scholarly journals Long−Distance Aeromedical Transport of Patients with COVID−19 in Fixed−Wing Air Ambulance Using a Portable Isolation Unit: Opportunities, Limitations and Mitigation Strategies

2020 ◽  
Vol Volume 12 ◽  
pp. 411-419
Author(s):  
Dirk Schwabe ◽  
Bernhard Kellner ◽  
Dirk Henkel ◽  
Heinz Jürgen Pilligrath ◽  
Stefanie Krummer ◽  
...  
Keyword(s):  
Mitigation Strategies ◽  
Long Distance ◽  
Air Ambulance ◽  
Aeromedical Transport

scholarly journals Comparative Study of Structural Reliability Assessment Methods for Fixed Offshore Structures

2021 ◽  
Author(s):  
E. Mat Soom ◽  
M.K. Abu Husain ◽  
N.I. Mohd Zaki ◽  
N.A. Mukhlas ◽  
S.Z.A. Syed Ahmad ◽  
...  
Keyword(s):  
Structural Reliability ◽  
Oil And Gas ◽  
Offshore Structures ◽  
Mitigation Strategies ◽  
Life Extension ◽  
Risk Level ◽  
Long Distance ◽  
Design Assessment ◽  
Integrity Assessment ◽  
Structural Deterioration

The oil and gas sector has recognised structural integrity assessment of ageing platform for prospective life extension as a rising concern, particularly in encountering the randomness of the harsh ocean environments. This condition leads to uncertainty in wave-in-deck load estimates and a high load level being imposed on offshore structures. This emphasises the necessity of enhanced reliability, as failure might result in inaccessibility because of the uncertainties related to long-distance services, such as accuracy of predictions of loads and responses. Even though the established guidelines present a fundamental assessment, additionally, comprehensive rules are required. This paper performed a reliability analysis incorporating practical approaches that can more accurately represent time-dependent structural deterioration. The following two procedures have been adopted by a majority of significant oil and gas operators to monitor the safety and integrity of these structures: a) Ultimate Strength Assessment (USA) method and b) Reliability Design Assessment (ReDA) method. A comparison of these two reliability approaches was performed on selected ageing jacket structures in the region of the Malaysian sea. The comparative findings, namely, reserve strength ratio (RSR) at various years of the return period (RP) and ratio value for risk of failure regarding the probability of failure (POF), provided a check and balance in strengthening confidence in the results. The findings showed that the structural components might safely survive either using the USA and ReDA method in such conditions, as the reliability indexes were determined to be satisfactory compared to allowable values from ISO 19902 design specifications. Therefore, these evaluations were determined to control the risk level of the structure during the remaining of its lifetime and undertake cost-effective inspections or mitigation strategies when necessary.

The New South Wales Air Ambulance

1968 ◽  
Vol 72 (695) ◽  
pp. 956
Author(s):  
Nancy-Bird Walton
Keyword(s):  
New South ◽  
New South Wales ◽  
First Year ◽  
Long Distance ◽  
Air Ambulance ◽  
Good Friday ◽  
The Road ◽  
South Wales ◽  
Specialist Treatment ◽  
On The Road

The Air Ambulance of New South Wales came into operation on Good Friday 1967. Less than sixteen months later as I write it has carried 2348 patients in 807 flights. Four hundred and eleven of these patients have been emergencies and it is highly probable that most of them would not have survived a long distance road journey. With few exceptions all patients have been sent in by country doctors for specialist treatment in the metropolitan area. Introduced as an Air Arm to the excellent road ambulance service it was intended to avoid the road journeys for distances of more than 175 miles. In the first year it saved that service 932 760 road miles. The time that patients would have spent on the road was 16 201 hours, this was reduced by air to 3 094 hours. It is hardly necessary to add what this means to a sick or injured person. Although deeply unconscious and in a state of shock patients have been transported without their condition deteriorating.

scholarly journals Oceanic Records of North American Bats and Implications for Offshore Wind Energy Development in the United States

2021 ◽  
Author(s):  
Donald Solick ◽  
Christian Newman
Keyword(s):  
United States ◽  
North America ◽  
Wind Energy ◽  
North American ◽  
The United States ◽  
Mitigation Strategies ◽  
Offshore Wind ◽  
Offshore Wind Energy ◽  
Long Distance ◽  
Terrestrial Environment

Offshore wind energy is a growing industry in the United States, and renewable energy from offshore wind is estimated to double the country’s total electricity generation. There is growing concern that land-based wind development in North America is negatively impacting bat populations, primarily long-distance migrating bats, but the impacts to bats from offshore wind energy is unknown. Bats are associated with the terrestrial environment, but have been observed over the ocean. In this review, we synthesize historic and contemporary accounts of bats observed and acoustically recorded offshore over North American waters to ascertain the spatial and temporal distribution of bats flying offshore. We integrate these records with studies of offshore bats in Europe and of bat behavior at land-based wind energy studies to examine how offshore wind development could impact North American bat populations. We find that most offshore bat records are of long-distance migrating bats and records occur during autumn migration, the period of highest fatality rates for long-distance migrating bats at land-based wind facilities in North America. We summarize evidence that bats may be attracted to offshore turbines for roosting and foraging opportunities, potentially increasing their risk of collision, but that higher wind speeds offshore can potentially reduce the amount of time that bats are exposed to risk. We identify knowledge gaps and hypothesize that a combination of mitigation strategies may be the most effective approach for minimizing impacts to bats and maximizing offshore energy production.

scholarly journals Nociception testing during fixed-wing ambulance flights. An interventional pilot study on the effects of flight-related environmental changes on the nociception of healthy volunteers

2019 ◽  
Author(s):  
Johannes Prottengeier ◽  
Stefan Elsner ◽  
Andreas Wehrfritz ◽  
Andreas Moritz ◽  
Joachim Schmidt ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Environmental Changes ◽  
Sensory System ◽  
Real Life ◽  
Systemic Effects ◽  
Healthy Individuals ◽  
Sensory Testing ◽  
Long Distance ◽  
Air Ambulance ◽  
Systematic Effects

AbstractBackgroundThe effects of environmental changes on the somato-sensory system during long-distance air ambulance flights need to be further investigated. Changes in nociceptive capacity are conceivable in light of previous studies performed under related environmental settings. We used standardized somato-sensory testing to investigate nociception in healthy volunteers during air-ambulance flights.MethodsTwenty-five healthy individuals were submitted to a test compilation analogous to the quantitative sensory testing battery – performed during actual air-ambulance flights. Measurements were paired around the major changes of external factors during take-off/climb and descent/landing. Bland-Altman-Plots were calculated to identify possible systemic effects.ResultsBland-Altman-analyses suggest that the thresholds of stimulus detection and pain as well as above-threshold pain along critical waypoints of travel are not subject to systemic effects but instead demonstrate random variations.ConclusionsWe provide a novel description of a real-life experimental setup and demonstrate the general feasibility of performing somato-sensory testing during ambulance flights. No systematic effects on the nociception of healthy individuals were apparent from our data. Our findings open up the possibility of future investigations into potential effects of ambulance flights on patients suffering acute or chronic pain.

scholarly journals A model based on a high-resolution flux matrix explains the spread of diseases in a spatial network and the effect of mitigation strategies

2021 ◽  
Author(s):  
Guillaume Le Treut ◽  
Greg Huber ◽  
Mason Kamb ◽  
Kyle Kawagoe ◽  
Aaron McGeever ◽  
...  
Keyword(s):  
Cell Phone ◽  
Mitigation Strategies ◽  
Spatial Network ◽  
Long Distance ◽  
Global Parameter ◽  
Slowing Down ◽  
Transmission Parameters ◽  
Epidemic Size ◽  
Edge Betweenness ◽  
The Usa

Propagation of an epidemic across a spatial network of communities is described by a variant of the SIR model accompanied by an intercommunity infectivity matrix. This matrix is estimated from fluxes between communities, obtained from cell-phone tracking data recorded in the USA between March 2020 and February 2021. We have applied this model to the 2020 dynamics of the SARS-CoV-2 pandemic. We find that the numbers of susceptible and infected individuals predicted by the model agree with the reported cases in each community by fitting just one global parameter representing the frequency of interaction between individuals. The effect of "shelter-in-place" policies introduced across the USA at the onset of the pandemic is clearly seen in our results. We then consider the effect that alternative policies would have had, namely restricting long-range travel. We find that this policy is successful in decreasing the epidemic size and slowing down the spread, at the expense of a substantial restriction on mobility as a function of distance. When long-distance mobility is suppressed, this policy results in a traveling wave of infections, which we characterize analytically. In particular, we show the dependence of the wave velocity and profile on the transmission parameters. Finally, we discuss a policy of selectively constraining travel based on an edge-betweenness criterion.

scholarly journals Characterization of Long-range Aeromedical Transport and Its Relationship to the Development of Traumatic Extremity Compartment Syndrome: A 7-year, Retrospective Study

2021 ◽  
Vol 187 (1-2) ◽  
pp. e224-e231
Author(s):  
Joseph K Maddry ◽  
Alejandra G Mora ◽  
Crystal A Perez ◽  
Lauren K Reeves ◽  
Joni A Paciocco ◽  
...  
Keyword(s):  
At Risk ◽  
Lower Extremity ◽  
Compartment Syndrome ◽  
Long Range ◽  
Medical Center ◽  
Vital Signs ◽  
Long Distance ◽  
Aeromedical Evacuation ◽  
Temporal Features ◽  
Aeromedical Transport

ABSTRACT Background Military aeromedical transport evacuates critically injured patients are for definitive care, including patients with or at risk for developing traumatic compartment syndrome of the extremities (tCSoE). Compartment pressure changes of the extremities have not been determined to be associated with factors inherent to aeromedical transport in animal models, but the influence of aeromedical evacuation (AE) transport on the timing of tCSoE development has not been studied in humans. Using a registry-based methodology, this study sought to characterize the temporal features of lower extremity compartment syndrome relative to the timing of transcontinental AE. With this approach, this study aims to inform practice in guidelines relating to the timing and possible effects of long-distance AE and the development of lower extremity compartment syndrome. Using patient care records, we sought to characterize the temporal features of tCSoE diagnosis relative to long-range aeromedical transport. In doing so, we aim to inform practice in guidelines relating to the timing and risks of long-range AE and postulate whether there is an ideal time to transport patients who are at risk for or with tCSoE. Methods We performed a retrospective record review of patients with a diagnosis of tCSoE who were evacuated out of theater from January 2007 to May 2014 via aeromedical transport. Data abstractors collected flight information, laboratory values, vital signs, procedures, in-flight assessments, and outcomes. We used the duration of time from injury to arrival at Landstuhl Regional Medical Center (LRMC) to represent time to transport. We compared groups based on time of tCSoE (inclusive of upper and lower extremity) diagnosis relative to injury day and time of transport (preflight versus postflight). We used descriptive statistics and multivariable regression models to determine the associations between time to transport, time to tCSoE diagnosis, and outcomes. Results Within our study window, 238 patients had documentation of tCSoE. We found that 47% of patients with tCSoE were diagnosed preflight and 53% were diagnosed postflight. Over 90% in both groups developed tCSoE within 48 hours of injury; the time to diagnosis was similar for casualties diagnosed pre- and postflight (P = .65). There was no association between time to arrival at LRMC and day of tCSoE diagnosis (risk ratio, 1.06; 95% CI, 0.96-1.16). Conclusion The timing of tCSoE diagnosis is not associated with the timing of transport; therefore, AE likely does not influence the development of tCSoE.

The Fine Structure of Phloem Cells

1985 ◽  
Vol 43 ◽  
pp. 632-635
Author(s):  
James Cronshaw
Keyword(s):  
Structural Studies ◽  
High Concentration ◽  
Long Distance ◽  
Phloem Tissue ◽  
Sieve Elements ◽  
Long Distance Transport ◽  
P Protein ◽  
Companion Cells ◽  
Electron Microscopical ◽  
Distance Transport

Long distance transport in plants takes place in phloem tissue which has characteristic cells, the sieve elements. At maturity these cells have sieve areas in their end walls with specialized perforations. They are associated with companion cells, parenchyma cells, and in some species, with transfer cells. The protoplast of the functioning sieve element contains a high concentration of sugar, and consequently a high hydrostatic pressure, which makes it extremely difficult to fix mature sieve elements for electron microscopical observation without the formation of surge artifacts. Despite many structural studies which have attempted to prevent surge artifacts, several features of mature sieve elements, such as the distribution of P-protein and the nature of the contents of the sieve area pores, remain controversial.

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