Analysis of the Results of the Borowiec SLR Station (7811) for the Period 1993–2019 as an Example of the Quality Assessment of Satellite Laser Ranging Stations

This paper presents the results of an orbital analysis of satellite laser ranging data performed by the Borowiec SLR station (7811) in the period from July 1993 to December 2019, including the determination of the station positions and velocity. The analysis was performed using the GEODYN-II orbital program for the independent monthly orbital arcs from the results of the LAGEOS-1 and LAGEOS-2 satellites. Each arc was created from the results of the laser observations of a dozen or so selected stations, which were characterized by a large number of normal points and a good quality of observations. The geocentric and topocentric coordinates of the station were analyzed. Factors influencing the uncertainty of the measurements were determined: the number of the normal points, the dispersion of the normal points in relation to the orbits, and the long-term stability of the systematic deviations. The position leap at the end of 2002 and its interpretation in ITRF2014 were analyzed. The 3D stability of the determined positions throughout the period of study was equal to 12.7 mm, with the uncertainty of determination being at the level of 4.3 mm. A very high compliance of the computed velocity of the Borowiec SLR station (24.9 mm/year) with ITRF2014 (25.0 mm/year) was found.

Inside the Velvet Glove: Sustaining Private Regulatory Institutions Through Hollowing and Fortifying

The forces that threaten to break apart private regulatory institutions are well known, but the forces that sustain them are not. Through a longitudinal inductive study of the Toward Sustainable Mining (TSM) program in the Canadian mining industry, we demonstrate how private regulatory institutions are sustained by strategically manipulating different aspects of an institution’s stringency. Our findings show how shifts in external conditions decreased benefits of participation for firms, triggering institutional destabilization. We demonstrate how the interdependent mechanisms of hollowing—actions that ratchet down aspects of stringency associated with high compliance costs—and fortifying—actions that ratchet up aspects of stringency associated with low compliance costs—worked together to stabilize the institution by rebalancing the competing pressures that underpin it. However, these same mechanisms can hinder the ability of these institutions to substantively address the targeted issues, even as they become more stringent in some areas. Our study advances research on private regulation by showing how different aspects of stringency can be simultaneously ratcheted up and ratcheted down to sustain private regulatory institutions. Further, in positioning institutional stability as an ongoing negotiation, we elucidate the key custodial role of governing organizations like trade associations in institutional maintenance.

Enhanced recovery after surgery: importance of compliance audits

Background: The enhanced recovery after surgery (ERAS) protocol is associated with improved clinical outcomes. However, implementation of ERAS in clinical practice is difficult because it requires a multidisciplinary approach and complex standardization. Moreover, maintenance and auditing of ERAS protocols is another challenge.Current Concepts: The ERAS society provides guidelines for surgery in almost all areas, and each guideline consists of approximately 20 items. Audits are performed to determine whether the items are being applied appropriately in a compliant manner as well as monitor and improve ERAS protocols. Numerous studies have reported that even with the application of the same ERAS protocol, postoperative short-term outcomes such as reductions of hospital stay and postoperative complications were better in the high-compliance group than in the low-compliance group. In addition, some recent studies have reported that application of ERAS protocols with high compliance can improve the long-term survival outcomes in cancer patients. In this regard, ERAS has been hypothesized to improve long-term oncological outcomes by minimizing surgical stress and reducing the postoperative inflammatory response and damage to immune function.Discussion and Conclusion: In addition to the development of appropriate protocols, auditing of compliance is also an important part of ERAS implementation. High compliance may lead to improved clinical outcomes.

Association between lung compliance phenotypes and mortality in COVID-19 patients with acute respiratory distress syndrome

ABSTRACT Introduction: Acute respiratory distress syndrome (ARDS) in COVID-19 is associated with a high mortality rate, though outcomes of the different lung compliance phenotypes are unclear. We aimed to measure lung compliance and examine other factors associated with mortality in COVID-19 patients with ARDS. Methods: Adult patients with COVID-19 ARDS who required invasive mechanical ventilation at 8 hospitals in Singapore were prospectively enrolled. Factors associated with both mortality and differences between high (<40mL/cm H2O) and low (<40mL/cm H2O) compliance were analysed. Results: A total of 102 patients with COVID-19 who required invasive mechanical ventilation were analysed; 15 (14.7%) did not survive. Non-survivors were older (median 70 years, interquartile range [IQR] 67–75 versus median 61 years, IQR 52–66; P<0.01), and required a longer duration of ventilation (26 days, IQR 12–27 vs 8 days, IQR 5–15; P<0.01) and intensive care unit support (26 days, IQR 11–30 vs 11.5 days, IQR 7–17.3; P=0.01), with a higher incidence of acute kidney injury (15 patients [100%] vs 40 patients [46%]; P<0.01). There were 67 patients who had lung compliance data; 24 (35.8%) were classified as having high compliance and 43 (64.2%) as having low compliance. Mortality was higher in patients with high compliance (33.3% vs 11.6%; P=0.03), and was associated with a drop in compliance at day 7 (-9.3mL/cm H2O (IQR -4.5 to -15.4) vs 0.2mL/cm H2O (4.7 to -5.2) P=0.04). Conclusion: COVID-19 ARDS patients with higher compliance on the day of intubation and a longitudinal decrease over time had a higher risk of death. Keywords: ARDS, COVID-19-associated respiratory failure, high-flow nasal cannula therapy, HFNC, post-intubation, ventilation strategies