How Effective Is Security Screening of Airline Passengers?

With a simple mathematical model, we explored the antiterrorist effectiveness of airport passenger prescreening systems. Supporters of these systems often emphasize the need to identify the most suspicious passengers, but they ignore the point that such identification does little good unless dangerous items can actually be detected. Critics often focus on terrorists\u27 ability to probe the system and thereby thwart it, but ignore the possibility that the very act of probing can deter attempts at sabotage that would have succeeded. Using the model to make some preliminary assessments about security policy, we find that an improved baseline level of screening for all passengers might lower the likelihood of attack more than would improved profiling of high-risk passengers

Antibody-Based Ticagrelor Reversal Agent in Healthy Volunteers.

BACKGROUND: Ticagrelor is an oral P2Y12 inhibitor that is used with aspirin to reduce the risk of ischemic events among patients with acute coronary syndromes or previous myocardial infarction. Spontaneous major bleeding and bleeding associated with urgent invasive procedures are concerns with ticagrelor, as with other antiplatelet drugs. The antiplatelet effects of ticagrelor cannot be reversed with platelet transfusion. A rapid-acting reversal agent would be useful. METHODS: In this randomized, double-blind, placebo-controlled, phase 1 trial, we evaluated intravenous PB2452, a monoclonal antibody fragment that binds ticagrelor with high affinity, as a ticagrelor reversal agent. We assessed platelet function in healthy volunteers before and after 48 hours of ticagrelor pretreatment and again after the administration of PB2452 or placebo. Platelet function was assessed with the use of light transmission aggregometry, a point-of-care P2Y12 platelet-reactivity test, and a vasodilator-stimulated phosphoprotein assay. RESULTS: Of the 64 volunteers who underwent randomization, 48 were assigned to receive PB2452 and 16 to receive placebo. After 48 hours of ticagrelor pretreatment, platelet aggregation was suppressed by approximately 80%. PB2452 administered as an initial intravenous bolus followed by a prolonged infusion (8, 12, or 16 hours) was associated with a significantly greater increase in platelet function than placebo, as measured by multiple assays. Ticagrelor reversal occurred within 5 minutes after the initiation of PB2452 and was sustained for more than 20 hours (P\u3c0.001 after Bonferroni adjustment across all time points for all assays). There was no evidence of a rebound in platelet activity after drug cessation. Adverse events related to the trial drug were limited mainly to issues involving the infusion site. CONCLUSIONS: In healthy volunteers, the administration of PB2452, a specific reversal agent for ticagrelor, provided immediate and sustained reversal of the antiplatelet effects of ticagrelor, as measured by multiple assays. (Funded by PhaseBio Pharmaceuticals; ClinicalTrials.gov number, NCT03492385.)

Provider Awareness Alone Does Not Improve Transition Readiness Skills in Adolescent Patients With Inflammatory Bowel Disease

ABSTRACT Objective: Adolescent patients with chronic health conditions must gradually assume responsibility for their health. Self-management skills are needed for a successful transfer from adolescent to adult health care, but the development of these skills could be resource intensive. Pediatric providers are already instrumental in teaching patients about their health and may improve these skills. The aim of the study was to evaluate whether informal education of pediatric providers regarding transition improves inflammatory bowel disease (IBD) patient self-management skills. Methods: Consecutive patients with IBD older than 10 years who presented to the outpatient setting were administered a survey regarding self-management behaviors in 2008 and 2011. During this time, several conferences on transition were presented to the providers. Results: In 2008, 294 patients completed the survey (82%) compared with 121 patients (89%) in 2011. The patient groups were comparable with respect to sex (boys 50% vs 42%), mean age (16.7 vs 16.2 years), and type of IBD (Crohn 68% vs 66%). The 13- to 15-year-olds reported calling in refills (11%, 8%, respectively), scheduling clinic appointment (0, 1%), preparing questions (13%, 5%), and taking the main role in talking during clinic visits (15%, 24%). The 16- to 18-year-olds reported calling in refills (13%, 27%), scheduling clinic appointments (9%, 6%), preparing questions (9%, 16%), and taking the main role in talking in clinic visits (36%, 45%). Responsibility for behaviors gradually increases with age, but did not differ significantly between 2008 and 2011. Conclusions: Increasing awareness around transition readiness for pediatric providers had an insignificant effect on the self-management skills of patients with IBD. A more formal or structured approach is likely required to improve transition skills in adolescent patients

Lunar Surface Mission Operations Scenario and Considerations

Planetary surface operations have been studied since the last visit of humans to the Moon, including conducting analog missions. Mission Operations lessons from these activities are summarized. Characteristics of forecasted surface operations are compared to current human mission operations approaches. Considerations for future designs of mission operations are assessed

Modelling Esker Formation on Mars

International audience<p><strong>Introduction:</strong>  Eskers are sinuous sedimentary ridges that are widespread across formerly glaciated landscapes on Earth. They form when sediment in subglacial tunnels is deposited by meltwater. Some sinuous ridges on Mars have been identified as eskers; whilst some are thought to have formed early in Mars’ history beneath extensive ice sheets, smaller, younger systems associated with extant glaciers in Mars’ mid latitudes have also been identified. Elevated geothermal heating and formation during periods with more extensive glaciation have been suggested as possible prerequisites for recent Martian esker deposition.</p><p>Here, we adapt a model of esker formation with g and other constants altered to Martian values, using it initially to investigate the impact of Martian conditions on subglacial tunnel systems, before investigating the effect of varying water discharge on esker deposition.</p><p><strong>Methods:</strong> To investigate the effect of these values on the operation of subglacial tunnel systems we first conduct a series of model experiments with steady water discharge, varying the assumed liquid density (r<sub>w</sub>) from 1000 kgm<sup>-3</sup> to 1980 kgm<sup>-3</sup> (the density of saturated perchlorate brine) and ice hardness (A) from 2.4x10<sup>-24</sup> Pa<sup>-3</sup>s<sup>-1</sup> to 5x10<sup>-27</sup> Pa<sup>-3</sup>s<sup>-1</sup> (a temperature range of 0°C to -50°C). We then investigate the impact of variable water discharge on esker formation to simulate very simply a possible release of meltwater from an assumed geothermal event beneath a Martian glacier or ice cap.</p><p><strong>Results and Discussion:</strong>  A key aspect of model behaviour is the decrease in sediment carrying capacity towards the ice margin due to increased tunnel size as ice thins. Our results suggest that Martian parameters emphasise this effect, making deposition more likely over a greater length of the conduit. Lower gravity has the largest impact; it reduces the modeled closure rate of subglacial tunnels markedly as this varies with overburden stress (and hence g) cubed. Frictional heating from flowing water also drops, but much less sensitively. Thus, for a given discharge, the tunnels tend to be larger, leading to lower water pressure and a reduction in flow power. This effect is amplified for harder ice. Higher inferred fluid density raises the flow power, but by a smaller amount.</p><p>These effects are clearly seen in the variable discharge experiments. Sediment is deposited on the falling limb of the hydrograph, when the tunnels are larger than the equivalent steady-state water discharge would produce. Sediment deposition occurs much further upglacier from the glacier snout, and occurs earlier on the falling limb leading to longer periods in which deposition occurs.</p><p><strong>Conclusions:</strong> Our results suggest that esker formation within a subglacial meltwater tunnel would be more likely on Mars than Earth, primarily because subglacial tunnels tend to be larger for equivalent water discharges, with consequent lower water flow velocities. This allows sediment deposition over longer lengths of tunnel, and to greater depths, than for terrestrial systems. Future work will use measured bed topography of a mid-latitude esker to assess the impact of topography on deposition patterns and esker morphology, and we will expand the range of discharges and sediment supply regimes investigated.</p&gt

Resting-state anticorrelations between medial and lateral prefrontal cortex: Association with working memory, aging, and individual differences

We examined how variation in working memory (WM) capacity due to aging or individual differences among young adults is associated with intrinsic or resting-state anticorrelations, particularly between (1) the medial prefrontal cortex (MPFC), a component of the default-mode network (DMN) that typically decreases in activation during external, attention-demanding tasks, and (2) the dorsolateral prefrontal cortex (DLPFC), a component of the fronto-parietal control network that supports executive functions and WM and typically increases in activation during attention-demanding tasks. We compared the magnitudes of MPFC-DLPFC anticorrelations between healthy younger and older participants (Experiment 1) and related the magnitudes of these anticorrelations to individual differences on two behavioral measures of WM capacity in two independent groups of young adults (Experiments 1 and 2). Relative to younger adults, older adults exhibited reductions in WM capacity and in MPFC-DLPFC anticorrelations. Within younger adults, greater MPFC-DLPFC anticorrelation at rest correlated with greater WM capacity. These findings show that variation in MPFC-DLPFC anticorrelations, whether related to aging or to individual differences, may reflect an intrinsic functional brain architecture supportive of WM capacity.National Institutes of Health (U.S.) (National Institute on Aging Grant R21 AG030770)National Institutes of Health (U.S.) (Grant T32 GM007484)Barbara J. Weedon Fund Fellowshi

Possible Transport of Basal Debris to the Surface of a Mid-Latitude Glacier on Mars

International audience<p><strong>Introduction:</strong> We observe internal flow structures within a viscous flow feature (VFF; 51.24°W, 42.53°S) interpreted as a debris-covered glacier in Nereidum Montes, Mars. The structures are exposed in the wall of a gully that is incised through the VFF, parallel to its flow-direction. They are near to the glacier terminus and appear to connect its deep interior (and possibly its bed) to arcuate flow-transverse foliations on its surface. Such foliations are common on VFF surfaces, but their relation to VFF-internal structures and ice flow is poorly understood. The VFF-internal structures we observe are reminiscent of up-glacier dipping shear structures that transport basal debris to glacier surfaces on Earth.</p><p>Subglacial environments on Mars are of astrobiological interest due to the availability of water ice and shelter from Mars’ surface radiation environment. However, current limitations in drilling technology prevent their direct exploration. If debris on VFF surfaces contains a component of englacial and/or subglacial debris, those materials could be sampled without access to the subsurface. This could reduce the potential cost and complexity of future missions that aim to explore englacial and subglacial environments on Mars.</p><p><strong>Methods: </strong>We use a 1 m/pixel digital elevation model (DEM) derived from 25 cm/pixel High Resolution Imaging Science Experiment (HiRISE) stereo-pair images, and a false-colour (merged IRB) HiRISE image. We measured the dip and strike of the VFF-internal structures using ArcGIS 10.7 and QGIS software. We also input the DEM (and an inferred glacier bed topography derived from it) into ice flow simulations using the Ice Sheet System Model, assuming no basal sliding and present-day mean annual surface temperature (210K).</p><p><strong>Results and Discussion: </strong>The VFF-internal structures dip up-glacier at ~20° from the bed. This is inconsistent with their formation by bed-parallel ice-accumulation layering without modification by ice flow. The VFF-internal structures and surface foliations are spectrally ‘redder’ than adjacent VFF portions, which appear ‘bluer’. This could result from differences in debris concentration and/or surficial dust trapping between the internal structures and the bulk VFF. Modelling experiments suggest that the up-glacier-dipping structures occur at the onset of a compressional regime as ice flow slowed towards the VFF terminus.</p><p>In cold-based glaciers on Earth, up-glacier-dipping folds are common approaching zones of enhanced ice rigidity near the glacier margin. Where multiple folds co-exist, the outermost typically comprises basal ice with a component of subglacial debris entrained in the presence of interfacial films of liquid water at sub-freezing temperatures. In polythermal glaciers, debris-rich up-glacier-dipping thrust faults form where sliding wet-based ice converges with cold-based ice.</p><p><strong>Conclusions: </strong>We propose that the observed up-glacier-dipping VFF-internal structures are englacial shear zones formed by compressional ice flow. They could represent transport pathways for englacial and subglacial material to the VFF surface. The majority of extant mid-latitude VFF on Mars are thought to have been perennially cold-based; thus we favour the hypothesis that the VFF-internal structures are folds formed under a cold-based thermal regime. Under this mechanism, the outermost surface foliation, and its corresponding VFF-internal structure, is the most likely to contain subglacial debris.</p&gt

Internal Structure of a Glacier on Mars Revealed by Gully Incision

International audienceDebris transport from / A Mars glacier bed to / Flowlines on surface

Management of histoplasmosis by infectious disease physicians

BACKGROUND: The Infectious Diseases Society of America (IDSA) guidelines for the management of histoplasmosis were last revised 15 years ago. Since those guidelines were compiled, new antifungal treatment options have been developed. Furthermore, the ongoing development of immunomodulatory therapies has increased the population at increased risk to develop histoplasmosis. METHODS: An electronic survey about the management practices of histoplasmosis was distributed to the adult infectious disease (ID) physician members of the IDSA\u27s Emerging Infections Network. RESULTS: The survey response rate was 37% (551/1477). Only 46% (253/551) of respondents reported seeing patients with histoplasmosis. Regions considered endemic had 82% (158/193) of physicians report seeing patients with histoplasmosis compared to 27% (95/358) of physicians in regions not classically considered endemic ( CONCLUSIONS: Though there are increased reports of histoplasmosis diagnoses outside regions classically considered endemic, a majority of ID physicians reported not seeing patients with histoplasmosis. Most respondents reported adherence to IDSA guidelines recommending itraconazole in each clinical situation. New histoplasmosis guidelines need to reflect the growing need for updated general guidance, particularly for immunocompromised populations