A NASA/RAE cooperation in the development of a real-time knowledge-based autopilot

As part of a US/UK cooperative aeronautical research program, a joint activity between the NASA Dryden Flight Research Facility and the Royal Aerospace Establishment on knowledge-based systems was established. This joint activity is concerned with tools and techniques for the implementation and validation of real-time knowledge-based systems. The proposed next stage of this research is described, in which some of the problems of implementing and validating a knowledge-based autopilot for a generic high-performance aircraft are investigated

Seed limitation, not soil legacy effects, prevents native understory from establishing in oak woodlands in Scotland after removal of Rhododendron ponticum

We thank Scottish Natural Heritage for funding this work via a PhD studentship to JM. The National Trust for Scotland provided the field site and fenced the experiment. In particular we thank Kate Sampson and Lindsay Mackinlay at NTS staff for their assistance in establishing this experiment. RJM and RJP were funded through the 2011-2016 and 2016-2021 Strategic Research Programmes of the Scottish Government.Peer reviewedPostprin

Considerations for preparing a randomized population health intervention trial: lessons from a South African–Canadian partnership to improve the health of health workers

Background: Community-based cluster-randomized controlled trials (RCTs) are increasingly being conducted to address pressing global health concerns. Preparations for clinical trials are well-described, as are the steps for multi-component health service trials. However, guidance is lacking for addressing the ethical and logistic challenges in (cluster) RCTs of population health interventions in low- and middle-income countries. Objective: We aimed to identify the factors that population health researchers must explicitly consider when planning RCTs within North–South partnerships. Design: We reviewed our experiences and identified key ethical and logistic issues encountered during the pre-trial phase of a recently implemented RCT. This trial aimed to improve tuberculosis (TB) and Human Immunodeficiency Virus (HIV) prevention and care for health workers by enhancing workplace assessment capability, addressing concerns about confidentiality and stigma, and providing onsite counseling, testing, and treatment. An iterative framework was used to synthesize this analysis with lessons taken from other studies. Results: The checklist of critical factors was grouped into eight categories: 1) Building trust and shared ownership; 2) Conducting feasibility studies throughout the process; 3) Building capacity; 4) Creating an appropriate information system; 5) Conducting pilot studies; 6) Securing stakeholder support, with a view to scale-up; 7) Continuously refining methodological rigor; and 8) Explicitly addressing all ethical issues both at the start and continuously as they arise. Conclusion: Researchers should allow for the significant investment of time and resources required for successful implementation of population health RCTs within North–South collaborations, recognize the iterative nature of the process, and be prepared to revise protocols as challenges emerge

Family engagement and compassion fatigue in alternative provision

© 2021 The Author. Published by Taylor & Francis. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1080/13603116.2021.1938713In a sector largely ignored in policy and the public imagination, Alternative Provision works to care for and educate children for whom mainstream schooling does not work. Central to their mission is the engagement of families, often seen as both the cause of their child’s difficulties and the solution to their successful educational re-engagement. Practitioners within Alternative Provision work within sophisticated strategies of family engagement, from regular communication to the more intensive interventions of home visits, supporting families with everything from filling in forms to cleaning, from managing outbursts to sourcing furniture. With the majority of families living within contexts of deprivation, many have life histories containing trauma, trauma that Alternative Provision Practitioners listen to, confront and, often, internalise, risking ‘compassion fatigue’. This article focuses on the potential for compassion fatigue within family engagement in Alternative Provision, beginning with the impact on practitioners. It then discusses the role of leadership in building an assemblage of organisation interventions to both mitigate compassion fatigue and maximise ‘compassion satisfaction’, the fulfilment that comes from empathic work. Finally, it examines how compassion satisfaction could mitigate the deleterious impact of vicarious trauma.Published onlin

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

New perspectives on architectures for real-time mission simulators: Agents, ambassadors and components.

Mission simulators are in widespread use for the evaluation of military systems under circumstances of appropriate realism. This thesis reports on a series of investigations into the architectures which could result from a synthesis of existing simulation methodologies with novel computing techniques being developed largely for the needs of the internet. The techniques selected were component architectures and mobile agent systems. A framework for simulation based on a component architecture is presented. Entitled MulTiSIM, it permits models to be distributed over a network, and for their interactions to be unaffected by changes in physical distribution and model type. Instances of models can be assembled into arbitrarily complex distributed structures to permit modelling of complex entities, while a degree of structural transparency over interactions with such entities is maintained. Examples of real-time simulators developed using this framework are presented, including a driving simulator for the Thrust super-sonic car and a helicopter mission simulator at DERA. The thesis goes on to suggest various generic roles for mobile agents in medium and large-scale simulations. These roles include communications management functions, dynamic control over model distribution and mediation of specific interactions. Prototypes of the communications management and mediation roles are described, the latter being implemented in the form of what has here been termed an 'ambassador system', employing only a sub-set of the facilities normally required for a system of frilly autonomous mobile agents, while representing the specific interests of a simulation model within a remote operator's station

New perspectives on architectures for real-time mission simulators: Agents, ambassadors and components.

Mission simulators are in widespread use for the evaluation of military systems under circumstances of appropriate realism. This thesis reports on a series of investigations into the architectures which could result from a synthesis of existing simulation methodologies with novel computing techniques being developed largely for the needs of the internet. The techniques selected were component architectures and mobile agent systems. A framework for simulation based on a component architecture is presented. Entitled MulTiSIM, it permits models to be distributed over a network, and for their interactions to be unaffected by changes in physical distribution and model type. Instances of models can be assembled into arbitrarily complex distributed structures to permit modelling of complex entities, while a degree of structural transparency over interactions with such entities is maintained. Examples of real-time simulators developed using this framework are presented, including a driving simulator for the Thrust super-sonic car and a helicopter mission simulator at DERA. The thesis goes on to suggest various generic roles for mobile agents in medium and large-scale simulations. These roles include communications management functions, dynamic control over model distribution and mediation of specific interactions. Prototypes of the communications management and mediation roles are described, the latter being implemented in the form of what has here been termed an 'ambassador system', employing only a sub-set of the facilities normally required for a system of frilly autonomous mobile agents, while representing the specific interests of a simulation model within a remote operator's station

Malaria parasite cGMP-dependent protein kinase regulates blood stage merozoite secretory organelle discharge and egress.

The malaria parasite replicates within an intraerythrocytic parasitophorous vacuole (PV). Eventually, in a tightly regulated process called egress, proteins of the PV and intracellular merozoite surface are modified by an essential parasite serine protease called PfSUB1, whilst the enclosing PV and erythrocyte membranes rupture, releasing merozoites to invade fresh erythrocytes. Inhibition of the Plasmodium falciparum cGMP-dependent protein kinase (PfPKG) prevents egress, but the underlying mechanism is unknown. Here we show that PfPKG activity is required for PfSUB1 discharge into the PV, as well as for release of distinct merozoite organelles called micronemes. Stimulation of PfPKG by inhibiting parasite phosphodiesterase activity induces premature PfSUB1 discharge and egress of developmentally immature, non-invasive parasites. Our findings identify the signalling pathway that regulates PfSUB1 function and egress, and raise the possibility of targeting PfPKG or parasite phosphodiesterases in therapeutic approaches to dysregulate critical protease-mediated steps in the parasite life cycle