Modeling the Use of an Airborne Platform for Cellular Communications Following Disruptions

In the wake of a disaster, infrastructure can be severely damaged, hampering telecommunications. An Airborne Communications Network (ACN) allows for rapid and accurate information exchange that is essential for the disaster response period. Access to information for survivors is the start of returning to self-sufficiency, regaining dignity, and maintaining hope. Real-world testing has proven that such a system can be built, leading to possible future expansion of features and functionality of an emergency communications system. Currently, there are no airborne civilian communications systems designed to meet the demands of the public following a natural disaster. A system allowing even a limited amount of communications post-disaster is a great improvement on the current situation, where telecommunications are frequently not available. It is technically feasible to use an airborne, wireless, cellular system quickly deployable to disaster areas and configured to restore some of the functions of damaged terrestrial telecommunications networks. The system requirements were presented, leading to the next stage of the planned research, where a range of possible solutions were examined. The best solution was selected based on the earlier, predefined criteria. The system was modeled, and a test ii system built. The system was tested and redesigned when necessary, to meet the requirements. The research has shown how the combination of technology, especially the recent miniaturizations and move to open source software for cellular network components can allow sophisticated cellular networks to be implemented. The ACN system proposed could enable connectivity and reduce the communications problems that were experienced following Hurricane Sandy and Katrina. Experience with both natural and man-made disasters highlights the fact that communications are useful only to the extent that they are accessible and useable by the population

The importance of spirituality in caring for patients

Key points: According to the GMC, attention to spiritual issues is expected as part of a medical assessment. 1. Spirituality is hard to define precisely but it can be understood as what gives meaning and purpose and a sense of connectedness to life. 2. Religion and spirituality overlap but are distinct and there are non-religious as well as religious approaches to spirituality. 3. Serious illness and injury may challenge patients’ spirituality and clinicians need to be sensitive to this and provide or arrange support as appropriate to meet their spiritual needs. 4. Training to address these issues is in its infancy in the UK, though nursing research has identified key competencies than can be applied to medicine, too. 5. The present challenges in the NHS mean we need to pay particular attention to organisational issues related to spirituality

Costa, cancer and coronavirus: contractualism as a guide to the ethics of lockdown.

Lockdown measures in response to the COVID-19 pandemic involve placing huge burdens on some members of society for the sake of benefiting other members of society. How should we decide when these policies are permissible? Many writers propose we should address this question using cost-benefit analysis (CBA), a broadly consequentialist approach. We argue for an alternative non-consequentialist approach, grounded in contractualist moral theorising. The first section sets up key issues in the ethics of lockdown, and sketches the apparent appeal of addressing these problems in a CBA frame. The second section argues that CBA fundamentally distorts the normative landscape in two ways: first, in principle, it allows very many morally trivial preferences-say, for a coffee-might outweigh morally weighty life-and-death concerns; second, it is insensitive to the core moral distinction between victims and vectors of disease. The third section sketches our non-consequentialist alternative, grounded in Thomas Scanlon's contractualist moral theory. On this account, the ethics of self-defence implies a strong default presumption in favour of a highly restrictive, universal lockdown policy: we then ask whether there are alternatives to such a policy which are justifiable to all affected parties, paying particular attention to the complaints of those most burdened by policy. In the fourth section, we defend our contractualist approach against the charge that it is impractical or counterintuitive, noting that actual CBAs face similar, or worse, challenges

Cosmological Evolution of Heavy Element and Molecular Hydrogen Abundances

Spectroscopic observations of distant quasars have resulted in the detection of molecular hydrogen in intervening damped Lyman-alpha absorption clouds (DLAs). We use observations compiled from different experimental groups to show that the molecular hydrogen abundance exhibits a dramatic increase over a cosmological time period corresponding to 13% to 24% of the age of the universe. We also tentatively show that the heavy element abundances in the same gas clouds exhibit a faster and more well-defined cosmological evolution compared to the general DLA population over the same time baseline. We argue that this latter point is unsurprising, because the general DLA population arises in a wide variety of galaxy types and environments, and thus a spans broad range of ISM gas-phases and abundances at the same cosmic time. DLAs exhibiting H2 absorption may therefore circumvent this problem, efficiently identifying a narrower class of objects, and provide a more sensitive probe of cosmological chemical evolution.Comment: 5 pages, 2 figures. Accepted by MNRAS Letters. v2: Added table summarizing H2-bearing DLA properties, added figure showing [Fe/H] vs. redshift, added more discussio

Bringing Spirituality and Wisdom into Practice

This chapter considers the way in which the split between "objective" reductionist approaches and a more subjective understanding of the human ccondition arose in the 17th century with spirituality associated with the subjective approach. The consequent difference between the biomedical and the broader biopsychosocial approach to medical practice is discussed. The relationship between spirituality, religion, secularism and wisdom is explored. The concepts of a shared journey and of spiritually competent practice are used to illustrate how spirituality and wisdom can be integrated into truly holistic person-centred practice. Obstacles and facilitators to this kind of practice are considered alongside approaches to educating practitioners in this area

A qualitative investigation of paediatric intensive care staff attitudes towards the diagnosis of lower respiratory tract infection in the molecular diagnostics era

Background In the past decade, molecular diagnostic syndromic arrays incorporating a range of bacterial and viral pathogens have been described. It is unclear how paediatric intensive care unit (PICU) staff diagnose lower respiratory tract infection (LRTI) and integrate diagnostic array results into antimicrobial decision-making. Methods An online survey with eleven questions was distributed throughout paediatric intensive care societies in the UK, continental Europe and Australasia with a total of 755 members. Participants were asked to rate the clinical factors and investigations they used when prescribing for LRTI. Semi-structured interviews were undertaken with staff who participated in a single-centre observational study of a 52-pathogen diagnostic array. Results Seventy-two survey responses were received; most responses were from senior doctors. Whilst diagnostic arrays were used less frequently than routine investigations (i.e. microbiological culture), they were of comparable perceived utility when making antimicrobial decisions. Prescribers reported that for arrays to be clinically impactful, they would need to deliver results within 6 h for stable patients and within 1 h for unstable patients to inform their immediate decision to prescribe antimicrobials. From 16 staff interviews, we identified that arrays were helpful for the diagnosis and screening of bacterial LRTI. Staff reported it could be challenging to interpret results in some cases due to the high sensitivity of the test. Therefore, results were considered within the context of the patient and discussed within the multidisciplinary team. Conclusions Diagnostic arrays were considered of comparable value to microbiological investigations by PICU prescribers. Our findings support the need for further clinical and economic evaluation of diagnostic arrays in a randomised control trial. Trial registration Clinicaltrials.gov, NCT04233268. Registered on 18 January 2020

IL2RA Genetic Heterogeneity in Multiple Sclerosis and Type 1 Diabetes Susceptibility and Soluble Interleukin-2 Receptor Production

Multiple sclerosis (MS) and type 1 diabetes (T1D) are organ-specific autoimmune disorders with significant heritability, part of which is conferred by shared alleles. For decades, the Human Leukocyte Antigen (HLA) complex was the only known susceptibility locus for both T1D and MS, but loci outside the HLA complex harboring risk alleles have been discovered and fully replicated. A genome-wide association scan for MS risk genes and candidate gene association studies have previously described the IL2RA gene region as a shared autoimmune locus. In order to investigate whether autoimmunity risk at IL2RA was due to distinct or shared alleles, we performed a genetic association study of three IL2RA variants in a DNA collection of up to 9,407 healthy controls, 2,420 MS, and 6,425 T1D subjects as well as 1,303 MS parent/child trios. Here, we report “allelic heterogeneity” at the IL2RA region between MS and T1D. We observe an allele associated with susceptibility to one disease and risk to the other, an allele that confers susceptibility to both diseases, and an allele that may only confer susceptibility to T1D. In addition, we tested the levels of soluble interleukin-2 receptor (sIL-2RA) in the serum from up to 69 healthy control subjects, 285 MS, and 1,317 T1D subjects. We demonstrate that multiple variants independently correlate with sIL-2RA levels

Rapid Assay for Sick Children with Acute Lung infection Study (RASCALS): diagnostic cohort study protocol.

INTRODUCTION: Lower respiratory tract infection (LRTI) is the most commonly treated infection in critically ill children. Pathogens are infrequently identified on routine respiratory culture, and this is a time-consuming process. A syndromic approach to rapid molecular testing that includes a wide range of bacterial and fungal targets has the potential to aid clinical decision making and reduce unnecessary broad spectrum antimicrobial prescribing. Here, we describe a single-centre prospective cohort study investigating the use of a 52-pathogen TaqMan array card (TAC) for LRTI in the paediatric intensive care unit (PICU). METHODS AND ANALYSIS: Critically ill children with suspected LRTI will be enrolled to this 100 patient single-centre prospective observational study in a PICU in the East of England. Samples will be obtained via routine non-bronchoscopic bronchoalveolar lavage which will be sent for standard microbiology culture in addition to TAC. A blood draw will be obtained via any existing vascular access device. The primary outcomes of the study will be (1) concordance of TAC result with routine culture and 16S rRNA gene sequencing and (2) time of diagnostic result from TAC versus routine culture. Secondary outcomes will include impact of the test on total antimicrobial prescriptions, a description of the inflammatory profile of the lung and blood in response to pneumonia and a description of the clinical experience of medical and nursing staff using TAC. ETHICS AND DISSEMINATION: This study has been approved by the Yorkshire and the Humber-Bradford Leeds Research Ethics Committee (REC reference 20/YH/0089). Informed consent will be obtained from all participants. Results will be published in peer-reviewed publications and international conferences. TRIAL REGISTRATION NUMBER: NCT04233268

Mesobot : An Autonomous Underwater Vehicle for Tracking and Sampling Midwater Targets

Mesobot, a new class of autonomous underwater vehicle, will address specific unmet needs for observing slow-moving targets in the midwater ocean. Mesobot will track targets such as zooplankton, fish, and descending particle aggregates using a control system based on stereo cameras and a combination of thrusters and a variable buoyancy system. The vehicle will also be able to collect biogeochemical and environmental DNA (eDNA) samples using a pumped filter sampler