Evaluation of GPS L5 and Galileo E1 and E5a Performance for Future Multi Frequency and Multi Constellation GBAS

In this paper, we show a performance analysis of different signals from the new Galileo satellites in the E1 and E5a frequency bands as well as GPS L5 signals in DLR’s experimental Ground Based Augmentation System (GBAS). We show results of noise and multipath evaluations of the available Galileo satellites and compare their performance to the currently used GPS L1 and the new GPS L5 signals which were presented in a recent paper. The results show that the raw noise and multipath level of Galileo signals is smaller than of GPS. Even after smoothing, Galileo signals perform somewhat better than GPS and are less sensitive to the smoothing time constant. Another issue to be considered in a future multi frequency system is inter-frequency bias. These biases differ between satellites and depend on satellite and receiver hardware, but they can be determined a priori. With known receiver and antenna configurations, it is possible to correct for these biases and avoid errors introduced by different hardware in the airborne receiver and GBAS ground system. A residual uncertainty associated with the bias correction has to be taken into account. This can be modelled as part of σ_(pr\_gnd)

CIRCULATING ADIPOCYTE-DERIVED EXOSOMAL MICRORNAs ASSOCIATED WITH DECREASED INSULIN RESISTANCE AFTER GASTRIC BYPASS

OBJECTIVE: Exosomes from obese adipose contain dysregulated microRNAs linked to insulin signaling, as compared to lean controls, providing a direct connection between adiposity and insulin resistance. The current study tested the hypotheses that gastric bypass surgery and its subsequent weight loss would normalize adipocyte-derived-exosomal microRNAs associated with insulin signaling and the associated metabolome related to glucose homeostasis. METHODS: African-American female subjects with obesity (N=6; age: 38.5±6.8 years; BMI: 51.2±8.8 kg/m(2)) were tested before and one year after surgery. Insulin resistance (HOMA), serum metabolomics and global microRNA profiles of circulating adipocyte-derived exosomes were evaluated via ANCOVA and correlational analyses. RESULTS: One-year post-surgery, patients showed decreased BMI (−18.6±5.1 kg/m(2); p<0.001), ameliorated insulin resistance (HOMA: 1.94±0.6 pre-surgery, 0.49±0.1 post-surgery; p<0.001), and altered metabolites including branched chain amino acids. Biological pathways analysis of predicted mRNA targets of 168 surgery-responsive microRNAs (p<0.05) identified the insulin signaling pathway (p=1.27E-10; 52/138 elements), among others, in our dataset. The insulin signaling pathway was also a target of 10 microRNAs correlated to changes in HOMA (p<0.05; r>0.4), and 48 microRNAs correlated to changes in BCAA levels. CONCLUSIONS: These data indicate that circulating adipocyte-derived exosomes are modified following gastric bypass surgery and correlate to improved post-surgery insulin resistance

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

An overview of GBAS integrity monitoring with a focus on ionospheric spatial anomalies

249-260The Local Area Augmentation System (LAAS) or, more generally, the Ground Based Augmentation System (GBAS), has been developed over the past decade to meet the accuracy, integrity, continuity and availability needs of civil aviation users. The GBAS utilizes a single reference station (with multiple GNSS receivers and antennas) within an airport and provides differential corrections via VHF data broadcast (VDB) within a 50-km region around that airport. This paper provides an overview of GBAS integrity verification, explaining how integrity risk is allocated to various potential safety threats and how monitors are used to meet these allocations. In order to illustrate GBAS integrity monitoring in detail, this paper examines the potential threat of ionospheric spatial anomalies (e.g., during ionospheric “storms”) to GBAS and how GBAS protects users against this threat. In practice, the need to mitigate potential ionospheric anomalies is what dictates CAT I GBAS availability