Organizational Change in the Russian Airborne Forces: The Lessons of the Georgian Conflict

This monograph considers the recent history of organizational change in the Russian Airborne Forces (VDV). In particular, it looks at how the VDV has changed since the end of Russia’s conflict with Georgia in 2008. The VDV, a force much admired in Russian media and society has, in fact, escaped fairly lightly during the comprehensive reform of the Russian Army more generally over the last few years. In large part this has been down to the personality of the current head of the VDV, Lieutenant-General Vladimir Shamanov. Close to Prime Minister Vladimir Putin, Shamanov--a maverick --has used his political connections to help ward off many of the cuts and reforms that have impacted the rest of the Army. He has managed to keep the basic structure of the VDV intact, while also dealing with a number of problematic issues related to manning, equipment, and training regimes within his organization. This monograph goes on to point out the level of professionalism in the VDV that was demonstrated during the Georgian war. It also though, highlights the fact that, while some battalions within the VDV will be very effective and well trained, other battalions will not. Thus it is difficult to judge precisely how battle-ready the VDV’s divisions now are. Ultimately, this monograph seeks to establish just what sort of Russian airborne forces U.S. or NATO troops may one day have to either work alongside or, indeed, face in some sort of confrontation.https://press.armywarcollege.edu/monographs/1562/thumbnail.jp

Covid-19: Wie eine Pandemie die Flexibilität des neuen russischen Militärs aufzeigt

Nach einer Phase der Professionalisierung und Modernisierung werden die Streitkräfte Russlands von der Öffentlichkeit als kompetente und effiziente Institution wahrgenommen, und das in einem Land, in dem diese Eigenschaften nach allgemeiner Ansicht bei staatlichen Organen nur selten anzutreffen sind. Das zunehmende öffentliche Profil, das das Militär in der Covid-19-Krise erhält, ist zugleich ein weiteres Beispiel, wie der russische Präsident versucht, einen Teil des Renommees, das diese Institution in Russland jetzt genießt, für sich zu vereinnahmen. Unabhängig davon verfolgt das Militär immer noch seine traditionellen Ziele, nämlich eine Schwächung der NATO und der EU, und zeigt auch hier seine Flexibilität

Mitral regurgitation quantification by cardiac magnetic resonance imaging (MRI) remains reproducible between software solutions [version 3; peer review: 1 approved, 1 approved with reservations]

BACKGROUND: The reproducibility of mitral regurgitation (MR) quantification by cardiovascular magnetic resonance (CMR) imaging using different software solutions remains unclear. This research aimed to investigate the reproducibility of MR quantification between two software solutions: MASS (version 2019 EXP, LUMC, Netherlands) and CAAS (version 5.2, Pie Medical Imaging). METHODS: CMR data of 35 patients with MR (12 primary MR, 13 mitral valve repair/replacement, and ten secondary MR) was used. Four methods of MR volume quantification were studied, including two 4D-flow CMR methods (MRMVAV and MRJet) and two non-4D-flow techniques (MRStandard and MRLVRV). We conducted within-software and inter-software correlation and agreement analyses. RESULTS: All methods demonstrated significant correlation between the two software solutions: MRStandard (r=0.92, p<0.001), MRLVRV (r=0.95, p<0.001), MRJet (r=0.86, p<0.001), and MRMVAV (r=0.91, p<0.001). Between CAAS and MASS, MRJet and MRMVAV, compared to each of the four methods, were the only methods not to be associated with significant bias. CONCLUSIONS: We conclude that 4D-flow CMR methods demonstrate equivalent reproducibility to non-4D-flow methods but greater levels of agreement between software solutions

Devotions for Advent 2022 Canticles of Luke

Each week of this Advent devotional will focus on one of the four Lukan canticles, putting it in its context as well as making connections to other portions of Scripture. At the end of this Advent season, may we, like those who have gone before us, “sing to the Lord, bless his name; tell of his salvation from day to day” (Ps. 96:2). Many thanks to all the CSL and CTSFW students who contributed devotional reflections. A special note of thanks to my counterpart, Zachary Roll, who organized this effort at Concordia Seminary, St. Louis who has been a joy to work with and to get to know. A final note of thanks to Kim Hosier in the print shop and Rev. Dr. Paul Grime for their aid in completing this devotional booklet.https://scholar.csl.edu/osp/1021/thumbnail.jp

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

A Geographic Database for the Environmental Analysis of the Santa Ana River Corridor

The Santa Ana River is the largest river system in Southern California and it flows to the southwest in an arc from the San Bernardino Mountains to the ocean at Huntington Beach. Since 1915, when the idea for a recreational trail paralleling the river originated, the watershed has been under relentless encroachment by urban growth. Despite this pressure, the vision of the trail has grown as well. Its supporters now embrace the concept of a recreational parkway: The Santa Ana River Trail (SART). When complete the trail will serve multiple uses by providing public access into open space areas that can withstand human activity such as hiking, bicycling, equestrian use, camping, environmental education, and health and fitness. Additionally its supporters plan to provide interpretation of the Inland Empire\u27s rich history and natural environment. Ultimately, the trail will parallel the river from its headwaters at the Pacific Crest Trail to its mouth at the Pacific Ocean at Huntington Beach. The purpose of this study served to create a geographical database to improve data access and analysis capabilities for research from all entities (governmental agencies, advocacy groups, etc) involved with the SART planning process. Before the creation of this geodatabase there was no centralized method for accessing this data. The geodatabase can serve as a planning aid for the various parties involved with the Santa Ana River Trail project