Conceptual-level evaluation of a variable stiffness skin for a morphing wing leading edge

A morphing leading edge produces a continuous aerodynamic surface that has no gaps between the moving and fixed parts. The continuous seamless shape has the potential to reduce drag, compared to conventional devices, such as slats that produce a discrete aerofoil shape change. However, the morphing leading edge has to achieve the required target shape by deforming from the baseline shape under the aerodynamic loads. In this paper, a conceptual-level method is proposed to evaluate the morphing leading edge structure. The feasibility of the skin design is validated by checking the failure index of the composite when the morphing leading edge undergoes the shape change. The stiffness of the morphing leading edge skin is spatially varied using variable lamina angles, and comparisons to the skin with constant stiffness are made to highlight its potential to reduce the actuation forces. The structural analysis is performed using a two-level structural optimisation scheme. The first level optimisation is applied to find the optimised structural proper- ties of the leading edge skin and the associated actuation forces. The structural properties of the skin are given as a stiffness distribution, which is controlled by a B spline interpolation function. In the second level, the design solution of the skin is investigated. The skin is assumed to be made of variable stiffness composite. The stack sequence of the composite is optimised element-by-element to match the target stiffness. A failure criterion is employed to obtain the failure index when the leading edge is actuated from the baseline shape to the target shape. Test cases are given to demonstrate that the optimisation scheme is able to provide the stiffness distribution of the leading edge skin and the actuation forces can be reduced by using a spatially variable stiffness skin

Capacidade para o trabalho entre trabalhadores de higiene e limpeza de um hospital universitário público

A capacidade para o trabalho é a base do bem-estar para o ser humano e a sua manutenção envolve condições de saúde e trabalho adequadas. Com o objetivo de verificar a capacidade para o trabalho entre trabalhadores de higiene e limpeza,realizou-se uma pesquisa quantitativa, do tipo descritivo-exploratória, em um hospital universitário público do norte paranaense, de março a junho de 2008, por meio da aplicação de um questionário constituído por dados sócio-demográficos e ocupacionais, e pelo Índice de Capacidade para o Trabalho (ICT). Os dados foram analisados pelo programa Epi Info 2002. A população foi composta por 98 trabalhadores, sendo que 82,4% possuem mais de 41 anos e 96,9% são mulheres. Quanto à avaliação da capacidade para o trabalho, 45,9% dos entrevistados obtiveram um ICT bom, 23,5% ótimo, 22,4% moderado e 8,2% baixo, com escore mínimo de 16 e máximo de 49. As doenças músculo esqueléticas foram as mais referidas pelos entrevistados. Os fatores relacionados à capacidade para o trabalho são múltiplos, assim, as ações para a prevenção erecuperação desta capacidade devem ser discutidas e conciliadas entre empregados e empregadores, garantindo um espaço para contextualização e reflexão acerca do processo de trabalho

Thyroid Fine-Needle Aspiration under Ultrasound Guidance: Experience from an Academic Tertiary Care Center in Lebanon

Thyroid nodules are common. Malignancy was reported in only 5-15% of cases. Fine needle aspiration under US guidance (USG-FNA) proved to be accurate for the detection of thyroid cancer. This is a retrospective review of 400 radiology and cytology USG-FNA reports, randomly selected among those done at the Radiology Department at a tertiary care center in Beirut during the last five years. The specimen was inadequate in 60 (12%) of cases but FNA was repeated in 10 cases only. The final diagnosis was benign in 76.7% of cases, mostly in women. 35% of the malignant and 19% of the benign nodules were hypoechoic, p=0.03. No significant correlation was observed between malignancy and other ultrasonic characteristics. Hypoechogenecity was also more common in nodules with inadequate specimen (40% versus 21.4%, p=0.01). Age, gender, location and size of the nodule did not differ between groups of adequate and inadequate specimen. In conclusion, 3 out of 4 thyroid nodules referred for USG-FNA are benign, mostly in women. Inadequate specimen was observed in 12% of cases. Hypoechogenecity but not other ultrasonic characteristics was associated with malignancy and with test failure.   Key words: Thyroid nodule, fine needle aspirate, ultrasound guidance, thyroid cancer, inadequate.  &nbsp

Using Innovation-Corps (I-Corps™) methods to adapt a mobile health (mHealth) obesity treatment for community mental health settings

BACKGROUND: We employed Innovation Corps (I-Corps™) methods to adaptation of a mobile health (mHealth) short-message-system (SMS) -based interactive obesity treatment approach (iOTA) for adults with severe mentall illness receiving care in community settings. METHODS: We hypothesized jobs to be done in three broad stakeholder groups: decision makers (DM = state and community clinic administrators), clinician consumers (CC = case managers, peer supports, nurses, prescribers) and service consumers (SC = patients, peers and family members). Semistructured interviews ( RESULTS: Four themes emerged across groups: education, inertia, resources and ownership. Sub-themes in education and ownership differed between DM and CC groups on implementation ownership, intersecting with professional development, suggesting the importance of training and supervision in scalability. Sub-themes in resources and intertia differed between CC and SC groups, suggesting illness severity and access to healthy food as major barriers to engagement, whereas the SC group identified the need for enhanced emotional support, in addition to pragmatic skills like menu planning and cooking, to promote health behavior change. Although SMS was percieved as a viable education and support tool, CC and DM groups had limited familiarity with use in clinical care delivery. CONCLUSIONS: Based on customer discovery, the characteristics of a minimum viable iOTA for implementation, scalability and sustainability include population- and context-specific adaptations to treatment content, interventionist training and delivery mechanism. Successful implementation of an SMS-based intervention will likely require micro-adaptations to fit specific clinical settings

Use of an interactive obesity treatment approach in individuals with severe mental illness: Feasibility, acceptability, and proposed engagement criteria

BACKGROUND: Digital and mobile health interventions are increasingly being used to support healthy lifestyle change, including in certain high-risk populations such as those with severe mental illnesses (SMIs). Life expectancy in this population lags 15 years behind counterparts in the general population, primarily due to obesity-related health conditions. OBJECTIVE: We tested the feasibility and usability of a 12-week interactive obesity treatment approach (iOTA) to adults with chronic SMIs (depression, bipolar disorder and schizophrenia spectrum disorder) receiving treatment in community settings. The iOTA incorporates short message service (SMS) text messages to supplement monthly in-person health coaching. METHODS: Factors hypothesized to be associated with weight change were illness severity and treatment engagement. Severe psychiatric symptoms were defined as baseline Clinical Global Impression severity score of \u3e5. Criterion engagement was defined as a text messaging response rate \u3e80% during the first 4 weeks of treatment. Disordered eating, assessed with the Loss of Control Over Eating Scores, was also evaluated. Participants provided qualitative data, further informing assessment of intervention feasibility, usability, and acceptability. RESULTS: A total of 26 participants were enrolled. The mean age was 48.5 (SD 15.67) years; 40% (10/26) were Black and 60% (15/26) female. Participants with lower symptom severity and adequate engagement demonstrated significantly decreased weight (F CONCLUSIONS: These results demonstrate the feasibility of delivering an adapted iOTA to SMI patients receiving care in community settings and suggest testable criteria for defining sufficient treatment engagement and psychiatric symptom severity, two factors known to impact weight loss outcomes. These important findings suggest specific adaptations may be needed for optimal treatment outcomes in individuals with SMI

Proportion of At-Risk Alcohol Consumers According to the New French Guidelines: Cross-Sectional Weighted Analyses From the CONSTANCES Cohort

Objective: To estimate the proportion of the participants of the French national population-based CONSTANCES cohort exceeding the new low-risk drinking guidelines according to sociodemographic and clinical factors.Methods: From 34,470 participants with follow-up data in 2019, among volunteers aged 18–69 years and invited to enroll in the CONSTANCES cohort in 2016 and 2017, weighted prevalence and odds ratios with 95% confidence intervals (CI) exceeding the guidelines using logistic regressions were presented stratified for age, gender, education, occupational grade, employment, income, marital status, pregnancy, work stress, depression, alcohol dependence, binge drinking, cannabis use, smoking status, e-cigarette use, cardiovascular diseases, and cancer.Results: The guidelines were exceeded more by men at 60.2% (95%CI: 59.3%–61.0%) than by women at 36.6% (95%CI: 35.9%–37.4%). Exceeding the guidelines increased with age, socioeconomic status, smoking, vaping, using cannabis, binge drinking, and alcohol dependence. Being depressed was associated with exceeding the guidelines in women. Even though pregnant women were less likely to exceed the guidelines, 7.6% (95%CI: 5.4%–10.6%) were at-risk drinkers.Conclusion: These findings highlight the need to implement effective prevention measures for at-risk alcohol use among the French population

Quantifying the Speed of Chromatophore Activity at the Single-Organ Level in Response to a Visual Startle Stimulus in Living, Intact Squid

The speed of adaptive body patterning in coleoid cephalopods is unmatched in the natural world. While the literature frequently reports their remarkable ability to change coloration significantly faster than other species, there is limited research on the temporal dynamics of rapid chromatophore coordination underlying body patterning in living, intact animals. In this exploratory pilot study, we aimed to measure chromatophore activity in response to a light flash stimulus in seven squid, Doryteuthis pealeii. We video-recorded the head/arms, mantle, and fin when squid were presented with a light flash startle stimulus. Individual chromatophores were detected and tracked over time using image analysis. We assessed baseline and response chromatophore surface area parameters before and after flash stimulation, respectively. Using change-point analysis, we identified 4,065 chromatophores from 185 trials with significant surface area changes elicited by the flash stimulus. We defined the temporal dynamics of chromatophore activity to flash stimulation as the latency, duration, and magnitude of surface area changes (expansion or retraction) following the flash presentation. Post stimulation, the response’s mean latency was at 50 ms (± 16.67 ms), for expansion and retraction, across all body regions. The response duration ranged from 217 ms (fin, retraction) to 384 ms (heads/arms, expansion). While chromatophore expansions had a mean surface area increase of 155.06%, the retractions only caused a mean reduction of 40.46%. Collectively, the methods and results described contribute to our understanding of how cephalopods can employ thousands of chromatophore organs in milliseconds to achieve rapid, dynamic body patterning

Novo modelo de estadiamento para indicação de cirurgia faríngea em pacientes com apneia obstrutiva do sono,

Introduction: The success of pharyngeal surgery in the treatment of obstructive sleep apnea syndrome depends on the appropriate selection of patients. Objective: To propose a new staging for indication of pharyngeal surgery in obstructive sleep apnea syndrome. Methods: A total of 54 patients undergoing extended tonsillectomy were retrospectively included, divided into six stages. Stage I: patients with palatine tonsils grade 3/4 and modified Mallampati index 1/2; stage II: palatine tonsils 3/4 and modified Mallampati index 3/4; stage III: palatine tonsils 1/2 and modified Mallampati index 1/2; stage IV: palatine tonsils 1/2 and modified Mallampati index 3/4; stage V: body mass index ≥40 kg/m2 with palatine tonsils 3/4 and modified Mallampati index 1, 2, 3, or 4. Stage VI: body mass index ≥40 with palatine tonsils 1/2 and modified Mallampati index 1, 2, 3, or 4. Results: The surgical success rates were 88.9%, 75.0%, 35.7%, 38.5%, and 100.0% in stages I–V. Conclusion: The presence of hypertrophic palatine tonsils was the anatomical factor in common in the most successful stages (I, II, and V), regardless of body mass index. Although the modified Mallampati index classes 3 and 4 reduced the success rate of surgery in patients with hypertrophic tonsils (stage II), the presence of modified Mallampati index classes 1 and 2 did not favor surgical success in patients with normal tonsils (stage III).Introdução: O sucesso da cirurgia faríngea no tratamento da síndrome da apneia obstrutiva do sono (SAOS) depende da adequada seleção de pacientes. Objetivo: Propor um novo estadiamento para indicação de cirurgia faríngea na SAOS. Método: Estudo retrospectivo, onde foram inclusos, 54 pacientes submetidos a amigdalectomia ampliada, divididos em 6 estádios. Estádio I: pacientes com tonsilas palatinas graus 3/4 e índice de Mallampati modificado (IMM) 1/2; Estádio II: tonsilas palatinas 3/4 e IMM 3/4; Estádio III: tonsilas palatinas 1/2 e IMM 1/2; Estádio IV: tonsilas palatinas 1/2 e IMM 3/4; Estádio V: IMC (índice de massa corpórea) ≥ com tonsilas palatinas 3/4 e IMM 1, 2, 3 ou 4. Estádio VI: IMC ≥ kg/m2 com tonsilas palatinas 1 ou 2 e IMM 1, 2, 3, ou 4. Resultados: As taxas de sucesso cirúrgico foram de 88,9%; 75,0%; 35,7%; 38,5% e 100,0% nos estádios I a V. Conclusão: A presença de tonsilas palatinas hipertróficas foi o fator anatômico em comum nos estádios de maior sucesso (I, II e V), independente do IMC. Apesar do IMM classe III e IV diminuir a taxa de sucesso da cirurgia em pacientes com tonsilas hipertróficas (estádio II), a presença de IMM classe I e II não favoreceu o sucesso cirúrgico em pacientes com tonsilas normotróficas (estádio III).Universidade Federal de São Paulo (UNIFESP) Department of OtorhinolaryngologyUniversidade Federal de São Paulo (UNIFESP) Department of PsychobiologyInstituto do Ronco e Apneia de MaringáSão José dos Campos Clínica OpusUNIFESP, Department of OtorhinolaryngologyUNIFESP, Department of PsychobiologySciEL

Planters reap : investment decisions for agribusiness risk mitigation

Este caso de ensino é baseado nas publicações do Committee of Sponsoring Organizations of the Treadway Commission (COSO) relacionadas à gestão dos riscos empresariais e ao apetite ao risco. Objetiva auxiliar alunosna compreensão dos fundamentos da gestão de riscos, definindo decisões de investimento para mitigação de riscos de um agronegócio. É estruturado em diferentes etapas da gestão de risco, explorando procedimentos e reflexões relacionados à escassez de recursos de investimento em controles internos e impossibilidade de garantir o risco zero ao processo. Apresenta-se, como preparação prévia, a compreensão da empresa estudada e a leitura das publicações propostas, debatidas por meio de questões individuais. A gestão de risco é desenvolvida por etapas como a identificação dos riscos, considerando sua probabilidade e impacto e identificação de controles internos, atendendo relevância e capacidade de investimento dos sócios. Propõe-se discussões para o grande grupo, retomando conceitos abordados e promovendo o debate referente às diferentes escolhas possíveis para a empresa no tocante à gestão de riscos e aos fatores que podem influenciar nas decisões. Este caso de ensinoé aplicável as turmas de Graduação e Pós-Graduação em Ciências Contábeis e Administraçãode Empresas, representando uma aplicabilidade prática da gestão de risco como estratégia gerencial.This teaching case is based on the Committee of Sponsoring Organizations of the Treadway Commission (COSO) publications related to enterprise risk management and risk appetite. It aims to assist students in understanding the fundamentals of risk management, defining investment decisions for risk mitigation in an agribusiness. It is structured in different stages of risk management, exploring procedures and reflections related to the scarcity of resources for investment in internal controls and the impossibility of guaranteeing zero risk to the process. It presents, as a previous preparation, the understanding of the company studied and the reading of the proposed publications, discussed through individual questions. Risk management is developed through steps such as the identification of risks, considering their probability and impact, and the identification of internal controls, taking into account the relevance and investment capacity of the partners. Large group discussions are proposed, reviewing concepts covered and promoting debate about the different possible choices for the company regarding risk management and the factors that may influence decisions. This teaching case is applicable to undergraduate and graduate accounting and business administration classes, representing a practical applicability of risk management as a management strategy