How could computer games be used to augment training for fighter pilots? This paper is aimed at providing one answer to this research question. Three current methods of training fighter pilots are: working in the actual aircraft, working with high fidelity aircraft simulators, and working with desktop computer based courseware systems. All of these approaches have strengths and weaknesses. This paper describes a low cost game based training framework that attempts to provide pilot instruction that students would actually want to use. This framework is meant to augment, not replace, the existing training modalities. First we describe our requirement gathering process and the set of requirements we defined for a game based training system aimed at a specific group of fighter pilots. Next, we explain a prototype game based training system for the iPod Touch that was developed based on this research. Following this we present a description of the initial game based training system developed in response to feedback on the prototype system. We conclude with a discussion of the future directions for this research.

Study Design: Case Report. Capitolunate instability is a form of midcarpal instability. If conservative management is unsuccessful, surgical reconstruction is often indicated. However, the literature is limited regarding postoperative management after reconstruction. Often patients are immobilized for a 6- to 12-week period, which can produce secondary complications, including wrist stiffness, tendon adherence, and muscle atrophy. The purpose of the case report was to demonstrate that controlled early mobilization may be implemented postoperatively after dorsal capsulodesis procedures to correct capitolunate instability. This early mobilization may prevent secondary complications, which can be associated with lengthy immobilization periods. A 27-year-old female underwent a dorsal capsulodesis procedure to correct capitolunate instability. The intraoperative findings of the reconstruction and tension on the capsulodesis procedure were communicated to the therapist by the surgeon. This close communication allowed the therapist to institute early controlled mobilization immediately postoperatively using a hinged wrist splint. The patient was followed by our unit for 13 years. Early controlled mobilization using a hinged wrist splint may have maximized the subject's recovery, with no secondary complications. At 13-year follow-up, fluoroscopic and radiographic examination was normal, and no symptoms of pain or instability had reoccurred. In conclusion, early controlled mobilization using a hinged wrist splint may optimize the recovery period while retaining the desired arc of motion that is set intraoperatively.Level of Evidence: 4. J HAND THER. 2010;23:404-11.

This paper will introduce critical chain and explain its basic concepts It might be said that CPM scheduling concerns itself with only the technical aspects of running a project whereas project management involves the human side. Critical chain scheduling seeks to wed these two aspects of running a project into a single system. Project management involves making and keeping commitments under uncertainty, accompanied by complexity and interdependency. Falling short of a commitment can result in the project being deemed a failure, with attendant negative consequences to stakeholders. Evidence suggests a high rate of project management failure exists industry-wide. Critical Chain project management deals with various scheduling issues, including the student syndrome, Parkinson's law, multi-tasking, buffering and buffer management. A decade of field testing and refinement of critical chain has demonstrated how it has increased project success.

Intelligent Tutoring Systems (ITSs) are being applied to an increasing proportion of military training. Most ITSs are interfaced to simulations, usually involving real-time tactical scenarios. The simulation and ITS are generally developed by different companies at different times. This makes interfacing the ITS and the simulation problematic, experience has shown. An industry-wide interoperability standard would enable different vendors of simulations and ITSs to easily integrate their products, save time and money, and increase the training value of simulation exercises. The Intelligent Tutoring System Interoperability Study Group (ITSI SG) was formed to study the issues associated with an ITS/Simulation Interoperability Standard (I/SIS). This paper describes the results of the ITSI SG meeting held at the Fall, '04 SIW in Orlando which resulted in a refined set of use cases and requirements and a prototype of the I/SIS. They are presented here for comment and discussion and follow up on the paper, "Requirements of an Intelligent Tutoring System (ITS)/Simulation Interoperability Standard (I/SIS)" presented at the Fall, '04 SIW (1). Four primary use cases were identified - tactical decision-making training, equipment operations and maintenance training, ITS-centered training systems, and simulation-centered training systems - along with combinations of them. Several requirements were identified and sorted by use case and level. The Study Group decided that it was important to have both a minimal level I/SIS that simulation developers could easily meet (Level 1) and would allow a reasonable integration and level of functionality and a higher capability level (Level 2) that provided a much better integration and supported a much fuller range of desired capabilities. A small number of optional levels were also identified to support very specific capabilities, such as an integrated scenario editor. The requirements include data from the simulation needed by the ITS, such as the trainee's actions for automatic evaluation; facilities needed by the ITS, such as an avenue to present feedback and other information to the trainee through the simulation; and facilities needed by the simulation, such as automatic trainee evaluation, on request. The prototype standard allows for data transfer through either the Distributed Interactive Simulation (DIS) or High Level Architecture (HLA) protocols at the simulation developer's discretion. TCP-IP sockets are also being considered. The XML Battle Management Language (XBML) would be used to format tactical orders. Other data needed by the ITS or simulation would be in XML format. This paper will present examples of each of the use cases and requirements from actual Simulation-ITS integration projects as well as examples of how the standard would have applied had it already existed. This paper supports the ITSI SG by promoting discussion of I/SIS use cases, requirements, and prototype standard with an audience larger than the study group.

Stottler Henke, in conjunction with the US Navy, has developed and deployed a flexible, low-cost PChosted desktop crew trainer for the Navy’s new MH-60S and MH-60R helicopters: Operator Machine Interface Assistant (OMIA). OMIA is currently in use by HSC-2, HSC-3 and HSM-41. This paper emphasizes some of the flexible, low-cost, rapid development methods used to reach the present deployment and are allowing for the continued flexible, low-cost, and rapid evolution of OMIA to meet evolving Navy needs. These methods include re-use of COTS software, design for evolving COTS hardware/software, and design for evolving requirements. In addition to many COTS solutions, some proprietary software was built. COTS software utilization includes the integration of MicrosoftTM Flight Simulator for many aviation aspects of OMIA, and the use of twoand threedimensional COTS libraries to develop the user interface and cockpit. The foundation that permits the flexible and rapid use of different components is the underlying design for evolving requirements. The flexible design for evolving requirements is necessary because the Common Cockpit has and continues to evolve. The flexible design allows OMIA to work with and control MicrosoftTM Flight Simulator when it is available, to use COTS and/or custom hardware when attached, and to still function as a complete standalone application. Continuing enhancements of the trainer are allowing it to teach an increasingly broad variety of aviation and mission tasks; for example, OMIA software driving the MH-60S Mission Avionics Systems Trainer (MAST).

Pro PHP XML and Web Services is the authoritative guide to using the XML features of PHP 5 and PHP 6. No other book covers XML and Web Services in PHP as deeply as this title. The first four chapters

77 years old female with CAD, CVA, and polycystic kidney disease was admitted for 2 weeks of abdominal pain and 20 lb weight loss with anorexia over 6 months. Three weeks prior to this admission, she was given stool softeners for constipation. Subsequently, she had diarrhea and developed sharp left lower quadrant abdominal pain radiating to her back; associated with nausea and bilious vomiting. She also had 1 week of fevers up to 100°F which dissipated upon admission. Physical exam revealed normoactive bowel sounds and left lower quadrant tenderness without rebound or guarding. Lab data: hemoglobin 9.0 gm/dl, white count 9.2 k/cu mm, BUN 52 mg/dl and creatinine 2.6 mg/dl, bicarbonate 14 mmol/liter and lactate 0.5 mmol/liter. A CT scan of the abdomen revealed large tumor involving the sigmoid colon, sigmoid diverticula, polycystic kidneys, and small pericardial effusion. Empiric antibiotics (levofloxacin and metronidazole) were given. During hospitalization, she developed K+ 5.1 mg/dl for which she received a dose of oral sodium polystyrene (SPS). Flexible-sigmoidoscopy up to 35 cm from the anal verge revealed multiple diverticula and edematous and erythematous folds from 15 cm to 20 cm (biopsy showed acute colitis with focal non-necrotizing granulomas). Immediately post-sigmoidoscopy, she developed distended, tympanic abdomen and became tachycardic. An abdominal x-ray revealed free air and she underwent emergency exploratory laparotomy. The left colon was rock hard and the right colon was dusky with gross fecal soilage from cecal perforation. A right hemicolectomy was performed along with an abdominal wash out. Pathological examination revealed acute ischemic perforation of cecum with SPS crystals noted within the feces and in the perforation tract. She continued to deteriorate and expired one week later.

Information on genetic susceptibility to Graves' disease in African Americans is limited. We studied DRB1, DQB1, DRB3 subtypes, DQA1*0501, DQA1*0201, and CTLA-4 polymorphisms in 49 African American patients with adult onset Graves' disease and 47 racially-matched controls using PCR-based sequence-specific priming methods. There were no significant differences in DRB1 or DQB1 allelic frequencies or CTLA-4 polymorphisms between patients and controls. However, we found that the frequency of DRB3 was significantly increased in the patients (75.5% vs. 57.4%, P = 0.006, X2 = 3.52), especially for the DRB3*0202 subtype (53.1% vs. 23.4, P = 0.003, X2 = 8.91). In this one respect, the finding was in concordance with our previous observations in Caucasian patients with adult-onset Graves' disease. In addition, whereas the frequency of DQA1*0501 was increased (P = 0.018, X2 = 5.63) in our patients, the haplotype of DRB3/DQA1*0501, or DRB3*0202/DQA1*0501 was found to be more strongly associated (P = 0.008, X2 = 7.0; P = 0.0008, X2 = 11.34, respectively). These data suggest that DRB3*0202, particularly when found with DQA1*0501 in a haplotype is a susceptible gene(s) for Graves' disease in adult African Americans. Considering these data with those in Caucasian patients, our results would suggest that the primary Graves susceptible locus is likely DRB3 and not DRB1.

Science NewsVolume 156, Issue 23 p. 355-355 Department Letters First published: 01 July 2009 https://doi.org/10.2307/4011848AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume156, Issue234 December 1999Pages 355-355 RelatedInformation

A novel enzyme-linked immunosorbent assay (ELISA) technology was developed for detecting saxitoxin or evaluation of anti-saxitoxin antibodies, which is based on non-covalent immobilization of 'free' saxitoxin to Maxisorp microtitre plates. The effect of pH on immobilization was studied in media with wide-range buffering capacities (piperazine-glycylglycine and barbiturate buffers). Increasing pH resulted in better responses, although this was mainly due to non-specific interactions. At pH 10.0, however, saxitoxin immobilization was quite effective and specific. The same pattern was found under four different conditions; absence vs presence of bovine serum albumin precoating and absence vs presence of 150 mM NaCl. The best results (high specific response) were achieved with bovine serum albumin precoating in the presence of 150 mM NaCl. The method of choice involved precoating Maxisorp with 5 μg/ml albumin followed by addition of 5 μM saxitoxin in 0.01 M piperazine-glycylglycine buffer, pH 10.0. The efficacy of this technology was demonstrated on a polyclonal rabbit anti-saxitoxin antibody and compared with a conventional ELISA of saxitoxin using saxitoxin-bovine serum albumin conjugate as the coating antigen. In the experiments investigating cross-reactivities of various saxitoxin derivatives based on a competitive assay, significantly greater sensitivity was achieved with the novel approach, e.g. 35 pM saxitoxin could be detected (3 × 104 times lower concentrations than using the conjugate). The assay works well with mussel tissue homogenates, and because it does not require the use of the covalent saxitoxin-carrier conjugates it offers a simpler alternative to the traditional ELISA for saxitoxin.

Using a combination of immunoblotting, double immunoprecipitation, immunoglobulin-affinity chromatography, and isoelectrofocusing, we have been able to identify a group of proteins that display CDP-reductase activity and contain antigenic epitopes recognized by anti-ribonucleotide reductase M1 subunit and anti-ubiquitin antibodies. In the cytoplasm of rat liver cells, we could detect a total of five proteins with molecular masses of 92, 89, 56, 45, and 37 kilodaltons which reacted with the anti-M1 subunit serum. All of them, except the 89-kilodalton protein (the nascent unmodified M1), were also recognized by the anti-ubiquitin antibody. In normal liver cells, all of the apparently ubiquitinated species of the M1 protein were found in the cytoplasm, but not in the nuclear envelope associated pool of the enzyme. However, we did not detect ubiquitinated M1 protein fragments in the cytoplasm of Morris hepatoma 5123tc. The level of the apparently ubiquitinated fragments of the M1 subunit increased in parallel to the DNA-synthetic activity of normal liver cells, suggesting that ubiquitination plays a key role in the regulation of the activity of the enzyme during the cell cycle.

Epitope-specific antibodies to the M1 and M2 subunits of mammalian ribonucleotide reductase were prepared using peptides predicted to have a high antigenic index. Western blotting demonstrated that the anti-M1 antibody was specific for the 89-kilodalton M1 subunit (and its degradation fragments) and the anti-M2 antibody specifically recognized the 45-kilodalton M2 subunit. Both antibodies inhibited the CDP-reductase activity of the holoenzyme. Using these antibodies, both the M1 and M2 subunits were shown to be localized in the cytoplasm and in the nuclear regions of a number of cell types, including B77 avian sarcoma virus transformed NRK cells, T51B rat liver cells, 5123tc hepatoma cells, and rat liver cells in vivo. In addition, the M1 subunit was found to be localized as a halo around isolated rat liver nuclei. Biochemical analysis of the cytoplasmic fraction of liver cells and a Triton X-100 wash of nuclei from these cells confirmed the location of the enzyme activity in these cellular compartments. The M1 subunit appears to be glycosylated, as indicated by its retention on a Affi-Gel-concanavalin A affinity column. Therefore, in mammalian cells ribonucleotide reductase appears to be not only in the cytoplasm, but is also associated with the nuclear membrane or nuclear lamina. The activity of the enzyme in the membrane fraction changes dynamically during the cell cycle.

Although they are proliferatively quiescent, the cells in the intact adult rat liver express the gene coding for the M1 subunit of ribonucleotide reductase. But since they do not need deoxyribonucleotides, they promptly inactivate the 88 to 90 kDa M1 products and degrade them into 40 kDa fragments. Partial hepatectomy signals the remaining cells to start proliferating. Two hours before the onset of DNA replication, around 16 to 18 hr after partial hepatectomy, the cells start accumulating a large pool of functional ribonucleotide reductase M2 subunits. Near the end of the G1 build-up the cells step up M1 gene expression, stop inactivating, and reduce the degradation of the M1 products. The accumulating functional 88 to 90 kDa M1 subunits, each with more than one catalytic site, couple with functional M2 subunits to produce active ribonucleotide reductase holoenzyme which accumulates in the outer nuclear membrane from which they supply deoxyribonucleotide precursors to intranuclear replication enzymes. At the end of the S phase, the cell reduces M1 gene expression and resumes degrading 88 to 90 kDa M1 subunits. At least some of the 40 kDa M1 fragments are still active and can form partially active "holoenzymes" when mixed with a standard preparation of functional M2 subunits. The M1 control mechanism appears not to operate in hepatoma cells and Ehrlich ascites tumor cells, both of which maintain a pool of undegraded 88 to 90 kDa M1 components.

A formula relating the upper yield stress δ y, following stress aging, in a constant strain rate test to the delay time for yield td([sgrave]r) at a constant nominal reference stress δ r has been derived, viz., where ε is the imposed strain rate, E is Young's modulus of the polymer, V* is a shear activation volume, kB is the Boltzmann constant, and T is the absolute temperature. Measurements of the upper yield stress following stress aging are reported, which, together with previous measurements of delay times, confirm the form of this equation. It is also demonstrated that stress aging cannot be due to a change in the shape of the shoulder of the neck. Ringing and oscillation of the stress after stress aging are shown to be the result of alternate cycles of thermal runaway of the neck, which causes rapid stress drops, and of further stress aging during reloading, which causes yield points.