Canadian Astronaut Will Strum Christmas Carols in Space.


chris-hadfield-guitarAfter years of leading his fellow astronauts in Christmas carols on the ground, Chris Hadfield will be playing holiday tunes this year on the International Space Station.

The Canadian astronaut will blast off toward the station Dec. 19 to join the Expedition 34 and 35 missions.

He will spend the next five months, including the festive season, in space, separated from his family. Hadfield will also be away from Max Q and Bandella, the two astronaut bands he belongs to that occasionally do gigs in Houston.

Luckily for Hadfield, he doesn’t have to leave music on the ground completely. There is at least one musical souvenir from his country already onboard the orbiting laboratory: a Larrivée Parlor acoustic guitar, which was shipped to NASA years ago from its company’s headquarters in Vancouver, Canada. Hadfield, a veteran of two space shuttle flights, plans to play the guitar during his down time on the station. [Video: How to Play the Zero-G Guitar]

Christmas in orbit

At Christmastime, Hadfield and his crewmates will enjoy a festive dinner in space, likely with turkey and gravy for the main course and peach ambrosia for dessert.

“We will do the best to host a traditional Christmas kind of dinner,” he said during a preflight press conference Tuesday (Dec. 11), telephoning from his quarantined room at Kazakhstan’s Baikonur Cosmodrome, where a Russian Soyuz rocket is being prepared to launch Hadfield and two crewmates next week.

He added that the diversity of nations represented on the space station never guarantees a holiday will be celebrated by all, due to the workload that needs to be accomplished.

But Christmas is recognized by most of the space station residents this time around; the Russian cosmonauts, who celebrate Orthodox Christmas in January, have agreed to join in on Dec. 25 as well.

Music psychology

While music will have a festive use around Christmas time, Hadfield expects to use tunes as a tool to boost crew morale throughout his five months in space.

Hadfield will assume command of the space station during Expedition 35, becoming the first Canadian to do so. He’s spent brief times on space stations before, having visited Mir and the ISS during his shuttle missions. This time, when he takes the helm, Hadfield said the health of the crew will be his primary focus.

Music, he pointed out, is a way to celebrate the good times and to mark the bad times. “Music is just an expression and the extension of life itself,” he said.

Hadfield talked with his crewmates about how they will proceed if a loved one dies on Earth — “my worst fear.” He previously served as part of the support team for American astronaut Dan Tani, whose mother died in a car crash in 2007 while Tani was in space.

Hadfield wanted to ensure a procedure is in place if tragedy befalls one of his crewmates during the upcoming mission.

“That would be extremely hard to deal with psychologically, for the whole crew,” Hadfield acknowledged. But with the procedures set, he’s hoping the worst doesn’t happen, “touch wood.”

Possible spacewalk

Much of Hadfield’s time will be taken up in work while he’s on the orbiting lab. There will be an estimated 130 scientific experiments being performed on board, each with a set of tasks and goals that require astronaut assistance. Among them is a Canadian experiment called Microflow, an Iron Man-like device that does near-instantaneous blood work on the astronaut guinea pigs.

One of Hadfield’s notable achievements in spaceflight is extra-vehicular activity — in 2001, he was the first Canadian to do a spacewalk. For the occasion, NASA played Canada’s national anthem in space (also a first) and dubbed Hadfield’s spacewalking partner, Scott Parazynski, an “honorary Canadian.”

NASA has no immediate plans to do a spacewalk during Hadfield’s upcoming flight — yet. However, Hadfield acknowledged some “pretty intense conversations” are ongoing because of the breakdown of one minor system on station.

In the meantime, Hadfield said he’s aiming to stay in the best shape possible in case there’s a need to go outside. In any case, physical conditioning will be paramount for when the crew comes home and re-adapts to Earth’s gravity.

And when that happens, Hadfield has one main hope for his crewmates: “When they land on Earth they are inspired to get to the front of the line, and get on that ride again.”

Source:Space.com

 

 


Graphics are Overrated

5. Christmas Time (Don’t Let the Bells End) – The Darkness

You know you want that two-fretted guitar.

4. All Alone on Christmas – Darlene Love

The greatest song from Home Alone 2: Lost in New York.

3. All I Want For Christmas is You – Mariah Carey

You know it’s nearly Christmas when you hear this on the radio. In November.

2. Last Christmas – Wham

1. Do They Know It’s Christmas? – Band Aid (1984)

The two later versions are nowhere near as brilliant as the original (Some scenes may be upsetting)

What’s your favourite Christmas Song?

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Five things Microsoft must do for Windows 8 in 2013.


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Reactions to Windows 8‘s launch mirrored the operating system’s own split personality. Here’s what Microsoft needs to do to keep the OS from getting left on the showroom floor.

Microsoft’s ambitious Windows 8 gamble may have launched this past October, but it’s 2013 that will make or break the new operating system. I have five recommendations that Microsoft should implement sooner rather than later to keep Windows 8 from going the way of Vista.

Make the case for Windows RT
“That’s right, it filets, it chops, it dices, slices, never stops, lasts a lifetime, mows your lawn, and it mows your lawn and it picks up the kids from school…” —Tom Waits, “Step Right Up”

Waits wasn’t talking about Windows RT when he wrote and recorded “Step Right Up” in the mid-’80s, but he could’ve been. Microsoft wants the tablets that run the OS to be unifying devices that are portable like a tablet but powerful enough for the heavy lifting of Microsoft Office. Claiming that the OS can step up to that challenge, and actually proving that it can, are not the same thing.

Here’s the problem with Windows RT: Even after writing CNET’s FAQ on Windows RT, I still have problems clearly explaining what it is and why people should want it. It’s “Windows 8 Lite,” but it’s so much more complex than that. Sure, the Surface is a nice piece of hardware, but besides its utility as a tablet-and-skateboard combo it’s a hard sell.

I have a semibaked theory that Windows RT will become Windows 9, especially because of its ability to run on lower-powered, more secure ARM chips, but right now RT is closer to being the next Kin than the next Xbox.

Focus on apps
Though some Microsoft defenders point out that it took Google years to bulk up Android‘s app catalog to 500,000-plus titles, Redmond doesn’t have that kind of time when it comes to Windows 8.

Windows is not some in-development mobile operating system; it’s the mature senior statesman of the computing world. It’s on more computers than any other OS, and that’s not going to change anytime soon. We know Microsoft wants the world to move as quickly as possible to Windows 8 — there’s no other explanation for the soon-to-expire $39.99 upgrade and the push for new, interesting, touch-screen hardware.

While it’s true that Windows 8 can run legacy software just fine in Desktop mode, Metro apps are what will sell people. Some good apps currently available demonstrate the possibilities of Metro, but they don’t offer a compelling reason to change your entire work flow.

The strength of iOS is that Apple’s operating system is the cleanest around. Android basks in the glow of Google’s best apps and services, from Gmail to Goggles to Translate to search. The Windows 8 app experience has yet to be defined, which could benefit Microsoft in that it has an open canvas to paint on.

The bad? Don’t expect competitors to look the other way as Microsoft refines its app pitch to developers.

Convertibles and hybrids need a Surface, too
The Surface hardware went a long way toward drumming up interest in Windows 8 and Windows RT, not to mention a lot of sturm und drang from Microsoft’s hardware partners. While it could be interesting to see a Redmond-designed convertible or hybrid laptop, it’s not strictly necessary. But what the burgeoning, occasionally confusing category does require is a hybrid or convertible that Microsoft can point to and exclaim to the public, “This!”

It may not want to, but right now all that we’ve seen are oversize tablet-tops with hinges. You can’t easily tell people why they must have a new category of hardware without a signature device.

Wherefore art thou, settings and preferences?
Settings aren’t sexy, but they shouldn’t be confusing, either. Microsoft ought to make some decisions, and fast, about cleaning up the confusing mess of its under-the-hood options.

Sometimes they’re behind the Settings charm in Metro. Other times they’re buried in some Desktop mode window. Currently, I find it easiest to simply start typing for what I’m looking for, and let the powerful search tool do the hard work. But if Microsoft wants Windows 8 to have long-standing appeal for nonexperts, it’s going to have to demystify this stuff.

Get people and businesses excited about Windows 8
Microsoft has done itself a great disservice by coming up with a fairly interesting, unique approach to the ecosystem problem, and then letting substandard marketing heighten people’s questions and uncertainties.

Solving the above problems alone won’t work without helping people realize what’s so great about Windows 8. And without the massive license buys that businesses can provide, Windows 8 will struggle in a consumer marketplace that is increasingly turning to Macs to solve its problems.

How Microsoft can best do that I’ll leave to greater marketing minds than myself. On some level, though, it would seem easiest to have compelling hardware that people want to use. The interest in the Surface is a step in the right direction, just as Samsung’s Galaxy S3 and Google’s Nexus 7 did wonders for Android. Maybe there’s a killer “laptablet” coming at the beginning of next year, but there’s little doubt that Windows 8 has a hard path to trek in 2013.

By Seth Rosenblatt

Seth Rosenblatt is a senior editor at CNET, and has written about nearly every category of software and app available. At CNET since 2006, he currently focuses on browsers, security, and operating systems, with occasional forays into tech and pop culture.

Source:CNET

PSY’s ‘Gangnam Style’ Hits 1 Billion Views on YouTube.


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PSYs “Gangnam Style” has just become the first video in the history of the Internet to surpass one billion views.

At some point in the 10 o’clock hour ET on Friday (Dec. 21), PSY’s mega-hit reached this unprecedented milestone just 27 days after surpassing Justin Bieber’s “Baby” as the most watched video on YouTube. The video’s YouTube page updated with 1,000,382,639 at 10:50 a.m. A precise time has not been announced.

In the days after breaking the 803 million YouTube view record, “Gangnam Style” has sustained over 6.5 million views per day – that’s 76.4 view per second.

To compare to the second most popular video on the Internet, “Baby” likely won’t cross the 1 billion view mark until late 2014, according to projections provided by Next Big Sound. Its decelerating view count currently hovers just above 300,000 per day, or only 3 views per second – a rate that is likely to continue to shrink.

Unsurprisingly, PSY has gone on to become the platform’s top trending YouTube video in 2012.

“Gangnam Style” spent 5 weeks at No. 1 on the Billboard K-Pop Hot 100, reaching the No. 1 spot before even debuting on the Hot 100. The song is in its 15th week on the U.S.-based Hot 100, with 7 weeks spent in the No. 2 position, held from the throne by Maroon 5‘s “One More Night”

For a time “Gangnam Style” was the most listened to song on streaming platforms such as Spotify, Rdio and Mog, holding the No. 1 spot on the On-Demand Songs chart for 5 weeks.

As YouTube has become the number one place teens go to listen to new music, according to a Nielsen study, the platform has emerged as a revenue generator for many artists. What exactly does 1 billion views look like from an earnings standpoint? Using conservative estimates across several verticals, we can create a breakdown of “Gangnam Style” approximate earnings. At a reported rate of $2 for every 1,000 views, Gangnam generates $2,000,000 from YouTube alone. Factoring in 3.07 million $1.29 digital single downloads of “Gangnam Style” (according to Nielsen Soundscan), PSY brings in an estimated additional $3,960,000 from digital downloads and $50,000 in additional revenues generated from On-Demand streaming services such as Spotify, Rdio and Mog. Excluding additional his puts “Gangnam Style” an estimated $6.01 million in revenues from this recorded piece of music in just the 5 months the single has been out.

Undoubtedly, the greatest contributing factor to “Gangnam Style’s” success were the fans who created covers and shared the songs with friends, helping the video to go viral. But the song also gained a lift from the exposure it received on radio and television. It garnered 519 million in cumulative audience, according to Nielsen BDS, over its 12-weeks-and-counting run on Hot 100 airplay (Radio Songs chart). It peaked at No. 12 on the ranking the week of Oct. 27.

“Gangnam Style’s” popularity afforded PSY a litany of opportunities to appear on television, both in the US and abroad. He appeared on ABC News, NBC’s “Today” show (twice), the MTV Video Music Awards, “Ellen” (twice), “Saturday Night Live,” “Chelsea Lately,” “Jimmy Kimmel Live!”, “The View,” the American Music Awards, MTV’s “EMAs,” as well as a halftime show during a Buffalo Bills-Seattle Seahawks game.

These are just his in-person appearances — his music or video has also been featured on “Glee,” Fox News’ “The O’Reilly Factor,” CNN, etc; but not his actual self appearing.

The rapper’s 2012 isn’t over, though. Look out for PSY performing on “Christmas In Washington 2012” tonight on TBS and he’ll close out the year with an appearance on “New Year’s Rockin’ Eve.” He’s also at work on new material for his newly-minted deal with Scooter Braun’s Schoolboy Record and Universal Republic.

Enjoy the video on Youtube, URL: http://youtu.be/9bZkp7q19f0

Source: Billboard

Maya Calendars Actually Predict That Life Goes On.


maya-monument-6-does-not-predict-apocalypse_62225_600x450Doomsday? No way. Ancient Maya said we’ll be around another 7,000 years or so.

This December, not everyone is concerned with making plans for the New Year—especially not the people who think doomsday will get here first. Instead of planning parties, they’re stockpiling food, refining escape routes, and honing survival skills ahead of the alleged date on which the Maya calendar “ends”—December 21, 2012.

So should we all be preparing for imminent apocalypse? According to the scholars, no.

The ancient Maya are usually cited as the predictors of the world coming to an end this month: One of their “great cycles” supposedly ends now. But the Maya were brilliant mathematicians and fantastic record keepers. They didn’t have just one calendar. They developed many different kinds, including a cyclical solar calendar and a sacred almanac. They also measured time with something known as the Long Count, which were great cycles of 5,000 years.

Somewhere along the way a rumor spread about the current great cycle, indicating it ends on December 21, 2012. This sparked the belief among some that the last of our days are upon us.

Rebirth

It’s not the first time that the possibility of apocalypse has sparked the human imagination. Doomsday prophecies have a rich history, and believers tend to overlook the scientific evidence that disproves them. In this case, the doomsdayers fail to take into account the intricacies of Maya timekeeping.

“There’s only one [Maya] monument that even has the 2012 date on it,” says Maya scholar Ricardo Agurcia, adding that apocalypse anticipators are ignoring that according to the Maya, when one great cycle ends, another begins. “It’s about rebirth, not death.” (Read about the rise and fall of the Maya in National Geographic magazine.)

Indeed, the Maya predicted the world would most certainly not end in 2012. Earlier this year, archaeologist and National Geographic Grantee William Saturno discovered a series of numbers painted on the walls at a Maya complex in Guatemala. The calculations included dates that go far into the future. “The ancient Maya predicted the world would continue, that 7,000 years from now, things would be exactly like this,” he said in a press release. (See ultra-high-resolution, zoomable pictures from inside a newfound Maya chamber.)

“We keep looking for endings. The Maya were looking for a guarantee that nothing would change. It’s an entirely different mindset.” (Watch: Mysterious Maya Calendar and Mural Uncovered.)

It Came From Outer Space?

That should be enough to soothe Maya-inspired worries about doomsday scenarios. But what about other potential agents of catastrophe—coronal mass ejections, a “killer planet,” polar shifts?

On these possibilities, NASA can shed some light. On his blog Ask an Astrobiologist, NASA space scientist David Morrison has fielded some 5,000 questions about doomsday 2012. People want to know about the existence of Nibiru, or Planet X, and whether it’s coming to destroy Earth or not. Others inquire about alignment of the heavenly bodies, shifting of the magnetic poles, and bursting of solar flares. In a YouTube video, Morrison said, “There is no threat to Earth in 2012. Nibiru does not exist. There are no special forces when planets align. Don’t worry about 2012, and enjoy 2013 when it comes.”

Despite this emphatic professional pushback, anxiety over our impending demise persists. According to an article in the New York Times, a number of Russians have fallen under the apocalypse spell, snatching up essentials as December 21st approaches. The story also cites apprehension in southern France, where certain camps believe Bugarach mountain has the power to protect in a doomsday scenario.

In the United States, doomsday preparers have help from people like Larry Hall, who is building underground luxury “survival condos” in Kansas missile silos leftover from the Cold War era. Careful not to judge anyone’s reason for worry, he said, “I’m not saying you’re right or you’re wrong. I’m just trying to have a one-size-fits-all solution to whatever your threats may be.”

Catherine Zuckerman knows her apocalypses. She is author of National Geographic’s e-book “Doomsday 2012,” which examines the enduring fascination with doomsday predictions.

Source:NGC

Telomere Function and Cancer.


PF-inside-2When Titia de Lange was about 16 years old and living in Holland, she saw an electron microscope image of a chromosome in a Dutch newspaper that changed her life.

“I remember being completely struck by it,” said Dr. de Lange. “Massive amounts of DNA were packaged in all of these endless loops. And our genetic information had to function within this element; that is how it has to work.

“But how could it work?” she said. “Everything I’ve done in my career goes back to that image and to that question.”

Dr. de Lange began pursuing the answer as an undergraduate student. Organic chemistry was what she really wanted to focus on, but because there weren’t many women in the field, and perhaps also because her grandmother was a biologist (who earned a Ph.D. in 1911), she chose biology instead.

Eventually, she found her way back to the molecular realm, first working with Dr. Richard Flavell, her undergraduate advisor at the National Institute for Medical Research in Mill Hill, London, and then with Dr. Piet Borst, her thesis advisor at the University of Amsterdam, who showed her how to manipulate DNA and to clone genes.

She then accepted a postdoctoral position in Dr. Harold Varmus’ laboratory at the University of California, San Francisco, to learn more about genome instability in cancer. It was there that Dr. de Lange eventually focused her work on telomeres, which are long stretches of repeated nucleotide sequences that are found at the ends of linear chromosomes.

The End-Protection Problem

When a cell divides, it must copy its genetic information so that each daughter cell has its own set of instructions. But a small amount of DNA is lost from the ends of a chromosome each time it is replicated. The bits that are left off are part of the telomeres, which protect the chromosomes themselves from being degraded. Telomeres also prevent the ends of different chromosomes from fusing with each other.

In most normal cells, telomere degradation continues for 20 or 30 cell divisions until they become too short, at which point the cell stops dividing and eventually dies. In this sense, telomeres limit the lifespan of cells. In embryonic and adult stem cells, as well as many cancer cells, an enzyme called telomerase replenishes the telomere repeats lost during replication, keeping the cells alive indefinitely.

If telomeres don’t work correctly, the chromosome becomes unstable, which can lead to DNA mutations, wholesale losses, and rearrangement of chromosomes that are characteristic of some cancers.

Dr. de Lange studies the molecular and cell biology of telomeres and how telomere function is altered in cancer. In the early 1990s, after joining the faculty at Rockefeller University, she identified a binding factor on telomeres that she called TRF. Over the next 10 years, she and others isolated five more proteins that work together with this binding factor to form a complex named shelterin.

DNA has magnet-like stickiness and recombines easily when one end gets close to the end of a neighboring chromosome, which can cause structural rearrangements such as fusions and translocations. By protecting chromosome ends, shelterin prevents such rearrangements. It also keeps telomeres safely hidden from the machinery in the cell that would otherwise mistake them for chromosome breaks that need to be repaired.

The need to keep telomeres hidden so that chromosomes remain stable is known as the end-protection problem, and work in Dr. de Lange’s laboratory has made substantial progress in terms of describing it.

“Now the question,” she said, “is how does the [shelterin] complex do this? It’s not trivial. Six proteins and six pathways mean six tricks. We think one trick is the t-loop”—physically, the telomere end is tucked back into itself as a loop, a finding that she and her collaborator, Dr. Jack Griffith at the University of North Carolina, Chapel Hill, first published in 1999—”but that would only take care of two pathways, and we still need to understand the other four. We have a big task ahead of us to figure out mechanistically how this complex does such a clever job.”

Targeting Telomeres in Oncology: NCI’s Investment

In principle, the telomeres of cancer cells should be an ideal target for cancer treatment. The enzyme telomerase is inactive in most adult cells, aside from stem cells, but about 80 to 95 percent of cancer cells use telomerase to extend their telomeres and to attain immortality. Other cancer cells use something called the ALT pathway to attain immortality.

“If we can selectively figure out how to block the mechanisms by which cancer cells overcome their natural limits, that would be almost like a magic bullet,” said Dr. Richard Pelroy, program director in NCI’s Division of Cancer Biology.

Several agents that target the enzyme telomerase are being tested in clinical trials, including small-molecule inhibitors, immunotherapies, and viral therapies. So far, none has shown the level of effectiveness that is hoped for, Dr. Pelroy said. “We need more-detailed molecular and mechanistic knowledge of what is happening at the telomeres during normal division and abnormal division.”

To that end, NCI is funding basic research grants in this area, hoping to learn more about the risk factors that are associated with telomere dysfunction and cancer, as well as to refine the approach for targeting this potentially vulnerable feature of cancer cells.

Her recent work has described cellular features that may one day be used to home in on cells that use something other than expression of telomerase—namely, a process called the alternative lengthening of telomeres, or ALT, pathway—to prevent their own death. (See the sidebar.)

Science for the Right Reasons

Dr. de Lange’s research has brought her accolades and wide recognition. During the last 12 or so years, “she’s virtually defined the field of telomere protection,” said Dr. Richard Pelroy, program director in the DNA and Chromosome Aberrations Branch of NCI’s Division of Cancer Biology. “It was known that cells must be able to detect telomere dysfunction and deal with it in order to have normal cell division,” he explained, “but the discussion was merely conceptual before her work.”

For Dr. de Lange, life as a scientist is much easier now than it was when she first started down the path. As a young scientist, she had very little money and no laboratory assistance. “Nobody cared about telomeres,” she said. “It was backwater research. We had meetings on telomeres in the early ’90s—unofficial meetings, of course—and there were literally fewer than a dozen people who attended them.”

What she did have, she said, was intuition and enthusiasm. “I loved telomeres,” she said. “This is very important, to love something to death and be willing to do something important for it.” That is the message that she tries to impress on everyone who works with her: Find your love in science first, and then good things will follow.

“She is 100 percent, fully dedicated,” said Dr. Dirk Hockemeyer, an assistant professor at the University of California, Berkeley, who first worked with Dr. de Lange as an undergraduate exchange student from Germany and returned to earn his Ph.D. under her mentorship. “She’s interested in really understanding how things work, and she won’t let go until she’s figured them out,” he said. Dr. Hockemeyer recalled an example from 2006, when Dr. de Lange took a sabbatical from teaching so that she could work at the bench in her own laboratory and continue experiments that she had started 10 years earlier.

“She taught me to be happy with science for the right reasons,” said Dr. Nadya Dimitrova, who did her Ph.D. work with Dr. de Lange. Dr. Dimitrova recalled that when she was writing her graduate thesis, Dr. de Lange “returned the draft to me and said that my conclusion and discussion weren’t brave enough. ‘You need to take this opportunity to say everything that you think…your whole model and hypothesis that goes even beyond your findings.’ So, I started it all over and wrote a discussion that was far reaching and even prescient in some ways, and I’m very proud of that to this day.”

Dr. de Lange doesn’t believe that science has to be high risk in order to be satisfying, and she’s careful not to pontificate about what one must do to attain success. But she does have one bit of advice for people who are considering careers in basic research.

“If you do a project just because you anticipate a high payoff, and you don’t love the underlying science,” she said, “I don’t think you’ll be able to sustain it. My advice is to find your own niche, one that you truly like, and then it doesn’t matter so much. You’ll do high-risk stuff, you’ll do low-risk stuff, whatever is needed.”

Which is exactly what happened in her case.

“I thought there would be bigger things to pursue eventually, but we’re still working on telomeres,” she said. “It’s a much more complex and interesting subject than I ever could have anticipated.”

Source:NCI

Decreasing ventricular infections through the use of a ventriculostomy placement bundle.


Ventricular infection after ventriculostomy placement carries a high mortality rate. Responding to ventriculostomy infection rates, a multidisciplinary performance improvement team was formed, a comprehensive protocol for ventriculostomy placement was developed, and the efficacy was evaluated.

Methods

A best-practice protocol was developed, including hand hygiene before the procedure; prophylactic antibiotics; sterile gloves changed between preparation, draping, and procedure; hair removal by clipping for dressing adherence; skin preparation using iodine povacrylex (0.7% available iodine) and isopropyl alcohol (74%); full body and head drape; full surgical attire for the surgeon and other bedside providers; and an antimicrobial-impregnated catheter. A checklist of critical components was used to confirm proper insertion and to monitor practice. Procedure-specific infection rates were calculated using the number of infections divided by the number of patients in whom an external ventricular drainage (EVD) device was inserted × 100 (%). Data were reported back to providers and to the committee. Bundle compliance was monitored over a 4-year period.

Results

At the authors’ institution, 2928 ventriculostomies were performed between the beginning of the fourth quarter of 2006 and the end of the first quarter of 2012. Although the best-evidence bundle was applied to all patients, only 588 (20.1%) were checklist monitored (increasing from 7% to 23% over the study period). The infection rate for the 2 quarters before bundle implementation was 9.2%. During the study period, the rate decreased quarterly to 2.6% and then to 0%. Over a 4-year period, the rate was 1.06% (2007), 0.66% (2008), 0.15% (2009), and 0.34% (2010); it was 0% in 2011 and the first quarter of 2012. The overall EVD infection rate was 0.46% after bundle implementation.

Conclusions

Bundle implementation including an antimicrobial-impregnated catheter dramatically decreased EVD-related infections. Training and situational awareness of appropriate practice, assisted by the checklist, plus use of the antibiotic-impregnated catheter resulted in sustained reduction in ventriculitis.

Source: Journal of neurosurgery

 

Effects of platelet and plasma transfusion on outcome in traumatic brain injury patients with moderate bleeding diatheses.


Coagulopathy and thrombocytopenia are common after traumatic brain injury (TBI), yet transfusion thresholds for mildly to moderately abnormal ranges of international normalized ratio and platelet count remain controversial. This study evaluates associations between fresh frozen plasma (FFP) and platelet transfusions with long-term functional outcome and survival in TBI patients with moderate hemostatic laboratory abnormalities.

Methods

This study is a retrospective review of prospectively collected data of patients with mild to severe TBI. Data include patient demographics, several initial injury severity metrics, daily laboratory values, Glasgow Outcome Score- Extended (GOSE) scores, Functional Status Examination (FSE) scores, and survival to 6 months. Correlations were evaluated between these variables and transfusion of FFP, platelets, packed red blood cells (RBCs), cryoprecipitate, recombinant factor VIIa, and albumin. Ordinal regression was performed to account for potential confounding variables to further define relationships between transfusion status and long-term outcome. By analyzing collected data, mild to moderate coagulopathy was defined as an international normalized ratio 1.4–2.0, moderate thrombocytopenia as platelet count 50 × 109/L to 107 × 109/L, and moderate anemia as 21%–30% hematocrit.

Results

In patients with mild to moderate laboratory hematological abnormalities, univariate analysis shows significant correlations between poor outcome scores and FFP, platelet, or packed RBC transfusion; the volume of FFP or packed RBCs transfused also correlated with poor outcome. Several measures of initial injury and laboratory abnormalities also correlated with poor outcome. Patient age, initial Glasgow Coma Scale score, and highest recorded serum sodium were included in the ordinal regression model using backward variable selection. In the moderate coagulopathy subgroup, patients transfused with FFP were more likely to have a lower GOSE score relative to those who did not receive a transfusion (OR 5.20 [95% CI 1.72–15.73]). Patients with moderate coagulopathy who received FFP and packed RBCs were even more likely to be have a lower GOSE score (OR 7.17 [95% CI 2.12–24.12]). Moderately anemic patients who received packed RBCs alone were more likely to have a worse long-term functional outcome as determined by GOSE and FSE scores (GOSE: OR 2.41 [95% CI 1.51–3.85]; and FSE: OR 3.27 [95% CI 2.00–5.35]). No transfusion types or combinations were noted to significantly correlate with the 6-month mortality in ordinal regression.

Conclusions

In TBI patients with moderate coagulopathy, FFP transfusions alone or a combination of FFP and packed RBCs were associated with poorer long-term functional outcomes as measured by the GOSE. Red blood cell transfusions were associated with poor long-term functional outcome in TBI patients with moderate anemia. Platelet transfusion in patients with moderate thrombocytopenia was not significantly associated with outcome. Although transfusion is beneficial to many patients with severe hematological abnormalities, it is not without risk, and the indications for transfusion should be carefully considered in patients with moderate hematological abnormalities.

Source: Journal of neurosurgery

 

 

 

A single center’s experience with the bedside subdural evacuating port system: a useful alternative to traditional methods for chronic subdural hematoma evacuation.


The traditional methods for managing symptomatic chronic subdural hematoma (SDH) include evacuation via a bur hole or craniotomy, both with or without drain placement. Because chronic SDH frequently occurs in elderly patients with multiple comorbidities, the bedside approach afforded by the subdural evacuating port system (SEPS) is an attractive alternative method that is performed under local anesthesia and conscious sedation. The goal of this study was to evaluate the radiographic and clinical outcomes of SEPS as compared with traditional methods.

Methods

A prospectively maintained database of 23 chronic SDHs treated by bur hole or craniotomy and of 23 chronic SDHs treated by SEPS drainage at Tufts Medical Center was compiled, and a retrospective chart review was performed. Information regarding demographics, comorbidities, presenting symptoms, and outcome was collected. The volume of SDH before and after treatment was semiautomatically measured using imaging software.

Results

There was no significant difference in initial SDH volume (94.5 cm3 vs 112.6 cm3, respectively; p = 0.25) or final SDH volume (31.9 cm3 vs 28.2 cm3, respectively; p = 0.65) between SEPS drainage and traditional methods. In addition, there was no difference in mortality (4.3% vs 9.1%, respectively; p = 0.61), length of stay (11 days vs 9.1 days, respectively; p = 0.48), or stability of subdural evacuation (94.1% vs 83.3%, respectively; p = 0.60) for the SEPS and traditional groups at an average follow-up of 12 and 15 weeks, respectively. Only 2 of 23 SDHs treated by SEPS required further treatment by bur hole or craniotomy due to inadequate evacuation of subdural blood.

Conclusions

The SEPS is a safe and effective alternative to traditional methods of evacuation of chronic SDHs and should be considered in patients presenting with a symptomatic chronic SDH.

Source: Journal of neurosurgery

 

 

 

How to get back to the Moon in seven steps.


Forty years after the last Apollo flight to the Moon, our space correspondent examines the options facing companies and countries contemplating their own giant leap for mankind.

A long way back

It is 40 years since the last Apollo astronauts landed on the Moon, bring the total number of humans to set foot on the lunar surface to 12.

First steps

The Apollo programme was built around the Saturn V rocket – still the largest, most powerful rocket ever used. (Copyright: Nasa)

Moon shot

The first mission to the lunar surface blasted off on the 16 July 1969, when a Saturn V carried Michael Collins, Neil Armstrong and Buzz Aldrin into orbit. (Copyright: Nasa)

Flying Eagle

The awkward and angular looking Eagle lander carried Neil Armstrong and Buzz Aldrin to the surface of the Moon.

History books

On 20 July 1969 Neil Armstrong became the first human to walk on the Moon. Along with Buzz Aldrin, he spent more than two hours outside the lander.

Back to Earth

In total, the pair spent nearly one day on the lunar surface, before blasting off to rendezvous with Michael Collins who had been orbiting in a capsule above them.

View from above

The Apollo programme launched seven missions to the Moon, landing a total of 12 astronauts on the surface and introducing the world to a new view of the Earth.

Final mission

The last mission was Apollo 17, which took off from Launch Complex 39 at Kennedy Space Center in Florida on 7 December 1972.

Driving forces

The crew consisted of commander Eugene Cernan, astronaut Ronald Evans and Harrison Schmitt, the first and last scientist to land on the Moon.

End of an era

The crew left the Moon’s surface on 14 December and reentered the Earth’s atmosphere five days later, landing safely in the Pacific Ocean.

Going to the Moon is hard. And expensive. It took Nasa the equivalent of four million human-years to put twelve astronauts on the surface, at a cost of some $25 billion.

It is one of the reasons that ever since the Apollo 17 crew packed up their kit and flew home, we have not been back.

But, there now seems to be a renewed appetite for returning to the Moon. The Golden Spike Company recently announced that it can take you there by 2020 for $1.4 billion and we can only guess how much money China is putting into its lunar ambitions.

So, assuming you have the cash, what else do you need to get to the Moon? Here is BBC Future’s seven-step guide for any individual, nation or company wanting to take a giant leap:

A new rocket

Escaping the Earth’s gravity and getting people (and hardware) to the Moon requires a lot of energy. The 1960s solution, the Saturn V rocket, was a staggering piece of technology. Standing 30 stories high, the three-stage launcher was fitted with more than three million parts. But laying your hands on one may prove difficult. The only remaining Saturn V made up of original hardware intended for space, is in a giant shed in Houston. Nasa might notice if anyone tried to borrow it. And what was left of the failed Russian equivalent, the N1, has been made into bus shelters at the Baikonur Cosmodrome in Kazakhstan.

Given that there is no modern equivalent of the Saturn V or N1, and short of building a similarly massive rocket, you will need a plan B. Golden Spike proposes a multi-stage approach with multiple launches of smaller rockets (such as the Atlas 5) to ferry a lunar lander, crew capsule and two Lunar Transport Vehicles (LTV) into orbit. The LTVs will provide the power to take the lander and crew capsule from the Earth to the Moon.

Alternatively, you might choose to launch several sections of your spacecraft into Earth orbit, assemble them there and then fly onto the Moon. The various components could be launched on anything from aEuropean Ariane to a SpaceX Falcon. But you could only fly your crew on a rocket certified for human spaceflight such as a Russian Soyuz orChinese Long March.

Another way might be to use bigger rockets – or add new stages to existing rockets – to place your component parts into lunar orbit, and put the whole mission together there. Nasa is also developing a new heavy-lift rocket, the Space Launch System, which is slowly moving from the drawing board to the factory but the first tests aren’t scheduled until 2017.

Whatever you choose, the good news is that most of the technology is available and is coming down in price as private companies begin to offer alternatives.

A spacecraft

You may think that once the rocket is sorted, you are most of the way there. But that is only going to boost you into orbit. Once in space you need something to ferry you towards the Moon and land on its surface.

When they were designing Apollo in the early 1960s, Nasa engineers quickly realised that it made more sense to have two separate vehicles – an orbiter and a Moon lander – rather than a single spacecraft.

The 21st Century equivalent of the Apollo capsule is Nasa’s Orion module. It resembles a super-sized Apollo and the first test versions of this “deep space” capsule are now nearly complete. However, it will be several years before it’s ready for any crew.

If you cannot get hold of an Orion, Isle of Man company Excalibur Almaz Limited is reconditioning ex-Russian military space capsules for use in expeditions around the Moon. Joined to habitation modules, these spacecraft would be six times the size of Orion, making the journey much more comfortable.

So, when it comes to capsules, you have got some options.

But the same cannot be said of landers. There is nothing, in existence, like the Apollo lunar landers although concept designs have been developed. These include Nasa’s recent Altair craft, but that programme has now been abandoned. Still, you could dust off the blueprints and, with a bit of imagination, new materials and techniques, it should be possible to put something together. It is almost certainly going to be expensive and, as with any new space technology designed for astronauts, it is going to involve a lot of risks.

The right stuff

Going to the moon is not going to be fun. It is likely going to be tiring, cramped and most of all dangerous. So, even if you have the cash, you will need the “right stuff”.

Have you thought about the risks you are taking? How your family will cope if things go wrong? Have you even considered what to say when you get there? Will you come in peace for all mankind or are you just in it for personal glory?

For astronauts, the psychological aspects of being a spacefarer are every bit as important as the physical.

And then there is the training. An ability to work in a close-knit team and respond to emergencies in a calm, professional manner is vital if you want to get back alive.

Even Apollo’s only scientist-astronaut, geologist Harrison Schmitt, was a fully trained jet pilot. The other Apollo astronauts were, for the most part, super-fit flying aces and many of today’s astronauts are still from a flying background. Rookie UK astronaut Tim Peake, for instance, is a military helicopter test pilot – hardly a desk job.

If you plan to fly to the Moon before this decade is out then start training now. Even if you decide to employ professional astronauts to do most of the work, you still need to put in the hours. Apart from a rigorous fitness regime, you will have to learn how to fly the spacecraft, work in weightlessness and train for what to do when something goes wrong.

The right clothes

Once you and your hardy crew have escaped Earth’s orbit and touched down on the surface, you are going to want to step outside the capsule. And for that you need a spacesuit.

These are effectively miniature spacecraft – containing everything you need when planting flags, hitting golf balls or just taking in the views from the lunar surface. To cram all the life support, communications and computers in, spacesuits are bulky. This does not matter so much if you are on a spacewalk outside the International Space Station in zero gravity. But if you are attempting to bounce around on the Moon, you will need something that is relatively compact and light. It will also need to be strong enough to avoid getting torn on rocks or damaged by lunar dust.

Apollo spacesuits were individually tailored to each astronaut and sewn and glued together by seamstresses. They consisted of multiple layers – from a mesh of coolant pipes near the body to a tough outer protective suit of fire-proof Teflon cloth. The iconic Apollo helmets featured gold-plated visors to protect the astronauts from the Sun and the gloves were made as thin as possible to maintain flexibility.

Thanks to the development of new lightweight materials, future spacesuits should be a lot less bulky but they will still need to be immensely complex. Try the funky new ones being developed by the University of North Dakota’s Spacesuit Laboratory, for instance, which promise much greater range of movement and flexibility.

The maths

After President Kennedy made his 1961 pledge to put men on the Moon, Nasa drew up a list of all the challenges that would need to be overcome to make that goal possible. The gap between the tiny Mercury capsule, in which astronaut Alan Shepard had become the first American in space (but not even orbit) three weeks earlier, and the goal of men walking on the Moon seemed almost laughably insurmountable. There was so much that had to be figured out, with one of the biggest challenges being space navigation and rendezvous.

A lunar mission, then or now, involves spacecraft docking on the way to the Moon or in lunar orbit. If, for instance, Apollo astronauts failed to dock their command module with the lander, then the mission would be off. Worse, if on returning from the Moon, the lander failed to rendezvous successfully with the command module, then two astronauts would end up stranded, forever, in lunar orbit.

The maths of orbital mechanics and rendezvous became one of the primary objectives of the mid-60s Gemini missions, with MIT graduate Buzz “Dr Rendezvous” Aldrin taking a leading role. Although the navigation computer developed for the Apollo spacecraft was a marvel of 1960s engineering, astronauts still used sextants to verify their position.

Even with advances in computing, the challenges of space navigation remain. The spacecraft needs to know where it is. A glitch in the software and you could find yourself completely lost in space. China recently proved its orbital navigation capabilities, with its spacecraft docking to the Tiangong-1 space lab but if you want to go to the Moon, you must get your maths right. Half a degree out and you will never be seen again.

Mission control

Building, launching and flying a rocket to the Moon takes tremendous organisation. The genius at the heart of Apollo was mission control. Bringing together specialists from every aspect of the flight – from engine control to life support – and having a single Flight Director in charge, kept everything on track. The concept proved its worth when, during Apollo 13, things were going catastrophically wrong and the collected expertise at mission control saved the crew’s lives.

Even today, the International Space Station has a room full of people on the ground to keep the astronauts in orbit safe. For your flight to the Moon you will need a skilled team of experienced personnel and a communications system capable of reaching the crew during every minute of the mission. You will also need engineers, back-up astronauts and a public affairs staff to keep those journalists happy.

Money

Okay, so we’ve mentioned this once, but it is worth reiterating. Going to the Moon is going to need money. Lots of it.

The Apollo programme was initially estimated at $7 billion but this was quickly revised to around $20 billion. In the end, the final cost was reported to be  $25.4bn.

All of which should make any budding lunar travellers take estimates with a pinch of salt. If you have ever employed builders, you will know that final costs tend to be a great deal more than the original estimates. And, as with builders, you should consider getting some other quotes.

Golden Spike estimates $1.4 billion for a trip. But here at BBC Future, we reckon we could do you a mission to the Moon for $1.3 billion. Cash in hand.

Source:NASA02 03 01 04 05 08 09 10