Factors Contributing to Accidents During Aerobatic Flight Operations

2021 ◽  
Vol 92 (8) ◽  
pp. 612-618
Author(s):  
David G. Newman
Keyword(s):  
Fatal Outcome ◽  
Fatal Accidents ◽  
Aircraft Accidents ◽  
Flight Operations ◽  
Increased Risk ◽  
Operational Decision Making ◽  
Minor Injuries ◽  
Major Factors ◽  
Aircraft Accident ◽  
Injury Outcomes

INTRODUCTION: Aerobatic flight operations involve a higher level of risk than standard flight operations. Aerobatics imposes considerable stresses on both the aircraft and the pilot. The purpose of this study was to analyze civilian aerobatic aircraft accidents in Australia, with particular emphasis on the underlying accident causes and survival outcomes.METHODS: The accident and incident database of the Australian Transport Safety Bureau was searched for all events involving aerobatic flight for the period 19802010.RESULTS: A total of 51 accidents involving aircraft undertaking aerobatic operations were identified, with 71 aircraft occupants. Of the accidents, 27 (52.9) were fatal, resulting in a total of 36 fatalities. There were 24 nonfatal accidents. In terms of injury outcomes, there were 4 serious and 9 minor injuries, and 22 accidents in which no injuries were recorded. Fatal accidents were mainly due to loss of control by the pilot (44.4), in-flight structural failure of the airframe (25.9), and terrain impact (25.9). G-LOC was considered a possible cause in 11.1 of fatal accidents. Nonfatal accidents were mainly due to powerplant failure (41.7) and noncatastrophic airframe damage (25). Accidents involving aerobatic maneuvering have a significantly increased risk of a fatal outcome (odds ratio 26).DISCUSSION: The results of this study highlight the risks involved in aerobatic flight. Exceeding the operational limits of the maneuver and the design limits of the aircraft are major factors contributing to a fatal aerobatic aircraft accident. Improved awareness of G physiology and better operational decision-making while undertaking aerobatic flight may help prevent further accidents.Newman DG. Factors contributing to accidents during aerobatic flight operations. Aerosp Med Hum Perform. 2021; 92(8):612618.

scholarly journals Relation of severe COVID-19 to polypharmacy and prescribing of psychotropic drugs: the REACT-SCOT case-control study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul M. McKeigue ◽  
◽  
Sharon Kennedy ◽  
Amanda Weir ◽  
Jen Bishop ◽  
...  
Keyword(s):  
Primary Care ◽  
Rate Ratio ◽  
Case Control Study ◽  
Fatal Outcome ◽  
Case Control ◽  
Care Practice ◽  
Drug Classes ◽  
Increased Risk ◽  
Co Morbidity ◽  
Control Study

Abstract Background The objective of this study was to investigate the relation of severe COVID-19 to prior drug prescribing. Methods Severe cases were defined by entry to critical care or fatal outcome. For this matched case-control study (REACT-SCOT), all 4251 cases of severe COVID-19 in Scotland since the start of the epidemic were matched for age, sex and primary care practice to 36,738 controls from the population register. Records were linked to hospital discharges since June 2015 and dispensed prescriptions issued in primary care during the last 240 days. Results Severe COVID-19 was strongly associated with the number of non-cardiovascular drug classes dispensed. This association was strongest in those not resident in a care home, in whom the rate ratio (95% CI) associated with dispensing of 12 or more drug classes versus none was 10.8 (8.8, 13.3), and in those without any of the conditions designated as conferring increased risk of COVID-19. Of 17 drug classes postulated at the start of the epidemic to be “medications compromising COVID”, all were associated with increased risk of severe COVID-19 and these associations were present in those without any of the designated risk conditions. The fraction of cases in the population attributable to exposure to these drug classes was 38%. The largest effect was for antipsychotic agents: rate ratio 4.18 (3.42, 5.11). Other drug classes with large effects included proton pump inhibitors (rate ratio 2.20 (1.72, 2.83) for = 2 defined daily doses/day), opioids (3.66 (2.68, 5.01) for = 50 mg morphine equivalent/day) and gabapentinoids. These associations persisted after adjusting for covariates and were stronger with recent than with non-recent exposure. Conclusions Severe COVID-19 is associated with polypharmacy and with drugs that cause sedation, respiratory depression, or dyskinesia; have anticholinergic effects; or affect the gastrointestinal system. These associations are not easily explained by co-morbidity. Measures to reduce the burden of mortality and morbidity from COVID-19 should include reinforcing existing guidance on reducing overprescribing of these drug classes and limiting inappropriate polypharmacy. Registration ENCEPP number https://EUPAS35558

MO039THE 24-WEEK INTERIM ANALYSIS RESULTS OF A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED PHASE II STUDY OF ATACICEPT IN PATIENTS WITH IGA NEPHROPATHY AND PERSISTENT PROTEINURIA

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Jonathan Barratt ◽  
James A Tumlin ◽  
Yusuke Suzuki ◽  
Amy Kao ◽  
Aida Aydemir ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Phase Ii ◽  
Interim Analysis ◽  
Plasma Cells ◽  
Enzyme Inhibitor ◽  
Phase Ii Study ◽  
Fatal Outcome ◽  
Double Blind ◽  
Persistent Proteinuria ◽  
Increased Risk

Abstract Background and Aims IgA nephropathy (IgAN) is the most common primary glomerulonephritis in the world. Despite being described over 50 years ago, there remains no approved therapy for this common global cause of kidney failure. The central pathogenic feature in IgAN is the formation of circulating IgA containing immune complexes which have the propensity to deposit in the kidneys and trigger glomerular inflammation and tubulointerstitial scarring. The primary substrate for immune complex formation is an excess of poorly O-galactosylated polymeric IgA1 (Gd-IgA1) in the circulation. These IgA1 O-glycoforms are thought to trigger the formation of IgA and IgG autoantibodies. Atacicept is a human TACI-Ig fusion protein that inhibits B cell-stimulating factors, BLyS and APRIL, and has been associated with reductions in levels of serum IgA and IgG, as well as reductions in mature B cells and plasma cells. A number of studies have shown elevated levels of BLyS, APRIL and Gd-IgA1 in IgAN patients which have been linked to worse clinical outcomes. IgAN patients with persistent proteinuria >1 g/day are at increased risk of progression to end-stage renal disease. This Phase II study examines the safety and efficacy of atacicept in reducing pathogenic Gd-IgA1 levels and measures of renal activity in IgAN. Method This Phase II study (NCT02808429) enrolled patients with IgAN and proteinuria ≥1 g/day or 0.75 mg/mg on 24-hour urine protein-creatinine ratio (UPCR) despite maximal standard of care therapy (angiotensin converting enzyme inhibitor and/or angiotensin receptor blocker). Enrolled patients were randomized 1:1:1 to receive placebo or atacicept 25mg or 75mg once weekly by subcutaneous injection. The primary endpoint was a change in proteinuria by 24-hour UPCR at Week 48; key secondary endpoints included change in eGFR, serum immunoglobulin and Gd-IgA1 levels. Results Data from the 24-week interim analysis are reported here for enrolled patients (placebo=5; atacicept 25mg=6; atacicept 75mg=5). A consistent, dose-dependent reduction in serum immunoglobulins (IgA, IgG and IgM) and, in particular, Gd-IgA1 (Figure) were observed through Week 24. In parallel, proteinuria (24-hour UPCR) showed a higher median % reduction from baseline with atacicept at Week 24: -18.67% and -25.34% with atacicept 25 mg and 75 mg, respectively, vs +0.098% with placebo (Figure). eGFR remained stable over time. TEAEs were reported by 81% of the subjects. TEAEs were mild or moderate in severity, with no severe TEAEs reported. No serious related events, events with severe hypogammaglobulinemia or fatal outcome were reported. Conclusion These 24-week interim analysis results provide early proof of concept for the potential treatment of atacicept in patients with IgAN and persistent proteinuria.

scholarly journals Penguins, Birds, and Pilot Knowledge: Can an Overlooked Attribute of Human Cognition Explain Our Most Puzzling Aircraft Accidents?

2020 ◽  
pp. 001872082096087
Author(s):  
Richard Clewley ◽  
Jim Nixon
Keyword(s):  
Human Cognition ◽  
Pilot Training ◽  
Flight Safety ◽  
Aircraft Accidents ◽  
Event Knowledge ◽  
Flight Operations ◽  
Safety Event ◽  
Explicit Training ◽  
Pilot Behavior

Objective We extend the theory of conceptual categories to flight safety events, to understand variations in pilot event knowledge. Background Experienced, highly trained pilots sometimes fail to recognize events, resulting in procedures not being followed, damaging safety. Recognition is supported by typical, representative members of a concept. Variations in typicality (“gradients”) could explain variations in pilot knowledge, and hence recognition. The role of simulations and everyday flight operations in the acquisition of useful, flexible concepts is poorly understood. We illustrate uses of the theory in understanding the industry-wide problem of nontypical events. Method One hundred and eighteen airline pilots responded to scenario descriptions, rating them for typicality and indicating the source of their knowledge about each scenario. Results Significant variations in typicality in flight safety event concepts were found, along with key gradients that may influence pilot behavior. Some concepts were linked to knowledge gained in simulator encounters, while others were linked to real flight experience. Conclusion Explicit training of safety event concepts may be an important adjunct to what pilots may variably glean from simulator or operational flying experiences, and may result in more flexible recognition and improved response. Application Regulators, manufacturers, and training providers can apply these principles to develop new approaches to pilot training that better prepare pilots for event diversity.

Accidents and travel

1982 ◽  
Vol 82 (1-2) ◽  
pp. 63-71
Author(s):  
J. K. Mason
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Carbon Monoxide Poisoning ◽  
Air Travel ◽  
Fear Of Flying ◽  
Aircraft Accidents ◽  
Travel Abroad ◽  
Aircraft Accident ◽  
Relationship Of ◽  
The Relationship

SynopsisThis paper considers the hazards of getting to and from one's destination; the subject of accidents occurring as part of a holiday is too broad for present consideration.The symposium is mainh concerned with travel abroad but, since one has to reach the definitive means of travel, the epidemiology of road traffic accidents is first considered. An unusually optimistic view is taken of the current position as regards fatalities. Emphasis is placed on the importance of recent legislation in the prevention of injury. Overall, the chances of being killed on the roads are now not much greater than those of suffering an accidental death in the home. The effect of alcohol and common drugs on the holiday motorist are discussed and mention is made of the hazards of carbon monoxide poisoning.Death and injury due to travel by boat or train is so unusual as to eliminate them from useful discussion and most interest probably centres on the accidental hazards of air travel.The major anomaly here is that, on a passenger-mile basis, the worldwide chances of being killed in an accident involving a scheduled air carrier are about the same as for travelling on British Rail. The relationship of aircraft accidents to fatalities is discussed and reasons advanced for the remarkable improvement in both. Potentially survivable accidents are commonest at take off and landing. It is in such accidents that the hazard of fire is of maximal importance though adequate restraint is also highly significant. Suggestions are made for increased safety.The wholly fatal accident is commonly associated with a catastrope in flight and some of the dangers of exposure to high altitude are considered. There is considerable public interest in sabotage as a cause of aircraft accident and its incidence is briefly considered. The overall message is that air travel is quite remarkably safe and that the unduly widespread fear of flying is related, in the main, to the publicity which inevitably surrounds the occasional disaster.

Femoral artery infection associated with a percutaneous arterial suture device

VASA ◽  
2004 ◽  
Vol 33 (2) ◽  
pp. 83-85 ◽  
Author(s):  
Tiesenhausen ◽  
Tomka ◽  
Allmayer ◽  
Baumann ◽  
Hessinger ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Femoral Artery ◽  
Fatal Outcome ◽  
Aneurysm Rupture ◽  
Closure Device ◽  
Abdominal Aortic ◽  
Increased Risk ◽  
Diagnostic Angiography ◽  
Thoracic And Abdominal

This is a case report of a femoral artery infection with fatal outcome after using a percutaneous suture mediated closure device: A 77-year old patient underwent diagnostic angiography of his thoracic and abdominal aortic aneurysm, the puncture site was closed with the Perclose® system. He developed a staphylococcal femoral artery infection with groin abscess, requiring surgical intervention with debridement and removal of the Perclose® suture. After stent graft exclusion of the thoracic and abdominal aortic aneurysm a staphylococcal sepsis occurred and the patient died of aneurysm rupture months later despite long term antibiotic therapy. Since the use of the Perclose® device carries an increased risk of femoral artery infection with septic endarteritis and bacteremia, it should not be used in routine diagnostic angiography.

scholarly journals Anti-Osteoporotic Effects of n-trans-Hibiscusamide and Its Derivative Alleviate Ovariectomy-Induced Bone Loss in Mice by Regulating RANKL-Induced Signaling

Molecules ◽  
2021 ◽  
Vol 26 (22) ◽  
pp. 6820
Author(s):  
Hyung Jin Lim ◽  
Eun-Jae Park ◽  
Yeong-Seon Won ◽  
Seon Gyeong Bak ◽  
Sun Hee Cheong ◽  
...  
Keyword(s):  
Bone Structure ◽  
Osteoclast Differentiation ◽  
Mapk Signaling ◽  
Mitogen Activated Protein Kinase ◽  
Tartrate Resistant Acid Phosphatase ◽  
Bone Resorption Marker ◽  
Increased Risk ◽  
Women And Aging ◽  
Mitogen Activated Protein ◽  
Major Factors

Osteoporosis is characterized by the deterioration of bone structures and decreased bone mass, leading to an increased risk of fracture. Estrogen deficiency in postmenopausal women and aging are major factors of osteoporosis and are some of the reasons for reduced quality of life. In this study, we investigated the effects of n-trans-hibiscusamide (NHA) and its derivative 4-O-(E)-feruloyl-N-(E)-hibiscusamide (HAD) on receptor activator of nuclear factor kappa-Β (NF-κB) ligand (RANKL)-induced osteoclast differentiation and an ovariectomized osteoporosis mouse model. NHA and HAD significantly inhibited the differentiation of osteoclasts from bone marrow-derived macrophages (BMMs) and the expression of osteoclast differentiation-related genes. At the molecular level, NHA and HAD significantly downregulated the phosphorylation of mitogen-activated protein kinase (MAPK) signaling molecules. However, Akt and NF-κB phosphorylation was inhibited only after NHA or HAD treatment. In the ovariectomy (OVX)-induced osteoporosis model, both NHA and HAD effectively improved trabecular bone structure. C-terminal telopeptide (CTX), a bone resorption marker, and RANKL, an osteoclast stimulation factor, were significantly reduced by NHA and HAD. The tartrate-resistant acid phosphatase (TRAP)-stained area, which indicates the osteoclast area, was also decreased by these compounds. These results show the potential of NHA and HAD as therapeutic agents for osteoporosis.

scholarly journals SARS-CoV-2 seroprevalence and clinical features of COVID-19 in a German liver transplant recipient cohort: a prospective serosurvey study

2020 ◽  
Author(s):  
Conrad Rauber ◽  
Shilpa Tiwari-Heckler ◽  
Jan Pfeiffenberger ◽  
Arianeb Mehrabi ◽  
Frederike Lund ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
General Population ◽  
Liver Transplant ◽  
Seroconversion Rate ◽  
A Priori ◽  
Fatal Outcome ◽  
Clinical Signs ◽  
Source Of Infection ◽  
Increased Risk

AbstractIn liver transplant (LT) recipients with severe COVID-19 fatal outcome has been reported in a substantial subset of patients. Whether LT recipients are at increased risk for severe COVID-19 compared to the general population is controversial. Here we report the first results of a SARS-CoV-2 serosurvey in a large LT recipient cohort.Taking into account known risk factors, LT recipients a priori represented a high-risk cohort for severe COVID-19 with 101/219 (46.1 %) presenting with more than 2 risk factors for severe COVID-19. Out of 219 LT recipients 8 (3.7%) were either tested positive for nasopharyngeal SARS-CoV-2 RNA or anti-SARS-CoV-2 serum IgG. 5/8 (62.5 %) did not show any clinical signs of infection, 3/8 (37.5%) had self-limited disease, none required hospitalization for COVID-19. 5/8 (67.5%) SARS-CoV-2 positive patients showed high utilization of the healthcare system. 2/8 (25 %) had known exposure to infected health care personal. A majority of 65.4 % often or always avoided outside family social contacts. Face masks were commonly worn by all patients.In summary, LT recipients showed a SARS-CoV-2 seroconversion rate similar to the general population with a substantial percentage of unrecognized infections. The health care system can be the assumed source of infection in most of these cases.

scholarly journals Malignancy and Mortality in Pediatric-onset Inflammatory Bowel Disease: A Systematic Review

2018 ◽  
Vol 24 (4) ◽  
pp. 732-741 ◽  
Author(s):  
Martine A Aardoom ◽  
Maria E Joosse ◽  
Andrica C H de Vries ◽  
Arie Levine ◽  
Lissy de Ridder
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Severe Disease ◽  
Fatal Outcome ◽  
Patient Specific ◽  
Specific Information ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background Cancer and death are the most severe outcomes that affect patients with inflammatory bowel disease (IBD). These outcomes are even more severe if they occur at a young age but are rare, even in the general population. We conducted a systematic review to provide an overview of all reported pediatric (PIBD) patients with severe outcome. Methods A literature search identified publications that reported development of cancer or fatal outcome in PIBD patients. Studies were eligible for inclusion when (1) article written in English, (2) original data, (3) individual patient information, (4) full text available, (5) study population consisting of patients diagnosed with IBD under the age of 19 years, and (6) who developed malignancy or fatality at any point later in life. Results A total of 98 included studies comprised data of 271 PIBD patients who developed cancer and/or fatal outcome at any point later in life. Meta-analysis demonstrated an increased risk for cancer in PIBD patients (pooled standardized incidence ratio 2.23, 95% CI: 1.98–2.52). The most frequent type of non-fatal cancer was lymphoma, whereas colorectal carcinomas were the most frequently reported type of fatal cancer in PIBD patients and were particularly associated with primary sclerosing cholangitis. The majority of patients with noncancer-related fatal outcomes were diagnosed with ulcerative colitis and most often died due to infectious complications or severe disease-associated complications. Conclusions The data in this review confirm that PIBD associated malignancy and mortality are rare and detailed clinical characteristics are limited. Prospective and international collaborations are needed to obtain more detailed patient-specific information, which is necessary to investigate the relationship between severe outcomes in PIBD patients and the currently used therapeutic strategies.

scholarly journals Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246182
Author(s):  
Paul Balfanz ◽  
Bojan Hartmann ◽  
Dirk Müller-Wieland ◽  
Michael Kleines ◽  
Dennis Häckl ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Clinical Course ◽  
Virus Disease ◽  
Fatal Outcome ◽  
Clinical Manifestations ◽  
Risk Markers ◽  
Risk Of Death ◽  
Viral Spread ◽  
Early Risk ◽  
Increased Risk

Background Some patients with Corona Virus Disease 2019 (COVID-19) develop a severe clinical course with acute respiratory distress syndrome (ARDS) and fatal outcome. Clinical manifestations and biomarkers in early stages of disease with relevant predictive impact for outcomes remain largely unexplored. We aimed to identify parameters which are significantly different between subgroups. Design 125 patients with COVID-19 were analysed. Patients with ARDS (N = 59) or non-ARDS (N = 66) were compared, as well as fatal outcome versus survival in the two groups. Key results ARDS and non-ARDS patients did not differ with respect to comorbidities or medication on developing a fatal outcome versus survival. Body mass index was higher in patients with ARDS versus non-ARDS (p = 0.01), but not different within the groups in survivors versus non-survivors. Interleukin-6 levels on admission were higher in patients with ARDS compared to non-ARDS as well as in patients with fatal outcome versus survivors, whereas lymphocyte levels were lower in the different subgroups (all p<0.05). There was a highly significant 3.5-fold difference in fever load in non-survivors compared to survivors (p<0.0001). Extrapulmonary viral spread was detected more often in patients with fatal outcome compared to survivors (P = 0.01). Further the detection of SARS-CoV-2 in serum showed a significantly more severe course and an increased risk of death (both p<0.05). Conclusions We have identified early risk markers for a severe clinical course, like ARDS or fatal outcome. This data might help develop a strategy to address new therapeutic options early in patients with COVID-19 and at high risk for fatal outcome.

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