Objectives Natural and man-made disasters can result in power outages that can affect certain vulnerable populations dependent on electrically powered durable medical equipment. This study estimated the size and prevalence of that electricity-dependent population residing at home in the United States. Methods We used the Truven Health MarketScan* 2012 database to estimate the number of employer-sponsored privately insured enrollees by geography, age group, and sex who resided at home and were dependent upon electrically powered durable medical equipment to sustain life. We estimated nationally representative prevalence and used US Census population estimates to extrapolate the national population and produce maps visualizing prevalence and distribution of electricity-dependent populations residing at home. Results As of 2012, among the 175 million persons covered by employer-sponsored private insurance, the estimated number of electricity-dependent persons residing at home was 366 619 (95% confidence interval: 365 700-367 537), with a national prevalence of 218.2 per 100 000 covered lives (95% confidence interval: 217.7-218.8). Prevalence varied significantly by age group (χ2 = 264 289 95, P < .0001) and region (χ2 = 12 286 30, P < .0001), with highest prevalence in those 65 years of age or older and in the South and the West. Across all insurance types in the United States, approximately 685 000 electricity-dependent persons resided at home. Conclusions These results may assist public health jurisdictions addressing unique needs and necessary resources for this particularly vulnerable population. Results can verify and enhance the development of functional needs registries, which are needed to help first responders target efforts to those most vulnerable during disasters affecting the power supply.
Millions of individuals are in contact with horses through occupational or recreational activities. Injuries from horses are responsible for over 100,000 emergency room visits each year in the United States. Although various types of traumatic injuries related to direct contact with horses are well described, roughly 3% to 4.5% of all reported injuries are due to bites by equines. The immediate injuries are commonly either blunt or penetrating trauma to local tissue; however, the bite exposure may also transmit a microbial agent of equine origin that can lead to a zoonotic infection. In almost all jurisdictions in the United States, animal bites are considered public health events and should be reported to the local health departments. Many animals can harbor many unusual zoonotic pathogens that both the individual health provider and public health officials much consider as they can adversely impact both the patient and the community health. This review focuses on those zoonoses that have been reported in the literature, including those that may in theory be transmitted from equine to human by direct inoculation or exposure to oral/nasal secretions from horses and other equine species.
U) ABSTRACT (U) With the increased interest in multiple node space networks such as Brilliant Pebbles, Brilliant Eyes and Iridium', satellite-to-satellite communication connectivity via crosslinks over short ranges is an important consideration. Simultaneous link connectivity requires either several terminals per satellite or time division multiplexing approaches. This paper introduces a concept for integrating several small lightweight crosslink communication terminals to provide the desired simultaneous communication capability .(U) A suite of three laser communication crosslink terminals which have impact on satellite size, weight, and power is discussed. The total three terminal suite weight and power are given as 28 pounds and 58 watts maximum, respectively. The design provides one megabit per second point to point connectivity over 9,000 kilometers range with a bit error rate, and includes subsystem modal control.(U) The communication channel, link acquisition and cooperative tracking of the optical energy are discussed. The major components are identified and the technology risk associated with each is assessed. Risk is shown to be minimal. (U) INTRODUCTION(U) Multiple node distributed satellite networks are being considered for a number of applications in both the military and commercial arenas. With the large number of low earth orbit (LEO) satellites required for these systems, the costs associated with launch (related directly to weight) are extremely important.Light weight, low cost, and low power satellites are required to achieve the low life cycle costs demanded in fielding these large space based networks.(U) To achieve the global coverage desired by these systems, multiple orbital planes of multiple satellites per plane are envisioned2. One concept is illustrated for three planes in Figure 1. Full duplex communication connectivity between satellites is established fore and aft to form a ring network in-plane.(U) Cross-planeconnectivity is establishedvia selected nodes to UNCLASSIFIEC Figure 1: (U) Distributed Network Connectivity tions, a minimum of three terminals (fore, aft and across) are required per satellite.(U) Optical communication crosslink terminals offer many advantages in the above scenarios. Because of the high frequencies associated with optical links, narrow beam divergences, small field of views, and small aperture sizes can be used. These advantages work directly to reduce spacecraft design complexity. Narrow viewfields and beam divergences allow use of a single frequency source for both transmit and receive functions. This terminal simplicity is carried to the constellation level where only a single frequency is required. Complex frequency management is not required to mitigate self interference. High order network management functions are not necessary to allocate frequency or time slots to the crosslink function as would be necessary with conventional RF approaches.(U) Because of the greater than three orders of magnitude difference in frequency between optical crosslinks and...
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