Convective Weather Avoidance with Uncertain Weather Forecasts

Convective weather events have a disruptive impact on air traffic both in terminal area and in en-route airspaces. In order to make sure that the national air transportation system is safe and efficient, it is essential to respond to convective weather events effectively. Traffic flow control initiatives in response to convective weather include ground delay, airborne delay, miles-in-trail restrictions as well as tactical and strategic rerouting. The rerouting initiatives can potentially increase traffic density and complexity in regions neighboring the convective weather activity. There is a need to perform rerouting in an intelligent and efficient way such that the disruptive effects of rerouting are minimized. An important area of research is to study the interaction of in-flight rerouting with traffic congestion or complexity and developing methods that quantitatively measure this interaction. Furthermore, it is necessary to find rerouting solutions that account for uncertainties in weather forecasts. These are important steps toward managing complexity during rerouting operations, and the paper is motivated by these research questions. An automated system is developed for rerouting air traffic in order to avoid convective weather regions during the 20- minute - 2-hour time horizon. Such a system is envisioned to work in concert with separation assurance (0 - 20-minute time horizon), and longer term air traffic management (2-hours and beyond) to provide a more comprehensive solution to complexity and safety management. In this study, weather is dynamic and uncertain; it is represented as regions of airspace that pilots are likely to avoid. Algorithms are implemented in an air traffic simulation environment to support the research study. The algorithms used are deterministic but periodically revise reroutes to account for weather forecast updates. In contrast to previous studies, in this study convective weather is represented as regions of airspace that pilots are likely to avoid. The automated system periodically updates forecasts and reassesses rerouting decisions in order to account for changing weather predictions. The main objectives are to reroute flights to avoid convective weather regions and determine the resulting complexity due to rerouting. The eventual goal is to control and reduce complexity while rerouting flights during the 20 minute - 2 hour planning period. A three-hour simulation is conducted using 4800 flights in the national airspace. The study compares several metrics against a baseline scenario using the same traffic and weather but with rerouting disabled. The results show that rerouting can have a negative impact on congestion in some sectors, as expected. The rerouting system provides accurate measurements of the resulting complexity in the congested sectors. Furthermore, although rerouting is performed only in the 20-minute - 2-hour range, it results in a 30% reduction in encounters with nowcast weather polygons (100% being the ideal for perfectly predictable and accurate weather). In the simulations, rerouting was performed for the 20-minute - 2-hour flight time horizon, and for the en-route segment of air traffic. The implementation uses CWAM, a set of polygons that represent probabilities of pilot deviation around weather. The algorithms were implemented in a software-based air traffic simulation system. Initial results of the system's performance and effectiveness were encouraging. Simulation results showed that when flights were rerouted in the 20-minute - 2-hour flight time horizon of air traffic, there were fewer weather encounters in the first 20 minutes than for flights that were not rerouted. Some preliminary results were also obtained that showed that rerouting will also increase complexity. More simulations will be conducted in order to report conclusive results on the effects of rerouting on complexity. Thus, the use of the 20-minute - 2-hour flight time horizon weather avoidance teniques performed in the simulation is expected to provide benefits for short-term weather avoidance

Comparison of different luminex single antigen bead kits for memory B cell-derived HLA antibody detection

Transplantation and autoimmunit

Population structure and genetic variability in wild and farmed Mediterranean populations of gilthead seabream and European seabass inferred from a 60K combined species SNP array

publishedVersio

The interindividual variability of multimodal brain connectivity maintains spatial heterogeneity and relates to tissue microstructure

Humans differ from each other in a wide range of biometrics, but to what extent brain connectivity varies between individuals remains largely unknown. By combining diffusion-weighted imaging (DWI) and magnetoencephalography (MEG), this study characterizes the inter-subject variability (ISV) of multimodal brain connectivity. Structural connectivity is characterized by higher ISV in association cortices including the core multiple-demand network and lower ISV in the sensorimotor cortex. MEG ISV exhibits frequency-dependent signatures, and the extent of MEG ISV is consistent with that of structural connectivity ISV in selective macroscopic cortical clusters. Across the cortex, the ISVs of structural connectivity and beta-band MEG functional connectivity are negatively associated with cortical myelin content indexed by the quantitative T1 relaxation rate measured by high-resolution 7 T MRI. Furthermore, MEG ISV from alpha to gamma bands relates to the hindrance and restriction of the white-matter tissue estimated by DWI microstructural models. Our findings depict the inter-relationship between the ISV of brain connectivity from multiple modalities, and highlight the role of tissue microstructure underpinning the ISV

Damage of woven composite under tensile and shear stress using infrared thermography and micrographic cuts

Infrared thermography was used to study damage developing in woven fabrics. Two different experiments were performed, a ±45° tensile test and a rail shear test. These two different types of tests show different damage scenarios, even if the shear stress/strain curves are similar. The ±45° tension test shows matrix hardening and matrix cracking whereas the rail shear test shows only matrix hardening. The infrared thermography was used to perform an energy balance, which enabled the visualization of the portion of dissipated energy caused by matrix cracking. The results showed that when the resin is subjected to pure shear, a larger amount of energy is stored by the material, whereas when the resin is subjected to hydrostatic pressure, the main part of mechanical energy is dissipated as heat

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Musculoskeletal injuries among operating room nurses: results from a multicenter survey in Rome, Italy

Aim: Chronic disorders of the musculoskeletal system, particularly low back pain (LBP), are increasing and represent a social and economic problem of growing importance, especially if correlated with working conditions. Health care workers are at higher risk of developing LBP during work shifts in the hospital. The aim of this study was to assess the prevalence of LBP among operating room nurses and to investigate the risk factors for musculoskeletal injuries in the operating room. Methods: We carried out a cross-sectional study that included operating room nurses from nine hospitals. Information on sociodemographic characteristics, lifestyle habits, working activity and psychological attitude of nurses was collected using an anonymous self-administered structured questionnaire. We evaluated the association of frequency, localization and intensity of LBP (FLI) with qualitative variables, making use of univariate analysis, chi-square test and Fisher's exact test. Multiple logistic regression analysis was performed to identify the variables that affected the FLI. The covariates included in the model were the variables that had a p 35 years vs. age <35 (OR = 2.68; 95% CI = 1.17–6.18) and diurnal work shift vs. diurnal/ nocturnal (OR = 4.00; 95% CI = 1.72–9.0) represent risk factors associated with FLI, while physical activity is a protective factor (OR = 0.47; 95% CI = 0.20–1.08). Conclusion: The data suggest that it is important to promote new programs of prevention based on professional training and physical activity among nurses and to improve the organization of work shifts in the hospital

Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine .

COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including noncontrolled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine draws attention to patients with vascular disease (VD) and presents an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19. VAS recommends (1) a COVID-19-oriented primary health care network for patients with VD-CVR for identification of patients with VD-CVR in the community and patients' education for disease symptoms, use of eHealth technology, adherence to the antithrombotic and vascular regulating treatments, and (2) close medical follow-up for efficacious control of VD progression and prompt application of physical and social distancing measures in case of new epidemic waves. For patients with VD-CVR who receive home treatment for COVID-19, VAS recommends assessment for (1) disease worsening risk and prioritized hospitalization of those at high risk and (2) VTE risk assessment and thromboprophylaxis with rivaroxaban, betrixaban, or low-molecular-weight heparin (LMWH) for those at high risk. For hospitalized patients with VD-CVR and COVID-19, VAS recommends (1) routine thromboprophylaxis with weight-adjusted intermediate doses of LMWH (unless contraindication); (2) LMWH as the drug of choice over unfractionated heparin or direct oral anticoagulants for the treatment of VTE or hypercoagulability; (3) careful evaluation of the risk for disease worsening and prompt application of targeted antiviral or convalescence treatments; (4) monitoring of D-dimer for optimization of the antithrombotic treatment; and (5) evaluation of the risk of VTE before hospital discharge using the IMPROVE-D-dimer score and prolonged post-discharge thromboprophylaxis with rivaroxaban, betrixaban, or LMWH

ИНДИВИДУАЛИЗАЦИЯ ЛЕЧЕНИЯ ПАЦИЕНТОВ С ЦЕРЕБРАЛЬНЫМИ МЕТАСТАЗАМИ ЗЛОКАЧЕСТВЕННЫХ ОПУХОЛЕЙ. ПРОГНОСТИЧЕСКАЯ ШКАЛА TUNS

Improvement in the diagnosis and treatment of cancer patients, increase in frequency of prevalence and detection of metastatic lesions of the brain make the choice of treatment timely and important. The article presents data on the current prognostic scales for patients with cerebral metastases of solid tumors and the analysis of their features. The features of choice of tactics and strategy of treatment of patients with cerebral metastases of solid tumors depending on various prognostic factors are described. The original version of the rating scale for determining treatment options for patients with metastatic brain lesions is proposed. We suggest to consider oncological, neurological (neurosurgical), somatic (functional) groups of factors to choose the tactics of treatment of patients with brain metastases.Совершенствование диагностики и лечения онкологических пациентов, рост частоты распространенности и выявляемости метастатического поражения головного мозга делают вопрос выбора лечения своевременным и важным. В статье приводятся данные о современных прогностических шкалах для пациентов с церебральными метастазами солидных опухолей. Проводится анализ их особенностей. Описываются особенности выбора тактики и стратегии лечения пациентов с церебральными метастазами солидных опухолей в зависимости от различных прогностических факторов. Предлагается оригинальный вариант оценочной шкалы для определения возможностей лечения пациента с метастатическим поражением головного мозга. Для выбора тактики лечения пациентов с метастазами в головной мозг предлагается учитывать группы факторов: онкологические, неврологические (нейрохирургические), соматические (функциональные)