Evaluating the Adoption of Pure Electric Vehicles. An Examination of Sociotechnical Barriers Amongst UK Consumers

This study shows that the three major factors inhibiting EV market growth in the UK are: a lack of standardisation of rapid-charging facilities; sociotechnical issues linked to charge-point trauma (CPT); and a lack of sufficient and contiguous rapid-charging infrastructure. A buyer’s decision to choose an appropriate EV that suits their needs and lifestyle, depends upon three exogenous factors: product-related reviews, road tests, and private and government EV and general zero-emission data. This research uses primary and secondary research methodologies to evaluate the impact of the three main inhibiting factors (Chapters 3, 4 and 5) on the choices made by EV buyers/users/owners. The study presents barriers to EV adoption resulting from charge-point non-standardisation protocols. Additionally, the concept of charge-point trauma is introduced to the field for the first time, and finally the study creates a globally adaptable and portable model of calculating the volume of charge-points necessary to a given number of EVs. This investigation also uses primary research to collect evidence from current EV users and potential adopters concerning the significance of the three main inhibiting factors, showing how they influence consumer behaviour and growth in the sector. By exploring how current EV user’s experience influences public reviews and ratings, this research demonstrates the impact this public data has on EV consumer’s purchasing behaviour. The study gathered data within the UK through structured surveys of existing EV drivers, and used science-based field testing with data collection to analyse charge-point infrastructure protocol standardisation. Field tests and driver observation quantified the contiguous charge point network, its availability, and its capacity to satisfy current and future demand. This investigation utilises a non-generic model in each chapter to study the effects and outcomes of the three study phases, offering a graphical synopsis for all primary impact factors including the principal exogenous ones. The study integrates the principal impact factors to create for the first time, a precise model of behavioural apprehension and growth impedance among EV users and prospective buyers. This model is based on three main elements, including two major multi-locational field tests and trials, and a significant survey of more than 280 participants from the UK-based EV user community. The study develops an innovative, portable model to calculate the number of rapid chargers required to satisfy current and future EV demand anywhere in the world. This research makes a major contribution to the study of the barriers to adoption in the EV sector by considering all the influencers and stakeholders, that might indicate and potentially predict global trends within EV consumer behaviour. It therefore contributes to bridging the gap between industry and academic knowledge, thus helping reduce barriers to EV sector growth

Standardisation of UK Electric Vehicle Charging Protocol, Payment and Charge Point Connection

Standardisation is fundamental to ensuring that new technologies develop and grow unhindered by manufacturer-led standards. Dismissing this vital issue can have a detrimental effect on society regarding adopting new technologies, particularly when government targets and regulations are crucial for their success. We have witnessed competing global industries struggle for dominance, such as Betamax versus VHS, where each had a similar user outcome, but the confusion of differing formats slowed growth. We analyse emerging standards for electric vehicle rapid charging and investigate how standardisation challenges affect stakeholders by reviewing the existing literature on single-mode and polymodal harmonisation. By assimilating existing evidence, we then develop a new understanding of the science behind multi-model standardisation (MMS) approaches. Our literature review reveals three primary standardisation issues: (1) charge connections, (2) car to charger communication protocols, and (3) charge payment methods. We then analyse each mode type’s benefit, observing how each example contributes to the overall outcome, and suggest that their impact depends on car to charger handshake timing and intuitive user interaction. Using a structured survey of 282 respondents, we analyse end-user satisfaction for factors affecting growth in the EV sector and compare these findings with the factors identified during our literature review. We consequently articulate a programme for future research to understand EV rapid charger standardisation better, proposing recommendations for vested stakeholders that embrace sponsors in societal, technological and scientific transformation

Concepts of Integration for UAS Operations in the NAS

One of the major challenges facing the integration of Unmanned Aircraft Systems (UAS) in the National Airspace System (NAS) is the lack of an onboard pilot that can comply with the legal requirement identified in the US Code of Federal Regulations (CFR) that pilots see and avoid other aircraft. UAS will be expected to demonstrate the means to perform the function of see and avoid while preserving the safety level of the airspace and the efficiency of the air traffic system. This paper introduces a Sense and Avoid (SAA) concept for integration of UAS into the NAS that is currently being developed by the National Aeronautics and Space Administration (NASA) and identifies areas that require additional experimental evaluation to further inform various elements of the concept. The concept design rests on interoperability principles that take into account both the Air Traffic Control (ATC) environment as well as existing systems such as the Traffic Alert and Collision Avoidance System (TCAS). Specifically, the concept addresses the determination of well clear values that are large enough to avoid issuance of TCAS corrective Resolution Advisories, undue concern by pilots of proximate aircraft and issuance of controller traffic alerts. The concept also addresses appropriate declaration times for projected losses of well clear conditions and maneuvers to regain well clear separation

Cognitive dysfunction in body dysmorphic disorder: new implications for nosological systems and neurobiological models.

UNLABELLED: Introduction Body dysmorphic disorder (BDD) is a debilitating disorder, characterized by obsessions and compulsions relating specifically to perceived appearance, and which has been newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Obsessive-Compulsive and Related Disorders grouping. Until now, little research has been conducted into the cognitive profile of this disorder. METHODS: Participants with BDD (n=12) and participants without BDD (n=16) were tested using a computerized neurocognitive battery investigating attentional set-shifting (Intra/Extra Dimensional Set Shift Task), decision-making (Cambridge Gamble Task), motor response-inhibition (Stop-Signal Reaction Time Task), and affective processing (Affective Go-No Go Task). The groups were matched for age, IQ, and education. RESULTS: In comparison to controls, patients with BDD showed significantly impaired attentional set-shifting, abnormal decision-making, impaired response inhibition, and greater omission and commission errors on the emotional processing task. CONCLUSION: Despite the modest sample size, our results showed that individuals with BDD performed poorly compared to healthy controls on tests of cognitive flexibility, reward and motor impulsivity, and affective processing. Results from separate studies in OCD patients suggest similar cognitive dysfunction. Therefore, these findings are consistent with the reclassification of BDD alongside OCD. These data also hint at additional areas of decision-making abnormalities that might contribute specifically to the psychopathology of BDD.Academy of Medical SciencesThis is the author accepted manuscript. The final version is available from Cambridge University Press via https://doi.org/10.1017/S109285291600046

UAS in the NAS Air Traffic Controller Acceptability Study-1: The Effects of Horizontal Miss Distances on Simulated UAS and Manned Aircraft Encounters

This study examined air traffic controller acceptability ratings based on the effects of differing horizontal miss distances (HMDs) for encounters between UAS and manned aircraft. In a simulation of the Dallas/Fort Worth (DFW) East-side airspace, the CAS-1 experiment at NASA Langley Research Center enlisted fourteen recently retired DFW air traffic controllers to rate well-clear volumes based on differing HMDs that ranged from 0.5 NM to 3.0 NM. The controllers were tasked with rating these HMDs from "too small" to "too excessive" on a defined, 1-5, scale and whether these distances caused any disruptions to the controller and/or to the surrounding traffic flow. Results of the study indicated a clear favoring towards a particular HMD range. Controller workload was also measured. Data from this experiment and subsequent experiments will play a crucial role in the FAA's establishment of rules, regulations, and procedures to safely and efficiently integrate UAS into the NAS

UAS Air Traffic Controller Acceptability Study-2: Effects of Communications Delays and Winds in Simulation

This study evaluated the effects of Communications Delays and Winds on Air Traffic Controller ratings of acceptability of horizontal miss distances (HMDs) for encounters between UAS and manned aircraft in a simulation of the Dallas-Ft. Worth East-side airspace. Fourteen encounters per hour were staged in the presence of moderate background traffic. Seven recently retired controllers with experience at DFW served as subjects. Guidance provided to the UAS pilots for maintaining a given HMD was provided by information from self-separation algorithms displayed on the Multi-Aircraft Simulation System. Winds tested did not affect the acceptability ratings. Communications delays tested included 0, 400, 1200, and 1800 msec. For longer communications delays, there were changes in strategy and communications flow that were observed and reported by the controllers. The aim of this work is to provide useful information for guiding future rules and regulations applicable to flying UAS in the NAS

UAS Air Traffic Controller Acceptability Study

This study evaluated the effects of communications delays and winds on air traffic controller ratings of acceptability of horizontal miss distances (HMDs) for encounters between Unmanned Aircraft Systems (UAS) and manned aircraft in a simulation of the Dallas-Ft. Worth (DFW) airspace. Fourteen encounters per hour were staged in the presence of moderate background traffic. Seven recently retired controllers with experience at DFW served as subjects. Guidance provided to the UAS pilots for maintaining a given HMD was provided by information from Detect and Avoid (DAA) self-separation algorithms (Stratway+) displayed on the Multi-Aircraft Control System. This guidance consisted of amber "bands" on the heading scale of the UAS navigation display indicating headings that would result in a loss of well clear between the UAS and nearby traffic. Winds tested were successfully handled by the DAA algorithms and did not affect the controller acceptability ratings of the HMDs. Voice communications delays for the UAS were also tested and included one-way delay times of 0, 400, 1200, and 1800 msec. For longer communications delays, there were changes in strategy and communications flow that were observed and reported by the controllers. The aim of this work is to provide useful information for guiding future rules and regulations applicable to flying UAS in the NAS. Information from this study will also be of value to the Radio Technical Commission for Aeronautics (RTCA) Special Committee 228 - Minimum Performance Standards for UAS

Leptomeningeal carcinomatosis as the primary presentation of relapse in breast cancer

Leptomeningeal metastasis (LM) is an uncommon presentation of relapse in breast cancer, which is associated with poor clinical outcomes and poor prognosis. Notably, LM most commonly occurs in breast cancer. The aim of the present review was to investigate the occurrence of LM as the primary presentation of relapse following remission in breast cancer patients and to determine whether specific histological subtypes are predisposed to meningeal metastases. In addition, the present review evaluated whether patients presenting with LM as the primary site of relapse exhibit differences in survival when compared with patients exhibiting metastasis to other sites. Cross-sectional studies have demonstrated that LM is commonly associated with other sites of distant metastasis including lung, liver and bone metastases. The histological breast cancer subtype most commonly associated with LM was invasive lobular carcinoma, while triple-negative breast cancer patients appear to be predisposed to the development of LM when considering the overall prevalence of histological breast cancer subtypes. At present, data regarding LM as the primary site of relapse are limited due to its rarity as the first site of metastasis in breast cancer. Case-controlled studies are required to investigate the incidence of LM as the primary site of recurrence in breast cancer patients as this would enable treatment standardization and identification of prognostic factors for improved survival

Commentary on the article: “Maintenance of Wellness in Patients With Obsessive-Compulsive Disorder Who Discontinue Medication After Exposure/Response Prevention Augmentation A Randomized Clinical Trial”

© 2022 The Authors. Published by Elsevier Inc. This is an open access article distributed under the Creative Commons Non Commercial-No Derivatives Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by-nc-nd/4.0/Peer reviewe

Elective percutaneous coronary intervention in the elderly patient

Elderly patients account for an increasing number and proportion of patients requiring management of coronary artery disease. Whilst medical therapy remains the cornerstone of management, percutaneous coronary intervention (PCI) has been shown to improve symptoms of angina and quality of life in elderly patients. PCI is now a routine treatment for both acute and chronic coronary artery disease. In the last decade, a series of technological and therapeutic developments have reduced in-hospital complications following PCI. The transradial approach is associated with fewer vascular complications, reduced bed utilization and reduced time to ambulation. This has facilitated the introduction and expansion of outpatient PCI, which has been shown to be safe and effective in elderly patients. This article reviews the rationale for outpatient PCI in the elderly and the evidence for its effectiveness and safety