A Visual Language for Composable Simulation Scenarios

Modeling and Simulation plays an important role in how the Air Force trains and fights, Scenarios are used in simulation to give users the ability to specify entities and behaviors that should be simulated by a model: however, building and understanding scenarios can be a difficult and time-consuming process, furthermore, as composable simulations become more prominent, the need for a common descriptor for simulation scenarios has become evident. In order to reduce the complexity of creating and understanding simulation scenarios, a visual language was created, The research on visual languages presented in this thesis examines methods of visually specifying the high-level behavior of entities in scenarios and how to represent the hierarchy of the entities in scenarios. Through a study of current behavior specification techniques and the properties of mission-level simulation scenarios, Simulation Behavior Specification Diagrams (SBSD) were developed to represent the behavior of entities in scenarios, Additionally, the information visualization technique of treemaps was adapted to represent the hierarchy of entities in scenarios, After completing case studies on scenarios for the OneSAF simulation model, SBSDs and the application of treemaps to scenarios was considered successful, SBSD diagrams accurately represented the behavior of entities in the simulation scenarios and through software can be converted into code for use by simulation models, The treemap displayed the hierarchy of the entities along with information about the relative size of the entities when applied to simulation scenarios

National Income and Income Inequality, Family Affluence and Life Satisfaction Among 13 year Old Boys and Girls: A Multilevel Study in 35 Countries

Adolescence is a critical period where many patterns of health and health behaviour are formed. The objective of this study was to investigate cross-national variation in the relationship between family affluence and adolescent life satisfaction, and the impact of national income and income inequality on this relationship. Data from the 2006 Health Behaviour in School-aged Children: WHO collaborative Study (N = 58,352 across 35 countries) were analysed using multilevel linear and logistic regression analyses for outcome measures life satisfaction score and binary high/low life satisfaction. National income and income inequality were associated with aggregated life satisfaction score and prevalence of high life satisfaction. Within-country socioeconomic inequalities in life satisfaction existed even after adjustment for family structure. This relationship was curvilinear and varied cross-nationally. Socioeconomic inequalities were greatest in poor countries and in countries with unequal income distribution. GDP (PPP US$) and Gini did not explain between country variance in socioeconomic inequalities in life satisfaction. The existence of, and variation in, within-country socioeconomic inequalities in adolescent life satisfaction highlights the importance of identifying and addressing mediating factors during this life stage

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Microsimulation for Local Impact Analysis: an Application to Plant Shutdown

Microsimulation was introduced nearly 50 years ago but has recently experienced a revival in the social sciences. Its use in regional science, however, has been limited, although it offers some advantages over common regional analytic methods. This paper describes a microsimulation model that can be used to analyze the impact of a regional economic event. The model incorporates spatial, social, and economic factors and allows outcomes to be aggregated at different geographical scales, for different cohorts, and for variables not ordinarily considered in impact analysis. The model is used to simulate the effects of a plant shutdown on workers. Copyright Blackwell Publishers, 2005

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

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