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Exam Code: OG0-023 Practice exam 2022 by team
OG0-023 ArchiMate 2 Combined Part 1 and 2 Examination

This is a combined ArchiMate 2 Part 1 and Part 2 examination for candidates who want to achieve Level 2 certification directly.
Exam Name: ArchiMate® 2 Combined Part 1 and Part 2
Exam Number: OG0-023 (English), OG0-023-ESL (ESL)
Qualification upon passing: ArchiMate 2 Certified
Delivered at: Authorized Open Group Examination Provider Testing Centers and through some ArchiMate Accredited Training Course Providers
Prerequisites: None
Supervised: Yes
Open Book: Dependent on section. This examination comprises two separate sections. The ArchiMate 2 Part 1 section is CLOSED Book. The ArchiMate 2 Part 2 section is OPEN book. An electronic copy of the specification is built into the exam and becomes available in Part 2 only (*).
Exam type: The exam comprises two sections. Section 1: 40 Simple Multiple Choice questions + Section 2: 8 Scenario Based, Complex Multiple Choice
Number of questions: 48
Pass score: The pass mark for Part 1 is 60%, which means 24 or more points out of maximum of 40 points. For Part 2, the pass mark is 70%, which means 28 or more points out of a maximum of 40 points. Note that you must pass both parts of the exam to achieve an overall pass result. If you fail either part you fail the examination, however you only need retake the examination(s) corresponding to the failed section(s).
Time limit: 150 Minutes total (**). Each section has a maximum time limit as follows: 60 Minutes on ArchiMate 2 Part 1. 90 Minutes on ArchiMate 2 Part 2. Once you complete the ArchiMate 2 Part 1 section you cannot return to it. There is no break between sections; Part 1 directly follows Part 2.
Retake policy: If you fail you must wait one month before another attempt on any ArchiMate 2 examination. This applies even if you only need to retake one of the two parts of the examination.
Examination Fee: See Fees
Recommended Study: A Study Guide is available. The Self-Study Pack includes the Study Guide bundled with the Pocket Guide and other materials.

ArchiMate 2 Combined Part 1 and 2 Examination
The-Open-Group Examination Study Guide
Killexams : The-Open-Group Examination Study Guide - BingNews Search results Killexams : The-Open-Group Examination Study Guide - BingNews Killexams : TOGAF certification guide: Options, training, cost, exam info

TOGAF is a longstanding, popular, open-source enterprise architecture framework that is widely used by large businesses, government agencies, non-government public organizations, and defense agencies. Offered by The Open Group, TOGAF advises enterprises on how best to implement, deploy, manage, and maintain enterprise architecture.

The Open Group offers several options for those who want to be certified in the TOGAF 9. Earning a cert is a great way to demonstrate to employers that you are qualified to work in an enterprise architecture environment using the TOGAF 9.2 Standard framework. TOGAF is designed to help organizations implement enterprise architecture management using a standardized framework that is still highly customizable to a company’s specific enterprise architecture needs.

Earlier this year, The Open Group announced the latest update to the TOGAF framework, releasing TOGAF Standard, 10th Edition. The update brought changes to the structure of the framework, making it easier to navigate and more accessible for companies to adopt and customize for their unique business needs. Currently, The Open Group offers certifications only for TOGAF 9, but there are plans to release new certifications that align with TOGAF Standard, 10th Edition. This article will be updated once the new certifications are announced in the coming months.

TOGAF 9 Foundation and TOGAF 9 Certified

The TOGAF 9 Foundation and TOGAF 9 Certified are the two main certifications for the TOGAF Standard, Version 9.2 offered by The Open Group. To earn your TOGAF 9 Foundation certification, you’ll need to pass the TOGAF 9 Part 1 exam. To earn the next level of certification, the TOGAF 9 Certified designation, you’ll need to pass the TOGAF 9 Part 2 exam.

You can opt to take each exam separately at different times, or you can take the TOGAF 9 Combined Part 1 and Part 2 exam to earn both certifications at once. There are no prerequisites for the TOGAF 9 Part 1 exam, but you will need to pass the first exam to qualify for the TOGAF 9 Part 2 examination.  

The TOGAF 9 Part 1 exam covers basic and core concepts of TOGAF, introduction to the Architecture Development Method (ADM), enterprise continuum and tools, ADM phases, ADM guidelines and templates, architecture governance, architecture viewpoints and stakeholders, building blocks of enterprise architecture, ADM deliverables, and TOGAF reference models.

The TOGAF 9 Part 2 exam has eight scenario-based questions that demonstrate your ability to apply your foundational knowledge from the first exam to real-world enterprise architecture situations. The eight questions are drawn from courses such as ADM phases, adapting the ADM, architecture content framework, TOGAF reference models, and the architecture capability framework.  

TOGAF Business Architecture Level 1

The Open Group offers the TOGAF Business Architecture Level 1 certification, which focuses on validating your knowledge and understanding of business modeling, business capabilities, TOGAF business scenarios, information mapping, and value streams.

Integrating Risk and Security Certification

The Open Group also offers the Integrating Risk and Security Certification, which validates that you understand several security and risk concepts as they apply to enterprise architecture. The certification covers important security and risk concepts as they relate to the TOGAF ADM, information security management, enterprise risk management, other IT security and risk standards, enterprise security architecture, and the importance of security and risk management in an organization. There are no prerequisites for the exam, but to pass you will need to attend three hours of training from an accredited training course and then pass the assessment. There is an option for self-study training via an e-learning platform.

TOGAF certification training

The Open Group offers self-study material, with two available study guides that cover the TOGAF 9 Foundation and learning outcomes that go beyond the foundational level. Those who wish to attend prep courses can search through accredited courses. Some courses also include the examination at the end of the course, depending on the program.

TOGAF certification cost

For the English TOGAF exams the current rate is US$360 for Part 1, US$360 for Part 2, or US$550 for the Combined Part 1 and Part 2 exam. The English TOGAF Business Architecture Level 1 exam is priced at US$315. There is currently no pricing information available for the Integrating Risk and Security Certification.

It’s also important to note that pricing and rates per exam will change depending on where you’re located. To see the rates for other countries and languages, check The Open Group’s website for more information.

TOGAF Role-Based Badges

The Open Group also offers TOGAF Role-Based Badges designed for IT professionals seeking to demonstrate enterprise architecture knowledge and skills. The Badges are digital and Tested by “secure metadata” as a way for you to display achievements and awards online, and for organizations to easily verify certifications of potential candidates. They can also be used to identify various milestones as you work your way toward a full certification. Badges can be used in email signatures, on your personal website or resume, and on your social media accounts.

The Open Group offers three categories of Role-Based Badges for TOGAF 9.2: Enterprise Architecture, Enterprise Architecture Modeling, and Digital Enterprise Architecture. Under each category, there are two types of badges you can earn, Team Member or Practitioner. You’ll earn different badges depending on which certifications you complete or how far along you are in completing the TOGAF 9.2 Certified credential.

Sun, 24 Jul 2022 15:17:00 -0500 Author: Sarah K. White en-US text/html
Killexams : Prepare for the CCST Exam
  • The correct answer is D, A/D converter. A digital controller requires a digital signal as its input. A 4-20 mA transmitter outputs an analog signal. Therefore, a device to convert an analog (A) signal to a digital (D) is required. This class of device is referred to as an A/D converter.

    An I/P transducer is used to convert an analog current (I) signal to a pneumatic (P) signal, as for actuation of final control elements. A P/I transducer is used to convert a pneumatic signal (P) to an analog current (I) signal, as for a pneumatic transmitter in a programmable logic controller loop. A DP transmitter is a differential pressure transmitter, which can output a pneumatic, an analog, or a digital signal, depending on the model of transmitter used.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • The correct answer is C, "sample conditioning system." Answers A and C are items not generally associated with extractive field analyzers. Capillary tubes are used for collecting small samples (water, for instance) from a larger container. There are special capillary tubes that can be used in the analyzer chamber of a gas chromatograph, but they are not constructed from glass. Smooth-walled pipe is important for reducing friction losses in piping systems.

    A sample probe calibration system is important to the overall function and maintenance of an extractive field analyzer. However, these systems are not used to prepare the sample for analysis, but rather to provide a mechanism to verify and maintain analyzer performance.

    A sample conditioning system can contain devices, such as filters, demisters, flow regulators, and heaters. sample conditioning systems are used to bring the sample to the ideal process conditions for accurate measurement in the analyzer itself. The sample conditioning system can be a key maintenance item in an analyzer system, since each device needs to be calibrated, cleaned, etc.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • The correct answer is B, "equal to." In order for air to be discharged from the end of a bubbler purge tube, the air pressure in the tube must be equal to (or higher than) the pressure exerted by the liquid head in the tank.

    As the tank level is decreased, the liquid head pressure at the tip of the purge tube decreases, and more bubbles per unit of time can escape. The corresponding reduction in pressure in the purge tube is proportional to the level in the tank. Therefore, the point at which the liquid head pressure and the purge tube pressure are equal is the highest level (URV = 100%) that the device will measure.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • The correct answer is A, "51 K ohms ± 5%."

    The four-color band coding is:
    Color    Value    Multiplier
    Black    0    1
    Brown    1    10
    Red    2    100
    Orange    3    1000
    Yellow    4    10 K
    Green    5    100K
    Blue    6    1 M
    Violet    7    10 M
    Gray    8     
    White    9     
    Gold    ± 5%    0.1
    Silver    ± 10%    0.01

    So a resistor with four bands, green-brown-orange-gold, has a value of: 5 1 x 1000 ± 5% or 51 KΩ.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • The correct answer is D, series and energized. To measure current, you must connect the two leads of the ammeter in the circuit so that the current flows through the ammeter. In other words, the ammeter must become a part of the circuit itself. The only way to measure the current flowing through a simple circuit is to insert your ammeter into the circuit (in series) with the circuit energized.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • The correct answer is A; it prevents the formation of a second temperature measurement junction.

    A thermocouple measurement junction is formed wherever two dissimilar metals are joined. KX-type thermocouple extension wire is made of the same metals as the K-type thermocouple (chromel and alumel). When extending the thermocouple leads with an extension wire back to the control system input card, KX thermocouple extension wire must be used, and the chromel wire and the alumel wire must be joined to the wire of the same metal in the extension cable. If JX or another type of extension wire is used, another measurement junction is formed. For instance, if JX extension cable is used in the example in this problem, the point where the iron and chromel wires are joined would form another thermocouple. This will negatively affect the intended measurement signal. Proper installation of thermocouple extension wires also requires special terminal blocks to prevent additional junctions from being formed.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • The correct answer is B, "hydraulic actuation." Although many pneumatic actuators can provide a large force, they require either a large diaphragm area (in the case of a diaphragm actuator) or a large cylinder (in the case of a rack and pinion actuator).

    Hydraulic actuators are driven by a high-pressure fluid (up to 4,000 psig) that can be delivered to the actuator by a pump that is remote from the actuator itself. Hydraulic cylinders can deliver up to 25 times more force than a pneumatic cylinder of the same size.

    Manual actuation is accomplished by turning a valve handle, and is limited to the amount of force that an operator can exert on the lever or hand wheel.

    Electric actuation delivers high torques for rotary-style valves, but electric actuators tend to be large and heavy compared to hydraulic actuators.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • The correct answer is D; they measure pressure by sensing the deflection of the diaphragm. For most pressure applications, changes in pressure are detected by the change in deflection of a measuring diaphragm.

    The deflection is converted into an electrical signal (voltage) by a piezoelectric or capacitance device. The small electrical current is converted to a standard signal (e.g., 4-20 mA or a digital signal) by a transmitter. Therefore, answer B is not correct.

    Answer A is not correct, because pressure sensors can measure very small pressure changes (inches of water) and in some cases, millimeters of water.

    Pressure measurement devices are not affected by volume, since they are measuring force over an area only. Many pressure sensors are sensitive to temperature (capillary tubes are filled with fluids that can expand with temperature). Therefore, answer C is not correct.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • The correct answer is C, "Gather information about the problem." Once a problem is identified, data must be gathered and analyzed to determine a viable set of potential actions and solutions.

    The logical analysis troubleshooting method consists of (in order):
    1. Identify and define the problem.
    2. Gather information about the problem.
    3. Evaluate the information/data.
    4. Propose a solution or develop a test.
    5. Implement the solution or conduct the test.
    6. Evaluate the results of the solution or test.
    7. If the problem is not resolved, reiterate until the problem is found and resolved.
    8. If the problem is resolved: document, store/file, and send to the appropriate department for follow up if required.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • The correct answer is B, “location, elevation, and tag number.” Instrument location plans are most often used to support new plant installations and give the installer information about the genuine physical location of the installation of an instrument, the elevation of installation (at grade, on a platform, at what height on a process line, etc.), and the tag number of the instrument to be installed.

    Specification numbers (part of answers C and D) are usually indicated on instrument lists and instrument installation details. Wiring plans (part of answer A) are typically shown on conduit and wiring schedules or cabling diagrams. Although these details are useful in the installation of a plant, they are not part of the instrument installation plans.

    Reference: Goettsche, L.D. (Editor), Maintenance of Instruments and Systems, Second Edition, ISA, 2005.

  • Thu, 02 Dec 2021 09:44:00 -0600 en text/html
    Killexams : What should people know about Paxlovid rebound? Our medical analyst explains No result found, try new keyword!CNN Medical Analyst Dr. Leana Wen answers questions about the phenomenon known as Paxlovid rebound, why it happens and who should take this antiviral medication after contracting Covid-19. Sun, 07 Aug 2022 22:44:49 -0500 en-us text/html Killexams : The Generalizability Puzzle


    In 2013, the president of Rwanda asked us for evaluation results from across the continent that could provide lessons for his country’s policy decisions. One program tested in Kenya jumped out, and the Rwandan government wanted to know whether it would likely work in Rwanda as well. “Sugar Daddies Risk Awareness,” an HIV-prevention program, was remarkably effective in reducing a key means of HIV transmission: sexual relationships between teenage girls and older men. A randomized controlled trial (RCT) found that showing eighth-grade girls and boys a 10-minute video and statistics on the higher rates of HIV among older men dramatically changed behavior: The number of teen girls who became pregnant with an older man within the following 12 months fell by more than 60 percent.1

    This study was compelling partly because of its methodology: Random assignment determined which girls received the risk awareness program and which girls continued to receive the standard curriculum. Our government partners could thereby have confidence that the reduction in risky behavior was actually caused by the program. But if they replicated this approach in a new context, could they expect the impact to be similar?

    Policy makers repeatedly face this generalizability puzzle—whether the results of a specific program generalize to other contexts—and there has been a long-standing debate among policy makers about the appropriate response. But the discussion is often framed by confusing and unhelpful questions, such as: Should policy makers rely on less rigorous evidence from a local context or more rigorous evidence from elsewhere? And must a new experiment always be done locally before a program is scaled up?

    These questions present false choices. Rigorous impact evaluations are designed not to replace the need for local data but to enhance their value. This complementarity between detailed knowledge of local institutions and global knowledge of common behavioral relationships is fundamental to the philosophy and practice of our work at the Abdul Latif Jameel Poverty Action Lab (J-PAL), a center at the Massachusetts Institute of Technology (founded in 2003) with a network of affiliated professors and professional staff around the world.

    Four Misguided Approaches

    To give a sense of our philosophy, it may help to first examine four common, but misguided, approaches about evidence-based policy making that our work seeks to resolve.

    Can a study inform policy only in the location in which it was undertaken? Kaushik Basu has argued that an impact evaluation done in Kenya can never tell us anything useful about what to do in Rwanda because we do not know with certainty that the results will generalize to Rwanda.2 To be sure, we will never be able to predict human behavior with certainty, but the aim of social science is to describe general patterns that are helpful guides, such as the prediction that, in general, demand falls when prices rise. Describing general behaviors that are found across settings and time is particularly important for informing policy. The best impact evaluations are designed to test these general propositions about human behavior.

    Should we use only whatever evidence we have from our specific location? In an effort to ensure that a program or policy makes sense locally, researchers such as Lant Pritchett and Justin Sandefur argue that policy makers should mainly rely on whatever evidence is available locally, even if it is not of very good quality.3 But while good local data are important, to suggest that decision makers should ignore all evidence from other countries, districts, or towns because of the risk that it might not generalize would be to waste a valuable resource. The challenge is to pair local information with global evidence and use each piece of evidence to help understand, interpret, and complement the other.

    Should a new local randomized evaluation always precede scale up? One response to the concern for local relevance is to use the global evidence base as a source for policy ideas but always to test a policy with a randomized evaluation locally before scaling it up. Given J-PAL’s focus on this method, our partners often assume that we will always recommend that another randomized evaluation be done—we do not. With limited resources and evaluation expertise, we cannot rigorously test every policy in every country in the world. We need to prioritize. For example, there have been more than 30 analyses of 10 randomized evaluations in nine low- and middle- income countries on the effects of conditional cash transfers. While there is still much that could be learned about the optimal design of these programs, it is unlikely to be the best use of limited funds to do a randomized impact evaluation for every new conditional cash transfer program when there are many other aspects of antipoverty policy that have not yet been rigorously tested.

    Must an identical program or policy be replicated a specific number of times before it is scaled up? One of the most common questions we get asked is how many times a study needs to be replicated in different contexts before a decision maker can rely on evidence from other contexts. We think this is the wrong way to think about evidence. There are examples of the same program being tested at multiple sites: For example, a coordinated set of seven randomized trials of an intensive graduation program to support the ultra-poor in seven countries found positive impacts in the majority of cases. This type of evidence should be weighted highly in our decision making. But if we only draw on results from studies that have been replicated many times, we throw away a lot of potentially relevant information.

    Focus on Mechanisms

    These four misguided approaches would have blocked a useful path forward in deciding whether to introduce the HIV information program in Rwanda. This is because they ignore the key insight from an evaluation: what it potentially tells us about mechanism—about why people responded the way they did.4 Focusing on mechanisms, and then judging whether a mechanism is likely to apply in a new setting, has a number of practical advantages for policy making.

    First, such a focus draws attention to more relevant evidence. When considering whether to implement a specific policy or program, we may not have much existing evidence about that exact program. But we may have a deep evidence base to draw from if we ask a more general question about behavior. For example, imagine a public health agency that would like to encourage health-care providers to promote flu vaccinations. They are considering whether to give providers information on how their patients’ flu-vaccination rates compare with rates of their peers’ patients. A review of the literature may produce few, if any, rigorous evaluations of this specific approach. The general question of how people change their behavior after learning about their peers’ behavior, however, has a deep evidence base.

    Second, underlying human behaviors are more likely to generalize than specific programs. Take, for example, a program in rural India run by the nonprofit Seva Mandir that one of us, Rachel Glennerster, helped evaluate. The program held regularly scheduled mobile immunization camps and, in a random subset, gave 1 kg of lentils to parents at each childhood immunization visit and a set of metal plates when the immunization schedule was completed. In communities around the incentive camps, full immunization jumped to 39 percent, compared with 6 percent in the control communities.5 The trouble was not that parents were suspicious of vaccines. Even without incentives, 78 percent of children got at least one vaccine. But incentives helped to get parents to bring their children back regularly until the end of the schedule.

    The specific program of providing lentils to encourage vaccination may not translate well to other contexts: Lentils may not be a particularly attractive incentive in other parts of the world. However, the failure of humans to maintain behaviors that help prevent future health problems generally holds: Think of all those broken diets and unused gym memberships. Similarly, the finding that the adoption of preventive health measures is sensitive to price also generalizes very well. More than half a dozen randomized evaluations of six preventive health products in five countries show that a small price cut can sharply increase demand for preventive health products.6 Incentives can extend this finding, since they can reduce the overall cost of taking children to a clinic, which could include travel and time costs.

    It is worth stressing the potentially counterintuitive point that more theory-based or “academic” impact evaluations can be particularly useful for policy purposes, because they are designed to produce general lessons. Some researchers have argued that we should have more evaluations that focus on questions that apply only to specific organizations: for example, helping Seva Mandir learn whether, locally, parents would respond better to lentils or to wheat flour.7 But answering more theory-driven questions, such as whether take-up of preventive health is highly price sensitive, can inform the practices of many other organizations around the world.


    Third, focusing on mechanisms can point us to specific local evidence that can help us predict whether a result might generalize to a new context. Common sense suggests that we are more likely to find a similar result in a new context, if the new context is similar to the one where the program was first tested. But what do we mean by “similar”? Do we mean a location that is geographically close, has the same income level, the same density of population, or the same level of literacy? There is no absolute answer. It depends on the behavior we are interested in, and it depends on theory.

    What do we mean by “theory”? Theory simplifies the world to help us make (and test) predictions about behavior and about which policies are likely to be effective and where they are likely to be effective. There are many ways to make simplifying generalizations about the world. Economic theory helps us prioritize among these simplifications. For example, it suggests that what was important about giving lentils in the example above was that they are valued locally. Behavioral economic theory also suggests that people may be more sensitive to prices of preventive health than to prices of acute care when they are sick. Thus, if we want to generalize the lesson of incentives influencing the adoption of preventive health measures, we should be more cautious if the new context focuses on acute care rather than preventive health.

    The relevant theory for the immunization program also suggested that incentives would work only if parents could reliably access vaccines and were not strongly opposed to vaccines. A “similar” context therefore would be one where a large number of children got at least one vaccine (signaling the fact that access was possible and hostility to vaccines was low) but where parents failed to persist to the end of the schedule.

    The Generalizability Framework

    At J-PAL we adopt a generalizability framework for integrating different types of evidence, including results from the increasing number of randomized evaluations of social programs, to help make evidencebased policy decisions. We suggest the use of a four-step generalizability framework that seeks to answer a crucial question at each step:

    Step 1: What is the disaggregated theory behind the program?
    Step 2: Do the local conditions hold for that theory to apply?
    Step 3: How strong is the evidence for the required general behavioral change?
    Step 4: What is the evidence that the implementation process can be carried out well?

    To understand how this framework works, let us turn to several real-world examples of policy dilemmas. Our first case study in applying this generalizability framework concerns childhood immunizations, which are among the most cost-effective health interventions known. The World Health Organization estimates that 1.5 million more lives could be saved if immunization rates improved. Our study in India, referenced above, found that small incentives for parents, coupled with reliable services at convenient mobile clinics, increase full immunization rates six-fold, from 6 percent to 39 percent.8 Could this approach work in Sierra Leone, which has one of the world’s worst rates of mortality for children younger than 5 years old? And what about in the Indian state of Haryana or urban Karachi in Pakistan?

    If we see evaluations as testing a “black box” program—if we assume that we cannot understand the mechanism at work—we would ask how many impact evaluations have tested the relationship between using incentives for immunization and immunization rates. And since only one rigorous impact evaluation assesses this relationship, we might conclude that the evidence supporting this program is quite weak. However, assessing the evidence of the different factors in the theory behind the program suggests that there is much more evidence behind this relationship than might at first be apparent.

    Step 1: As we discussed above, the theory behind the original Indian study was that parents wanted to vaccinate their children—or at least had no strong opposition to vaccination. Their willingness to persist through the schedule was sensitive to small changes in price. The evidence that small costs, such as the time and transport cost of getting a child to a clinic, can deter people from persisting with preventive health behaviors is far more extensive than the blackbox approach acknowledges. (See “A Generalizability Framework for Incentives for Immunization.”)

    Step 2: J-PAL is working with governments in Sierra Leone; Karachi, Pakistan; and Haryana, India to determine whether the conditions required for this program hold locally. Knowledge of local institutions is important for determining basic conditions such as whether clinics open regularly and whether the vaccine supply is reliable. Publicly available data is also useful. In particular, if most children receive at least one immunization but rates fall off over the schedule, this suggests a problem similar to that observed in the original study in India. Sierra Leone, Karachi, and Haryana all fit this pattern.

    Step 3: The next step concerns the evidence about behavioral conditions. Substantial evidence suggests that people worldwide underinvest in highly effective preventive health measures but spend a lot of money on acute care.9 There is also a lot of evidence that small changes in the price of preventive health care can dramatically Excellerate adoption rates.10 Small incentives have also been found to have surprisingly big impacts on health behavior.11

    Step 4: The final step focuses on the details of local implementation. Figuring out how to ensure that the incentive is delivered to the clinics and that health workers provide it to parents who get their child immunized is critical. What the incentive is, how it is delivered, and how its delivery is monitored will likely need to be adapted to the local situation.

    In Karachi and Haryana, the potential to provide secure electronic payments directly to parents is dramatically reducing the logistical challenges that have plagued efforts to scale up incentives for immunization. In Sierra Leone, low penetration of mobile money in poor rural areas makes this approach less feasible. However, because of the high levels of malnutrition in Sierra Leone, agencies are keen to provide pregnant and lactating mothers with fortified food, which, local testing suggests, is highly valued. The next step in Sierra Leone, therefore, is to test whether food can be effectively distributed to parents bringing their children to be immunized. Does it reach the intended beneficiaries? Does the distribution hinder the smooth running of immunization clinics?

    If the logistics of distributing food as an incentive to promote immunization proves too challenging in Sierra Leone, we should not conclude that the original study does not generalize. All we will have found is that the local implementation failed, not that the underlying behavioral response to incentives was different.

    From Kenya To Rwanda

    We do not always proceed through every step of the generalizability framework. To illustrate this point, consider our second case study, which returns to the Rwandan government’s question about preventing teenage pregnancy. How do we decide whether, in Rwanda, telling adolescent girls the relationship between men’s age and HIV will help alleviate the problem? In this instance, we only used the first two steps.

    Step 1: First we consider the theory behind the Kenyan HIV-information program. (See “A Generalizability Framework for the HIV Risk Awareness Program.”) Adolescent girls trade off the benefits and costs of having sexual relationships and of having them with different partners. Girls receive various benefits from relationships with older men. In particular, older men are better able to look after them financially if they get pregnant. But relationships with older men also have risks: Older men are more likely to be infected with HIV. If girls do not know that older men are more likely than younger men to be HIV-positive, these relationships look more attractive than they really are. Knowing the relative HIV risks changes their risk-benefit calculus and reduces the number of unprotected sexual acts between teenage girls and older men.


    The first steps in the theory are all assumptions about the local context, which would need to hold before we could expect that the program might work. Telling girls about the relative risk of HIV by age is not going to reduce the number of pregnancies with older men unless such relationships are common, older men have higher rates of HIV than younger men, and girls do not realize that older men have higher rates than younger men.

    Step 2: The next step is to assess whether these conditions hold in Rwanda. Using publicly available data, we found that in Rwanda, too, HIV infection rates are higher among older men than younger men, and many of the teenage girls who are sexually active are so with men at least five years older than them.

    But there were also important differences. In Rwanda, men ages 25-29 have an HIV rate of 1.7 percent compared with 28 percent in the district in Kenya where the original evaluation was carried out. We also found no publicly available data on perceptions of HIV risk in Rwanda. In Kenya, the fact that girls did not realize that HIV risk rose with age until they went through the program was likely to be a key driver of impact. It was therefore important to understand whether there was a similar gap between perceptions of HIV risk by age and action HIV risk by age in Rwanda.

    A team from J-PAL Africa at the University of Cape Town, led by Emily Cupito, worked with the Rwanda Biomedical Center to collect local descriptive data on what teenage girls and boys knew about HIV risk. These data showed that in Rwanda most teenage girls already knew the relative risk: They correctly identified that older men were more likely to be infected with HIV than younger men. Overall, the girls in Rwanda had a pretty good understanding of the relative risk of men of different ages, although they massively overestimated the percentage of both younger and older men who have HIV. For example, 42 percent of students estimated that more than 20 percent of men in their 20s would have HIV. Only 1.7 percent of surveyed students correctly identified the HIV prevalence rate for men in their 20s as being less than 2 percent.

    Note that the data that ultimately helped to diagnose whether the treatment might be effective in Rwanda did not come from an impact evaluation or an RCT. They were simple descriptive or observational data that were collected quickly (over two weeks) to assess whether the conditions were right for a program to be effective.

    Funneling this local information back into our generalizability framework raised a serious concern. If an information campaign causes teenage girls dramatically to lower their perception of HIV risk associated with unprotected sex in general, but does not change their perception of relative risk, it is possible that the program could lead teenage girls to increase the amount of unprotected sex they have with both younger and older men.

    Consequently, J-PAL did not recommend trying a “Sugar Daddies Risk Awareness” campaign in Rwanda and instead suggested exploring other mechanisms for reducing teenage pregnancy. It is important to stress, however, that we do not have a lot of evidence on exactly how and why the program worked so dramatically in Kenya. We also cannot rule out that the Kenyan program might work in Rwanda. But clearly some local conditions that theory suggests could be important for this approach do not hold in Rwanda. In this case, we concluded with the second step and recommended alternative approaches.

    From India to Chicago

    Depending on the mechanisms at work, lessons from one context can and do successfully transfer to other contexts. Let us turn to a final example that illustrates this point. Recently, our Education Lab colleagues in Chicago worked with the Chicago Public Schools to help high school boys who had fallen years behind the curriculum make progress. The individualized two-on-one tutoring program they tested with a randomized evaluation in collaboration with Match Education gained national attention for its large improvements in math scores.12

    What informed the choice to try individualized learning in Chicago? The research team drew not only from quasi-experimental evaluations of high-dosage tutoring in Texas,13 but also from randomized evaluations done in Kenya and India—contexts no one would categorize as similar to Chicago. But a look at the underlying mechanisms that helped struggling students catch up academically finds very consistent evidence across extremely dissimilar contexts.

    In Kenya, an early randomized evaluation found that providing classrooms with new textbooks did not help children learn—except for those children who were already at the top of the class.14 This suggested that part of the problem was that the curricula and textbooks were tailored to some but not all the wide range of learning levels in the class. A follow-up evaluation tested the idea of helping teachers provide instruction more tailored to the needs of students by grouping them by initial learning levels; it found that learning improved for students in all groups.15

    Meanwhile, in India, Pratham, an NGO dedicated to improving education, was addressing the same challenge by enlisting local volunteers to tutor young children in basic literacy and numeracy. Though the context and approach were different, the program engaged a similar underlying mechanism: Children who had fallen years behind the official curriculum were able to catch up relatively quickly with focused teaching at the right level. Over the past 10 years, our colleagues have worked with Pratham to test different iterations of their tutoring programs in different settings: rural and urban, instruction by volunteers or government teachers, during the school day or during summer break. The results have been consistently positive.16

    When our colleagues reviewed all the relevant evidence as they designed the Chicago study, they found parallels in the local conditions most relevant to the generalizability framework. In Chicago—as in India and Kenya—some of the students had fallen years behind the curriculum, but teachers faced incentives to teach grade-level material rather than catch-up material targeted to students’ genuine learning levels. Features of program implementation also had parallels: Tutors could be trained to teach to the level of the student and implement this without having to worry about managing a whole classroom with a wide range of needs. An otherwise prohibitively expensive step (teaching in very small groups) was made feasible by Match Education’s approach of bringing in well-educated individuals who were willing to work for a year for a modest stipend as a public service. As in India, by removing the need for the specialized training of complex classroom management and incentives to focus only on the grade-level curriculum, they were able to run a small-group program for a more scalable cost.

    This example underscores the importance of drawing connections between seemingly dissimilar studies in a way that a good literature review does. These academic reviews that discuss the common mechanisms behind effective programs are useful for policy makers precisely because they home in on the underlying behaviors that generalize across superficially different contexts. This is very different from the growing fashion in some policy circles of promoting metaanalyses, which are traditionally used in medicine and simply average the effects found across different studies. Although such meta-analysis can give an overview of a particular category of studies, it would not have helped our colleagues in Chicago: The textbook evaluation would have been averaged with other studies testing the effect of other inputs (such as chairs and desks), while the tutoring studies would have been put into another group of studies. A meta-analysis cannot draw the theoretical connections between two studies that are motivated by the same theory but test different interventions.

    Understanding Context

    Too often, those who care about local context and those who do impact evaluations are seen as opposed, but this perception is false. Those of us who conduct impact evaluations and help governments integrate the lessons into policy care passionately about understanding the local context. The key to the generalizability puzzle is recognizing that we have to break any practical policy question into parts: Some parts of the problem will be answered with local institutional knowledge and descriptive data, and some will be answered with evidence from impact evaluations in other contexts.

    The generalizability framework set out in this paper provides a practical approach for combining evidence of different kinds to assess whether a given policy will likely work in a new context. If researchers and policy makers continue to view results of impact evaluations as a black box and fail to focus on mechanisms, the movement toward evidence-based policy making will fall far short of its potential for improving people’s lives.

    Read more stories by Mary Ann Bates & Rachel Glennerster.

    Wed, 18 May 2022 18:31:00 -0500 en-us text/html
    Killexams : Scientists explore post-COVID-19 conditions among children

    In a recent study published in JAMA Network Open, scientists evaluated post coronavirus disease 2019 (COVID-19) conditions (PCC) across children 90 days following COVID-19 infection.

    Study: Post–COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection. Image Credit: FamVeld/Shutterstock
    Study: Post–COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection. Image Credit: FamVeld/Shutterstock


    Following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, PCCs characterized as chronic, new, or reoccurring health issues may develop. Even though PCCs have been reported predominantly among adults, concern for PCCs among children is now rising.

    However, the risk factors and likelihood of children getting PCCs are poorly understood. Furthermore, it is uncertain how many SARS-CoV-2-infected children who underwent emergency department (ED) testing reported PCCs 90 days following their ED visits.

    To inform the care of high-risk children and guide public health policies, a thorough understanding of pediatric PCCs is necessary.

    About the study

    The current work aimed to determine the percentage of children who tested positive for COVID-19 and developed PCCs 90 days later, compare that percentage to that of children who tested negative for SARS-CoV-2 and evaluate risk factors for PCCs.

    The present prospective cohort study accomplished in 36 EDs in eight nations between 7 March 2020 and 20 January 2021 encompassed 1884 COVID-19-positive children who finished 90-day monitoring; 1686 were frequency matched by country, hospitalization status, and enrollment date with 1701 COVID-19-negative controls. The eight countries involved in the analysis were the United States, Argentina, Costa Rica, Canada, Italy, Singapore, Paraguay, and Spain. 

    Eligible study volunteers included children under 18 years who had undergone SARS-CoV-2 screening at participating EDs due to epidemiologic risk factors (such as close contact with a COVID-19 case) or symptoms. Further, SARS-CoV-2 was detected using a nucleic acid test. The authors defined PCCs as any ongoing, novel, or recurring health issues documented in the research's 90-day follow-up assessment. 

    The main goal of the investigation was to gauge how many SARS-CoV-2-positive participants had PCCs 90 days following the baseline ED visit, differentiated by hospitalization status. The scientists were looking for COVID-19-positive children's PCC risk factors. To fully comprehend how PCCs and SARS-CoV-2 infection are related, they compared PCCs between virus-infected children and matched COVID-19-negative children.


    Overall, in a prospective multinational pediatric sample, the authors determined the percentage of children who had PCCs 90 days following SARS-CoV-2 screening, sorted by hospitalization status. They found risk factors for PCCs in children who tested positive for SARS-CoV-2 and contrasted the frequency of PCCs in this cohort to a matched group of SARS-CoV-2-negative children.

    The study results indicated that of the 8642 enlisted children, 2368, i.e., 27.4%, tested positive for SARS-CoV-2, and 2365, i.e.,99.9%, had baseline ED visit disposition information available. The team noted that out of the 1884 children, i.e., 79.7%, who underwent follow-up, the average age was three years, and 994, i.e., 52.8%, were boys.   

    In addition, 110 SARS-CoV-2-positive participants, i.e., 5.8%, reported PCCs, including 44 of 447 subjects, i.e., 9.8%, hospitalized during acute COVID-19 and 66 of 1437 subjects, i.e., 4.6%, non-hospitalized during acute illness. Weakness or fatigue was the most prevalent symptom among SARS-CoV-2-positive children, and 21 participants, or 1.1%, reported it.

    Factors associated with experiencing at least one PCC at 90 days were being hospitalized for ≥48 hours relative to not being hospitalized, reporting ≥four symptoms at the initial ED visit versus one to three symptoms, experiencing ≥seven symptoms, and being ≥14 years compared to younger than one year old. PCCs were reported more likely by children who tested positive for SARS-CoV-2 at 90 days than COVID-19-negative children. This was observed in the non-hospitalized group with 55 of 1295 subjects versus 35 of 1321 subjects and the hospitalized group with 40 of 391 subjects versus 19 of 380 subjects.

    In addition, reporting PCCs 90 days following the baseline ED visit, especially systemic health issues (such as weakness, fatigue, or fever), was linked to SARS-CoV-2 positivity.


    In the present cohort analysis of 1884 COVID-19-positive children with 90-day surveillance, 5.8% of participants, comprising 4.6% of children who were discharged and 9.8% of children who were hospitalized, reported PCCs. Being hospitalized for 48 hours or longer, mentioning four or more symptoms at the initial ED visit, and being 14 years or older were traits connected to PCCs. The current findings can guide public health officials on PCC screening methods for people with severe SARS-CoV-2 infections and COVID-19 mitigation tactics for children.

    According to the current study, children who test SARS-CoV-2-positive require proper counseling and follow-up, especially if they are older and have numerous acute symptoms since PCCs are so common. 

    Wed, 27 Jul 2022 01:49:00 -0500 en text/html
    Killexams : The Bar exam Is Incredibly Difficult To Pass. It’s Even Harder For Those Who Are Pregnant Or Nursing.

    When Estefania Parra Simmons took the California bar exam in February 2021, she was six months pregnant. She had recently graduated from law school and had studied hard, gritting her teeth through the severe pain that accompanied her growing baby bump, in order to pass the exam and become a licensed attorney.

    Preparing for the bar can already be stressful enough — but in Parra’s case, sitting for the hourslong, two-day test was likely to be physically excruciating.

    “Even by the time I was 40 minutes in, my back was killing me, and my baby was moving around like she was doing Zumba in there,” Parra, 37, told BuzzFeed News. “My ribs hurt so badly … [it] was torture.”

    Unable to concentrate through the pain, Parra ran out of time, filling in “C” for the remaining multiple choice questions. When her results came in months later, she wasn’t surprised to have failed. “I knew in my heart I did not pass,” she said. “[It was] devastating on so many different levels.”

    Parra had applied for pregnancy accommodations for the exam, requesting longer break times, but she was denied due to a missing supplemental form for physical disabilities, which she had not realized was needed. Instructions for requesting accommodations found on the California bar website state that “applicants with temporary medical conditions, such as a pregnancy or broken leg, and mothers who are nursing” may request accommodations, but does not specify that they are classifying these individuals as disabled — a confusing distinction as it deviates from the Americans With Disabilities Act, which covers pregnancy-related disabilities, but not pregnancy or lactation in and of themselves.

    “I’m sorry, but I was 36 years old, and nowhere in my brain did it ever cross my mind that I would have to declare myself physically disabled while I was pregnant,” Parra said. “And there’s absolutely nothing on their website — I read the rules, the requirements for accommodations, everything, [and] there is nothing that says this is what you have to do.”

    Now, Parra is preparing to retake the exam on Tuesday, but again, she will not be granted the longer breaks she requested to pump milk for her 1-year-old daughter. Her request was denied because a form she needed from her doctor wasn’t finalized until a day or two before the deadline, which coincided with the death of her 16-year-old dog.

    Between the stress of studying, caring for her baby, and grieving her pet, she narrowly missed the deadline — her mistake, she acknowledges, but she was disheartened when administrators wouldn’t make an exception and flatly rejected her appeal.

    Without the necessary accommodations, Parra is likely to once again suffer through physical pain during the exam. “My boobs are going to harden, they become like rocks,” she said. “And it really hurts — it’s like little needles being stuck into your boob.”

    The bar is famously arduous, anxiety-provoking, and difficult to pass. Less than 40% of people passed the California exam in February 2021, the same test that Parra took. But for pregnant or nursing test takers like Parra, one of the biggest challenges can be accessing the accommodations they need for the two-day exam. The rules for accommodations, both in what is offered and how they are requested, vary widely by state — and even for meticulous future lawyers, the process can be perplexing and unforgiving. As a result, some across the US have their requests denied, putting them at a disadvantage for the exam that can hinder them in beginning their careers.

    This is far from a brand-new issue. In 2014, an Illinois woman was initially denied extra time to pump, but after contacting the ACLU and speaking out in the media, administrators granted her the requested breaks. In October 2020, a pregnant woman, also in Illinois, was denied accommodations for the bar exam she would be taking just two weeks before her due date. She wound up going into labor during the first day of the exam, but continued, going to the hospital only after she was done. She gave birth the next day, after which she completed the rest of the exam from her hospital bed — and passed. And lawyers aren’t the only professionals who may find themselves held back by insufficient accommodations for exams; in 2007, a Massachusetts mother preparing for her medical licensing exam was not permitted extra break time for pumping. She sued, and five years later, a state court ruled in her favor.

    Maddie Abuyuan / BuzzFeed News; Courtesy Estefania Parra Simmons; The Bar of the State of California; Getty Images

    “It’s very concerning that at this critical time, where women are seeking an entry point into their legal careers, that such barriers exist,” attorney Melinda Koster, who specializes in discrimination cases, told BuzzFeed News. “This can mean that women end up postponing taking the bar examination altogether, or they have to experience significant anxiety or pain while taking the bar.”

    In a statement to BuzzFeed News, the State Bar of California’s Chief of Programs Donna Hershkowitz said they are reviewing their accommodations policies and recently held a forum to discuss issues that have arisen and how they might be addressed. “We look forward to working with former and current applicants as well as the disability rights community as we revise and reshape our process. That being said, unfortunately we are not in a position to comment on individual cases,” Hershkowitz said.

    A breastfeeding mother taking the exam in another state this week, who asked to remain anonymous due to fears of harming future job prospects, told BuzzFeed News she also tried to apply for accommodations. She, too, was denied; her jurisdiction offers a space to pump and allows test takers to bring their equipment, but denied her request for additional breaks so she could pump as needed. Administrators said extra breaks would only be granted to applicants with disabilities covered by the ADA, which lactation is not.

    “I was told I could just pump during my lunch break,” she said. “Right now, I feed my baby every two hours … so really, you’re looking at four hours between pumping.”

    With no recourse, the mother has little choice but to accept the decision and get back to studying. She plans to pump in her car up until the moment she has to go inside for the exam, then pump in the car again during lunch. Days before the exam, she took a practice test, during which she “practiced” pumping according to the schedule the bar will force her to follow.

    For lactating people, being told to “just pump during lunch” is insufficient to address their individual needs. The inflexible schedule of the bar can mean test takers are unable to express human milk as regularly as they need to, putting them at risk for health complications including painfully engorged breasts, a reduced milk supply, clogged ducts, or even mastitis, a bacterial infection that can become serious.

    “Philosophically, people think breastfeeding is a choice,” attorney Fran Griesing told BuzzFeed News. “[But] it’s not something you can turn on and off easily … [or] say, ‘I’m not going to do it today.’ To say it’s a choice, whether to start in the first place or somehow not do it during the bar exam, is beyond ridiculous.”

    And it’s even less of a “choice” than ever right now, due to the severe formula shortage that’s left parents across the US struggling to feed their babies.

    Learning of future lawyers struggling to access pregnancy-related bar accommodations has felt particularly grim following the repeal of Roe v. Wade, Griesing said. And it’s not the only way she’s seen sex inequality in bar exam practices — it was just last year that the American Bar Association passed a resolution urging that examinees should be permitted to bring menstrual products, but many state bar examiners still don’t offer clear guidance. These policies can have an outsize impact not just on cisgender women, but also on trans and nonbinary people, for whom accommodations may be even harder to access and put them at risk of being involuntarily outed.

    “To me, it’s sadly ironic … that the highest court in the land has made that decision,” Griesing said of the Supreme Court’s abortion ruling. “But the same profession that those justices come from and the leaders of that profession are making it harder and harder for women to become lawyers.”

    MothersEsquire, an organization advocating for mothers in the legal field, has taken a leading role in pushing for those struggling to get pregnancy accommodations for the bar. Michelle Browning Coughlin, the group’s founder, told BuzzFeed News she typically hears from at least one person going through this each bar cycle. For the upcoming July bar, she has heard from three.

    “There is such a contradiction around the fact that [bar administrators] are presumably interested in seeking justice, fairness, the kinds of things the law is supposed to stand for,” Coughlin said. “And yet here they are in a situation where their own ability to enter that profession is being hampered merely because they’re a breastfeeding mother.”

    Many in the legal field argue that the denial of these accommodations is discriminatory, due to the disproportionate impact it can have on pregnant or nursing people. But the liminal status of most of these people — people who have completed law school, but don’t have jobs yet or haven’t begun their employment — means that federal laws that might have protected them do not apply during this period of limbo. As students, Title IX would forbid discrimination on the basis of sex, including being pregnant or a parent. Once employed, federal laws give people who lactate the right to express milk in the workplace and prohibit pregnancy-based discrimination.

    In the absence of federal legislation that would unambiguously protect pregnant or breastfeeding bar examinees, Coughlin must advocate for every person who reaches out to MothersEsquire individually, familiarizing herself with the wildly varying policies of any of the 50 states.

    But even in states where pregnancy-related accommodations can be accessed, such policies are often vaguely written and difficult to find, causing some applicants to be denied over minor errors or missing forms they never knew were needed.

    Koster, the lawyer, told BuzzFeed News that women are spending time researching their rights, speaking to lawyers, and going through "extremely burdensome" appeals processes at a time when they should be studying instead.

    Maddie Abuyuan / BuzzFeed News; The Bar of The State of California; Getty Images

    “It sounds hyperbolic, but it’s basically saying to someone, ‘You can either be a mom or you can be a lawyer — which one do you choose? You can either take this bar exam, or you can feed your baby — which one do you want to do?’ And which one do you think most people are going to do?” Coughlin said.

    And being denied these necessary accommodations can have long-lasting effects on test takers’ lives and finances, holding them back from beginning their legal careers.

    “The lack of accommodations could very well mean that an exam taker who’s pumping will fail the bar, because the reality is, the break time that’s offered during the bar examination doesn’t necessarily align with when women need to pump,” Koster said.

    The possibility of this outcome is all too familiar for Parra, who can only hope she is able to focus on the exam despite the pain she’s likely to experience. If she doesn’t pass this time, she does not plan to try again in February 2023 — it’s been deeply demoralizing, and she needs a break, she said.

    Parra can’t help but cry when she considers what preparing for the bar has meant for her as a mother. Her husband has also been studying for it, so Parra’s mom has stepped in to help with much of the childcare.

    “I’ve missed so many firsts of my daughter because I was studying for this exam. … She started walking in early June, and I missed it,” she said. “Studying for this exam literally makes me feel like a bad mother.” ●

    Mon, 25 Jul 2022 09:15:00 -0500 en-US text/html
    Killexams : Airbus and CFM launch flight test demonstrator for advanced open fan architecture

    Photo Credit, all images: Airbus

    Airbus (Toulouse, France) and CFM International (Cincinnati, Ohio, U.S.), a 50/50 joint company between GE Aviation (Cincinnati) and Safran Aircraft Engines (Courcouronnes, France), are collaborating to flight test CFM’s cutting-edge open fan engine architecture.


    Joint flight-testing ambitions

    The joint demonstration program will use shared flight test assets. The plan is for CFM to perform engine ground tests, along with flight test validation, at GE Aviation’s Flight Test Operations center in Victorville, Calif., U.S.

    A second phase of flight tests will be performed from the Airbus flight test facility in Toulouse, France, in the second half of the decade. For these tests, the open fan engine will be mounted under the wing of a specially configured and instrumented A380 testbed aircraft.

    The joint Airbus and CFM objectives for the open fan joint demonstration on the A380 are extensive. The high-level goals include: evaluation of open fan propulsive efficiency and performance on an aircraft; acceleration and maturity of technologies through ground testing; assessment of aircraft/engine integration and aerodynamics (thrust, drag, loads); and evaluation of internal and external noise levels.

    The goal is to achieve future engine and aircraft efficiency improvements, including propulsive system efficiency gains; improved fuel efficiency that could provide a 20% reduction in CO2 emissions compared to today’s most efficient engines and ensuring compatibility with 100% sustainable aviation fuels (SAF). Note, a reduction in CO2 emissions beyond 20% can be realized using SAF versus conventional jet fuel.

    Prediction capabilities are key to find the right design that meets both the fuel efficiency and the acoustic targets (for the communities around airports and also for passengers inside the cabin). And because CFM’s engine and the wing will be very close-coupled, these capabilities have to be developed in close collaboration. 

    Read more about preparing the flight test hardware and evolution from two counter-rotating fans to a single plus fixed stators at “Could an open fan engine cut carbon emissions for more sustainable aviation?


    Open fan revolution and CFRP blades

    In the Nov. 2021 GE Aviation blog, “Why the Time for Open Fan is Now,” GE Aviation Chief Engineer, Chris Lorence, explains the open fan’s revolution:

    “It wasn’t just a breakthrough, it was radical. A single-stage fan that wasn’t simply a propeller, but rather one set of rotating fan blades with the same speed and performance of a counter-rotating fan.”

    He points out that the 20% efficiency gain the open fan is geared toward is no small feat:

    “The LEAP engine, introduced in 2016, is 15% more efficient than CFM56-5B and -7B engines. The GEnx engine is up to 15% more efficient than the CF6-80C2, and the GE9X engine has been designed to be up to 10% more efficient than the GE90-115B. But the push for 20% greater fuel efficiency in one generation? That is something different.”

    He then includes carbon fiber-reinforced polymer (CFRP) blades as a key part of the latest design:

    “Over the last 50 years, we’ve learned how to make the open fan engine design simpler and lighter. Stationary outlet guide vanes replace previous two-stage, counter-rotating fan blades in our latest designs. This change is significant because we can direct air flow and fly at speeds consistent with conventional turbofan engine architectures.

    Add to that our fourth generation — and the industry’s only — carbon fiber composite fan blades, which are well suited to move to an open fan engine. No one else in the industry has the depth of expertise or composite fan experience that GE Aviation has.”


    Removing the nacelle

    Lorence also discusses why removing the nacelle provides efficiency gains, and how it affects the size of the CFRP fan blades:

    “While ducts (or fan cases/nacelles) perform some aerodynamic function, their primary function is structural. But they weigh a ton. Literally. And when you take most of that weight away with the open fan design, you also remove propulsion drag.

    We joke that removing the nacelle lets a fan blade be a fan blade. When there is a nacelle, you have to decide how big you want the fan to be. But when you remove the nacelle, the fan is able to be as big as it needs to be from an aerodynamic standpoint. Even with larger blades, the open fan is not much bigger than the nacelle we have around the CFM LEAP engine today. In fact, the blades for the RISE Program’s open fan are not much bigger than the GE9X fan blades.”

    Airbus and CFM commitment

    “New propulsion technologies will play an important role in achieving aviation’s net-zero objectives, along with new aircraft designs and sustainable energy sources,” Sabine Klauke, Airbus chief technical officer (CTO), says. “By evaluating, maturing and validating open fan engine architecture using a dedicated flight test demonstrator, we are collaboratively making yet another significant contribution to the advancement of technology bricks that will enable us to reach our industry-wide decarbonization targets.”

    “The CFM RISE Program is all about pushing the technology envelope, redefining the art of the possible and helping to achieve more sustainable long-term growth for our industry,” Gaël Méheust, president and CEO of CFM International, adds. “CFM, its parent companies and Airbus all share the same vision and commitment for the future; the open fan flight test demonstration program is an exciting next step toward achieving the industry’s net-zero goals.”

    This collaboration with CFM is just one part of Airbus’ technology demonstrator portfolio. In Feb. 2022, the two companies announced a joint flight test program to validate hydrogen propulsion capability. Airbus, CFM and CFM’s parent companies, GE Aviation and Safran, are committed to fulfilling the promise they made in signing the Air Transport Action Group goal in Oct. 2021 to achieve aviation industry net-zero carbon emissions by 2050, and developing and testing the technologies required.


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    Wed, 20 Jul 2022 05:14:00 -0500 en text/html
    Killexams : Is Surgery the Only Safe Option for Acute Uncomplicated Appendicitis?

    For decades, surgical appendectomy has been the standard treatment for acute appendicitis. But nonoperative management with antibiotics is an option for some patients. For acute, uncomplicated appendicitis, a new meta-analysis reports, nonoperative management with antibiotics is safe and effective.

    Avoiding surgery may eliminate some risks, such as those associated with invasive treatment or COVID-19, but the choice may have drawbacks. The study also found increased risk of appendicitis recurrence and a longer hospital stay associated with nonoperative management compared to surgery.

    The results can help surgeons guide patients in decision-making, the authors conclude. The article was published in JAMA Surgery on July 27.

    Dr Rodrigo Moises de Almeida Leite

    "Our work does not intend to prove that antibiotics should be a first-line option or a standard of care of treatment in appendicitis," first author Rodrigo Moises de Almeida Leite, MD, told Medscape Medical News.

    Rather, said Leite, who is an affiliate of the Colon and Rectal Surgery Department at Massachusetts General Hospital, "antibiotics [are] another safe option."

    Dr Pauline Park

    "Patients often want to know if they can delay or even avoid surgery as a treatment option, and there's really increasing focus on this patient-centered aspect of decision-making," Pauline Park, MD, a clinical professor of acute care surgery at the University of Michigan Medical School, told Medscape. Park was not involved with the study.

    Surgery or Antibiotics?

    For their systematic review, eight trials met the authors' inclusion criteria for meta-analysis — randomized clinical trials involving adults with uncomplicated acute appendicitis in which the study compared nonoperative management with appendectomy. Outcomes were treatment success (as each study defined it) and major adverse events, both at 30 days.

    Antibiotics were delivered in accordance with various protocols. Surgery could be open, laparoscopic, or robotic. Patients were excluded if their condition was unstable or there were complications, such as perforation, abscess, or peritonitis.

    The eight trials were published between 1995 and 2020 and involved 3528 patients in North America and Europe. Primary outcomes and definitions of treatment success were similar. Follow-up durations varied.

    Similar Short-Term Results

    For the two primary outcomes of efficacy and safety at 30 days, nonoperative management was comparable to surgery. Overall, the risk ratio (RR) of treatment success in operative vs nonoperative groups was 0.85 (95% CI, 0.66 – 1.11). In six trials, there was no difference between the two approaches, while one trial favored surgery, and another found antibiotics superior.

    Six trials reported major adverse events. The two approaches again appeared comparable, with an overall RR with antibiotics vs surgery of 0.72 (95% CI, 0.29 – 1.79). Again, one trial favored each approach, while the remaining four found no difference.

    In two secondary outcomes, surgery had the advantage.

    Length of stay, reported in three trials, was significantly shorter for surgical patients. In addition, four trials reported the need for appendectomy due to recurrence after nonoperative treatment. This outcome affected a median of 18% of nonoperative patients (range, 7% to 29%).

    Limitations included high heterogeneity and a lack of patient-reported outcomes or detail about surgical technique. In addition, the authors included only English-language studies and excluded most patients who had appendicoliths because of an expected higher failure rate of nonoperative management.

    An Option for Some

    For many patients with uncomplicated appendicitis, surgery remains a clear first choice. But nonoperative management may sometimes be preferred, such as for patients who cannot tolerate surgery or in settings in which surgical resources are scarce, such as hospitals experiencing COVID-19 surges.

    Dr Rose Chasm

    Nonoperative management has been practiced for decades, particularly in rural and military settings and in Europe, according to Rose Chasm, MD, an assistant professor of emergency medicine at the University of Maryland School of Medicine, who spoke with Medscape. She was not involved in the study.

    However, she added, the patients who are considered for this approach typically represent a select population.

    "The appendicitis can't be severe. It has to be very localized. The patient can't have peritonitis on exam...[nor] complications, such as an abscess or a perforation. They cannot have an appendicolith," Chasm said. "[Nonoperative management] shouldn't be utilized in pregnant patients or patients who are immunocompromised."

    Patients outside that group may face a higher possibility of disease progression, while avoiding surgery also may lead to missed or delayed diagnosis of malignancy, she added.

    Another caveat, Chasm added, is that there is no consensus standard on an antibiotic regimen. Typically, it begins with intravenous antibiotics followed by outpatient treatment, but agents and duration can vary.

    Risks and benefits of both options should be fully discussed with the patient, Chasm said.

    The variation in antibiotic treatment regimens has a bearing in interpreting lengths of hospital stay, noted Park — and practices are changing: "Data from even right before COVID may not [reflect current] practice."

    Park was involved with CODA, one of the trials analyzed in the meta-analysis. CODA's results helped inform the American College of Surgery's pandemic guidelines regarding appendicitis. Park was also involved with the Treatment Individualized Appendicitis Decision-making (TRIAD) trial, which offers a patient-facing decision aid at

    "We need to continue work focused on increasing patient knowledge and understanding of nuances so that they can make informed decisions that are best for them," Park said.

    The study did not receive funding. One co-author works for Daiichi Sankyo. The other co-authors and the commenters report no relevant financial relationships.

    JAMA Surg. Published online July 27, 2022. Abstract

    Jenny Blair, MD, is a journalist, writer, and editor in Vermont.

    For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

    Wed, 03 Aug 2022 03:45:00 -0500 en text/html
    Killexams : Subarachnoid Hemorrhage

    Aneurysmal subarachnoid hemorrhage is diagnosed by computed tomography of the head and by CT angiography, catheter angiography, or both. Randomized trials suggest that aneurysms treatable by either open surgery or endovascular intervention are usually better treated by the latter.

    Sat, 12 Mar 2022 17:33:00 -0600 en text/html
    Killexams : JEECUP Result 2022: UP Polytechnic results declared at
    JEECUP Result 2022 (Today): UPJEE Polytechnic Entrance exam Result has been declared today - 18 July 2022. Check JEECUP 2022 results online through the official website -

    Ending the long wait, UPJEE Polytechnic Entrance exam Result has been released today - 18th July 2022. As per the earlier update, Joint Entrance Examination Council of Uttar Pradesh (JEECUP) was set to declare JEECUP 2022 Result, State Level Entrance Exam. The results of UPJEE (Polytechnic) have been declared today in online format and is available in the form of a digital scorecard on the portal -


    You have successfully cast your vote

    Alternatively, a direct link to check and obtain JEECUP Result 2022 scorecard has also been provided below, post the formal announcement by the examination authority.

    JEECUP Result 2022 Direct link

    Scorecard details on JEECUP Polytechnic Result 2022

    JEECUP Result 2022 has been declared in the form of a digital scorecard containing important details about the candidate as well as their performance in the polytechnic entrance exam. JEECUP Polytechnic Result 2022 contains key details such as candidate's name, parent's name, date of birth, gender and their JEECUP roll number. On the performance front, JEECUP Scorecard 2022 includes the group name, aggregate marks, qualifying status, category-wise open rank and other such details. Candidates are advised to go through all these details carefully while checking JEECUP 2022 Result. In case of any error or discrepancy, it is mandatory to bring it to the notice of the examination authority at the earliest.

    How to check JEECUP Result 2022 online, step-by-step guide

    • Similar to the application process and admit card download, JEECUP 2022 result has been declared by the authority in online mode.
    • To obtain JEECUP result 2022 scorecard, candidates need to log on to the official portal - and scroll down to the candidate activity section.
    • Here they will get a link for 'JEECUP Result 2022 - obtain Scorecard'.
    • Clicking on the link will redirect them to a login page where candidates have to enter their date of birth and application number.
    • After filling and submitting the details, JEECUP Result 2022 will be displayed on the screen.
    • Then, you can easily obtain JEECUP Result Scorecard 2022 softcopy/PDF format and save it for further.

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    Mon, 18 Jul 2022 06:10:00 -0500 text/html
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