An Operational evaluation of head up displays for civil transport operations. NASA/FAA phase 3 report

The advantages and disadvantages of head-up displays (HUDs) in commercial jet transport approach and landing operations was evaluated. Ten airline captains currently qualified in the B-727 aircraft flew a series of instrument landing system (ILS) and nonprecision approaches in a motion base simulator using both a flight director HUD concept and a flightpath HUD concept as well as conventional head-down instruments under a variety of environmental and operational conditions to assess: (1) the potential benefits of these HUDs in airline operations; (2) problems which might be associated with their use; and (3) flight crew training requirements and flight crew operating procedures suitable for use with the HUDs. Results are presented in terms of objective simulator based performance measures, subject pilot opinion and rating data, and observer data

Cascading parallel fractures on Enceladus

Active eruptions from the south polar region of Saturn's small (~500 km diameter) moon Enceladus are concentrated along a series of lineaments known as the `tiger stripes', thought to be partially open fissures that connect to the liquid water ocean beneath the ice shell. Whereas aspects of the tiger stripes have been addressed in previous work, no study to date simultaneously explains why they should be located only at the south pole, why there are multiple approximately parallel and regularly spaced fractures, and what accounts for their spacing of ~35 km. Here we propose that secular cooling and the resulting ice shell thickening and global tensile stresses cause the first fracture to form at one of the poles, where the ice shell is thinnest due to tidal heating. The tensile stresses are thereby partially relieved, preventing a similar failure at the opposite pole. We propose that subsequent activity then concentrates in the vicinity of the first fracture as the steadily erupted water ice loads the flanks of the open fissure, causing bending in the surrounding elastic plate and further tensile failure in bands parallel to the first fracture, leading to a cascading sequence of parallel fissures until the conditions no longer permit through-going fractures.Comment: 18 pages, 9 figure

Biclustering models for structured microarray data

©2005 IEEE. Personal use of this material is permitted. However, permission to reprint/republish this material for advertising or promotional purposes or for creating new collective works for resale or redistribution to servers or lists, or to reuse any copyrighted component of this work in other works must be obtained from the IEEE.Microarrays have become a standard tool for investigating gene function and more complex microarray experiments are increasingly being conducted. For example, an experiment may involve samples from several groups or may investigate changes in gene expression over time for several subjects, leading to large three-way data sets. In response to this increase in data complexity, we propose some extensions to the plaid model, a biclustering method developed for the analysis of gene expression data. This model-based method lends itself to the incorporation of any additional structure such as external grouping or repeated measures. We describe how the extended models may be fitted and illustrate their use on real data

Type and timing of heralding in ST-elevation and non-ST-elevation myocardial infarction: an analysis of prospectively collected electronic healthcare records linked to the national registry of acute coronary syndromes.

AIMS: It is widely thought that ST-elevation myocardial infarction (STEMI) is more likely to occur without warning (i.e. an unanticipated event in a previously healthy person) than non-ST-elevation myocardial infarction (NSTEMI), but no large study has evaluated this using prospectively collected data. The aim of this study was to compare the evolution of atherosclerotic disease and cardiovascular risk between people going on to experience STEMI and NSTEMI. METHODS: We identified patients experiencing STEMI and NSTEMI in the national registry of myocardial infarction for England and Wales (Myocardial Ischaemia National Audit Project), for whom linked primary care records were available in the General Practice Research Database (as part of the CALIBER collaboration). We compared the prevalence and timing of atherosclerotic disease and major cardiovascular risk factors including smoking, hypertension, diabetes, and dyslipidaemia, between patients later experiencing STEMI to those experiencing NSTEMI. RESULTS: A total of 8174 myocardial infarction patients were included (3780 STEMI, 4394 NSTEMI). Myocardial infarction without heralding by previously diagnosed atherosclerotic disease occurred in 71% STEMI (95% CI 69-72%) and 50% NSTEMI patients (95% CI 48-51%). The proportions of myocardial infarctions with no prior atherosclerotic disease, major risk factors, or chest pain was 14% (95% CI 13-16%) in STEMI and 9% (95% CI 9-10%) in NSTEMI. The rate of heralding coronary diagnoses was particularly high in the 12 months before infarct; 4.1-times higher (95% CI 3.3-5.0) in STEMI and 3.6-times higher (95% CI 3.1-4.2) in NSTEMI compared to the rate in earlier years. CONCLUSIONS: Acute myocardial infarction occurring without prior diagnosed coronary, cerebrovascular, or peripheral arterial disease was common, especially for STEMI. However, there was a high prevalence of risk factors or symptoms in patients without previously diagnosed disease. Better understanding of the antecedents in the year before myocardial infarction is required

Predicting mortality after acute coronary syndromes in people with chronic obstructive pulmonary disease

Objective To assess the accuracy of Global Registry of Acute Coronary Events (GRACE) scores in predicting mortality at 6 months for people with chronic obstructive pulmonary disease (COPD) and to investigate how it might be improved. Methods Data were obtained on 481 849 patients with acute coronary syndrome admitted to UK hospitals between January 2003 and June 2013 from the Myocardial Ischaemia National Audit Project (MINAP) database. We compared risk of death between patients with COPD and those without COPD at 6 months, adjusting for predicted risk of death. We then assessed whether several modifications improved the accuracy of the GRACE score for people with COPD. Results The risk of death after adjusting for GRACE score predicted that risk of death was higher for patients with COPD than that for other patients (RR 1.29, 95% CI 1.28 to 1.33). Adding smoking into the GRACE score model did not improve accuracy for patients with COPD. Either adding COPD into the model (relative risk (RR) 1.00, 0.94 to 1.02) or multiplying the GRACE score by 1.3 resulted in better performance (RR 0.99, 0.96 to 1.01). Conclusions GRACE scores underestimate risk of death for people with COPD. A more accurate prediction of risk of death can be obtained by adding COPD into the GRACE score equation, or by multiplying the GRACE score predicted risk of death by 1.3 for people with COPD. This means that one third of patients with COPD currently classified as low risk should be classified as moderate risk, and could be considered for more aggressive early treatment after non-ST-segment elevation myocardial infarction or unstable angina

Transcriptomics and disease vector control

Next-generation sequencing can be used to compare transcriptomes under different conditions. A study in BMC Genomics applies this approach to investigating the effects of exposure to a range of xenobiotics on changes in gene expression in the larvae of Aedes aegypti, the mosquito vector of dengue fever

Data Resource Profile: Cardiovascular disease research using linked bespoke studies and electronic health records (CALIBER)

The goal of cardiovascular disease (CVD) research using linked bespoke studies and electronic health records (CALIBER) is to provide evidence to inform health care and public health policy for CVDs across different stages of translation, from discovery, through evaluation in trials to implementation, where linkages to electronic health records provide new scientific opportunities. The initial approach of the CALIBER programme is characterized as follows: (i) Linkages of multiple electronic heath record sources: examples include linkages between the longitudinal primary care data from the Clinical Practice Research Datalink, the national registry of acute coronary syndromes (Myocardial Ischaemia National Audit Project), hospitalization and procedure data from Hospital Episode Statistics and cause-specific mortality and social deprivation data from the Office of National Statistics. Current cohort analyses involve a million people in initially healthy populations and disease registries with ∼105 patients. (ii) Linkages of bespoke investigator-led cohort studies (e.g. UK Biobank) to registry data (e.g. Myocardial Ischaemia National Audit Project), providing new means of ascertaining, validating and phenotyping disease. (iii) A common data model in which routine electronic health record data are made research ready, and sharable, by defining and curating with meta-data >300 variables (categorical, continuous, event) on risk factors, CVDs and non-cardiovascular comorbidities. (iv) Transparency: all CALIBER studies have an analytic protocol registered in the public domain, and data are available (safe haven model) for use subject to approvals. For more information, e-mail [email protected]

Real world challenges in delivering person centred care: A community based case study

Community nurses face many challenges when trying to practice evidence-based, person-centred care. Ongoing concerns regarding the impact of the 2013 Francis Report (Ford and Lintern, 2017) suggest that individualised and holistic care is an impossible dream, one made harder when the client appears uncooperative. This paper presents a case study that sets out how some of these challenges were met in a potentially difficult situation experienced by a student nurse and her mentor in practice, in which the student was supported to further examine and explore issues that may have influenced the situation. In this instance, the solution came with the recognition that the client had expertise and knowledge that needed to be taken into account, alongside that of the nurses looking after him. His care became a partnership, not an imposition of expertise; a principle which is transferable to many other situations. Underpinning it was the recognition of our shared humanity, wherein lies the essence of truly holistic care, and student nurses learning this, through the guidance and support of their mentor.

Titan's gravity field and interior structure after Cassini

Since its arrival at Saturn in 2004, Cassini performed nine flybys devoted to the determination of Titan's gravity field and its tidal variations. Here we present an updated gravity solution based on the final data set collected during the gravity-dedicated passes, before Cassini's plunge into Saturn's atmosphere. The data set includes an additional flyby (T110, March 2015, primarily devoted to imaging Titan's north polar lakes) carried out with the low-gain antenna. This flyby was particularly valuable because the closest approach occurred at a high latitude (75°N), over an area not previously sampled. Previously published gravity results (Iess et al., 2012) indicated that Titan is subject to large eccentricity tides in response to the time varying perturbing potential exerted by Saturn. The magnitude of the response quadrupole field, expressed in the tidal Love number k_2, was used to infer the existence of an internal ocean. The new gravity field determination provides an improved estimate of k_2 of about 0.62, accurate to a level of a few percent. The value is higher than the simplest models of Titan suggest and the interpretation is unclear; possibilities include a high density ocean (as high as 1300 kg/m^3), a partially viscous response of the deeper region, or a dynamic contribution to the tidal response. The new solution includes higher degree and order harmonic coefficients (up to 5) and offers an improved map of gravity anomalies. The geoid is poorly correlated with the topography, implying strong compensation. In addition, the updated geoid and its associated uncertainty could be used to refine the gravity-altimetry correlation analysis and for improved interpretation of radar altimetric data