Performance, Stability, and Control Investigation at Mach Numbers from 0.60 to 1.05 of a Model of the "Swallow" with Outer Wing Panels Swept 75 degree with and without Power Simulations

An investigation of the performance, stability, and control characteristics of a variable-sweep arrow-wing model with the outer wing panels swept 75 deg. has been conducted in the Langley 16-foot transonic tunnel. Four outboard engines located above and below the wing provided propulsive thrust, and, by deflecting in the pitch direction and rotating in the lateral plane, also produced control forces. The engine nacelles incorporated swept lateral and vertical fins for aerodynamic stability and control. Jet-off data were obtained with flow-through nacelles, simulating inlet flow; jet thrust and hot-jet interference effects were obtained with faired-nose nacelles housing hydrogen peroxide gas generators. Six-component force and moment data were obtained at Mach numbers from 0.60 to 1.05 through a range of angles of attack and angles of side-slip. Control characteristics were obtained by deflecting the nacelle-fin combinations as elevators, rudders, and ailerons at several fixed angles for each control. The results indicate that the basic wing-body configuration becomes neutrally stable or unstable at a lift coefficient of 0.15; addition of nacelles with fins delayed instability to a lift coefficient of 0.30. Addition of nacelles to the wing-body configuration increased minimum drag from 0.0058 to 0.0100 at a Mach number of 0.60 and from 0.0080 to 0.0190 at a Mach number of 1.05 with corresponding reductions in maximum lift-drag ratio of 12 percent and 33 percent, respectively. The nacelle-fin combinations were ineffective as longitudinal controls but were adequate as directional and lateral controls. The model with nacelles and fins was directionally and laterally stable; the stability generally increased with increasing lift. Jet interference effects on stability and control characteristics were small but the adverse effects on drag were greater than would be expected for isolated nacelles

Transonic Aerodynamic Loading Characteristics of a Wing-Body-Tail Combination Having a 52.5 deg. Sweptback Wing of Aspect Ratio 3 With Conical Wing Camber and Body Indentation for a Design Mach Number of Square Root of 2

An investigation has been made of the effects of conical wing camber and body indentation according to the supersonic area rule on the aerodynamic wing loading characteristics of a wing-body-tail configuration at transonic speeds. The wing aspect ratio was 3, taper ratio was 0.1, and quarter-chord-line sweepback was 52.5 deg. with 3-percent-thick airfoil sections. The tests were conducted in the Langley 16-foot transonic tunnel at Mach numbers from 0.80 to 1.05 and at angles of attack from 0 deg. to 14 deg., with Reynolds numbers based on mean aerodynamic chord varying from 7 x 10(exp 6) to 8 x 10(exp 6). Conical camber delayed wing-tip stall and reduced the severity of the accompanying longitudinal instability but did not appreciably affect the spanwise load distribution at angles of attack below tip stall. Body indentation reduced the transonic chordwise center-of-pressure travel from about 8 percent to 5 percent of the mean aerodynamic chord

Performance, Stability, and Control Investigation at Mach Numbers from 0.4 to 0.9 of a Model of the "Swallow" with Outer Wing Panels Swept 25 degree with and without Power Simulation

An investigation of the performance, stability, and control characteristics of a variable-sweep arrow-wing model (the "Swallow") with the outer wing panels swept 25 deg has been conducted in the Langley 16-foot transonic tunnel. The wing was uncambered and untwisted and had RAE 102 airfoil sections with a thickness-to-chord ratio of 0.14 normal to the leading edge. Four outboard engines located above and below the wing provided propulsive thrust, and, by deflecting in the pitch direction and rotating in the lateral plane, also produced control forces. A pair of swept lateral fins and a single vertical fin were mounted on each engine nacelle to provide aerodynamic stability and control. Jets-off data were obtained with flow-through nacelles, stimulating the effects of inlet flow; jet thrust and hot-jet interference effects were obtained with faired-nose nacelles housing hydrogen peroxide gas generators. Six-component force and moment data were obtained through a Mach number range of 0.40 to 0.90 at angles of attack and angles of sideslip from 0 deg to 15 deg. Longitudinal, directional, and lateral control were obtained by deflecting the nacelle-fin combinations as elevators, rudders, and ailerons at several fixed angles for each control

Extended latissimus dorsi kite flap (eld-k flap). Revisiting an old place for a total autologous breast reconstruction in patients with medium to large breasts

Background: The latissimus dorsi (LD) flap represents one of the most reliable methods for autologous breast reconstruction. However, in many patients, the exclusive use of this technique may not guarantee the restoration of an adequate volume and projection. We report our experience with the extended latissimus dorsi kite flap (ELD-K flap), an alternative surgical approach to maximize the volume of the fleur-de-lis pattern LD flap, for total autologous breast reconstruction. Methods: Between 2016 and 2018, 23 patients were subjected to mastectomy and immediate autologous reconstruction with "extended latissimus dorsi kite flap" (ELD-K flap), technique that employs an extended version of the LD musculocutaneous flap, based on the skeletonized thoracodorsal pedicle and a trilobate skin incision with an inferiorly based vertical branch. The BREAST-Q questionnaire was administered preoperatively, and one year after surgery to evaluate the quality of life results of the patients. BREAST-Q latissimus dorsi module was also provided. Results: Average body mass index was 29.7 kg/m2 (range 25–40 kg/m2). Mild complications occurred in only six cases, and eight patients underwent treatment to improve the donor site scar outcome. Patients indicated high scores in quality of life measures with an increase in all BREAST domains from the preoperative to the postoperative period. A statistically significant increase (p < 0.05) was noted in: “overall satisfaction with breasts” (p < 0.05), “psychosocial well-being” (p < 0.05), “physical impact of the surgery” (p < 0.05). Within the LD module, participants reported a mean score of, respectively, 73.8 and 67.9 for “satisfaction with back” and “satisfaction with shoulder and back function” domains. Conclusions: The extended incision allows the recruitment of additional tissue to provide enough volume to complete the reconstruction without implants. The isolation of the vascular pedicle allows for extreme freedom and mobilization of the flap, ensuring adequate filling of the breast. ELD-K flap may expand the indications for a total autologous LD immediate breast reconstruction, representing an additional and reliable alternative in selected cohorts of patients. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

Controlateral Symmetrisation in SRM for Breast Cancer: Now or Then? Immediate versus Delayed Symmetrisation in a Two-Stage Breast Reconstruction

Introduction: The timing of contralateral symmetrisation in patients with large and ptotic breasts undergoing a unilateral skin-reducing mastectomy (SRM) is one of the most debated topics in the reconstructive field. There is no evidence to support the advantage of immediate or delayed symmetrisation to help surgeons with this decision. The aim of this study was to investigate the clinical and aesthetic outcomes of immediate symmetrisation. Methods: A randomised observational study was conducted on patients who underwent an SRM for unilateral breast cancer. Based on a simple randomisation list, patients were divided into two groups: a delayed symmetrisation group versus an immediate symmetrisation group. The postoperative complications, BREAST-Q outcomes and reoperations were compared. Results: Out of a total of 84 patients undergoing an SRM between January 2018 and January 2021, 42 patients underwent immediate symmetrisation and 42 patients had delayed symmetrisation. Three implant losses (7.2%) were observed and we reported three wound dehiscences; one of these was in a contralateral breast reconstruction in the immediate symmetrisation group. The BREAST-Q patient-reported outcome measures recorded better aesthetic outcomes and a high patient satisfaction for the immediate symmetrisation group. Conclusions: Simultaneous controlateral symmetrisation is a good alternative to achieve better satisfaction and quality of life for patients; from a surgical point of view, it does not excessively impact on the second time of reconstruction

Swift observations of IBL and LBL objects

BL Lacs are an enigmatic class of active galactic nuclei (AGNs), characterized by the non-thermal continuum typically attributed to synchrotron and inverse Compton emission. Depending on the frequency location of the maxima of these components, they are subdivided into three subclasses LBLs, IBLs, and HBLs. We present the results of a set of observations of eight BL Lac objects of LBL and IBL type performed by the XRT and UVOT detectors onboard the Swift satellite between January 2005 and November 2006. We are mainly interested in measuring the spectral parameters, and particularly the steepness between the UV and the X-ray band, useful for determining the classification of these sources. We compare the behavior of these sources with previous XMM-Newton, BeppoSAX obser- vations and with historical data in the X-ray and in the optical band. We are also interested in classifying the sources in our sample on the basis of the observations and comparing them with their classification presented in literature. We performed X-ray spectral analysis of observed BL Lac objects using a simple powerlaw and in a few cases the log-parabolic model. We also combined the UV emission with the low energy X-ray data to We used observational data to classify sources in our sample and derived parameters of their spectral energy distribution. We found that for the IBLs X-rays low states show features of the high energy component, usually interpreted as due to inverse Compton emission. Sources in our sample exhibit a range of temporal UV and X-ray behaviors, some objects having clear and neat correlated UV and X-ray variations (e.g. ON231) and other objects showing no clear (e.g. AO 0235+164) UV and X-ray correlation. Finally, we also note that our estimates of spectral curvature are in the range of that measured for the HBLs.Comment: 10 pages, 7 figures, published in A&

COVID-19 recovery packages can benefit climate targets and clean energy jobs, but scale of impacts and optimal investment portfolios differ among major economies

To meet the Paris temperature targets and recover from the effects of the pandemic, many countries have launched economic recovery plans, including specific elements to promote clean energy technologies and green jobs. However, how to successfully manage investment portfolios of green recovery packages to optimize both climate mitigation and employment benefits remains unclear. Here, we use three energy-economic models, combined with a portfolio analysis approach, to find optimal low-carbon technology subsidy combinations in six major emitting regions: Canada, China, the European Union (EU), India, Japan, and the United States (US). We find that, although numerical estimates differ given different model structures, results consistently show that a >50% investment in solar photovoltaics is more likely to enable CO2 emissions reduction and green jobs, particularly in the EU and China. Our study illustrates the importance of strategically managing investment portfolios in recovery packages to enable optimal outcomes and foster a post-pandemic green economy

Demonstrating vaccine effectiveness during a waning epidemic: A WHO/NIH meeting report on approaches to development and licensure of Zika vaccine candidates.

Since its peak in early 2016, the incidence of Zika virus (ZIKV) cases has declined to such low levels that Phase 3 field efficacy trials may be infeasible. While great progress was made to rapidly advance several vaccine candidates into Phase 1 and 2 clinical trials, in the absence of sustained viral transmission it may be difficult to evaluate the effectiveness of ZIKV vaccine candidates by conducting traditional clinical disease endpoint efficacy studies. However, ZIKV is still circulating at low levels in some areas and is likely to re-emerge in naïve populations or in sites of prior epidemics once population immunity wanes. Therefore, the public health need for a ZIKV vaccine remains. To facilitate continued ZIKV vaccine development efforts, the World Health Organization's Initiative for Vaccine Research and the National Institutes of Health's National Institute of Allergy and Infectious Diseases co-hosted a meeting of experts in March 2018 to identify strategies to demonstrate vaccine effectiveness in view of waning ZIKV disease incidence. This paper outlines points for consideration for developers, regulators, and other stakeholders working towards a licensed ZIKV vaccine. These deliberations may also be applicable to development of vaccines for other emerging infections where the size, unpredictability, and ephemeral nature of outbreaks makes clinical disease endpoint efficacy trials to demonstrate vaccine effectiveness infeasible

Where is the EU headed given its current climate policy? A stakeholder-driven model inter-comparison.

Recent calls to do climate policy research with, rather than for, stakeholders have been answered in non-modelling science. Notwithstanding progress in modelling literature, however, very little of the scenario space traces back to what stakeholders are ultimately concerned about. With a suite of eleven integrated assessment, energy system and sectoral models, we carry out a model inter-comparison for the EU, the scenario logic and research questions of which have been formulated based on stakeholders' concerns. The output of this process is a scenario framework exploring where the region is headed rather than how to achieve its goals, extrapolating its current policy efforts into the future. We find that Europe is currently on track to overperforming its pre-2020 40% target yet far from its newest ambition of 55% emissions cuts by 2030, as well as looking at a 1.0-2.35 GtCO2 emissions range in 2050. Aside from the importance of transport electrification, deployment levels of carbon capture and storage are found intertwined with deeper emissions cuts and with hydrogen diffusion, with most hydrogen produced post-2040 being blue. Finally, the multi-model exercise has highlighted benefits from deeper decarbonisation in terms of energy security and jobs, and moderate to high renewables-dominated investment needs

Reduced Quantitative Ultrasound Bone Mineral Density in HIV-Infected Patients on Antiretroviral Therapy in Senegal

Background: Bone status in HIV-infected patients on antiretroviral treatment (ART) is poorly documented in resource-limited settings. We compared bone mineral density between HIV-infected patients and control subjects from Dakar, Senegal. Methods: A total of 207 (134 women and 73 men) HIV-infected patients from an observational cohort in Dakar (ANRS 1215) and 207 age-and sex-matched controls from the general population were enrolled. Bone mineral density was assessed by quantitative ultrasound (QUS) at the calcaneus, an alternative to the reference method (i.e. dual X-absorptiometry), often not available in resource-limited countries. Results: Mean age was 47.0 (+/- 8.5) years. Patients had received ART for a median duration of 8.8 years; 45% received a protease inhibitor and 27% tenofovir; 84% had undetectable viral load. Patients had lower body mass index (BMI) than controls (23 versus 26 kg/m(2), P<0.001). In unadjusted analysis, QUS bone mineral density was lower in HIV-infected patients than in controls (difference: -0.36 standard deviation, 95% confidence interval (CI): -0.59;-0.12, P = 0.003). Adjusting for BMI, physical activity, smoking and calcium intake attenuated the difference (-0.27, CI: -0.53; -0.002, P = 0.05). Differences in BMI between patients and controls explained a third of the difference in QUS bone mineral density. Among patients, BMI was independently associated with QUS bone mineral density (P<0.001). An association between undetectable viral load and QUS bone density was also suggested (beta = 0.48, CI: 0.02; 0.93; P = 0.04). No association between protease inhibitor or tenofovir use and QUS bone mineral density was found. Conclusion: Senegalese HIV-infected patients had reduced QUS bone mineral density in comparison with control subjects, in part related to their lower BMI. Further investigation is needed to clarify the clinical significance of these observations