Military Sealift Command

In this paper, we investigated the dispersion behavior of two particular water-based nanofluids, namely water-Al <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> O <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3</sub> and water-Cu mixtures. Under different pH values the absorbency and zeta potential of the nanofluids were measured. The results showed that the stability of nanofluids was highly dependent on pH values, an optimal pH value can result in the highest stability of the nanofluids. The calculated Derjaguin-Landau-Verwey-Overbeek (DLVO) inter-particle interaction potentials verified the experimental results of the pH effect on the stability behavior.

This study tried to investigate the effects of number of medications and age on antihypertensive medication adherence in a real-world setting using a nationwide representative cohort.We obtained data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) of Korea, which is a sample of 2.2% (N = 1,048,061) of total population (N = 46,605,433). Patients aged 20 years or older (N = 150,550) who took antihypertensive medications for at least 1 year were selected. Medication possession ratio (MPR) was used for measuring adherence. The subjects were divided into 5 subgroups according to total number of medications: 1-2, 3-4, 5-6, 7-8, and 9 or more. The mean age and the mean number of medications were 60.3 ± 12.6 years and 4.1 ± 2.2, respectively. The mean MPR was 80.4 ± 23.9%, and 66.9% (N = 100,645) of total subjects were adherent (MPR ≥ 80%). The overall tendency of antihypertensive medication adherence according to the total number of medications displayed an inverted U-shape with a peak at 3-4 drugs. Adherence consistently increased as the age increased until age 69 and started to decrease from age 70. The proportion of adherent patients (MPR ≥ 80%) according to the total number of medications also showed an inverted U-shape with a peak at 3-4 drugs. When the same number of drugs was taken, the proportion of adherent patients according to age featured an inverted U- shape with a peak at 60 to 69 years. Patients taking 9 or more total drugs had the overall odds ratio (95% CI) of non-adherence (MPR < 80%) with 1.17 (1.11-1.24) compared with those taking 1 to 8 total drugs and the odds ratios in the age subgroups of 40 to 49, 50 to 59, 60 to 69 years were 1.57 (1.31-1.87), 1.21 (1.08-1.36), and 1.14 (1.04-1.25), respectively (P < .05).Association between age, total number of medications, and antihypertensive adherence displayed an inverted U-shape with a peak at 3 to 4 total medications and at age 60 to 69 years. When the total number of drugs was 9 or more, adherence decreased prominently, regardless of age.

This review is a synopsis of the decisions that shaped global policy on platelet (PLT) storage temperature and a focused appraisal of the literature on which those discussions were based. We hypothesize that choices were centered on optimization of preventive PLT transfusion strategies, possibly to the detriment of the therapeutic needs of acutely bleeding patients. Refrigerated PLTs are a better hemostatic product, and they are safer in that they are less prone to bacterial contamination. They were abandoned during the 1970s because of the belief that clinically effective PLTs should both be hemostatically functional and survive in circulation for several days as indicated for prophylactic transfusion; however, clinical practice may be changing. Data from two randomized controlled trials bring into question the concept that stable autologous stem cell transplant patients with hypoproliferative thrombocytopenia should continue to receive prophylactic transfusions. At the same time, new findings regarding the efficacy of cold PLTs and their potential role in treating acute bleeding have revived the debate regarding optimal PLT storage temperature. In summary, a "one-size-fits-all" strategy for PLT storage may not be adequate, and a reexamination of whether cold-stored PLTs should be offered as a widely available therapeutic product may be indicated.

Military experience and recent in vitro laboratory data provide a biological rationale for whole-blood use in the treatment of exsanguinating hemorrhage and have renewed interest in the reintroduction of fresh whole blood and cold-stored whole blood to patient care in austere environments. There is scant evidence to support, in a field environment, that a whole blood-based resuscitation strategy is superior to a crystalloid/colloid approach even when augmented by a limited number of red blood cell (RBC) and plasma units. Recent retrospective evidence suggests that, in this setting, resuscitation with a full compliment of RBCs, plasma, and platelets may offer an advantage, especially under conditions where evacuation is delayed. No current evacuation system, military or civilian, is capable of providing RBC, plasma, and platelet units in a prehospital environment, especially in austere settings. As a result, for the vast minority of casualties, in austere settings, with life-threatening hemorrhage, it is appropriate to consider a whole blood-based resuscitation approach to provide a balanced response to altered hemostasis and oxygen debt, with the goal of reducing the risk of death from hemorrhagic shock. To optimize the successful use of fresh whole blood/cold-stored whole blood in combat field environments, proper planning and frequent training to maximize efficiency and safety will be required. Combat medics will need proper protocol-based guidance and education if whole-blood collection and transfusion are to be successfully and safely performed in austere environments. In this article, we present the Norwegian Naval Special Operation Commando unit-specific remote damage control resuscitation protocol, which includes field collection and transfusion of whole blood. This protocol can serve as a template for others to use and adjust for their own military or civilian unit-specific needs and capabilities for care in austere environments.

Remote damage control resuscitation is a recently defined term used to describe techniques and strategies to provide hemostatic resuscitation to injured patients in the prehospital setting. In the civilian setting, unlike the typical military setting, patients who require treatment for hemorrhage come in all ages with all types of comorbidities and have bleeding that may be non-trauma related. Thus, in the austere setting, addressing the needs of the patient is no less challenging than in the military environment, albeit the caregivers are typically not putting their lives at risk to provide such care. Two organizations have pioneered remote damage control resuscitation in the civilian environment: Mayo Clinic and Royal Caribbean Cruises Ltd. The limitations in rural Minnesota and shipboard are daunting. Patients who have hemorrhage requiring transfusion are often hundreds of miles from hospitals able to provide damage control resuscitation. This article details the development and implementation of novel programs specifically designed to address the varied needs of patients in such circumstances. The Mayo Clinic program essentially takes a standard-of-care treatment algorithm, by which the patient would be treated in the emergency department or trauma bay, and projects that forward into the rural environment with specially trained prehospital personnel and special resources. Royal Caribbean Cruises Ltd has adapted a traditional military field practice of transfusing warm fresh whole blood, adding significant safety measures not yet reported on the battlefield (see within this Supplement the article entitled "Emergency Whole Blood Use in the Field: A Simplified Protocol for Collection and Transfusion"). The details of development, implementation, and preliminary results of these two civilian programs are described herein.

This study was conducted to determine the control of helminth egg contamination of raw vegetables by washing. A total of 199 unwashed and 199 washed lettuce, parsley, carrots, dill, rocket, and green-peppers, provided by a catering service in Bursa, Turkey, between March and June 2009, were subjected to helminth egg count under light microscopy. Helminth eggs were detected in six (3.0%) unwashed samples and not in any washed samples (p<0.01). Ascaris lumbricoides and Toxocara spp. were detected in four (2.0%) and two (1.0%) unwashed vegetables, respectively, mostly among leafy vegetables such as lettuce and parsley. Our data confirm that washing procedures before consumption of raw vegetables regardless of the providers' sanitation should be performed to avoid transmission of helminths.

OBJECTIVES: To examine whether the degree of stress associated with adverse physical side effects correlates with overall quality of life (QOL) and compliance rates. To determine if instruments used to assess QOL can detect differences between treatments that have no known central nervous system effects. PATIENTS AND METHODS: This randomized, double-blind, parallel group study evaluated 180 to 480 mg of controlled onset, extended release (COER)-verapamil (n = 259) or 30 to 120 mg/d of nifedipine gastrointestinal therapeutic system (GITS) (n = 269) in men and women between 21 and 80 years of age with stages 1 to 3 hypertension. A battery of questions evaluating psychological well-being and a physical symptom distress index was administered after a 4-week placebo washout (baseline) and after 10 weeks of treatment or at dropout. RESULTS: Both treatments effectively lowered blood pressure, and there were no significant between-group differences in psychosocial QOL. A difference in the level of physical symptom distress was detected between treatments (P = .002; multivariate analysis of variance), with 7 significant univariate treatment effects, all favoring COER-verapamil, being noted-pedal edema, polyuria, rapid heart beat or palpitations, hives, muscle cramps, abdominal cramps, and headaches. Constipation-related distress increased significantly (P = .001) but to a similar extent with both treatments. The difference in symptom distress tended to predict compliance as there were more withdrawals in the nifedipine GITS group (n = 85) vs COER-verapamil group (n = 64) (P = .08). CONCLUSIONS: Patient-assessed physical symptom distress is a sensitive, simple technique to evaluate the effect of antihypertensive medications on QOL and tolerability, as shown by its ability to detect the improvement associated with COER-verapamil. Depending on the agents involved, the Physical Symptom Distress Index may more closely predict dropout rates than the traditional psychosocial instruments, as suggested by the lower dropout rate in the COER-verapamil group. Thus, in studying treatment effects on QOL, both the distress of physical symptoms and the impact of psychosocial factors should be evaluated.

AIMS: To evaluate whether activating α7 nicotinic acetylcholine receptor (α7nAChR) could inhibit the NOD-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome through regulation of β-arrestin-1 in monocyte/macrophage system, thus contributing to the control of neuroinflammation. METHODS: The protein levels of NLRP3, caspase-1 (Casp-1) p20 and proCasp-1, interleukin-1β (IL-1β) p17 and proIL-1β, IL-18 and proIL-18 were measured using Western blotting. The mRNA levels of Casp-1 and IL-1β were detected by real-time PCR (RT-PCR). The colocalization and interaction of NLRP3 protein and β-arrestin-1 were measured by immunofluorescence staining and immunoprecipitation. RESULTS: The expression of β-arrestin-1 was significantly increased and colocalized with CD45-positive cells in spinal cord of experimental auto-immune encephalomyelitis (EAE) mice when compared with the sham mice, which was attenuated by pretreatment with PNU282987, a specific α7nAChR agonist. PNU282987 also significantly inhibited the activation of NLRP3 inflammasome and thus decreased the production of IL-1β and IL-18 both in lipopolysaccharide (LPS)/ATP-stimulated BV2 microglia in vitro and spinal cord from EAE mice in vivo, while inverse effects were observed in α7nAChR knockout mice. Furthermore, overexpression of β-arrestin-1 attenuated the inhibitory effect of PNU282987 on NLRP3 inflammasome activation in LPS/ATP-stimulated BV2 microglia. PNU282987 inhibited the interaction between β-arrestin-1 and NLRP3 protein in vitro. CONCLUSIONS: The present study demonstrates that activating α7nAChR can lead to NLRP3 inflammasome inhibition via regulation of β-arrestin-1 in monocyte/microglia system.

Marine information gathering, transmission, processing, and fusion play an important role in many areas, such as marine science research, environmental expedition, resource exploitation, and security and defense. Owing to its specific application environment, it has also become a popular information science research area. Like other branches of information science, the development of marine information technology over the last thirty years has benefited significantly from advances and achievements in general information theory. However, the manner in which it highlights the close bonding among propagation physics, signal processing, and the marine environment is seldom seen in other areas. This paper first gives a comprehensive overview of the current status of the theory and methods used in surface target acquisition, underwater target recognition, underwater communications and sea-air integrated information transmission, oceanic remote sensing, and data processing and information fusion. Subsequently, with the aim of helping to advance fundamental research on marine information important scientific problems to be addressed are presented.

Chemical composition of the aqueous solution within crevices on two different Ni-Cr-Mo-Fe alloys immersed in natural seawater was determined using a semiquantitative thin-layer chromatographic method. Active crevices were found to contain concentrated amounts of dissolved Ni2+, Cr3+, Mo3+, and Fe2+ ions. Propagation of crevice corrosion for the two alloys was determined from anodic polarization curves in model crevice solutions based upon stoichiometric dissolution or selective dissolution of alloy components. Both alloys 625 (UNS N06625) and C276 (UNS N10276) underwent crevice corrosion in the model crevice electrolytes. For the model crevice solution based upon selective dissolution of alloy constituents, the anodic dissolution rate for alloy 625 was higher than that for alloy C276. This trend was reversed for the model crevice solution based upon uniform dissolution of alloy constituents.

BACKGROUND: Escherichia coli is one of the major causative agents of bovine mastitis worldwide, and is typically associated with acute, clinical mastitis. Besides this, E. coli strains which belong to the extra-intestinal pathogenic group are also the major cause of urinary tract infections and pyometra in dogs. OBJECTIVES: In this study, it was aimed to investigate phylo-groups/subgroups in 155 E. coli isolates obtained from acute bovine mastitis, 43 from urinary tract infections of dogs and 20 from canine pyometra by a formerly described triplex PCR and recently described new quadruplex polymerase chain reaction (PCR) method. RESULTS: Group A1 (n = 118; 76%) and B1 (n = 71; 46%) were found to be the most prevalent groups by triplex and quadruplex PCR assays in mastitis isolates, respectively. Phylo-typing of 43 urinary tract isolates also revealed that most of the isolates belonged to A1 (n = 23; 54%) by triplex and B2 (n = 36; 84%) by quadruplex PCR assays. The isolates assigned as group A1 (n = 17; 85%) by triplex PCR could not be classified by quadruplex PCR in pyometra isolates. CONCLUSIONS: The results support the hypothesis that E. coli strains isolated from bovine mastitis cases are environmental. Also, groups C, E and F were identified as new phylo-groups for the first time in acute bovine mastitis cases. The comparison of triplex PCR with quadruplex PCR results revealed that most of the groups assigned in triplex PCR were altered by quadruplex PCR assay.

BACKGROUND AND METHODS: Active duty US Army and Air Force military personnel undergo mandatory biennial HIV antibody screening. We compared pre- and post-HIV seroconversion health status by conducting a case-control study, which evaluated all medical encounters and sociodemographic factors among incident HIV seroconverters and HIV-negative controls from June 2000 through February 2004. RESULTS: A total of 274 HIV seroconverters and 6205 HIV-negative personnel were included. In multivariate analysis restricted to male personnel (cases = 261, controls = 5801), single marital status (adjusted odds ratio [AOR] = 14.37), clinical indicators or symptoms within four years of HIV diagnosis (AOR = 6.22), black race (AOR = 5.88), nonindicator clinical syndromes within 2 years of HIV diagnosis (AOR = 3.31), any mental disorder within 4 years of HIV diagnosis (AOR = 3.04), increasing service-connected time (AOR = 1.69), and older age (AOR = 1.12) were associated with HIV diagnosis among males. A prior history of a sexually transmitted infection (STI) was associated with post-HIV seroconversion STI (OR(M-H) = 4.10). Similarly, a prior history of mental disorder was associated with post-HIV seroconversion mental disorder (OR(M-H) = 4.98). Forty-seven (18%) male cases were hospitalized at least once after HIV diagnosis; infectious diseases, and mental disorders made up 53% of initial admissions. CONCLUSIONS: HIV seroconversion was associated with increased health care-seeking behavior, STIs, and mental disorders, some of which may be amenable to screening. The higher STI rate after HIV diagnosis may partially be a consequence of monitoring, but secondary transmission of STI and possibly HIV require further definition and subsequent tailored preventive interventions.

The development of an object-oriented port simulation (PORTSIM) that addresses military mobility issues will be described, with a brief description of the tool selection process. This system provides users with (1) a graphical user interface, (2) the ability to simulate military units through a specified port, with each individual cargo item (i.e. piece of equipment) represented, (3) utilization statistics for all port resources e.g. gates, staging areas, berths, inspectors, and material handling equipments, (4) utilization statistics for ships that arrive at the port, and (5) a graphical dynamic animation that allows for identification of bottlenecks and facilitates the playing of what-if scenarios to maximize throughput. Cargo is simulated from the time it arrives at a gate or end ramp to the time it is loaded onto a ship. Animation is directly integrated with the simulation to allow for modifications to the scenario while the simulation is running and to have the new parameters used from that point forward in time. The simulation is flexible and allows for multiple cargo types (breakbulk, container, and roll-on/roll-off) and multiple ship types.

Abstract Spars are considered to have excellent motion characteristics in wave environments. However, they are susceptible to vortex-induced motions (VIM), where they can exhibit significant in-line and transverse motions under current conditions. Such motions have implications for the fatigue life of risers attached to the Spars. Due to the potential impact of VIM on riser fatigue life, it is imperative that this issue be properly addressed in riser design and analysis. Furthermore, the higher degree of uncertainty inherent in the prediction of Spar VIM (compared to similar predictions for typical motions of floating systems) complicates the problem. However, recognizing VIM uncertainties and careful selection of VIM suppression devices may achieve a reliable riser system [1]. Currently, the impact of vortex induced Spar motions on riser fatigue life does not receive full consideration in the design of deep-water risers such as steel catenary risers (SCRs). However, when performing a comprehensive fatigue analysis, all fatigue damages contributions should be combined at the same point to predict the total fatigue life of any riser system. In certain cases, it is seen that VIM induced fatigue is almost as important as the other aspects such as VIV fatigue, wave induced fatigue and installation fatigue, in the fatigue design of the riser. In this paper we shall address the impact of Vortex Induced Motions (VIM) of a Spar on riser design. A 12" gas export SCR and a 12" oil export SCR under environmental conditions representative of the Gulf of Mexico region are treated in detail, in order to address the critical issues. In addition, a sensitivity analysis is carried out to evaluate the influence of the soil stiffness, flex-joint stiffness, design pressure and hang-off angle. In one of the examples of fatigue analyses presented in this paper, while combining fatigue damages from VIV, wave induced fatigue and installation fatigue, the riser system met the required criterion of 200 years. However, under additional consideration of VIM fatigue damage, the system failed to do the same. This indicates the importance of considering Spar VIM in SCR fatigue design. It is also concluded that currents applied out-of-plane to riser generate higher fatigue damage than currents applied in plane to the SCR. Moreover, VIM fatigue life is observed to be sensitive to the hang-off angles. The paper concludes with a summary of the sensitivity analysis results. INTRODUCTION VIM of Spars originates when fluid passing a bluff body causes low-pressure eddies (or vortices) to form down stream of the body. These vortices are shed periodically at frequencies that are fluid velocity dependent. Primarily, vortex shedding induces loading on the body normal to the direction of current flow. If the frequency of excitation of the vortices is close to the natural frequency of the Spar, resonance will occur. Consequently, large and damaging amplitudes of oscillation may be induced when interaction between the flow (usually current) and structure motion causes lock-in. Spar motions induce cyclic ranges of tensions and curvatures in the riser causing fatigue damages. Hence it is important to investigate the effects of VIM on riser fatigue. In the absence of preventive measures, fatigue failure of the risers may occur.

U.S. Navy Asbestos Medical Surveillance Program B-reading reports were analyzed for variability in identifying pneumoconiosis in 278,944 chest radiographs done from 1990 to 2004 using commercial database and statistical software. Reported presence of pneumoconiosis by 33 B-readers ranged from 1.85 to 32.28%. The reported presence of parenchymal abnormalities ranged from 0.11 to 15.07%; increased profusion (to 1/0 or greater) of small parenchymal opacities ranged from 0.10 to 17.70%; presence of large opacities ranged from 0.00 to 0.67%; and presence of pleural abnormalities ranged from 1.08 to 23.93%. Ranges appear to be decreasing slightly as rates of abnormal findings are diminishing. Differences between U.S. East Coast, West Coast, and midcontinent were not statistically significant.

The cessation of hostilities between coalition and Iraqi forces in January 1991 did not mark the end of war for the peoples of Iraq. Following a failed rebellion by Kurds in the north of the country, Saddam Hussein's reprisals against the Kurdish people precipitated a massive flow of refugees into the hostile mountains of the border between Iraq and Turkey. From April to July, a ‐multi national relief operation was mounted, with the British and Dutch combining their forces in Operation HAVEN. Major General Ross, Commander, Commando Forces Royal Marines in Operation HAVEN, assesses the role of the military in such humanitarian interventions. He highlights the need for high quality, well trained and equipped troops, cooperation and communication between the different components of the operation and their HQs, the role of political advisers in sensitive operations, and the necessity for forward deployment of teams to assess real needs on the ground to tailor and target aid to specific conditions and situations. If, as Major General Ross hopes, the lessons of this exercise are properly learnt, the success of Operation HAVEN may prove a blueprint for the future deployment of forces for disaster relief.

We have investigated the complex metal hydrides involving light weight elements or compounds for the reversible hydrogen storage. The complex hydrides are prepared via an inexpensive solid state mechanochemical process under reactive atmosphere at ambient temperatures. The complex metal hydride, LiBH4 with different mole concentrations of ZnCl2 were characterized for the new phase formation and hydrogen decomposition characteristics of Zn(BH4)2. Furthermore, the complex metal hydride is destabilized using the addition of nano MgH2 for the reversible hydrogen storage characteristics. The structural, microstructural, surface, and other physicochemical behaviors of these lightweight complex metal hydrides have been studied via various metrological tools such as x-ray diffraction, Fourier transform infrared spectroscopy, thermal programed desorption, and PCT hydrogen absorption methods.

In this paper, the stability of Al₂O₃ nano-particles in water were investigated at different pH values and different concentration of sodium dodecylbenzenesulfonate (SDBS) dispersant by measurement of the zeta potential and absorbency. The experimental results show that zeta potential is relation with absorbency, and the higher magnitude of zeta potential corresponds to the higher absorbency, and the better dispersion and good stability of the Al₂O₃-H₂O nano-suspensions. It is also found that the concentration of SDBS can significantly affect the value of zeta potential and absorbency. The experimental results show that for SDBS there is an optimizing concentration in the nanofluids which can induce high zeta potential and high absorbency, and that in 0.1% Al₂O₃ -H₂O nano-suspensions the optimizing concentration of SDBS is 0.09%, which has the best disperse results of the nanofluids.

This article explores the topic of military involvement in disaster response. This was debated during a conference held at the Royal Society of Medicine, through presentations on experiences and procedures within both the military and civilian roles. The conference was run jointly by the Haywood Club Tri-Service Medical Society and the Catastrophes & Conflict Forum of the Royal Society of Medicine on 20th April 2007. Issues of collaboration and accountability are seen as key themes of disaster response, within which the military can have a role, but which needs to be carefully administered in order to avoid an inappropriate response with an associated political fallout.

Рассматривается проблема формирования русского языка и его норм в Западной Сибири в период освоения края русскими первопоселенцами. Реконструируется языковая ситуация в регионе в XVII-XVIII веках, характеризуемая как «сибирский фронтир». Определяется стабилизирующая роль русского языка, отмечается культурно-языковое влияние со стороны языков сибирских народов-автохтонов. Указанные факторы касаются прежде всего функционирования русского языка как средства межнационального общения. В связи с этим охарактеризован состав населения: местные народы и сибирские первопоселенцы (с учетом данных об их происхождении). Особое внимание уделено выяснению характера нормы в начальный период формирования русского национального языка и выявлению особенностей перестройки именного склонения во множественном числе (к кодикологическому исследованию привлекаются памятники деловой письменности города Томска XVII века). Материал документов позволяет объективно и непротиворечиво интерпретировать факты языкового варьирования у имен и выявить определенные закономерности в становлении именной полупарадигмы. Доказано, что результатом взаимодействия ареальных языковых особенностей с общерусскими элементами является региональный узус делового языка XVII века, который воплощается в языковой вариативности местных памятников письменности.