Keeping patients with epilepsy safe: a surmountable challenge?

This quality improvement project was inspired as an answer to a problem that intellectual disability teams have been struggling to manage whilst caring for people with epilepsy (PWE). The issue was that despite guidance to discuss the possibility of sudden unexpected death in epilepsy (SUDEP) be discussed with a newly diagnosed PWE this is rarely done. Additionally when, how, and what to discuss about SUDEP and reduce its risk is arbitrary, non-person centred, and with no structured evidence. Prior to initiating changes a discussion of SUDEP was recorded in just 10% of PWE. We introduced a check-list to help identify risk factors for SUDEP. We then modified the check-list, and then used it via telehealth, a way of contacting patients and their carers over the phone using the check-list approach. Following interventions, discussions of SUDEP are now recorded in 80% of PWE. Feedback from patients, carers and primary and secondary care professionals has been positive. We are now developing an app so that patients and carers can monitor their own risk factors, thus empowering them and increasing their knowledge and awareness of SUDEP

Fabrication and mechanical testing of a new sandwich structure with carbon fiber network core

The aim is the fabrication and mechanical testing of sandwich structures including a new core material known as fiber network sandwich materials. As fabrication norms for such a material do not exist as such, so the primary goal is to reproduce successfully fiber network sandwich specimens. Enhanced vibration testing diagnoses the quality of the fabrication process. These sandwich materials possess low structural strength as proved by the static tests (compression, bending), but the vibration test results give high damping values, making the material suitable for vibro-acoustic applications where structural strength is of secondary importance e.g., internal panelling of a helicopter

A novel investigation into the application of non-destructive evaluation for vibration assessment and analysis of in-service pipes

Flow induced vibrations that are close to resonance frequencies are a major problem in all oil and gas processing industries, so all piping systems require regular condition monitoring and inspection to assess changes in their dynamic characteristics and structural integrity in order to prevent catastrophic failures. One of the main causes of pipe failure is weak support causing low frequency high amplitude flow-induced vibration. This causes wear and tear, especially near joints due to their dissimilar stiffness resulting in fatigue failure of joints caused by vibration-induced high cyclic stress. Other contributing factors in pipe failure are poor or inadequate design, poor workmanship during installation or maintenance and inadequate or weak and flexible support. These pipes are usually required to work non-stop for 24 hours a day 7 days a week for weeks, months or years at a time. Regular monitoring and in-service dynamic analysis should ensure continuous and safe operation. A novel method of non-destructive testing and evaluation of these pipes, while in service, is proposed in this paper. This technique will enable early detection and identification of the root causes of any impending failure due to excess vibration as a result of cyclic force induced by the flow. The method pinpoints the location of the impending failure prior to condition-based maintenance procedures. The technique relies on the combined application of Operating Deflection Shapes (ODS) analysis and computational mechanics utilizing Finite Element Analysis (FEA), i.e. linear elastic stress analysis. Any structural modification to the pipes and their supports can then be applied virtually and their effects on the system can be analysed. The effect on vibration levels is assessed and verified. The effect of any change in the forces corresponding to changes in the Differential Pressure (DP) at constant flow rate through the pipes can then be estimated. It was concluded that maintaining the differential pressure above some “critical” threshold ensures the pipe operates under the allowable dynamic stress for a theoretically “indefinite” life cycle

Failure Analysis of Flow-induced Vibration Problem of in-serviced Duplex Stainless Steel Piping System in Oil and Gas Industry

Failure of the duplex stainless steel piping system in oil and gas industry can have disastrous effects. In this study, a novel method of failure analysis of flow-induced vibration problem of in-serviced duplex stainless steel piping system is proposed. The proposed non-destructive technique is able to determine a suitable operating condition for continuous operation without failure. The technique relies on the combined operation of operational modal analysis, operating deflection shape analysis and linear elastic finite element analysis. The effect of different operating conditions for two distinct valve opening cases (i.e. fully opened and partially opened) on the dynamic stress is examined, and they are utilised for forecasting purpose in failure analysis. The result shows that maximum operating conditions are 360 and 400 mmscfd for fully opened and partially opened flow control valves, respectively. Beyond this limit, the piping system most likely will fail

The design and function of birds’ nests

All birds construct nests in which to lay eggs and/or raise offspring. Traditionally, it was thought that natural selection and the requirement to minimize the risk of predation determined the design of completed nests. However, it is becoming increasingly apparent that sexual selection also influences nest design. This is an important development as while species such as bowerbirds build structures that are extended phenotypic signals whose sole purpose is to attract a mate, nests contain eggs and/or offspring, thereby suggesting a direct tradeoff between the conflicting requirements of natural and sexual selection. Nest design also varies adaptively in order to both minimize the detrimental effects of parasites and to create a suitable microclimate for parents and developing offspring in relation to predictable variation in environmental conditions. Our understanding of the design and function of birds’ nests has increased considerably in recent years, and the evidence suggests that nests have four nonmutually exclusive functions. Consequently, we conclude that the design of birds’ nests is far more sophisticated than previously realized and that nests are multifunctional structures that have important fitness consequences for the builder/s

Threat-sensitive anti-predator defence in precocial wader, the northern lapwing Vanellus vanellus

Birds exhibit various forms of anti-predator behaviours to avoid reproductive failure, with mobbing—observation, approach and usually harassment of a predator—being one of the most commonly observed. Here, we investigate patterns of temporal variation in the mobbing response exhibited by a precocial species, the northern lapwing (Vanellus vanellus). We test whether brood age and self-reliance, or the perceived risk posed by various predators, affect mobbing response of lapwings. We quantified aggressive interactions between lapwings and their natural avian predators and used generalized additive models to test how timing and predator species identity are related to the mobbing response of lapwings. Lapwings diversified mobbing response within the breeding season and depending on predator species. Raven Corvus corax, hooded crow Corvus cornix and harriers evoked the strongest response, while common buzzard Buteo buteo, white stork Ciconia ciconia, black-headed gull Chroicocephalus ridibundus and rook Corvus frugilegus were less frequently attacked. Lapwings increased their mobbing response against raven, common buzzard, white stork and rook throughout the breeding season, while defence against hooded crow, harriers and black-headed gull did not exhibit clear temporal patterns. Mobbing behaviour of lapwings apparently constitutes a flexible anti-predator strategy. The anti-predator response depends on predator species, which may suggest that lapwings distinguish between predator types and match mobbing response to the perceived hazard at different stages of the breeding cycle. We conclude that a single species may exhibit various patterns of temporal variation in anti-predator defence, which may correspond with various hypotheses derived from parental investment theory

Wolf Rock lighthouse: past developments and future survivability under wave loading

Lighthouses situated on exposed rocky outcrops warn mariners of the dangers that lurk beneath the waves. They were first constructed when approaches to wave loading and structural response were relatively unsophisticated, essentially learning from previous failures. Here, we chart the evolution of lighthouses on the Wolf Rock, situated between Land's End and the Isles of Scilly in the UK. The first empirical approaches are described, followed by design aspects of the present tower, informed by innovations developed on other rocky outcrops. We focus on a particular development associated with the automation of lighthouses: the helideck platform. The design concept is described and the structure then scrutinized for future survivability, using the latest structural modelling techniques of the entire lighthouse and helideck. Model validation data were obtained through a complex logistical field operation and experimental modal analysis. Extreme wave loading for the model required the identification of the 250-year return period wave using a Bayesian method with informative prior distributions, for two different scenarios (2017 and 2067). The structural models predict responses of the helideck to wave loading which is characterized by differential displacements of 0.093m (2017) and 0.115m (2067) with associated high tension forces and plastic strain.</p

Elevated Uptake of Plasma Macromolecules by Regions of Arterial Wall Predisposed to Plaque Instability in a Mouse Model

Atherosclerosis may be triggered by an elevated net transport of lipid-carrying macromolecules from plasma into the arterial wall. We hypothesised that whether lesions are of the thin-cap fibroatheroma (TCFA) type or are less fatty and more fibrous depends on the degree of elevation of transport, with greater uptake leading to the former. We further hypothesised that the degree of elevation can depend on haemodynamic wall shear stress characteristics and nitric oxide synthesis. Placing a tapered cuff around the carotid artery of apolipoprotein E -/- mice modifies patterns of shear stress and eNOS expression, and triggers lesion development at the upstream and downstream cuff margins; upstream but not downstream lesions resemble the TCFA. We measured wall uptake of a macromolecular tracer in the carotid artery of C57bl/6 mice after cuff placement. Uptake was elevated in the regions that develop lesions in hyperlipidaemic mice and was significantly more elevated where plaques of the TCFA type develop. Computational simulations and effects of reversing the cuff orientation indicated a role for solid as well as fluid mechanical stresses. Inhibiting NO synthesis abolished the difference in uptake between the upstream and downstream sites. The data support the hypothesis that excessively elevated wall uptake of plasma macromolecules initiates the development of the TCFA, suggest that such uptake can result from solid and fluid mechanical stresses, and are consistent with a role for NO synthesis. Modification of wall transport properties might form the basis of novel methods for reducing plaque rupture