The development of model techniques for prediction of creep strains applied to steam turbine casings

Because of the long service expected from steam power plant it is not practicable to obtain creep data from prototype installations to assist design against excessive creep. Model techniques, however, allow accelerated creep testing in a laboratory environment, which will produce the required creep information in a period of weeks rather than years. Models are made of a lead alloy and subjected to the scaled mechanical service loads at room temperature. Similarity conditions, based on the usual stress-strain-time relationships, have been developed which allow the measured strain distribution to be used to predict the strains in the engineering component at any time during its useful service life. This prediction requires only the uniaxial creep characteristics of the model and component materials. At present the technique is limited to constant temperature conditions. A lead-antimony-arsenic alloy has been selected which can be cast in the laboratory, giving good homogeneity, isotropy and fine grain structure; this material shows sufficient creep strain due to conveniently small stresses at room temperature. The steady load stress-strain-time characteristics have been determined from uniaxial tests. The model technique has been used to study simplified steam turbine casings subjected to internal pressure. The shapes tested consisted of axially split, flanged cylinders with domed end closures containing large bossed central bores to simulate the turbine bearings and glands. The loading of the models was due to the bolting forces and due to internal pressure. Strains on the inner and outer surfaces were measured with electric resistance strain gauges

The development of model techniques for prediction of creep strains applied to steam turbine casings

Because of the long service expected from steam power plant it is not practicable to obtain creep data from prototype installations to assist design against excessive creep. Model techniques, however, allow accelerated creep testing in a laboratory environment, which will produce the required creep information in a period of weeks rather than years. Models are made of a lead alloy and subjected to the scaled mechanical service loads at room temperature. Similarity conditions, based on the usual stress-strain-time relationships, have been developed which allow the measured strain distribution to be used to predict the strains in the engineering component at any time during its useful service life. This prediction requires only the uniaxial creep characteristics of the model and component materials. At present the technique is limited to constant temperature conditions. A lead-antimony-arsenic alloy has been selected which can be cast in the laboratory, giving good homogeneity, isotropy and fine grain structure; this material shows sufficient creep strain due to conveniently small stresses at room temperature. The steady load stress-strain-time characteristics have been determined from uniaxial tests. The model technique has been used to study simplified steam turbine casings subjected to internal pressure. The shapes tested consisted of axially split, flanged cylinders with domed end closures containing large bossed central bores to simulate the turbine bearings and glands. The loading of the models was due to the bolting forces and due to internal pressure. Strains on the inner and outer surfaces were measured with electric resistance strain gauges

On bird species diversity and remote sensing – utilizing lidar and hyperspectral data to assess the role of vegetation structure and foliage characteristics as drivers of avian diversity

Avian diversity has long been used as a surrogate for overall diversity. In forest ecosystems, it has been assumed that vegetation structure, composition and condition have a significant impact on avian diversity. Today, these features can be assessed via remote sensing. This study examined how structure metrics from lidar data and narrowband indices from hyperspectral data relate with avian diversity. This was assessed in four deciduous-dominated woods with differing age and structure set in an agricultural matrix in eastern England. The woods were delineated into cells within which metrics of avian diversity and remote sensing based predictors were calculated. Best subset regression was used to obtain best lidar models, hyperspectral models and finally, the best models combining variables from both datasets. The aims were not only to examine the drivers of avian diversity, but to assess the capabilities of the two remote sensing techniques for the task. The amount of understorey vegetation was the best single predictor, followed by Foliage Height Diversity, reflectance at 830 nm, Anthocyanin Reflectance Index 1 and Vogelmann Red Edge Index 2. This showed the significance of the full vertical profile of vegetation, the condition of the upper canopy, and potentially tree species composition. The results thus agree with the role that vegetation structure, condition and floristics are assumed to have for diversity. However, the inclusion of hyperspectral data resulted in such minor improvements to models that its collection for these purposes should be assessed critically

Nucleon resonances in the fourth resonance region

Nucleon and $\Delta$ resonances in the fourth resonance region are studied in a multichannel partial-wave analysis which includes nearly all available data on pion- and photo-induced reactions off protons. In the high-mass range, above 1850\,MeV, several alternative solutions yield a good description of the data. For these solutions, masses, widths, pole residues and photo-couplings are given. In particular, we find evidence for nucleon resonances with spin-parities $J^P=1/2^+...7/2^+$. For one set of solutions, there are four resonances forming naturally a spin-quartet of resonances with orbital angular momentum L=2 and spin S=3/2 coupling to $J=1/2,...,7/2$. Just below 1.9\,GeV we find a spin doublet of resonances with $J^P=1/2^-$ and $3/2^-$. Since a spin partner with $J^P=5/2^-$ is missing at this mass, the two resonances form a spin doublet which must have a symmetric orbital-angular-momentum wave function with L=1. For another set of solutions, the four positive-parity resonances are accompanied by mass-degenerate negative-parity partners -- as suggested by the conjecture of chiral symmetry restoration. The possibility of a $J^P=1/2^+, 3/2^+$ spin doublet at 1900\,MeV belonging to a 20-plet is discussed.Comment: 16 page

Properties of baryon resonances from a multichannel partial wave analysis

Properties of nucleon and $\Delta$ resonances are derived from a multichannel partial wave analysis. The statistical significance of pion and photo-induced inelastic reactions off protons are studied in a multichannel partial-wave analysis.Comment: 12 pages, 8 Table

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Continuing medical education-driven skills acquisition and impact on improved patient outcomes in family practice setting.

BACKGROUND: An abundance of educational theory, design, and delivery of continuing medical education (CME) learning interventions, including their impact on learners, are described in the health and social sciences literature. However, establishing a direct correlation between the acquisition of new skills by learners and patient outcomes as a result of a planned CME learning intervention has been difficult to demonstrate. METHODS: The learning intervention described here tested the impact of an injection skills-acquisition program for family physicians treating osteoarthritis of the knee by measuring patient outcomes using the pain and function subscales of the Western Ontario and McMaster (WOMAC) 3.0 osteoarthritis index, a standardized and fully validated patient-centered outcome measurement. It was hypothesized that patients of family physicians who participated in this skills-acquisition CME program would benefit from treatment administered by their physician during the time between injection skills acquisition to 6 weeks post-injection. Inclusion of a validated health status measure administered pre- and post-injection in addition to more traditional faculty and participant program evaluations was deemed necessary to test this hypothesis. Rheumatology, orthopedic surgery, and family medicine specialists from across Canada were invited to contribute to the planning, curriculum elaboration, and delivery of the viscosupplement injector preceptorship (VIP) program. Thirty-nine orthopedic and rheumatology specialists agreed to serve as expert faculty and participated in training 474 Canadian family and general practitioners over 8 months. The learning intervention involved a review of pertinent literature by a local preceptor and a summary of recommendations of the planning committee, followed by demonstration of injector skills and then supervised practice with patients, who received hylan G-F 20 (Synvisc, Ridgefield, NJ) usually in the offices of the family physicians. The pain and function subscales of the WOMAC 3.0 questionnaire were self-administered to each patient in their physician's office, prior to receiving their joint injection and again at or near 6-weeks post-injection. Data were analyzed in the Department of Epidemiology and Biostatistics at The University of Western Ontario, London, ON. RESULTS: Clinically important statistically significant improvements in pain and physical function were noted in patients who received viscosupplementation treatment from family physicians who had recently acquired the necessary injection skills. Approximately three-quarters of the patients experienced a reduction in pain and an improvement in physical function of at least 20%. IMPLICATIONS: These results suggest a positive relationship between acquisition of a new skill by learners and improved patient outcomes as a result of this planned CME learning intervention