The effect of radio frequency interference on the 136- to 138-MHz return link and 400.5- to 401.5-MHz forward link of the Tracking and Data Relay Satellite System

The purpose is to update the RFI estimates in the 136- to 138-MHz VHF band and to make estimates for the first time for the 400.5- to 401.5-MHz UHF band. These preliminary predictions are based on primarily ITU frequency-registration data, with missing data bridged by engineering judgement

Major RFI conditions effecting TDRSS

An evaluation of the radio frequency interference (RFI) conditions which would affect operating frequency band selections and data communications equipment design approaches for the Tracking Data Relay Satellite System (TDRSS) is presented. The subjects discussed are: (1) the scope of the investigation, (2) relative RFI in the frequency bands considered, (3) radar RFI power and duty factor, (4) radio relay communications RFI, (5) radio frequency band usage recommendations, and (6) radar RFI impact areas

Effect of torso morphology on maximum hydrodynamic resistance in front crawl swimming

The aim of this study was to determine the influence of torso morphology on maximum instantaneous hydrodynamic resistance in front crawl swimming. Outlines of the torso in the frontal and anteroposterior planes were calculated from photographic images to determine continuous form gradients (m/m) for the anterior, posterior and lateral aspects of the torso. Torso cross-sectional areas at each vertical sample (0.001 m) were used to calculate maximal rate of change in cross-sectional area (m2/m) in the chest-waist and waist-hip segments. During the non-propulsive hand phase in middle-long distance front crawl, kicking propulsion is negligible and therefore the net force is equal to the drag. Drag coefficients were calculated at the instant of maximum horizontal deceleration of centre of mass during the non-propulsive hand phase of 400 m pace front crawl. Maximal rate of change in cross-sectional area (r = 0.44, p = 0.014) and posterior form gradient (r = 0.50, p = 0.006) of the waist-hip torso segment had moderate positive correlations with the maximal drag coefficient. A regression model including these variables explained 41% of the variance (p = 0.001). Indentation at the waist and curvature of the buttocks may result in greater drag force and influence swimming performance

Inhaled methoxyflurane (Penthrox®) versus placebo for injury-associated analgesia in children - The MAGPIE trial (MEOF-002): Study protocol for a randomised controlled trial

BackgroundPain from injuries is one of the commonest symptoms in children attending emergency departments (EDs), and this is often inadequately treated in both the pre-hospital and ED settings, in part due to challenges of continual assessment and availability of easily administered analgesic options. Pain practices are therefore a key research priority, including within the field of paediatric emergency medicine. Methoxyflurane, delivered via a self-administered Penthrox® inhaler, belongs to the fluorinated hydrocarbon group of volatile anaesthetics and is unique among the group in having analgesic properties at low doses. Despite over 30 years of clinical acute analgesia use, and a large volume of evidence supporting its safety and efficacy, there is a paucity of randomised controlled trial data for Penthrox®.MethodsThis is an international multi-centre randomised, double-blind, placebo-controlled phase III trial assessing the efficacy and safety of methoxyflurane delivered via the Penthrox® inhaler for the management of moderate to severe acute traumatic pain in children and young people aged 6–17 years. Following written informed consent, eligible participants are randomised to self-administer either inhaled methoxyflurane (maximum dose of 2 × 3 ml) or normal saline placebo (maximum dose 2 × 5 ml). Patients, treating clinicians and research nurses are blinded to the treatment. The primary outcome is the change in pain intensity at 15 min after the commencement of treatment, as measured by the Visual Analogue Scale (VAS) or the Wong-Baker FACES® Pain Rating scale, with the latter converted to VAS values. Secondary outcome measures include the number and proportion of responders who achieve a 30% reduction in VAS score compared to baseline, rescue medication requested, time and number of inhalations to first pain relief, global medication performance assessment by the patient, clinician and research nurse, and evaluation of adverse events experienced during treatment and during the subsequent 14 ± 2 days. The primary analysis will be by intention to treat. The total sample size is 110 randomised and treated patients per treatment arm.DiscussionThe Methoxyflurane AnalGesia for Paediatric InjuriEs (MAGPIE) trial will provide efficacy and safety data for methoxyflurane administered via the Penthrox® inhaler, in children and adolescents who present to EDs with moderate to severe injury-related pain.Trial registrationEudraCT, 2016–004290-41. Registered on 11 April 2017.ClinicalTrials.gov, NCT03215056. Registered on 12 July 2017

Understanding the Effects of Training on Underwater Undulatory Swimming Performance and Kinematics

In swimming, the underwater phase after the start and turn comprises gliding and dolphin kicking, with the latter also known as underwater undulatory swimming (UUS). Swimming performance is highly dependent on the underwater phase; therefore, understanding the training effects in UUS and underwater gliding can be critical for swimmers and coaches. Further, the development of technique in young swimmers can lead to exponential benefits in an athlete’s career. This study aimed to evaluate the effects of a training protocol on UUS and underwater gliding performance and kinematics in young swimmers. Seventeen age group swimmers (boys = 10, girls = 7) performed maximal UUS and underwater gliding efforts before and after a seven-week training protocol. Time to reach 10 m; intra-cyclic mean, peak, and minimum velocities; and gliding performance improved significantly after the training protocol. The UUS performance improvement was mostly produced by an improvement of the upbeat execution, together with a likely reduction of swimmers’ hydrodynamic drag. Despite the changes in UUS and gliding, performance was also likely influenced by growth. The findings from this study highlight kinematic variables that can be used to understand and quantify changes in UUS and gliding performance

Structures of paediatric pain management: A PERUKI service evaluation study

Background Pain is very common in childhood emergency department (ED) attendances, but is under-recognised and undertreated. Sequential national paediatric analgesia audits demonstrate suboptimal outcomes in several domains. The Donabedian framework examines the structures, processes and outcomes to evaluate quality of care. To date there has been no network-level exploration of structures supporting analgesic practices or attempts to address failure to attain national standards. Objective To benchmark current variation in assessment and management of childhood pain at network level. Methods Online survey distributed between December 2016 and January 2017 exploring health system structures including pain score tools, pain assessment/protocols, training, practice guidelines and analgesic agent usage. We explored structures, processes and outcomes to identify interventions, and their potential effectiveness and feasibility. Results In total 95% (38/40 sites) responded, including 25 tertiary (66%) and 13 secondary hospitals (34%), with a total annual paediatric ED census of 1 225 000 (range 11 500-65 000). Availability of analgesics varied included topical wound anaesthesia in 29/38 sites (76%), oral diclofenac sodium in 22/38 sites (58%) and tramadol in 16/38 sites (42%). Pain assessment was mandatory in initial assessment in 34/38 sites (89%), and 18/38 sites had a policy on frequency of pain assessment (47%). Local guidance aligned with national guidance in 21/38 sites (55%). There was no staff training at induction/orientation in 14/38 sites (37%) and no mandatory competencies in pain management in 23/38 sites (61%). Play specialist services were available in 21/38 sites (55%). Conclusion Despite national guidance and recommendations from multiple audits, there are substantial variations in structures relating to pain assessment and management across sites. The lack of uniformity is a likely root cause for the persistent suboptimal practices identified by serial national audits. A whole system and person-centred approach to improving pain outcomes by utilising effective interventions seeks to improve paediatric pain outcomes

Need for recovery amongst emergency physicians in the UK and Ireland: a cross-sectional survey.

OBJECTIVES: To determine the need for recovery (NFR) among emergency physicians and to identify demographic and occupational characteristics associated with higher NFR scores. DESIGN: Cross-sectional electronic survey. SETTING: Emergency departments (EDs) (n=112) in the UK and Ireland. PARTICIPANTS: Emergency physicians, defined as any registered physician working principally within the ED, responding between June and July 2019. MAIN OUTCOME MEASURE: NFR Scale, an 11-item self-administered questionnaire that assesses how work demands affect intershift recovery. RESULTS: The median NFR Score for all 4247 eligible, consented participants with a valid NFR Score was 70.0 (95% CI: 65.5 to 74.5), with an IQR of 45.5-90.0. A linear regression model indicated statistically significant associations between gender, health conditions, type of ED, clinical grade, access to annual and study leave, and time spent working out-of-hours. Groups including male physicians, consultants, general practitioners (GPs) within the ED, those working in paediatric EDs and those with no long-term health condition or disability had a lower NFR Score. After adjusting for these characteristics, the NFR Score increased by 3.7 (95% CI: 0.3 to 7.1) and 6.43 (95% CI: 2.0 to 10.8) for those with difficulty accessing annual and study leave, respectively. Increased percentage of out-of-hours work increased NFR Score almost linearly: 26%-50% out-of-hours work=5.7 (95% CI: 3.1 to 8.4); 51%-75% out-of-hours work=10.3 (95% CI: 7.6 to 13.0); 76%-100% out-of-hours work=14.5 (95% CI: 11.0 to 17.9). CONCLUSION: Higher NFR scores were observed among emergency physicians than reported in any other profession or population to date. While out-of-hours working is unavoidable, the linear relationship observed suggests that any reduction may result in NFR improvement. Evidence-based strategies to improve well-being such as proportional out-of-hours working and improved access to annual and study leave should be carefully considered and implemented where feasible

Spatial linear global instability analysis of the HIFiRE-5 elliptic cone model flow

The linear instability of the three-dimensional boundary-layer over the HIFiRE-5 flight test geometry, i.e. a rounded-tip 2:1 elliptic cone, at Mach 7, has been analyzed through spatial BiGlobal analysis, in a effort to understand transition and accurately predict local heat loads on next-generation ight vehicles. The results at an intermediate axial section of the cone, Re x = 8x10 5, show three different families of spatially amplied linear global modes, the attachment-line and cross- ow modes known from earlier analyses, and a new global mode, peaking in the vicinity of the minor axis of the cone, termed \center-line mode". We discover that a sequence of symmetric and anti-symmetric centerline modes exist and, for the basic ow at hand, are maximally amplied around F* = 130kHz. The wavenumbers and spatial distribution of amplitude functions of the centerline modes are documente

Modulation of detoxification gene expression in human colon HT29 cells by glutathione-S-transferase inhibitors

SUMMAR

Effects of insulin on intracellular GLUT4 vesicles in adipocytes: Evidence for a secretory mode of regulation

The facilitative glucose transporter, GLUT4 undergoes insulin-dependent movement to the cell surface in adipocytes, The magnitude of the insulin effect is much greater for CLUT4 than other recycling proteins such as the CD-MPR, In the present study we have studied the colocalisation of these proteins in adipocytes in an effort to explain this selective insulin-dependent recruitment of CLUT4, Using immunofluorescence microscopy or immuno-EM on 3T3-L1 adipocytes we find that there is considerable colocalisation between these proteins particularly within the area of the TGN, However, the distribution of CD-MPR was not significantly effected by insulin. The insulin-dependent recruitment of GLUT4 was concomitant with a selective decrease in GLUT4 labelling of cytoplasmic vesicles whereas the amount of CLUT4 in the TGN region (approx. 50% of total GLUT4) was relatively unaffected. To explore the possibility that the cytoplasmic GLUT4(+) vesicles represent an intracellular insulin-responsive storage compartment we performed quantitative immuno-EM on whole mounts of intracellular vesicles isolated from basal and insulin-stimulated adipocytes. These studies revealed that: (1) GLUT4 and CD-MPR were concentrated in small (30-200 nm) vesicles at a labelling density of 1-20+ gold particles/vesicle; (2) there was significant overlap between both proteins in that 70% of the total GLUT4 pool colocalised with CD-MPR; (3) a significant amount of GLUT4 (approx, 50% of total) was found in a subpopulation of vesicles that contained as little as 5% of the total CD-MPR pool; (4) the GLUT4(+)/CD-MPR(-) vesicles were highly insulin-responsive, and (5) the total number of GLUT4(+) vesicles, but not CD-MPR(+) vesicles, decreased by approx. 30% in response to insulin treatment. These data are consistent with a model in which GLUT4 is selectively sorted into a vesicular compartment in adipocytes that is recruited to the plasma membrane by insulin stimulation