Engineering simulation evaluation of the two-segment noise abatement approach in the Douglas DC-8-61

The development and operational evaluation are discussed of a noise abatement two-segment approach which is safe and operationally acceptable for routine use in air carrier service. An engineering simulation evaluation was conducted; it was found that the entry speed and initial configuration are more important in the DC-8-61 than in the 727 because of the DC-8's aerodynamic cleanliness and drag programming constraints. It was also found that the altitude required for the DC-8 upper and lower transitions is less than the 727 transitions principally due to the pitching moment from the underslung DC-8 engines as compared to the 727 engines which produce no pitching moment with a change in thrust. The 727 approach was a reduced flaps (30 degrees) procedure with a 10-knot airspeed bleed in the lower transition; the DC-8 approach is a full flaps (50 degrees) procedure with constant airspeed established as soon as possible after upper segment transition

Engineering simulation development and evaluation of the two-segment noise abatement approach conducted in the B-727-222 flight simulator

Profile modification as a means of reducing ground level noise from jet aircraft in the landing approach is evaluated. A flight simulator was modified to incorporate the cockpit hardware which would be in the prototype airplane installation. The two-segment system operational and aircraft interface logic was accurately emulated in software. Programs were developed to permit data to be recorded in real time on the line printer, a 14-channel oscillograph, and an x-y plotter. The two-segment profile and procedures which were developed are described with emphasis on operational concepts and constraints. The two-segment system operational logic and the flight simulator capabilities are described. The findings influenced the ultimate system design and aircraft interface

The Out of Service Guest Pilot Evaluation of the Two-segment Noise Abatement Approach in the Boeing B727-200

Guest pilot evaluation results of an approach profile modification for reducing ground level noise under the approach of jet aircraft runways are reported. Evaluation results were used to develop a two segmented landing approach procedure and equipment necessary to obtain pilot, airline, and FAA acceptance of the two segmented flight as a routine way of operating aircraft on approach and landing. Data are given on pilot workload and acceptance of the procedure

Operational flight evaluation of the two-segment approach for use in airline service

United Airlines has developed and evaluated a two-segment noise abatement approach procedure for use on Boeing 727 aircraft in air carrier service. In a flight simulator, the two-segment approach was studied in detail and a profile and procedures were developed. Equipment adaptable to contemporary avionics and navigation systems was designed and manufactured by Collins Radio Company and was installed and evaluated in B-727-200 aircraft. The equipment, profile, and procedures were evaluated out of revenue service by pilots representing government agencies, airlines, airframe manufacturers, and professional pilot associations. A system was then placed into scheduled airline service for six months during which 555 two-segment approaches were flown at three airports by 55 airline pilots. The system was determined to be safe, easy to fly, and compatible with the airline operational environment

Flight evaluation of two-segment approaches using area navigation guidance equipment

A two-segment noise abatement approach procedure for use on DC-8-61 aircraft in air carrier service was developed and evaluated. The approach profile and procedures were developed in a flight simulator. Full guidance is provided throughout the approach by a Collins Radio Company three-dimensional area navigation (RNAV) system which was modified to provide the two-segment approach capabilities. Modifications to the basic RNAV software included safety protection logic considered necessary for an operationally acceptable two-segment system. With an aircraft out of revenue service, the system was refined and extensively flight tested, and the profile and procedures were evaluated by representatives of the airlines, airframe manufacturers, the Air Line Pilots Association, and the Federal Aviation Adminstration. The system was determined to be safe and operationally acceptable. It was then placed into scheduled airline service for an evaluation during which 180 approaches were flown by 48 airline pilots. The approach was determined to be compatible with the airline operational environment, although operation of the RNAV system in the existing terminal area air traffic control environment was difficult

Enhanced fitness and renal function in Type 2 diabetes.

Aims To investigate the renal effects of fitness in people with diabetes with mild renal dysfunction. Methods The effect of a 12-week exercise programme on estimated GFR in 128 people with diabetes was evaluated. Results All cardiometabolic variables improved after 12 weeks of supervised exercise. Although there was a modest 3.9% increase in estimated GFR from baseline in the 128 people who completed the study, those with baseline chronic kidney disease stages 2 and 3 were found to have significant (6 and 12%, respectively; p \u3c 0.01) improvements in post-exercise estimated GFR. Moreover, 42% of the people with chronic kidney disease stage 3 improved to chronic kidney disease stage 2 after the intervention. Conclusion Short-term exercise improves renal function in those with more moderate baseline chronic kidney disease. Thus, renal function appears to be responsive to enhanced physical fitness. Being a strong and modifiable risk factor, enhanced fitness should be considered a non-pharmacological adjunct in the management of diabetic kidney disease

Utility of serum procalcitonin values in patients with acute exacerbations of chronic obstructive pulmonary disease: a cautionary note

Background: Serum procalcitonin levels have been used as a biomarker of invasive bacterial infection and recently have been advocated to guide antibiotic therapy in patients with chronic obstructive pulmonary disease (COPD). However, rigorous studies correlating procalcitonin levels with microbiologic data are lacking. Acute exacerbations of COPD (AECOPD) have been linked to viral and bacterial infection as well as noninfectious causes. Therefore, we evaluated procalcitonin as a predictor of viral versus bacterial infection in patients hospitalized with AECOPD with and without evidence of pneumonia. Methods: Adults hospitalized during the winter with symptoms consistent with AECOPD underwent extensive testing for viral, bacterial, and atypical pathogens. Serum procalcitonin levels were measured on day 1 (admission), day 2, and at one month. Clinical and laboratory features of subjects with viral and bacterial diagnoses were compared.Results: In total, 224 subjects with COPD were admitted for 240 respiratory illnesses. Of these, 56 had pneumonia and 184 had AECOPD alone. A microbiologic diagnosis was made in 76 (56%) of 134 illnesses with reliable bacteriology (26 viral infection, 29 bacterial infection, and 21 mixed viral bacterial infection). Mean procalcitonin levels were significantly higher in patients with pneumonia compared with AECOPD. However, discrimination between viral and bacterial infection using a 0.25 ng/mL threshold for bacterial infection in patients with AECOPD was poor. Conclusion: Procalcitonin is useful in COPD patients for alerting clinicians to invasive bacterial infections such as pneumonia but it does not distinguish bacterial from viral and noninfectious causes of AECOPD

Parathyroid adenoma apoplexy as a temporary solution of primary hyperparathyroidism: a case report

<p>Abstract</p> <p>Introduction</p> <p>The natural history of patients with spontaneous parathyroid necrosis is unknown. In this case report we describe the clinical course, laboratory, radiographic, bone densitometry tests, parathyroid ultrasonography and scintigraphy examinations of a patient performed over a period of eight years after she first presented with a sudden episode of spontaneous resolution of primary hyperparathyroidism (PHPT).</p> <p>Case presentation</p> <p>A 24-year-old woman with a clinical history and laboratory and radiographic tests compatible with PHPT suffered a sudden episode of cervical pain and presented with clinical evidence of hypocalcemia. Biopsy of a cervical nodule revealed necrotic material compatible with ischemia of the parathyroid. The follow-up of the patient presented four distinct phases: the first, which lasted two years, was compatible with a period of bone hunger during which it was necessary to introduce calcitriol and calcium carbonate. During this period, the patient showed bone mass gain. The second phase was characterized by normalization of calcium and parathyroid hormone levels and its end was difficult to define. During the third phase there was a recurrence of hypercalcemia associated with elevated parathyroid hormone (PTH) levels and loss of bone mass. The last phase corresponded to the interval after parathyroidectomy, which was characterized by normalization of serum levels of calcium and PTH, as well as bone mass gain.</p> <p>Conclusion</p> <p>This case report indicates that spontaneous resolution of PHPT by adenoma necrosis is potentially temporary. Thus, in cases in which a conservative approach is chosen, clinical and laboratory follow-up is indispensable. Bone mass measurement is a useful tool in the follow-up of these cases. However, this option exposes the patient to a potential roller-coaster ride of bone mass gain and loss, whose long term consequences are still unknown.</p