Survey of Applications of Active Control Technology for Gust Alleviation and New Challenges for Lighter-weight Aircraft

This report provides a historical survey and assessment of the state of the art in the modeling and application of active control to aircraft encountering atmospheric disturbances in flight. Particular emphasis is placed on applications of active control technologies that enable weight reduction in aircraft by mitigating the effects of atmospheric disturbances. Based on what has been learned to date, recommendations are made for addressing gust alleviation on as the trend for more structurally efficient aircraft yields both lighter and more flexible aircraft. These lighter more flexible aircraft face two significant challenges reduced separation between rigid body and flexible modes, and increased sensitivity to gust encounters due to increased wing loading and improved lift to drag ratios. The primary audience of this paper is engineering professionals new to the area of gust load alleviation and interested in tackling the multifaceted challenges that lie ahead for lighter-weight aircraft

Aeroelastic Tailoring of Transport Wings Including Transonic Flutter Constraints

Several minimum-mass optimization problems are solved to evaluate the effectiveness of a variety of novel tailoring schemes for subsonic transport wings. Aeroelastic stress and panel buckling constraints are imposed across several trimmed static maneuver loads, in addition to a transonic flutter margin constraint, captured with aerodynamic influence coefficient-based tools. Tailoring with metallic thickness variations, functionally graded materials, balanced or unbalanced composite laminates, curvilinear tow steering, and distributed trailing edge control effectors are all found to provide reductions in structural wing mass with varying degrees of success. The question as to whether this wing mass reduction will offset the increased manufacturing cost is left unresolved for each case

Aeroelastic Tailoring of the NASA Common Research Model via Novel Material and Structural Configurations

This work explores the use of tow steered composite laminates, functionally graded metals (FGM), thickness distributions, and curvilinear rib/spar/stringer topologies for aeroelastic tailoring. Parameterized models of the Common Research Model (CRM) wing box have been developed for passive aeroelastic tailoring trade studies. Metrics of interest include the wing weight, the onset of dynamic flutter, and the static aeroelastic stresses. Compared to a baseline structure, the lowest aggregate static wing stresses could be obtained with tow steered skins (47% improvement), and many of these designs could reduce weight as well (up to 14%). For these structures, the trade-off between flutter speed and weight is generally strong, although one case showed both a 100% flutter improvement and a 3.5% weight reduction. Material grading showed no benefit in the skins, but moderate flutter speed improvements (with no weight or stress increase) could be obtained by grading the spars (4.8%) or ribs (3.2%), where the best flutter results were obtained by grading both thickness and material. For the topology work, large weight reductions were obtained by removing an inner spar, and performance was maintained by shifting stringers forward and/or using curvilinear ribs: 5.6% weight reduction, a 13.9% improvement in flutter speed, but a 3.0% increase in stress levels. Flutter resistance was also maintained using straightrotated ribs although the design had a 4.2% lower flutter speed than the curved ribs of similar weight and stress levels were higher. These results will guide the development of a future design optimization scheme established to exploit and combine the individual attributes of these technologies

Agreement between PG-SGA Short Form, MUST and SNAQ in hospital patients

Rationale: The Patient-Generated Subjective Global Assessment (PG-SGA) is a validated instrument to assess malnutrition and its risk factors in clinical populations. Its patient component, PG-SGA Short Form (SF), can be used as screening instrument. In this cross-sectional study we aimed to assess agreement between the PG-SGA SF, Malnutrition Universal Screening Tool (MUST), and Short Nutritional Assessment Questionnaire (SNAQ) in patients at the University Medical Center Groningen, The Netherlands. Methods: Malnutrition risk was assessed by PG-SGA SF, MUST, and SNAQ in 81 patients from the Departments Ear Nose Throat (ENT), Oral and Maxillofacial Surgery (OMS) and Orthopedics. Point scores of PG-SGA SF=4-8, MUST=1, and SNAQ=2 were classified as ‘medium malnutrition risk’, and PG-SGA SF≥9, MUST ≥2, and SNAQ ≥3 as ‘high malnutrition risk’. Agreement in classification for malnutrition risk was assessed by weighted kappa (κ) and intra-class correlation coefficient (ICC). A p-value of <0.05 was considered statistically significant. Results: According to the PG-SGA SF, MUST and SNAQ, respectively 65%, 81%, and 80% of all patients were classified as ‘low malnutrition risk’; 24%, 8% and 6% as ‘medium malnutrition risk’; 11%, 10% and 14% as ‘high malnutrition risk’.Agreement between PG-SGA SF and MUST (κ=0.452, ICC=0.448; p<0.001), and between PG-SGA SF and SNAQ (κ=0.395, ICC=0.395; p<0.001) were both fair. In patients from the Departments ENT and OMS, PG-SGA SF classified more patients at medium/high malnutrition risk (n=26) as compared to the MUST (n=12) or SNAQ (n=14). Conclusion: We found only fair agreement between the PG-SGA SF and MUST and SNAQ, respectively. The PG-SGA SF classified three and four times more patients at medium malnutrition risk, compared to MUST and SNAQ respectively, due to its scoring on symptoms and activities/functioning. Hence, the PG-SGA SF may help facilitate proactive prevention of malnutrition

Mesenchymal chondrosarcoma: prognostic factors and outcome in 113 patients. A European Musculoskeletal Oncology Society study

BACKGROUND: Mesenchymal chondrosarcoma (MCS) is a distinct, very rare sarcoma with little evidence supporting treatment recommendations. PATIENTS AND METHODS: Specialist centres collaborated to report prognostic factors and outcome for 113 patients. RESULTS: Median age was 30 years (range: 11-80), male/female ratio 1.1. Primary sites were extremities (40%), trunk (47%) and head and neck (13%), 41 arising primarily in soft tissue. Seventeen patients had metastases at diagnosis. Mean follow-up was 14.9 years (range: 1-34), median overall survival (OS) 17 years (95% confidence interval (CI): 10.3-28.6). Ninety-five of 96 patients with localised disease underwent surgery, 54 additionally received combination chemotherapy. Sixty-five of 95 patients are alive and 45 progression-free (5 local recurrence, 34 distant metastases, 11 combined). Median progression-free survival (PFS) and OS were 7 (95% CI: 3.03-10.96) and 20 (95% CI: 12.63-27.36) years respectively. Chemotherapy administration in patients with localised disease was associated with reduced risk of recurrence (P=0.046; hazard ratio (HR)=0.482 95% CI: 0.213-0.996) and death (P=0.004; HR=0.445 95% CI: 0.256-0.774). Clear resection margins predicted less frequent local recurrence (2% versus 27%; P=0.002). Primary site and origin did not influence survival. The absence of metastases at diagnosis was associated with a significantly better outcome (P<0.0001). Data on radiotherapy indications, dose and fractionation were insufficiently complete, to allow comment of its impact on outcomes. Median OS for patients with metastases at presentation was 3 years (95% CI: 0-4.25). CONCLUSIONS: Prognosis in MCS varies considerably. Metastatic disease at diagnosis has the strongest impact on survival. Complete resection and adjuvant chemotherapy should be considered as standard of care for localised disease

An Easy-to-Use Prognostic Model for Survival Estimation for Patients with Symptomatic Long Bone Metastases

BACKGROUND: A survival estimation for patients with symptomatic long bone metastases (LBM) is crucial to prevent overtreatment and undertreatment. This study analyzed prognostic factors for overall survival and developed a simple, easy-to-use prognostic model. METHODS: A multicenter retrospective study of 1,520 patients treated for symptomatic LBM between 2000 and 2013 at the radiation therapy and/or orthopaedic departments was performed. Primary tumors were categorized into 3 clinical profiles (favorable, moderate, or unfavorable) according to an existing classification system. Associations between prognostic variables and overall survival were investigated using the Kaplan-Meier method and multivariate Cox regression models. The discriminatory ability of the developed model was assessed with the Harrell C-statistic. The observed and expected survival for each survival category were compared on the basis of an external cohort. RESULTS: Median overall survival was 7.4 months (95% confidence interval [CI], 6.7 to 8.1 months). On the basis of the independent prognostic factors, namely the clinical profile, Karnofsky Performance Score, and presence of visceral and/or brain metastases, 12 prognostic categories were created. The Harrell C-statistic was 0.70. A flowchart was developed to easily stratify patients. Using cutoff points for clinical decision-making, the 12 categories were narrowed down to 4 categories with clinical consequences. Median survival was 21.9 months (95% CI, 18.7 to 25.1 months), 10.5 months (95% CI, 7.9 to 13.1 months), 4.6 months (95% CI, 3.9 to 5.3 months), and 2.2 months (95% CI, 1.8 to 2.6 months) for the 4 categories. CONCLUSIONS: This study presents a model to easily stratify patients with symptomatic LBM according to their expected survival. The simplicity and clarity of the model facilitate and encourage its use in the routine care of patients with LBM, to provide the most appropriate treatment for each individual patient. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence

Static Loads Testing of a High Aspect Ratio Tow-Steered Wingbox

Static loads testing was performed on a 39-foot, high-aspect-ratio wingbox comprising carbon fiber tow-steered wing skins that were tailored for aircraft fuel efficiency under aeroelastic loads. The test article was designated the Passive Aeroelastic Tailored (PAT) wing. To date, the PAT wing, which has an aspect ratio of 13.5, is the largest wingbox designed and built to employ variably oriented carbon fibers along the span of the wing. During testing, distributed point loads were applied to the wingbox to simulate both -1g and 2.5g maneuver loads. To determine the wingboxs flexural axis location, individual point loads were applied. The global response of the wing (displacement and rotation measurements) showed similar trends compared to the finite element model predictions, though discrepancies of up to 17% were observed when comparing actual values between model and test. It was concluded that the boundary conditions and nonstructural features of the wingbox were the likely cause of the inconsistencies. The local response of the wingbox (strain measurements), which was much less affected by factors unrelated to tow-steering, exhibited good agreement with the model predictions, validating the modelling techniques employed for tow-steered composites

Time to positivity of acute and chronic periprosthetic joint infection cultures

Introduction: A prolonged incubation time is generally recommended for diagnosing periprosthetic joint infections (PJI). However, in literature, no distinction is made between acute and chronic infections. Methods: All patients with a PJI that underwent surgical debridement between November 2015 and February 2019 with or without revision of the prosthesis were retrospectively evaluated. Synovial fluid, 5 intraoperative periprosthetic tissue samples, and the sonicated prosthesis were cultured. Results: Fifty-nine patients were analyzed, including 21 acute PJIs (33 isolates) and 38 chronic PJIs (46 isolates). In acute PJIs, all isolates grew within 5 days, while this took 11 days for chronic PJIs. Sonication fluid showed the shortest time to positivity (78% at day 2) for chronic PJIs, but no difference was observed for acute PJIs compared to tissue cultures. Conclusion: In contrast to cultures from chronic PJIs, acute PJIs do not need a prolonged incubation time and no clear benefit is observed for sonication. (C) 2020 The Authors. Published by Elsevier Inc