A Revolutionary Lunar Space Transportation System Architecture Using Extraterrestrial Lox-augmented NTR Propulsion

The concept of a liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) engine is introduced, and its potential for revolutionizing lunar space transportation system (LTS) performance using extraterrestrial 'lunar-derived' liquid oxygen (LUNOX) is outlined. The LOX-augmented NTR (LANTR) represents the marriage of conventional liquid hydrogen (LH2)-cooled NTR and airbreathing engine technologies. The large divergent section of the NTR nozzle functions as an 'afterburner' into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging from the NTR's choked sonic throat: 'scramjet propulsion in reverse.' By varying the oxygen-to-fuel mixture ratio (MR), the LANTR concept can provide variable thrust and specific impulse (Isp) capability with a LH2-cooled NTR operating at relatively constant power output. For example, at a MR = 3, the thrust per engine can be increased by a factor of 2.75 while the Isp decreases by only 30 percent. With this thrust augmentation option, smaller, 'easier to develop' NTR's become more acceptable from a mission performance standpoint (e.g., earth escape gravity losses are reduced and perigee propulsion requirements are eliminated). Hydrogen mass and volume is also reduced resulting in smaller space vehicles. An evolutionary NTR-based lunar architecture requiring only Shuttle C and/or 'in-line' shuttle-derived launch vehicles (SDV's) would operate initially in an 'expandable mode' with NTR lunar transfer vehicles (LTV's) delivering 80 percent more payload on piloted missions than their LOX/LH2 chemical propulsion counterparts. With the establishment of LUNOX production facilities on the lunar surface and 'fuel/oxidizer' depot in low lunar orbit (LLO), monopropellant NTR's would be outfitted with an oxygen propellant module, feed system, and afterburner nozzle for 'bipropellant' operation. The LANTR cislunar LTV now transitions to a reusable mode with smaller vehicle and payload doubling benefits on each piloted round trip mission. As the initial lunar outposts grow to centralized bases and settlements with a substantial permanent human presence, a LANTR-powered shuttle capable of 36 to 24 hour 'one-way' trip times to the moon and back becomes possible with initial mass in low earth orbit (IMLEO) requirements of approximately 160 to 240 metric tons, respectively

An australian audit of vaccination status in children and adolescents with inflammatory bowel disease

<p>Abstract</p> <p>Background</p> <p>Children and adolescents with inflammatory bowel disease (IBD) are at increased risk of vaccine preventable diseases (VPD). This includes invasive pneumococcal disease and influenza. The primary aim of this study was to describe compliance with current Australian guidelines for vaccination of children and adolescents diagnosed with IBD. A secondary aim was to review the serological screening for VPD.</p> <p>Methods</p> <p>A random sample of patients (0-18 years at diagnosis), were selected from the Victoria Australia state based Pediatric Inflammatory Bowel Disease Register. A multi-faceted retrospective review of immunization status was undertaken, with hospital records audited, a telephone interview survey conducted with consenting parents and the vaccination history was checked against the primary care physician and Australian Childhood Immunization Register (ACIR) records. The routine primary childhood vaccinations and administration of the recommended additional influenza and pneumococcal vaccines was clarified.</p> <p>Results</p> <p>This 2007 audit reviewed the immunization status of 101individuals on the Victorian Pediatric IBD database. Median age at diagnosis was 12.1 years, 50% were on active immunosuppressive therapy. 90% (38/42) [95% confidence intervals (CI) 77%; 97%] with complete immunization information were up-to-date with routine primary immunizations. Only 5% (5/101) [95% CI 2%; 11%] received a recommended pneumococcal vaccine booster and 10% (10/101) [95% CI 5%; 17%] had evidence of having ever received a seasonal influenza vaccine. Those living in rural Victoria (p = 0.005) and younger at the age of diagnosis (p = 0.002) were more likely to have ever received an influenza vaccine Serological testing, reviewing historical protection from VPD, identified 18% (17/94) with evidence of at least one serology sample.</p> <p>Conclusion</p> <p>This study highlights poor compliance in IBD patients for additional recommended vaccines. A multi-faceted approach is required to maximize protection from VPD in this vulnerable special risk population.</p

Developing engineering students' research and technology assessment abilities

This article describes research done among M. Eng. students in several faculties of the Eindhoven University of Technology into their abilities to integrate nontechnical (social) elements in the research that led to their M. Eng. theses. It was found that these students often lacked research skills (the abilities to define the research problem, to comment upon research methodology, to reflect upon research outcomes). As a result, they also tended to neglect social factors relevant to their engineering research. Recommendations to improve this situation are formulated for the curriculum of engineering education programmes

ERS technical standard on bronchial challenge testing: General considerations and performance of methacholine challenge tests

This international task force report updates general considerations for bronchial challenge testing and the performance of the methacholine challenge test. There are notable changes from prior recommendations in order to accommodate newer delivery devices. Rather than basing the test result upon a methacholine concentration (provocative concentration (PC20) causing a 20% fall in forced expiratory volume in 1 s (FEV1)), the new recommendations base the result upon the delivered dose of methacholine causing a 20% fall in FEV1 (provocative dose (PD20)). This end-point allows comparable results from different devices or protocols, thus any suitable nebuliser or dosimeter may be used, so long as the delivery characteristics are known. Inhalation may be by tidal breathing using a breath-actuated or continuous nebuliser for 1 min (or more), or by a dosimeter with a suitable breath count. Tests requiring maximal inhalations to total lung capacity are not recommended because the bronchoprotective effect of a deep breath reduces the sensitivity of the test

ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing

Copyright ©ERS 2018. Recently, this international task force reported the general considerations for bronchial challenge testing and the performance of the methacholine challenge test, a "direct" airway challenge test. Here, the task force provides an updated description of the pathophysiology and the methods to conduct indirect challenge tests. Because indirect challenge tests trigger airway narrowing through the activation of endogenous pathways that are involved in asthma, indirect challenge tests tend to be specific for asthma and reveal much about the biology of asthma, but may be less sensitive than direct tests for the detection of airway hyperresponsiveness. We provide recommendations for the conduct and interpretation of hyperpnoea challenge tests such as dry air exercise challenge and eucapnic voluntary hyperpnoea that provide a single strong stimulus for airway narrowing. This technical standard expands the recommendations to additional indirect tests such as hypertonic saline, mannitol and adenosine challenge that are incremental tests, but still retain characteristics of other indirect challenges. Assessment of airway hyperresponsiveness, with direct and indirect tests, are valuable tools to understand and to monitor airway function and to characterise the underlying asthma phenotype to guide therapy. The tests should be interpreted within the context of the clinical features of asthma

International consensus on lung function testing during the COVID-19 pandemic and beyond.

Coronavirus disease 2019 (COVID-19) has negatively affected the delivery of respiratory diagnostic services across the world due to the potential risk of disease transmission during lung function testing. Community prevalence, reoccurrence of COVID-19 surges and the emergence of different variants of SARS-CoV-2 have impeded attempts to restore services. Finding consensus on how to deliver safe lung function services for both patients attending and for staff performing the tests are of paramount importance. This international statement presents the consensus opinion of 23 experts in the field of lung function and respiratory physiology balanced with evidence from the reviewed literature. It describes a robust roadmap for restoration and continuity of lung function testing services during the COVID-19 pandemic and beyond. Important strategies presented in this consensus statement relate to the patient journey when attending for lung function tests. We discuss appointment preparation, operational and environmental issues, testing room requirements including mitigation strategies for transmission risk, requirement for improved ventilation, maintaining physical distance and use of personal protection equipment. We also provide consensus opinion on precautions relating to specific tests, filters, management of special patient groups and alternative options to testing in hospitals. The pandemic has highlighted how vulnerable lung function services are and forces us to re-think how long-term mitigation strategies can protect our services during this and any possible future pandemic. This statement aspires to address the safety concerns that exist and provide strategies to make lung function tests and the testing environment safer when tests are required