Angels without Wings (1944)

https://digitalcommons.butler.edu/buyearbooks/1031/thumbnail.jp

Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine initiative: patient-centred outcomes

BACKGROUND: Patient-centred outcomes are increasingly used in perioperative clinical trials. The Standardised Endpoints in Perioperative Medicine (StEP) initiative aims to define which measures should be used in future research to facilitate comparison between studies and to enable robust evidence synthesis. METHODS: A systematic review was conducted to create a longlist of patient satisfaction, health-related quality of life, functional status, patient well-being, and life-impact measures for consideration. A three-stage Delphi consensus process involving 89 international experts was then conducted in order to refine this list into a set of recommendations. RESULTS: The literature review yielded six patient-satisfaction measures, seven generic health-related quality-of-life measures, eight patient well-being measures, five functional-status measures, and five life-impact measures for consideration. The Delphi response rates were 92%, 87%, and 100% for Rounds 1, 2, and 3, respectively. Three additional measures were added during the Delphi process as a result of contributions from the StEP group members. Firm recommendations have been made about one health-related quality-of-life measure (EuroQol 5 Dimension, five-level version with visual analogue scale), one functional-status measure (WHO Disability Assessment Schedule version 2.0, 12-question version), and one life-impact measure (days alive and out of hospital at 30 days after surgery). Recommendations with caveats have been made about the Bauer patient-satisfaction measure and two life-impact measures (days alive and out of hospital at 1 yr after surgery, and discharge destination). CONCLUSIONS: Several patient-centred outcome measures have been recommended for use in future perioperative studies. We suggest that every clinical study should consider using at least one patient-centred outcome within a suite of endpoints

WIND TUNNEL EXPERIMENTS AND NUMERICAL SIMULATIONS ABOUT THE FLOW AND CONCENTRATION FIELDS AROUND TWIN HIGH-RISE BUILDINGS WITH A DISTRICT HEATING PLANT

This report describes the results of wind tunnel experiments and numerical simulations about the flow and concentration fields around twin high-rise buildings. These experiments and simulations were conducted at Environmental Protection Agency during Dr. Ohba\u27s tenure from April in 1992 through March in 1993 as a visiting scientist. From the wind tunnel experiments, it was found that, provided the twin high-rise building models were located such that the separation distance between the twin building models were longer than a building height, then upwind building would reduce the effects on the flow fields near the top of the downwind building model, and the separation distance would not substantially affect the magnitude of the downwind surface concentration contours for the downwind building. The numerical simulations based on a k-ε model were conducted about three basic types of high-rise buildings using a CRAY supercomputer in EPA. Comparing the simulated results with experimental data for twin high-rise building models, the velocities along the upwind face of the downwind high-rise building model were predicted a little stronger than those in experimental data. Therefore, the reverse flow was not as clearly defined as that in the wind tunnel experiments. The overal good agreement with the wind tunnel data was achieved. However, for a single high-rise building model, the concentrations on the downwind surface were predicted higher than those for the twin high-rise buildings because the wake length was predicted longer than those for the twin building models. It is thought that our k-ε model needs to improve the accuracy of prediction

Kinematic Modeling of Separation Compression for Paired Approaches to Closely-Spaced Parallel Runways

In a simultaneous paired approach to closely-spaced parallel runways, a pair of aircraft flies in close proximity on parallel approach paths. The longitudinal separation between the aircraft must be maintained within a range that avoids wake encounters and, if one of the aircraft blunders, avoids collision. To increase operational availability, the approach procedure must accommodate a mixture of aircraft sizes and, consequently, approach speeds. In these procedures, the slower aircraft is placed in the lead position. The faster aircraft maintains separation from the slow aircraft in a dependent operation until final approach and flies independently afterward. Due to the higher approach speed of the fast aircraft, longitudinal separation will decrease during final approach. Therefore, the fast aircraft must position itself before the final approach so that it will remain within the safe range of separation as separation decreases. Given the approach geometry and speed schedule for each aircraft, one can use kinematics to estimate the separation loss between a pair of aircraft. A kinematic model can complement fast-time Monte-Carlo simulations of the approach by enabling a tailored reduction in the variation of starting position for the fast aircraft. One could also implement the kinematic model in ground-based or on-board decision support tools to compute the optimal initial separation for a given pair of aircraft. To better match the auto-coupled flight of real aircraft, the paper derives a kinematic model where the speed schedule is flown using equivalent airspeed. The predicted time of flight using the equivalent airspeed kinematic model compares well against a high-fidelity aircraft simulation performing the same approach. This model also demonstrates a modest increase in the predicted loss of separation when contrasted against a kinematic model that assumes the scheduled speed is true airspeed

Military Retention Incentives: Evidence from the Air Force Selective Reenlistment Bonus

The limited lateral entry and rigid pay structure for U.S. military personnel present challenges in retaining skilled individuals who have attractive options in the civilian labor market. One tool the services use to address this challenge is the Selective Reenlistment Bonus (SRB), which offers eligible personnel with particular skills a substantial cash bonus upon reenlistment. However, the sequential nature of the bonus offer and reenlistment process limits the ability to adjust manpower quickly, raising interest in research that estimates the effect of the SRB on retention. While this literature has acknowledged challenges including potential endogeneity of bonus levels, attrition, and reenlistment eligibility, many studies do not address these concerns adequately. This paper uses a comprehensive panel data set on Air Force enlisted personnel to estimate the effect of the SRB on retention rates. We exploit variation in bonus levels within skill groups, control for civilian labor market conditions, and model reenlistment eligibility to avoid common assumptions that lead to biased impact estimates. We find substantial heterogeneity in the effect of the bonus, with the largest effects on first-term service members and those whose skills have not historically received a substantial bonus. We also find evidence that the bonus affects the timing of reenlistment decisions in addition to their frequency

Genetic comorbidity between major depression and cardiometabolic traits, stratified by age at onset of major depression

It is imperative to understand the specific and shared etiologies of major depression and cardio-metabolic disease, as both traits are frequently comorbid and each represents a major burden to society. This study examined whether there is a genetic association between major depression and cardio-metabolic traits and if this association is stratified by age at onset for major depression. Polygenic risk scores analysis and linkage disequilibrium score regression was performed to examine whether differences in shared genetic etiology exist between depression case control status (N cases = 40,940, N controls = 67,532), earlier (N = 15,844), and later onset depression (N = 15,800) with body mass index, coronary artery disease, stroke, and type 2 diabetes in 11 data sets from the Psychiatric Genomics Consortium, Generation Scotland, and UK Biobank. All cardio-metabolic polygenic risk scores were associated with depression status. Significant genetic correlations were found between depression and body mass index, coronary artery disease, and type 2 diabetes. Higher polygenic risk for body mass index, coronary artery disease, and type 2 diabetes was associated with both early and later onset depression, while higher polygenic risk for stroke was associated with later onset depression only. Significant genetic correlations were found between body mass index and later onset depression, and between coronary artery disease and both early and late onset depression. The phenotypic associations between major depression and cardio-metabolic traits may partly reflect their overlapping genetic etiology irrespective of the age depression first presents

Impacts of highway traffic exhaust in alpine valleys on the respiratory health in adults: a cross-sectional study

BACKGROUND: Most studies having shown respiratory health effects from traffic exhaust were conducted in urban areas with a complex mixture of air pollution sources. This study has investigated the potential impact of traffic exhaust on respiratory symptoms among adults living along a Swiss alpine highway corridor, where traffic exhaust from the respective trans-Alpine highway is the predominant source of air pollution. METHODS: In summer 2005, we recruited 1839 adults aged 15 to 70 from a random sample of 10 communities along the Swiss alpine highway corridors. Subjects answered a questionnaire on respiratory health (asthmatic and bronchitic symptoms), risk factors, and potential confounding variables. We used logistic regression models to assess associations between respiratory symptoms and traffic exposure being defined a) as living within 200 m of the highway, and b) as a bell-shaped function simulating the decrease of pollution levels with increasing distance to the highway. RESULTS: Positive associations were found between living close to a highway and wheezing without cold (OR = 3.10, 95%-CI: 1.27-7.55) and chronic cough (OR = 2.88, 95%-CI: 1.17-7.05). The models using a bell-shaped function suggested that symptoms reached background levels after 400-500 m from the highway. The association with chronic cough was driven by a subgroup reporting hay fever or allergic rhinitis. CONCLUSIONS: Highway traffic exhaust in alpine highway corridors, in the absence of other industrial sources, showed negative associations with the respiratory health of adults, higher than those previously found in urban areas

An analysis of post-traumatic stress symptoms in United States Air Force drone operators

Remotely piloted aircraft (RPA), commonly referred to as “drones,” have emerged over the past decade as an innovative warfighting tool. Given there is a paucity of empirical research assessing drone operators, the purpose of this study was to assess for the prevalence of PTSD symptoms among this cohort. Of the 1084 United States Air Force (USAF) drone operators that participated, a total of 4.3% endorsed a pattern of symptoms of moderate to extreme level of severity meeting criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders-4th edition. The incidence of PTSD among USAF drone operators in this study was lower than rates of PTSD (10–18%) among military personnel returning from deployment but higher than incidence rates (less than 1%) of USAF drone operators reported in electronic medical records. Although low PTSD rates may be promising, limitations to this study are discussed

Full genome comparison and characterization of avian H10 viruses with different pathogenicity in Mink (Mustela vison) reveals genetic and functional differences in the non-structural gene

<p>Abstract</p> <p>Background</p> <p>The unique property of some avian H10 viruses, particularly the ability to cause severe disease in mink without prior adaptation, enabled our study. Coupled with previous experimental data and genetic characterization here we tried to investigate the possible influence of different genes on the virulence of these H10 avian influenza viruses in mink.</p> <p>Results</p> <p>Phylogenetic analysis revealed a close relationship between the viruses studied. Our study also showed that there are no genetic differences in receptor specificity or the cleavability of the haemagglutinin proteins of these viruses regardless of whether they are of low or high pathogenicity in mink.</p> <p>In poly I:C stimulated mink lung cells the NS1 protein of influenza A virus showing high pathogenicity in mink down regulated the type I interferon promoter activity to a greater extent than the NS1 protein of the virus showing low pathogenicity in mink.</p> <p>Conclusions</p> <p>Differences in pathogenicity and virulence in mink between these strains could be related to clear amino acid differences in the non structural 1 (NS1) protein. The NS gene of mink/84 appears to have contributed to the virulence of the virus in mink by helping the virus evade the innate immune responses.</p