Design considerations for a space database

Part of the information used in a real-time simulator is stored in the visual database. This information is processed by an image generator and displayed as a real-time visual image. The database must be constructed in a specific format, and it should efficiently utilize the capacities of the image generator that is was created for. A visual simulation is crucially dependent upon the success with which the database provides visual cues and recognizable scenes. For this reason, more and more attention is being paid to the art and science of creating effective real-time visual databases. Investigated here are the database design considerations required for a space-oriented real-time simulator. Space applications often require unique designs that correspond closely to the particular image-generator hardware and visual-database-management software. Specific examples from the databases constructed for NASA and its Evans and Sutherland CT6 image generator illustrate the various design strategies used in a space-simulation environment. These database design considerations are essential for all who would create a space database

The role of invertebrates in the diet, growth and survival of red grouse (Lagopus lagopus scoticus) chicks

The role of diet on the growth, survival and movement of red grouse chicks was examined. We compared two areas of moorland in Scotland; a dry heath with a low density of red grouse and poor chick survival and a wetter heath/bog with relatively higher red grouse numbers and higher rates of chick survival. There were no differences in clutch size, or the proportion of eggs hatching between the two moors but brood survival was significantly lower on the dry heath. Radiotagged hens with broods were monitored during the first 12 days following hatching, the chicks captured, weighed and faecal samples collected. Invertebrate samples were collected within brood feeding ranges. Analysis of chick faeces was used to identify dietary components. Heather comprised the major dietary component on both moors. Invertebrates formed a higher component of diet on the wet moor, and this was positively correlated with growth rates, which in turn were positively correlated with chick survival. We present data from an experiment carried out in 1982, in which chicks showed higher growth rates with increasing insect availability. We also show that broods in which all the chicks survived (4-10 days) had smaller home range areas than broods in which some of the chicks died during this period. We suggest that the differences in chick survival between the two populations was due to variations in the abundance of invertebrates, particularly Tipulids. The protein provided by a high invertebrate component in the diet is, therefore, an important determinant of young red grouse chick growth and survival in some areas

“It feels like someone is hammering my feet”: Understanding pain and its management from the perspective of people with Multiple Sclerosis

Background: Pain affects around 63% of people with multiple sclerosis (pwMS). Biomedical treatments demonstrate limited efficacy. More research is needed to understand pain from the individual’s perspective in order to better inform a patient-centred approach that improves engagement, self-management and outcome. Objective: The objective of this paper is to explore pwMS’ experience and responses to pain, and their perspectives on pain management. Methods: Twenty-five in-depth, semi-structured telephone interviews were conducted. Interviews were audiotaped, transcribed and analysed using an inductive thematic analysis approach with elements of grounded theory. Results: Key themes included vivid descriptions of pain and beliefs that pain is unpredictable, a sign of damage and may worsen. Anger was a common emotional response. Two dominant pain management themes emerged: one related to pain reduction and another to acceptance. Those focusing on pain reduction appeared to engage in cycles in which they struggled with symptoms and experienced continued distress. Conclusion: Findings identify pain-related beliefs, emotional reactions and disparate pain-management attitudes. All may influence pwMS’ responses to pain and what they ask of their clinicians. Uncovering pwMS’ personal beliefs about pain, and introducing a broader biopsychosocial understanding of pain in the clinical context, may provide opportunities to rectify potentially unhelpful management choices and enhance pain acceptance

Processing of Ice Cloud In-Situ Data Collected by Bulk Water, Scattering, and Imaging Probes: Fundamentals, Uncertainties and Efforts towards Consistency

In-situ observations of cloud properties made by airborne probes play a critical role in ice cloud research through their role in process studies, parameterization development, and evaluation of simulations and remote sensing retrievals. To determine how cloud properties vary with environmental conditions, in-situ data collected during different field projects processed by different groups must be used. However, due to the diverse algorithms and codes that are used to process measurements, it can be challenging to compare the results. Therefore it is vital to understand both the limitations of specific probes and uncertainties introduced by processing algorithms. Since there is currently no universally accepted framework regarding how in-situ measurements should be processed, there is a need for a general reference that describes the most commonly applied algorithms along with their strengths and weaknesses. Methods used to process data from bulk water probes, single particle light scattering spectrometers and cloud imaging probes are reviewed herein, with emphasis on measurements of the ice phase. Particular attention is paid to how uncertainties, caveats and assumptions in processing algorithms affect derived products since there is currently no consensus on the optimal way of analyzing data. Recommendations for improving the analysis and interpretation of in-situ data include the following: establishment of a common reference library of individual processing algorithms; better documentation of assumptions used in these algorithms; development and maintenance of sustainable community software for processing in-situ observations; and more studies that compare different algorithms with the same benchmark data sets

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

iACT-CEL: A Feasibility Trial of a Face-to-Face and Internet-Based Acceptance and Commitment Therapy Intervention for Chronic Pain in Singapore

Psychological interventions are increasingly utilising online or mobile phone based platforms to deliver treatment, including that for people with chronic pain. The aims of this study were to develop an adapted form of Acceptance and Commitment Therapy (ACT) for chronic pain in Singapore and to test the feasibility of elements of this treatment delivered via the internet and email. Methods. Thirty-three participants recruited from a tertiary pain management clinic and via the clinic website participated in this program over a period of five weeks with a 3-month follow-up. Treatment outcomes were assessed at three assessment time points. Results. 90.9% of participants completed the program, with 81.8% reporting high treatment satisfaction. Significant changes in depression, t=3.08, p=0.002 (baseline to posttreatment), t=3.28, p=0.001 (baseline to follow-up), and pain intensity, t=2.15, p=0.03 (baseline to follow-up) were found. Mainly small effect sizes (d=0.09–0.39) with a moderate effect size (d=0.51) for depression were found at posttreatment. Clinically meaningful improvement in at least one outcome was demonstrated in 75.8% of participants. Conclusions. An adaptation of ACT for people with chronic pain in Singapore appears promising. Optimal treatment design and more effective ways to target outcomes and processes measured here are required

Using mixed methods case-series evaluation in the development of a guided self-management hybrid CBT and ACT intervention for multiple sclerosis pain

<p><b>Purpose:</b> Two-thirds of the people with multiple sclerosis (pwMS) experience pain. Medications provide minimal relief, and current non-pharmacological interventions lack a clear conceptualization of MS pain. This study explored the potential efficacy of a telephone-supported hybrid cognitive behavior therapy and acceptance and commitment therapy self-management intervention for pwMS based on an empirically supported model of MS pain using a replicated single-case series design.</p> <p><b>Methods:</b> Seven pwMS with varied demographic and disease characteristics completed the 8-week home-based program alongside 3 hours of telephone support. Online questionnaires were completed every four days for 16 weeks (4-weeks baseline, 8-weeks treatment, 4-weeks follow-up). The primary outcomes were pain severity and pain interference. Psychological process variables drawn from the MS pain model were also completed, and post-treatment qualitative interviews conducted.</p> <p><b>Results:</b> Simulation modeling analysis (SMA) showed three patients had large improvements in pain outcomes, two showed no change and two worsened. Five participants showed significant change on various psychological process variables. Change in pain catastrophizing was the most consistent finding.</p> <p><b>Conclusions:</b> The findings suggest a self-management program for MS pain with minimal therapy support may be effective for some pwMS, but not those with more complex comorbidities. The participants suggested web-based delivery may simplify the approach, and therapist telephone contact was highly valued.</p> <p>Implications for Rehabilitation</p><p>This case series suggests a hybrid CBT/ACT self-management workbook program for MS pain improves severity and impact of pain in some pwMS.</p><p>Pain-related catastrophizing reduced in most pwMS, whilst change in other ACT and CBT process variables varied across the individuals.</p><p>PwMS feedback suggests a tailored web-based delivery of the program with therapist telephone support may be optimal.</p><p>PwMS with serious co-morbid depression and very advanced disease may not respond well to this self-management approach.</p><p></p> <p>This case series suggests a hybrid CBT/ACT self-management workbook program for MS pain improves severity and impact of pain in some pwMS.</p> <p>Pain-related catastrophizing reduced in most pwMS, whilst change in other ACT and CBT process variables varied across the individuals.</p> <p>PwMS feedback suggests a tailored web-based delivery of the program with therapist telephone support may be optimal.</p> <p>PwMS with serious co-morbid depression and very advanced disease may not respond well to this self-management approach.</p

Physical Therapy Informed by Acceptance and Commitment Therapy (PACT) Versus Usual Care Physical Therapy for Adults With Chronic Low Back Pain:A Randomized Controlled Trial

Chronic low back pain (CLBP) is a major cause of global disability and improving management is essential. Acceptance and commitment therapy (ACT) is a promising treatment for chronic pain but has not been modified for physical therapy. This randomized controlled trial (RCT) compared physical therapy informed by ACT (PACT) against standard care physical therapy for patients with CLBP. Patients with CLBP (duration ≥12 weeks, mean 3 years) were recruited from physical therapy clinics in 4 UK public hospitals. The Roland-Morris Disability Questionnaire (RMDQ) at 3 months' post-randomization was the primary outcome. Two hundred forty-eight participants (59% female, mean age = 48) were recruited and 219 (88.3%) completed measures at 3 and/or 12 months' follow-up. At 3 months, PACT participants reported better outcomes for disability (RMDQ mean difference = 1.07, p = .037, 95% CI = -2.08 to -.07, d = .2), Patient Specific Functioning (p = .008), SF12 physical health (p = .032), and treatment credibility (p < .001). At 12 months' follow-up, there were no significant differences between groups. PACT was acceptable to patients and clinicians and feasible to deliver. Physical therapists incorporated psychological principles successfully and treatment was delivered with high (≥80%) fidelity. Our results may inform the management of CLBP, with potential benefits for patients, health care providers, and society. PERSPECTIVE: Psychologically informed physical therapy has great potential but there are challenges in implementation. The training and support included in the PACT trial enabled the intervention to be delivered as planned. This successfully reduced disability in the short but not long term. Findings could inform physical therapists' treatment of CLBP