planes when performing a head tilt-chin lift as compared with the jaw thrust, and this was statistically significant (p.013). In addition, there was more displacement at the injured level with a head tilt-chin lift as compared with the jaw thrust. This was statistically significant for axial displacement and anteroposterior translation (p=.003 for both), and approached significance for mediolateral translation (p=.056).The jaw thrust maneuver results in less motion at an unstable C1-C2 injury as compared with the head tilt-chin lift maneuver. We therefore recommend the use of the jaw thrust to improve airway patency in the trauma patient with suspected cervical spine injury.

Spotting occurs in wildland fires when fire-lofted embers or hot particles are carried by the wind and fall in areas of unburnt yet flammable vegetation leading to ignition of new, discrete fires. Significant work has been conducted on predicting the trajectories of the embers but little fundamental work is available related to the capability of these embers or particles to ignite vegetation. This paper consists of an experimental and theoretical study of ignition of fuel beds by hot metal particles. Both laboratory and real life fuel beds have been tested. Spherical steel particles with diameters in the range 0.8 to 19.1 mm heated to temperatures between 500 and 1300oC are used in the experiments. A relationship between the size of the particle and temperature required for flaming or smoldering ignition is found in powdered cellulose. These results are used to assess a model based on Hot Spot Ignition Theory to determine the particle sizetemperature relationship required for ignition of a cellulose fuel bed. The model qualitatively predicts the ignition response of the fuel to a given particle size and temperature. Similar experiments were also conducted using pine needles as the fuel bed.

In order to reduce the risk of decompression sickness associated with spacewalks, NASA is considering designing the next generation of exploration vehicles and habitats with a different cabin environment than used previously. The proposed environment uses a total cabin pressure of 52.7 to 58.6 kPa with an oxygen concentration of 30 to 34% by volume and was chosen with material flammability in mind. Because materials may burn differently under these conditions and there is little information on how this new environment affects the flammability of the materials onboard, it is important to conduct material flammability experiments at the intended exploration atmosphere. One method to evaluate material flammability is by its ease of ignition. To this end, piloted ignition delay tests were conducted in the Forced Ignition and Spread Test (FIST) apparatus subject to this new environment. In these tests, polymethylmethacylate (PMMA) was exposed to a range of oxidizer flow velocities and externally applied heat fluxes. The ultimate goal is to determine the individual effect of pressure and the combined effect of pressure and oxygen concentration on the ignition delay. Tests were conducted for a baseline case of normal pressure and oxygen concentration, low pressure (58.6 kPa) with normal oxygen (21%). Future work will focus on low pressure with 32% oxygen concentration (space exploration atmosphere - SEA) conditions. It was found that reducing the pressure while keeping the oxygen concentration at 21% reduced the ignition time by 17% on average. It was also noted that the critical heat flux for ignition decreases in low-pressure conditions. Because tests conducted in standard atmospheric conditions will underpredict the flammability of materials intended for use on spacecraft, fire safety onboard at exploration atmospheres may be compromised.

The study purpose was to establish a descriptive measure of how strength and conditioning coaches feel about various aspects of their jobs using the Job Satisfaction Survey (Specter, 1997). Participants were strength and conditioning coaches from three major Division I-AA conferences. Data were collected using the standard Job Satisfaction Survey and a demographics questionnaire. The Job Satisfaction Survey was developed by Paul Spector and consists of nine facets: pay, promotion, supervision, benefits, contingent rewards, operating procedures, coworkers, nature of work, and communication. The 36-item survey is measured using 6 point rating scale: disagree very much, disagree moderately, disagree slightly, agree slightly, agree moderately, and agree very much. Fifty Division I-AA strength and conditioning coaches were contacted via email using Survey Monkey to participate in the study, additionally, follow up hard copy surveys were mailed to the non-responders. Of the 50 strength and conditioning coaches, 32 participated in the research for a completion rate of 64 percent. Twenty-eight of the respondents were White Americans and five were African American. A t-test was run on job satisfaction scores for strength and conditioning coaches versus societal norms as reported by Paul Spector. Additionally, correlations between variables were examined for Job Satisfaction Scores and years of experience, age, job title, education, and ethnicity. Statistically significant differences were found in total satisfaction scores between the sample strength and conditioning coaches and societal norms (p = .001). Significant correlations were found between job satisfaction and age (R2 = .379; p = 0.03), and ethnicity (R2 = −.345; p = 0.049). All other tests analyzed were found to be non-significant. Based on the findings, collegiate strength and conditioning coaches at the Division I-AA level have a significantly lower job satisfaction than reported societal norms from other groups using the job satisfaction survey. Additionally, it appears that job satisfaction differs with age and ethnicity. Specifically, as strength and conditioning coaches age, job satisfaction increases and African American strength and conditioning coaches have lower job satisfaction than their white counterparts. For aspiring strength and conditioning coaches, various aspects of the job satisfaction of the Division I-AA strength and conditioning professional can be taken from this research study. The longer strength and conditioning coaches are in the profession, the greater the level of job satisfaction. Unfortunately, these data suggest that job satisfaction can vary by ethnicity. More research needs to be done on a larger scale with Division I-A strength and conditioning coaches to further examine job satisfaction in all coaches.