Penalty finite element approximations of the stationary power- law Stokes problem

Finite element approximations of the stationary power-law Stokes problem using penalty formulation are considered. A priori error estimates under appropriate smoothness assumptions on the solutions are established without assuming a discrete version of the BB condition. Numerical solutions are presented by implementing a nonlinear conjugate gradient metho

Cost-Benefit Analysis of Flexibility Retrofits for Coal and Gas-Fueled Power Plants: August 2012 - December 2013

High penetrations of wind and solar power plants can induce on/off cycling and ramping of fossil-fueled generators. This can lead to wear-and-tear costs and changes in emissions for fossil-fueled generators. Phase 2 of the Western Wind and Solar Integration Study (WWSIS-2) determined these costs and emissions and simulated grid operations to investigate the full impact of wind and solar on the fossil-fueled fleet. This report studies the costs and benefits of retrofitting existing units for improved operational flexibility (i.e., capability to turndown lower, start and stop faster, and ramp faster between load set-points)

Pediatric Dysphagia: The 10th Anniversary Issue

ABSTRACT Over the past decade, speech-language pathologists (SLPs) have increased their involvement in the assessment and management of infants and children with complex feeding and swallowing problems. Given the complex problems demonstrated by these infants and children that vary across a range of conditions and degrees of severity, SLPs need to increase their knowledge in all the topics covered in this issue. This article will discuss the current state of evidence-based decision making, levels of evidence for studies of treatment efficacy, ethical principles in evidencebased decision making, and ethical decision-making considerations with feeding and swallowing issues using examples of three types of populations of infants and children with complex feeding and swallowing problems. KEYWORDS: Dysphagia, deglutition, evidence-based, bioethics, pediatric Learning Outcomes: As a result of this activity, the reader will be able to (1) describe ethical principles and their relationship to feeding and swallowing issues in infants and young children, (2) state three rules of ethics related to clinical intervention with infants and children with complex dysphagia, and (3) describe the three components of an evidence-based clinical approach to the care of infants and young children with feeding and swallowing problems. Over the past decade, speech-language pathologists (SLPs) have increasingly found themselves involved in assessment and management of infants and children with feeding and swallowing problems. These infants and children demonstrate complex problems that vary over a wide range of conditions and degrees of severity. Feeding issues frequently are at the forefront o

Targeting of nonlipidated, aggregated apoE with antibodies inhibits amyloid accumulation

The apolipoprotein E E4 allele of the APOE gene is the strongest genetic factor for late-onset Alzheimer disease (LOAD). There is compelling evidence that apoE influences Alzheimer disease (AD) in large part by affecting amyloid β (Aβ) aggregation and clearance; however, the molecular mechanism underlying these findings remains largely unknown. Herein, we tested whether anti-human apoE antibodies can decrease Aβ pathology in mice producing both human Aβ and apoE4, and investigated the mechanism underlying these effects. We utilized APPPS1-21 mice crossed to apoE4-knockin mice expressing human apoE4 (APPPS1-21/APOE4). We discovered an anti-human apoE antibody, anti-human apoE 4 (HAE-4), that specifically recognizes human apoE4 and apoE3 and preferentially binds nonlipidated, aggregated apoE over the lipidated apoE found in circulation. HAE-4 also binds to apoE in amyloid plaques in unfixed brain sections and in living APPPS1-21/APOE4 mice. When delivered centrally or by peripheral injection, HAE-4 reduced Aβ deposition in APPPS1-21/APOE4 mice. Using adeno-associated virus to express 2 different full-length anti-apoE antibodies in the brain, we found that HAE antibodies decreased amyloid accumulation, which was dependent on Fcγ receptor function. These data support the hypothesis that a primary mechanism for apoE-mediated plaque formation may be a result of apoE aggregation, as preferentially targeting apoE aggregates with therapeutic antibodies reduces Aβ pathology and may represent a selective approach to treat AD

Structure and Functions of Pediatric Aerodigestive Programs: A Consensus Statement

Aerodigestive programs provide coordinated interdisciplinary care to pediatric patients with complex congenital or acquired conditions affecting breathing, swallowing, and growth. Although there has been a proliferation of programs, as well as national meetings, interest groups and early research activity, there is, as of yet, no consensus definition of an aerodigestive patient, standardized structure, and functions of an aerodigestive program or a blueprint for research prioritization. The Delphi method was used by a multidisciplinary and multi-institutional panel of aerodigestive providers to obtain consensus on 4 broad content areas related to aerodigestive care: (1) definition of an aerodigestive patient, (2) essential construct and functions of an aerodigestive program, (3) identification of aerodigestive research priorities, and (4) evaluation and recognition of aerodigestive programs and future directions. After 3 iterations of survey, consensus was obtained by either a supermajority of 75% or stability in median ranking on 33 of 36 items. This included a standard definition of an aerodigestive patient, level of participation of specific pediatric disciplines in a program, essential components of the care cycle and functions of the program, feeding and swallowing assessment and therapy, procedural scope and volume, research priorities and outcome measures, certification, coding, and funding. We propose the first consensus definition of the aerodigestive care model with specific recommendations regarding associated personnel, infrastructure, research, and outcome measures. We hope that this may provide an initial framework to further standardize care, develop clinical guidelines, and improve outcomes for aerodigestive patients

Clinical practice: Swallowing problems in cerebral palsy

Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2–2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Early attention should be given to dysphagia and excessive drooling and their substantial contribution to the burden of a child with CP and his/her family. This review displays the important functional and anatomical issues related to swallowing problems in children with CP based on relevant literature and expert opinion. Furthermore, based on our experience, we describe a plan for approach of investigation and treatment of swallowing problems in cerebral palsy