RESUMEN
With advances in microscopy and computer science, the technique of digitally reconstructing, modeling, and quantifying microscopic anatomies has become central to many fields of biological research. MBF Bioscience has chosen to openly document their digital reconstruction file format, the Neuromorphological File Specification, available at www.mbfbioscience.com/filespecification (Angstman et al., 2020). The format, created and maintained by MBF Bioscience, is broadly utilized by the neuroscience community. The data format's structure and capabilities have evolved since its inception, with modifications made to keep pace with advancements in microscopy and the scientific questions raised by worldwide experts in the field. More recent modifications to the neuromorphological file format ensure it abides by the Findable, Accessible, Interoperable, and Reusable (FAIR) data principles promoted by the International Neuroinformatics Coordinating Facility (INCF; Wilkinson et al., Scientific Data, 3, 160018,, 2016). The incorporated metadata make it easy to identify and repurpose these data types for downstream applications and investigation. This publication describes key elements of the file format and details their relevant structural advantages in an effort to encourage the reuse of these rich data files for alternative analysis or reproduction of derived conclusions.
Asunto(s)
Metadatos , Programas InformáticosRESUMEN
OBJECTIVE: To explore the types of errors that commercial pilots may make when trying to resolve a suspected engine oil leak using the interfaces currently available. BACKGROUND: The decisions that pilots make often have to be made quickly and under time pressure, with the emphasis on avoiding critical situations from arising. To make the correct decisions, it is vital that pilots have accurate and up-to-date information available. However, interaction with flight deck interfaces may lead to error if they are not effectively designed. METHOD: A hierarchical task analysis was conducted using evidence from pilot interview data to understand the pilots' typical response to a suspected engine oil leak scenario. This was used as the primary input into the Systematic Human Error Reduction and Prediction Approach (SHERPA). RESULTS: A total of 108 possible errors were identified. The most common error type was a retrieval error, in which flight crews may retrieve the wrong information about the engine. A number of remedial measures are proposed to try and overcome such issues. CONCLUSION: This analysis provides an initial starting point for identifying potential future design ideas that can assist the pilots in dealing with oil leaks. APPLICATION: This work has identified the value of applying human error identification methodologies to the assessment of current flight deck processes surrounding engine oil leaks. The method presented permits the operational analysis of possible errors on the flight deck and facilitates the proposition of remedial measures to implement technological innovations that can mitigate error.
Asunto(s)
Aviación , Pilotos , Aeronaves , HumanosRESUMEN
The network analysis method, Event Analysis of Systemic Teamwork (EAST), was used to examine routine aviation operations from multiple perspectives from six key areas (i.e. Dispatch, ATC, ATM, Maintenance, Loading, and the Cockpit). Data was collected over a five-day observational field trial at an international air cargo operator. Researchers recorded the activities of agents operating within the six key areas over three outbound and two inbound flights. Three networks (i.e. social, information and task) were created for four key phases of flight: (i) pre-flight checks and engines start (ii) taxi, take-off and assent, (iii) descent, landing and taxi, and (iv) park and shut down. The networks represent a 'work audit' of short-haul cargo operations, which enabled a detailed understanding of the interactions and connections within the current system. Implications for the future of distributed crewing concepts are discussed. Practitioner Summary: An analysis of the aviation system was undertaken using the amalgamated data from three outbound and two inbound flights. These analyses show the social, information and task interactions for cargo operations. This has been used to specify requirements for future distributed crewing options.
Asunto(s)
Aviación/métodos , Investigación Operativa , Pilotos/psicología , Análisis y Desempeño de Tareas , Recursos Humanos/organización & administración , Adulto , Cognición , Femenino , Humanos , MasculinoRESUMEN
Nonalcoholic fatty liver disease occurs frequently in the setting of metabolic syndrome, but the factors leading to nonalcoholic steatohepatitis (NASH) are not fully understood. This study investigated Toll-like receptor 4 (TLR4) signaling in human liver with the goal of delineating whether activation of this pathway segregates those with nonalcoholic fatty liver from those with NASH. Experiments were performed using liver biopsy tissue obtained from class III obese subjects undergoing bariatric surgery, and extended to an immortalized human hepatocyte HepaRG cell line and primary human hepatocytes. The bacterial endotoxin lipopolysaccharide (LPS) and total free fatty acid levels were significantly increased in plasma of NASH patients. TLR4 mRNA levels were significantly increased in subjects with NASH compared with NAFL as was interferon regulatory factor (IRF) 3 in the myeloid differentiation factor 88-independent signaling pathway. In HepaRG cells, nuclear factor-κB (NF-κB) nuclear translocation and functional activity increased following treatment with the fatty acid, palmitate, and following exposure to LPS compared with hepatocytes stimulated with a lipogenic treatment that induced de novo lipogenesis. Palmitate and LPS induction of NF-κB activity was partially attenuated by chemical- or small-interfering RNA-mediated inhibition of TLR4. Expression of TLR4 and its downstream mediators was upregulated with palmitate and LPS. Similar results were observed using primary human hepatocytes from a lean donor. Interestingly, NF-κB activity assays showed obese donor hepatocytes were resistant to chemical TLR4 inhibition. In conclusion, TLR4 expression is upregulated in a large cohort of NASH patients, compared with those with NAFL, and this occurs within the setting of increased LPS and fatty acids.
Asunto(s)
Hígado/metabolismo , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Obesidad/metabolismo , Transducción de Señal , Receptor Toll-Like 4/metabolismo , Adulto , Línea Celular , Células Cultivadas , Femenino , Hepatocitos/efectos de los fármacos , Hepatocitos/metabolismo , Humanos , Factor 3 Regulador del Interferón/metabolismo , Lipopolisacáridos/sangre , Lipopolisacáridos/farmacología , Masculino , Persona de Mediana Edad , Factor 88 de Diferenciación Mieloide/metabolismo , FN-kappa B/metabolismo , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Obesidad/complicaciones , Ácido Palmítico/sangre , Ácido Palmítico/farmacología , ARN Mensajero/genética , ARN Mensajero/metabolismo , Receptor Toll-Like 4/genéticaRESUMEN
BACKGROUND & OBJECTIVES: There is a need to develop an affordable and reliable tool for hearing screening of neonates in resource constrained, medically underserved areas of developing nations. This study valuates a strategy of health worker based screening of neonates using a low cost mechanical calibrated noisemaker followed up with parental monitoring of age appropriate auditory milestones for detecting severe-profound hearing impairment in infants by 6 months of age. METHODS: A trained health worker under the supervision of a qualified audiologist screened 425 neonates of whom 20 had confirmed severe-profound hearing impairment. Mechanical calibrated noisemakers of 50, 60, 70 and 80 dB (A) were used to elicit the behavioural responses. The parents of screened neonates were instructed to monitor the normal language and auditory milestones till 6 months of age. This strategy was validated against the reference standard consisting of a battery of tests - namely, auditory brain stem response (ABR), otoacoustic emissions (OAE) and behavioural assessment at 2 years of age. Bayesian prevalence weighted measures of screening were calculated. RESULTS: The sensitivity and specificity was high with least false positive referrals for 70 and 80 dB (A) noisemakers. All the noisemakers had 100 per cent negative predictive value. 70 and 80 dB (A) noisemakers had high positive likelihood ratios of 19 and 34, respectively. The probability differences for pre- and post- test positive was 43 and 58 for 70 and 80 dB (A) noisemakers, respectively. INTERPRETATION & CONCLUSIONS: In a controlled setting, health workers with primary education can be trained to use a mechanical calibrated noisemaker made of locally available material to reliably screen for severe-profound hearing loss in neonates. The monitoring of auditory responses could be done by informed parents. Multi-centre field trials of this strategy need to be carried out to examine the feasibility of community health care workers using it in resource constrained settings of developing nations to implement an effective national neonatal hearing screening programme.
Asunto(s)
Trastornos de la Audición/diagnóstico , Pruebas Auditivas/métodos , Calibración , Femenino , Personal de Salud , Humanos , Lactante , Recién Nacido , Masculino , Tamizaje Neonatal/métodos , Padres , Estándares de ReferenciaAsunto(s)
Eutanasia Activa Voluntaria/legislación & jurisprudencia , Eutanasia Pasiva/legislación & jurisprudencia , Hipnóticos y Sedantes , Responsabilidad Legal , Médicos/legislación & jurisprudencia , Derecho a Morir/legislación & jurisprudencia , Suicidio Asistido/legislación & jurisprudencia , Cuidado Terminal/legislación & jurisprudencia , Analgésicos , Derecho Penal , Homicidio/legislación & jurisprudencia , Humanos , Hipnóticos y Sedantes/administración & dosificación , Cuidados para Prolongación de la Vida/legislación & jurisprudencia , Apoyo Nutricional , Cuidados Paliativos/legislación & jurisprudencia , Rol del Médico , Suicidio/legislación & jurisprudencia , Negativa del Paciente al Tratamiento/legislación & jurisprudencia , Estados Unidos , Ventiladores Mecánicos , Privación de Tratamiento/legislación & jurisprudenciaRESUMEN
This paper considers whether a physician is criminally liable for administering a dose of painkillers that hastens a patient's death. The common wisdom is that a version of the doctrine of double effect legally protects the physician. That is, a physician is supposedly acting lawfully so long as the physician's primary purpose is to relieve suffering. This paper suggests that the criminal liability issue is more complex than that. Physician culpability can be based on recklessness, and recklessness hinges on whether a physician has taken an unjustifiable risk of hastening death. The authors identify three conditions of justifiability. Their analysis helps to explain the distinction between euthanasia, which is legally banned, and the use of risky analgesics, which is permitted in limited circumstances.
Asunto(s)
Analgésicos/normas , Derecho Penal , Intención , Responsabilidad Legal , Cuidados Paliativos/legislación & jurisprudencia , Estrés Psicológico , Cuidado Terminal/legislación & jurisprudencia , Principio del Doble Efecto , Ética , Eutanasia Activa , Humanos , Mala Praxis/legislación & jurisprudencia , Dolor/tratamiento farmacológico , Dolor/epidemiología , Médicos/legislación & jurisprudencia , Incertidumbre , Estados Unidos/epidemiologíaRESUMEN
Growth monitoring, oral rehydration, breast-feeding and immunisation--female education, family spacing and food supplementation (GOBI-FFF) are a selective package of World Health Organisation primary health care strategies recommended by UNICEF. Changes over a 1-year period in the implementation of the components of GOBI-FFF were investigated in a rural village in Ciskei to detect any changes associated with a newly modified village health-worker (VHW) programme. A baseline survey was conducted before the introduction of a modified VHW programme and a second survey took place a year later. The principles of GOBI-FFF were already familiar to and have since been increasingly practised by the community and health personnel. Breast-feeding is widespread, most carers know how to make oral rehydration solution and most children have a 'Road to Health' card and are being weighed regularly. However, malnutrition remains a major problem and the food supplementation programme is operating poorly. The high coverage of the community by the village health-workers and the clinic suggest that these two channels should be used more intensively to strengthen the GOBI-FFF programme in the area.