The Miraculous Pale Blue Dot.

On october 13, 2021, Star Trek's Captain James Tiberius Kirk, in the guise of 90-year-old actor William Shatner, rode aboard a Blue Origin rocket ship 67 miles to the edge of space. He experienced about 3 minutes of weightlessness and was able to observe the Earth from a perspective few have had the privilege to undergo. From his elevated vantage point, he was able to see how really thin the Earth's atmosphere is and he could catch a glimpse of the dark enormity of the rest of the surrounding universe. He said that he was struck by the vulnerability of the Earth and the relative sliver of the atmosphere.

Resting Respiratory Resistance in Female Teenage Athletes With and Without Exercise-Induced Laryngeal Obstruction.

OBJECTIVE: Exercise-induced laryngeal obstruction (EILO) occurs with paradoxical vocal fold motion or supraglottic collapse during moderate to vigorous exercise. Previously, Gallena et al (2015) reported lower-than-normal inspiratory (Ri) and expiratory (Re) resistances during resting tidal breathing (RTB) in female teenage athletes with EILO. This study aimed to replicate that unexpected result. METHOD: The Airflow Perturbation Device measured Ri and Re during three 1-minute trials of RTB in 16 teenage female athletes with EILO and 16 sex-, age-, and height-matched controls. Multiple linear regression examined group, age, height, and weight as predictors of Ri and Re. RESULTS: Ri and Re tended to be lower in the EILO group than the control group [Ri: F(1,30) = 3.58, P = 0.068, d = 0.686; Re: F(1,30) = 3.28, P = 0.080, d = 0.640], but there was no statistically significant difference in the overall effect [F(2,29) = 1.75, P = 0.192]. After one outlier for Re from the EILO group and her matched control were removed, the overall difference was statistically significant, F(2,27) = 3.38, P = 0.049, with Re primarily contributing to the difference [Ri: F(1,28) = 3.66, P = 0.066, d = 0.719; Re: F(1,28) = 5.69, P = 0.024, d = 0.899]. CONCLUSION: These results did not replicate the robust differences found previously between Ri and Re during RTB in teenage girls with and without EILO, but the results trended in the same direction and met criterion for statistical significance once an outlier was removed from analysis. Overall, the observation that resting respiratory resistances were lower in most teenage girls with EILO suggests that reduced tone of the laryngeal and/or lower airways may predispose young athletes to EILO.

Getting Past the Know-It-All Stage.

A little knowledge can be a dangerous thing. Most of us have heard of this admonition, and it applies directly to engineering education. It turns out that people who know just a little about a subject greatly overestimate their understanding and abilities. "The Dunning-Kruger effect is a cognitive bias in which people wrongly overestimate their knowledge or ability in a specific area. This tends to occur because a lack of self-awareness prevents them from accurately assessing their own skills" [5].

Innovation Is Tied to Optimism.

"At the height of laughter, the universe is flung into a kaleidoscope of new possibilities."-Jean Houston.

Best If Used by Date.

We have likely all seen the dates stamped on food packages in the United States that say "Best if used by…" or "Sell by …" or some other phrase that suggests that the food item is not to be consumed after the date specified. It is not really clear by the phrase used if the food item becomes poison after this date, or if the food quality declines after this date, or if the date is just a convenience for the seller to move the product. There is a great deal of confusion about what to do with the product after the date given. Should it be thrown away or can it still be consumed safely but with some degradation of its quality?

Harmonicas.

It is easy for me to imagine life without harmonicas, but for my parents' generation, harmonicas were as common as rain. They were small and easy to fit in a shirt pocket or kit bag, and, whenever an idle moment presented itself, out came the harmonica to render a slightly reedy version of a well-known song: songs like "Red River Valley," "You Are My Sunshine," or "Tennessee Waltz." They were not far from the lips of anyone who played a harmonica.

Collateral Learning.

Students take engineering courses to learn techniques for solving problems. Thus, most engineering courses taken by undergraduate students are highly technical in nature. But, there are many additional techniques and skills that can be learned along the way. Other types of knowledge can also be incorporated into engineering science courses without diminishing the value of the engineering techniques being taught. These other skills, of an ancillary nature, can improve the value of a course to future engineers. This writing is a description of collateral learning that took place in my Transport Design course and, to a lesser extent, my Introduction to Electronic Design course.

Ethics in the Era of Artificial Intelligence.

Ethics can be interesting and fascinatingly compelling because of the subtle natures of its solutions in ambiguous situations. Articles on ethical issues and college courses on ethics rarely present answers to the questions that are posed. That is because ethical responses are highly situational and depend a lot on commonly accepted, but not codified, beliefs, and attitudes.

Consciousness in Animals.

Are humans the only species with a sense of consciousness? This question has intrigued me for most of my life. Having kept pets and livestock animals, and observed wild animals from both near and far, I have often wondered just how much they know about their surroundings and their place in it. Do they know how to reason out answers to questions important to them? Are they aware of the consequences of their actions? Can they anticipate what other animals, including those of close kin and other, more remote species, are likely to do in certain situations? Can they see themselves inside their minds, if they do, indeed, have minds? Do they dream?

School Security?

"Schools rethink security training" was the headline on page 1 of the 30 December 2019 issue of The Baltimore Sun daily newspaper. The accompanying article went on to explain that Maryland school students felt unsafe at school. Students on average rated their physical safety at 3.5 and emotional safety at 5.4, each on a scale of 1 to 10, with 10 being the best score. Many students gave their physical safety scores at 1 out of 10. And this is despite active shooter drills that are meant to teach them what to do if there is a violent confrontation, and in which they have all had to participate.

Short-Term Intensive Therapy and Outcomes for Athletes With Paradoxical Vocal Fold Motion Disorder.

Purpose The aim of the study was to develop a treatment for athletes with paradoxical vocal fold motion disorder (PVFMD) based on exercise physiology and learning theory principles and administer it over a preestablished time frame. Method A prospective, repeated-measures, within-subject group design was used. Eleven adolescent/teen athletes diagnosed with PVFMD via laryngoscopy received short-term intensive (STI) therapy. Eight of the athletes returned for extended follow-up. Changes in postexercise inspiratory ( R i) and expiratory ( R e) resistances and Modified Borg Dyspnea Scale (MBDS) ratings collected at baseline were compared immediately posttreatment and at extended follow-up. Dyspnea Index scores were collected at baseline and at extended follow-up. Two no-treatment control athletes with PVFMD participated in two exercise challenges-baseline and 6 weeks later. Results Immediately after STI therapy, athletes attained significant improvement in R i, R e, and MBDS ratings. These changes were maintained at extended follow-up as well as a significant change in Dyspnea Index scores. The 2 control athletes who were reassessed 6 weeks after baseline experienced negative changes in postexercise R i and MBDS ratings. Conclusion STI therapy that incorporated individuality, specificity, and variable practice effectively changed outcome measures posttreatment with further improvement observed at extended follow-up. These results provide preliminary evidence for STI therapy for PVFMD.

A War at All Costs?

War between the two worlds Eminiar VII and Vendikar had gone on for 500 years with no cessation in sight. This war was conducted by computer simulation, so that a virtual hit on one planet was retaliated by a computer-generated strike on the other. This avoided the large-scale death and destruction normally suffered during real wartime. To compensate for a war of this surgical nature, a segment of the population of a virtually stricken planet had to be assigned to die in disintegration chambers once the planet was targeted. People dutifully reported to these chambers once their fates were assigned. This was the basis of the episode titled "A Taste of Armageddon" of season one of the original Star Trek television series.

A Rapid, Handheld Device to Assess Respiratory Resistance: Clinical and Normative Evidence.

INTRODUCTION: Following reports of respiratory symptoms among service members returning from deployment to South West Asia (SWA), an expert panel recommended pre-deployment spirometry be used to assess disease burden. Unfortunately, testing with spirometry is high cost and time-consuming. The airflow perturbation device (APD) is a handheld monitor that rapidly measures respiratory resistance (APD-Rr) and has promising but limited clinical data. Its speed and portability make it ideally suited for large volume pre-deployment screening. We conducted a pilot study to assess APD performance characteristics and develop normative values. MATERIALS AND METHODS: We prospectively enrolled subjects and derived reference equations for the APD from those without respiratory symptoms, pulmonary disease, or tobacco exposure. APD testing was conducted by medical technicians who received a 10-min in-service on its use. A subset of subjects performed spirometry and impulse oscillometry (iOS), administered by trained respiratory therapists. APD measures were compared with spirometry and iOS. RESULTS: The total study population included 199 subjects (55.8% males, body mass index 27.7 ± 6.0 kg/m2, age 49.9 ± 18.7 yr). Across the three APD trials, mean inspiratory (APD-Ri), expiratory (APD-Re), and average (APD-Ravg) resistances were 3.30 ± 1.0, 3.69 ± 1.2, and 3.50 ± 1.1 cm H2O/L/s. Reference equations were derived from 142 clinically normal volunteers. Height, weight, and body mass index were independently associated with APD-Ri, APD-Re, and APD-Ravg and were combined with age and gender in linear regression models. APD-Ri, APD-Re, and APD-Ravg were significantly inversely correlated with FEV1 (r = -0.39 to -0.42), FVC (r = -0.37 to -0.40), and FEF25-75 (r = -0.31 to -0.35) and positively correlated with R5 (r = 0.61-0.62), R20 (r = 0.50-0.52), X5 (r = -0.57 to -0.59), and FRES (r = 0.42-0.43). Bland-Altman plots showed that the APD-Rr closely approximates iOS when resistance is normal. CONCLUSION: Rapid testing was achieved with minimal training required, and reference equations were constructed. APD-Rr correlated moderately with iOS and weakly with spirometry. More testing is required to determine whether the APD has value for pre- and post-deployment respiratory assessment.

Black and White and Shades of Gray [State of the Art].

"Moderation in all things" is a popular saying that many of us have heard all our lives. Still, a good number of people seem to have forgotten the sentiment behind this advice. Instead of looking for the good that exists within the bad and the bad that dwells within the good, people are choosing to line up behind one extreme or another. Nuances are being ignored in favor of strong positions on either side of the middle. This has led inevitably to polarization, partisanship, and balkanization in our society. For some reason, moderation has been forgotten.

The Impact of a Universal Decolonization Protocol on Hospital-Acquired Methicillin-Resistant Staphylococcus aureus in a Burn Population.

Hospital-acquired (HA) methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of HA infections and a significant concern for burn centers. The use of 2% chlorhexidine-impregnated wipes and nasal mupirocin significantly decreases the rate of HA-MRSA in adult intensive care units. The aim of this study was to examine the impact of universal decolonization on the rate of MRSA conversion in an American Burn Association verified adult and pediatric burn center. Universal decolonization protocol consisting of daily chlorhexidine baths and a 5-day course of nasal mupirocin was implemented in the burn unit. MRSA screening both on admission and weekly and contact isolation practices were in place in pre-decolonization and post-decolonization periods. Patient data were analyzed 2 years before and 1 year after implementation of the protocol. The incidence rate of MRSA was significantly decreased after the implementation of the decolonization protocol (11.8 vs 1.0 per 1000 patient days, P < .001). Secondary to the loss of the skin barrier and suppressed immune systems, burn patients are at greater risk for invasive infection leading to severe complications and death. The prevalence of HA-MRSA at our institution's burn center was significantly decreased after the implementation of a universal decolonization protocol.

Respirator masks protect health but impact performance: a review.

Respiratory protective masks are used whenever it is too costly or impractical to remove airborne contamination from the atmosphere. Respirators are used in a wide range of occupations, form the military to medicine. Respirators have been found to interfere with many physiological and psychological aspects of task performance at levels from resting to maximum exertion. Many of these limitations have been investigated in order to determine quantitatively how much performance decrement can be expected from different levels of respirator properties. The entire system, including respirator and wearer interactions, must be considered when evaluating wearer performances. This information can help respirator designers to determine trade-offs or managers to plan to compensate for reduced productivity of wearers.

The Effect of Exercise on Respiratory Resistance in Athletes With and Without Paradoxical Vocal Fold Motion Disorder.

PURPOSE: An investigational, portable instrument was used to assess inspiratory (R(i)) and expiratory (R(e)) resistances during resting tidal breathing (RTB), postexercise breathing (PEB), and recovery breathing (RB) in athletes with and without paradoxical vocal fold motion disorder (PVFMD). METHOD: Prospective, controlled, repeated measures within-subject and between-groups design. Twenty-four teenage female athletes, 12 with and 12 without PVFMD, breathed into the Airflow Perturbation Device for baseline measures of respiratory resistance and for two successive 1-min trials after treadmill running for up to 12 min. Exercise duration and dyspnea ratings were collected and compared across groups. RESULTS: Athletes with PVFMD had lower than control R(i) and R(e) values during RTB that significantly increased at PEB and decreased during RB. Control athletes' R(e) decreased significantly from RTB to PEB but not from PEB to RB, whereas R(i) did not change from RTB to PEB but decreased from PEB to RB. Athletes without PVFMD ran longer, providing lower dyspnea ratings. CONCLUSION: Immediately following exercise, athletes with PVFMD experienced increased respiratory resistance that affected their exercise performance. The difference in resting respiratory resistances between groups is intriguing and could point to anatomical differences or neural adaptation in teenagers with PVFMD. The Airflow Perturbation Device appears to be a clinically feasible tool that can provide insight into PVFMD and objective data for tracking treatment progress.