Compensability of Stress Heart Attacks in Pennsylvania

This article reviews the 1972 amendments to the Pennsylvania Workmen\u27s Compensation Act and recent judicial decisions to determine whether employees may recover for heart attacks precipitated by work-related physical or emotional strain. The author proposes that the evolving standards for compensability of injuries are broad enough to include stress heart attacks

Chet Baker\u27s Role in the Piano-Less Quartet of Gerry Mulligan.

The purpose of this study was to discover common traits and characteristics about Chet Baker\u27s early solo style. The primary sources for this investigation were the initial recordings of the Original Gerry Mulligan Quartet. Since this music was improvised, rather than notated, it was necessary to transcribe the pieces in order to create a musical score. The transcription process included the transfer of the scores to a computerized musical notation program. The resulting scores were then analyzed in order to determine the characteristics of Baker\u27s early playing and solo style, as well as formal structures of the compositions. Chapter one served as an introduction to Chet Baker and includes biographical information. The second chapter focuses on the eleven-month partnership of Gerry Mulligan and Chet Baker. A formal analysis of each piece is contained in chapter three and chapter four emphasizes various characteristics of Chet Baker\u27s early trumpet style. The appendixes contain eight analyzed transcriptions of the Gerry Mulligan Quartet\u27s first recordings

Examining the Influence of Safety Management in the Personal Spaceflight Industry

Suborbital flights will soon take flight as a viable commercial operation. Operators such as Virgin Galactic, along with their designer Scaled Composites, will be responsible for safety of the flight crew, Spaceflight Participants and indeed the uninvolved public beneath their flight trajectories. Within the United States, the Federal Aviation Authority’s Office of Commercial Transportation (FAA-AST) has provided Launch License Regulations and Guidelines for prospective design organisations and operators alike. The aim of this thesis is to analyse suborbital spaceflight approaches to safety management and to determine whether effective safety management is being or could be applied to influence vehicle design and subsequent operation. The thesis provides a review of current safety-related information on suborbital spaceflight, existing space safety information and also existing aviation safety information. The findings of the review concern two main areas; firstly that a gap exists within suborbital safety management criteria, and secondly that a gap exists in existing aviation-based safety guidelines. In the first case, the research concluded that FAA-AST safety management criteria did not present sufficiently explicit and rationalised guidelines for this new industry. Indeed, the thesis argues that the scope of the FAA-AST regulations (covering both orbital and suborbital aspects) is too broad, and that regulations and guidelines should be split into distinct orbital and suborbital sections so as to provide more effective directives. In Europe, no such regulations or guidelines exist as there has until now been no requirement (a ‘customer’) for the European Aviation Safety Agency (EASA) to implement such a framework. This thesis sought to address this gap by using a safety tool (Goal Structuring Notation) to construct a goal-based regulatory approach, which was included in a draft EASA suborbital Policy. Secondly, the main significant finding of this research is that a gap (literally) exists between current aviation-based design organisation safety guidelines and operator safety risk management guidelines. This absence of communication means operators are not managing their safety risks as effectively as they could. The thesis argues that the suborbital domain should take heed, as most vehicles are based on aircraft designs and therefore suborbital operators will, no doubt, apply ‘best practice’ either from the aviation or commercial space domains. Neither is appropriate or effective. As a result of the main finding a contiguous safety model has been developed which employs a ‘key (platform) hazard’ to join the design organisation analysis to the operator safety risk management, therefore completing an explicit sequence from the initiating causal event to the accident. The model is demonstrated using case studies from space disasters (Space Shuttle) and also from aviation accidents (Air France flight AF447); the model details the explicit accident sequence and shows missing or failed controls leading up to the accident. The research enabled models to be constructed and also proposed additional and explicit guidelines for the suborbital industry such as medical and training standards and separate safety criteria for vertical launch vehicles; these are included as recommendations and need to be ratified by recognised bodies such as the International Association for the Advancement of Space Safety’s Suborbital Space Safety Technical Committee for inclusion in their Space Safety Standards Manual. In the latter case these recommendations are already agenda items for the Technical Committee to address

The Cardiomyopathy of Sickle Cell Disease

Cardiac morbidity, early mortality, and sudden death are the major consequences of sickle cell disease (SCD) in patients surviving into adulthood. Pulmonary hypertension (PH), elevated tricuspid regurgitant jet velocity (TRV), and diastolic dysfunction have all been identified to correlate with early mortality in adults with SCD. However, the unifying pathophysiology behind these abnormalities and its connection with early mortality and sudden death have not been recognized previously. We have found that SCD patients have a unique cardiomyopathy characterized by restrictive physiology (diastolic dysfunction, left atrial dilation and normal systolic function) superimposed on features of hyperdynamic circulation (left ventricular [LV] enlargement and eccentric LV hypertrophy. The restrictive cardiomyopathy of SCD causes pulmonary congestion and post-capillary PH. This can be detected by a mild elevation in TRV, which is likely a marker of the SCD-related cardiomyopathy rather than pulmonary arterial disease. Similar to other restrictive cardiomyopathies, the SCD cardiomyopathy predisposes to arrhythmias and sudden death, even when pulmonary pressures are not severely elevated. We have also found that diffuse myocardial fibrosis is common in SCD and may underlie the diastolic dysfunction, but more studies are needed to understand the mechanisms of SCD-related cardiomyopathy and to identify new therapies to decrease cardiac morbidity and improve the life expectancy of SCD patients

Souvenir de Venise : Memories of Venice

https://digitalcommons.library.umaine.edu/mmb-ps/3039/thumbnail.jp

Sarcopenia, Obesity, and Natural Killer Cell Immune Senescence in Aging: Altered Cytokine Levels as a Common Mechanism

Human aging is characterized by both physical and physiological frailty. A key feature of frailty, sarcopenia is the age-associated decline in skeletal muscle mass, strength, and endurance that characterize even the healthy elderly. Increases in adiposity, particularly in visceral adipose tissue, are almost universal in aging individuals and can contribute to sarcopenia and insulin resistance by increasing levels of inflammatory cytokines known collectively as adipokines. Aging also is associated with declines in adaptive and innate immunity, known as immune senescence, which are risk factors for cancer and all-cause mortality. The cytokine interleukin-15 (IL-15) is highly expressed in skeletal muscle tissue and declines in aging rodent models. IL-15 inhibits fat deposition and insulin resistance, is anabolic for skeletal muscle in certain situations, and is required for the development and survival of natural killer (NK) lymphocytes. We review the effect that adipokines and myokines have on NK cells, with special emphasis on IL-15. We posit that increased adipokine and decreased IL-15 levels during aging constitute a common mechanism for sarcopenia, obesity, and immune senescence