Fatal road accidents caused by sudden death of the driver in Finland and Vaud, Switzerland

We investigated the incidence of fatal traffic accidents caused by sudden incapacity of the driver due to cardiac and other illnesses. The retrospective analysis was gleaned from Finnish traffic accident data files from 1984-1989, and police records of traffic accidents, from Canton de Vaud, Switzerland from 1986-1989. The annual rates of all traffic fatalities per million inhabitants were 125 in Finland and 212 in Vaud. Sudden driver incapacity due to acute illness caused 1.8 and 7.3 automobile driver deaths annually per million inhabitants in Finland and in Vaud, respectively. The corresponding rates for all-cause traffic deaths were 326 and 423, for driver deaths 105 and 167, and for those due to driver incapacity 4.7 and 15.6. Sudden driver incapacity caused 1. 5% of all traffic deaths in Finland, and 3. 4% in Vaud. Probable cardiac arrest caused 2. 1% of all drivers‘ deaths in Finland and 1. 7% in Vaud, respectively. Deaths caused by professional drivers' sudden incapacity were responsible for 0. 11% of all traffic deaths in Finland, and for 0% in Vaud. Old age and short mileage were associated with illness-caused accidents. Accidents caused by sudden incapacity of the driver are rare causes of traffic deaths and hard to foresee. While this report relates to all drivers, we suggest there should be individual risk stratification for professional drivers with heart disease. However, non-professional drivers who are elderly and who have symptomatic cardiac disease should limit their driving to short distances and at low spee

Teaching cardiac auscultation to trainees in internal medicine and family practice: Does it work?

BACKGROUND: The general proficiency in physical diagnostic skills seems to be declining in relation to the development of new technologies. The few studies that have examined this question have invariably used recordings of cardiac events obtained from patients. However, this type of evaluation may not correlate particularly well with bedside skills. Our objectives were 1) To compare the cardiac auscultatory skills of physicians in training with those of experienced cardiologists by using real patients to test bedside diagnostic skills. 2) To evaluate the impact of a five-month bedside cardiac auscultation training program. METHODS: 1) In an academic primary care center, 20 physicians (trainees in internal medicine and family practice) and two skilled academic cardiologists listened to 33 cardiac events in 13 patients directly at bedside and identified the cardiac events by completing an open questionnaire. Heart sounds, murmurs and diagnosis were determined beforehand by an independent skilled cardiologist and were validated by echocardiography. Thirteen primary cardiologic diagnoses were possible. 2) Ten of the physicians agreed to participate in a course of 45-minute sessions once a week for 5 months. After the course they listened again to the same patients (pre/post-interventional study). RESULTS: 1) The experts were the most skillful, achieving 69% recognition of heart sounds and murmurs and correct diagnoses in 62% of cases. They also heard all of the diastolic murmurs. The residents heard only 40% of the extra heart sounds and made a correct diagnosis in 24% of cases. 2) After the weekly training sessions, their mean percentage for correct diagnosis was 35% [an increase of 66% (p < 0.05)]. CONCLUSIONS: The level of bedside diagnostic skills in this relatively small group of physicians in training is indeed low, but can be improved by a course focusing on realistic bedside teaching

Manned Versus Unmanned Aircraft Accidents, Including Causation and Rates

Many consider aircraft reliability a primary deterrent to the further integration of unmanned aircraft into civil airspace. Discussions of unmanned aircraft reliability often include comparisons of accident rates of medium and large unmanned aircraft (like the MQ-1 Predator and MQ-9 Reaper) to those of manned aircraft. These comparisons, however, often consider a recent period only but do not consider platform maturity. While this approach is valid—and worthy of discussion—it does not present a complete picture of the unmanned aircraft safety record. This paper employs a chi-square goodness-of-fit approach to compare the progression of the U.S. Air Force MQ-9 mishap rate to that of six manned aircraft flown by the same service. The analysis found that the MQ-9 did not have a significantly different Class A mishap rate progression from the comparison aircraft. The only exception was the F-16, which had a considerably higher rate. In addition, to better understand mishap causation, a comparison of manned to unmanned aircraft mishap causal factors was conducted, primarily relying on journal articles that use the Human Factors and Classification System (HFACS) taxonomy. The analysis found that, like manned aircraft, crew errors contributed to a significant portion of unmanned aircraft accidents, and further, that skill-based errors were often the type of the crew error. The studies also indicated that increasing autonomous control, Human Machine Interface (HMI) design, and crew training will continue to play a significant role in unmanned aircraft mishap causation. Two case studies were also analyzed to highlight differences in manned and unmanned aircraft accident causation

Colchicine-Doubling of Germinating Seedlings of Interspecific Wildrye Hybrids

Colchicine has usually been applied to sterile clones of interspecific grass hybrids to restore fertility. However, when hybrids are partially fertile, colchicine can be applied to germinating seedlings. Four populations of Basin wildrye (Leymus cinereus) X beardless wildrye (L. triticoides) were treated with a 0.2% colchicine solution to double chromosome number from 4x=28 to 8x=56. Doubling percentage was 28, 33, 42, and 44% of all root-tips examined for the four populations. When plants without doubled sectors were discarded, doubling percentage increased to 56, 68, 78, and 78%. Plants with doubled sectors have been placed in crossing blocks to generate octoploid progeny. Octoploids identified through root-tip chromosome counts will be intercrossed to generate 8x populations

Fatal road accidents caused by sudden death of the driver in Finland and Vaud, Switzerland

We investigated the incidence of fatal traffic accidents caused by sudden incapacity of the driver due to cardiac and other illnesses. The retrospective analysis was gleaned from Finnish traffic accident data files from 1984-1989, and police records of traffic accidents, from Canton de Vaud, Switzerland from 1986-1989. The annual rates of all traffic fatalities per million inhabitants were 125 in Finland and 212 in Vaud. Sudden driver incapacity due to acute illness caused 1.8 and 7.3 automobile driver deaths annually per million inhabitants in Finland and in Vaud, respectively. The corresponding rates for all-cause traffic deaths were 326 and 423, for driver deaths 105 and 167, and for those due to driver incapacity 4.7 and 15.6. Sudden driver incapacity caused 1.5% of all traffic deaths in Finland, and 3.4% in Vaud. Probable cardiac arrest caused 2.1% of all drivers' deaths in Finland and 1.7% in Vaud, respectively. Deaths caused by professional drivers' sudden incapacity were responsible for 0.11% of all traffic deaths in Finland, and for 0% in Vaud. Old age and short mileage were associated with illness-caused accidents. Accidents caused by sudden incapacity of the driver are rare causes of traffic deaths and hard to foresee. While this report relates to all drivers, we suggest there should be individual risk stratification for professional drivers with heart disease. However, non-professional drivers who are elderly and who have symptomatic cardiac disease should limit their driving to short distances and at low speed

Commissioning and performance of a phase-compensated optical link for the AWAKE experiment at CERN

In this work, we analyze the performance of the solution adopted for the compensation of the phase drift of a 3 km optical fiber link used for the AWAKE experiment at CERN. The link is devoted to transmit the reference signals used to synchronize the SPS beam with the experiment to have a fixed phase relation, regardless of the external conditions of the electronics and the link itself. The system has been operating for more than a year without observed drift in the beam phases. Specific measurements have proven that the jitter introduced by the system is lower than 0.6 ps and the maximum phase drift of the link is at the picosecond level.Comment: Poster presented at LLRF Workshop 2017 (LLRF2017, arXiv:1803.07677

Longitudinal Emittance Blow-Up in the LHC

The LHC relies on Landau damping for longitudinal stability. To avoid decreasing the stability margin at high energy, the longitudinal emittance must be continuously increased during the acceleration ramp. Longitudinal blow-up provides the required emittance growth. The method was implemented through the summer of 2010. We inject band-limited RF phase-noise in the main accelerating cavities during the whole ramp of about 11 minutes. Synchrotron frequencies change along the energy ramp, but the digitally created noise tracks the frequency change. The position of the noise-band, relative to the nominal synchrotron frequency, and the bandwidth of the spectrum are set by pre-defined constants, making the diffusion stop at the edges of the demanded distribution. The noise amplitude is controlled by feedback using the measurement of the average bunch length. This algorithm reproducibly achieves the programmed bunch length of about 1.2 ns (4 ) at flat top with low bunch-to-bunch scatter and provides a stable beam for physics coast

How does ethical leadership trickle down? Test of an integrative dual-process model

Although the trickle-down effect of ethical leadership has been documented in the literature, its underlying mechanism still remains largely unclear. To address this gap, we develop a cross-level dual-process model to explain how the effect occurs. Drawing on social learning theory, we hypothesize that the ethical leadership of high-level managers could cascade to middle-level supervisors via its impact on middle-level supervisors’ two ethical expectations. Using a sample of 69 middle-level supervisors and 381 subordinates across 69 sub-branches from a large banking firm in China, we found that middle-level supervisors’ ethical efficacy expectation and unethical behavior–punishment expectation (as one form of ethical outcome expectations) accounted for the trickle-down effect. The explanatory role of middle-level supervisors’ ethical behavior–reward expectation (as the other form of ethical outcome expectations), however, was not supported. The theoretical and practical implications are discussed