Very Low SWaP-C Robotics Using Autodynamic Flexible Circuits

Spacecraft robotic appendages typically reflect terrestrial robots in that they are usually based on boom-and-joint designs. Here we present a radical departure from tradition in the form of an Autodynamic Flexible Circuit (AFC). While their more static flexible (flex) circuit progenitors have been used in space for decades, they are usually fixed, or are moved only by external forces. Here, a specific lacing of shape memory alloy actuator wire endows an otherwise-ordinary flex circuit with dexterous motion, to be positioned on command. AFCs have thus far been demonstrated in the laboratory and in space at \u3c 1U and 6U CubeSat scales, stowing flat in a practically two-dimensional configuration. Selected applications envisioned include orbital debris mitigation, in-space servicing, assembly, and manufacturing, extraterrestrial exploration systems, individual payload and spacecraft subsystem pointing, and large area, reconfigurable deployables. As such, AFCs promise a new era in low size, weight, power, and cost space robotics and space systems by enabling circuits to function both as conduits for electricity and a means of articulating large area, low mass structures

Imaging Biomarkers in Acute Ischemic Stroke Trials: A Systematic Review

Imaging biomarkers are increasingly used to provide a better understanding of the pathophysiology of acute ischemic stroke. However, this approach of routinely using imaging biomarkers to inform treatment decisions has yet to be translated into successful randomized trials. The aim of this study was to systematically review the use of imaging biomarkers in randomized controlled trials in patients with acute ischemic stroke, exploring the purposes for which the imaging biomarkers were used.We performed a systematic review of imaging biomarkers used in randomized controlled trials of acute ischemic stroke, in which a therapeutic intervention was trialed within 48 hours of symptom onset. Data bases searched included MEDLINE, EMBASE, strokecenter.org, and the Virtual International Stroke Trials Archive (1995-2014).Eighty-four studies met the criteria, of which 49 used imaging to select patients; 31, for subgroup analysis; and 49, as an outcome measure. Imaging biomarkers were broadly used for 8 purposes. There was marked heterogeneity in the definitions and uses of imaging biomarkers and significant publication bias among post hoc analyses.Imaging biomarkers offer the opportunity to refine the trial cohort by minimizing participant variation, to decrease sample size, and to personalize treatment approaches for those who stand to benefit most. However, within imaging modalities, there has been little consistency between stroke trials. Greater effort to prospectively use consistent imaging biomarkers should help improve the development of novel treatment strategies in acute stroke and improve comparison between studies

Graphic Warning Labels Elicit Affective and Thoughtful Responses from Smokers: Results of a Randomized Clinical Trial

Objective Observational research suggests that placing graphic images on cigarette warning labels can reduce smoking rates, but field studies lack experimental control. Our primary objective was to determine the psychological processes set in motion by naturalistic exposure to graphic vs. text-only warnings in a randomized clinical trial involving exposure to modified cigarette packs over a 4-week period. Theories of graphic-warning impact were tested by examining affect toward smoking, credibility of warning information, risk perceptions, quit intentions, warning label memory, and smoking risk knowledge. Methods Adults who smoked between 5 and 40 cigarettes daily (N = 293; mean age = 33.7), did not have a contra-indicated medical condition, and did not intend to quit were recruited from Philadelphia, PA and Columbus, OH. Smokers were randomly assigned to receive their own brand of cigarettes for four weeks in one of three warning conditions: text only, graphic images plus text, or graphic images with elaborated text. Results Data from 244 participants who completed the trial were analyzed in structural-equation models. The presence of graphic images (compared to text-only) caused more negative affect toward smoking, a process that indirectly influenced risk perceptions and quit intentions (e.g., image-\u3enegative affect-\u3erisk perception-\u3equit intention). Negative affect from graphic images also enhanced warning credibility including through increased scrutiny of the warnings, a process that also indirectly affected risk perceptions and quit intentions (e.g., image-\u3enegative affect-\u3erisk scrutiny-\u3ewarning credibility-\u3erisk perception-\u3equit intention). Unexpectedly, elaborated text reduced warning credibility. Finally, graphic warnings increased warning-information recall and indirectly increased smoking-risk knowledge at the end of the trial and one month later. Conclusions In the first naturalistic clinical trial conducted, graphic warning labels are more effective than text-only warnings in encouraging smokers to consider quitting and in educating them about smoking’s risks. Negative affective reactions to smoking, thinking about risks, and perceptions of credibility are mediators of their impact

Lesbian, gay, bisexual and transgender older people in Ireland: Mental health issues

International policy initiatives have highlighted the need to include older lesbian, gay, bisexual and transgender (LGBT) issues in the provision of appropriate health and social care. However, empirical studies in the area remain sparse. The aim of this study was to investigate the experiences and needs of LGBT people over the age of 55 years living in Ireland and this article reports on specific mental health issues. Mixed methods were used involving 144 surveys and 36 semi-structured in-depth interviews. The findings revealed that a significant number of the survey respondents had experienced a mental health problem at some point in their lives with interview participants providing further details of their concerns. It is recommended that policy makers address the mental health needs of older LGBT people in future strategic directives and develop standards of care that support the principles of equality, inclusion and respect for diversity

Older LGBT people's experiences and concerns with healthcare professionals and services in Ireland

BACKGROUND: The specific healthcare needs and concerns for older lesbian, gay, bisexual and transgender (LGBT) persons have not been explored to any degree within Ireland. AIMS AND OBJECTIVES: The aim of this paper, which is part of a larger study, is to detail older LGBT persons' usage, experiences and concerns with accessing healthcare services, disclosing their LGBT identity to professionals, preferences for care and their suggestions for improvement in services, including nursing services. DESIGN: A mixed methods research design combining quantitative survey and qualitative interview approaches of equal significance was used. METHODS: 144 respondents completed an 84-item questionnaire concerning their use of healthcare services, experiences and needs. The qualitative phase involved in-depth interviews where 36 participants' experiences and concerns around health services were explored more in-depth. Quantitative data were analysed using descriptive statistics. Qualitative analysis employed the constant comparative process to generate the leading themes. RESULTS: Only one in three participants believed that healthcare professionals have sufficient knowledge of LGBT issues, and less than half (43%) felt respected as an LGBT person by healthcare professionals. Although 26% had chosen not to reveal their LGBT status for fear of a negative response, many positive encounters of coming out to healthcare professionals were relayed in the interviews. LGBT persons have specific concerns around residential care, particularly in relation to the perception that the Irish healthcare services emanate a heteronormative culture. CONCLUSIONS: Irish healthcare services need to reflect on how they currently engage with older LGBT persons at both an organisational and practitioner level. Consideration needs to be given to the specific concerns of ageing LGBT persons, particularly in relation to long-term residential care. IMPLICATIONS FOR PRACTICE: Healthcare practitioners need to be knowledgeable of, and sensitive to, LGBT issues

Outcomes of patients with atypical haemolytic uraemic syndrome with native and transplanted kidneys treated with eculizumab: a pooled post hoc analysis

Atypical hemolytic uremic syndrome (aHUS) often leads to end-stage renal disease (ESRD) and kidney transplantation; graft loss rates are high due to disease recurrence. A post hoc analysis of four prospective clinical trials in aHUS was performed to evaluate eculizumab, a terminal complement inhibitor, in patients with native or transplanted kidneys. The trials included 26-week treatment and extension periods. Dialysis, transplant, and graft loss were evaluated. Study endpoints included complete thrombotic microangiopathy (TMA) response, TMA event-free status, hematologic and renal parameters, and adverse events. Of 100 patients, 74 had native kidneys and 26 in the transplant subgroup had a collective history of 38 grafts. No patients lost grafts and only one with preexisting ESRD received a transplant on treatment. Efficacy endpoints were achieved similarly in both subgroups. After 26 weeks, mean absolute estimated glomerular filtration rate increased from baseline to 61 and 37 mL/min/1.73 m2 in native (n=71; P<0.0001) and transplanted kidney (n=25; P=0.0092) subgroups. Two patients (one/subgroup) developed meningococcal infections; both recovered, one continued therapy. Eculizumab was well tolerated. Eculizumab improved hematologic and renal outcomes in both subgroups. In patients with histories of multiple graft losses, eculizumab protected kidney function. (ClinicalTrials. gov numbers : NCT00844545, NCT00844844, NCT00838513, NCT00844428, NCT01193348, and NCT01194973) This article is protected by copyright. All rights reserved

Visible Lives: Identifying the Experiences and Needs of Older LGBT People in Ireland

Huge progress has been made in recognising and supporting lesbian, gay, bisexual and transgender (LGBT) people in Ireland. In the space of twenty years we have seen the decriminalisation of homosexuality and the introduction of a sophisticated equality infrastructure, with the Employment Equality Act 1998 and the Equal Status Act 2000 having been at the forefront internationally in naming sexual orientation as a specific equality ground and in extending its scope outside the field of employment. More recently, in 2010 comprehensive Civil Partnership legislation was introduced and the Government is determined to bring forward legislation later this year to provide for the recognition of the acquired gender of transgender people, on the basis of the recommendations of the Gender Recognition Advisory Group published in June. This report is the first comprehensive study of the lives of older LGBT people in Ireland. It offers unique insights into the lives of those people who have lived through and been most personally affected by these changes in Irish society. It shows the negative consequences for LGBT people of living through a period where a fundamental aspect of their identity - to be themselves and to live openly and securely with the person they love - was stigmatised, criminalised or even viewed as an illness

SO050LONG-TERM FOLLOW-UP STUDY OF ECULIZUMAB FOR PREVENTION OF THROMBOTIC MICROANGIOPATHY IN PATIENTS WITH ATYPICAL HEMOLYTIC UREMIC SYNDROME

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