Supersonic Turbine Cascade Studies Using Computational Fluid Dynamics and Water Table Experiments

Design engineers use a variety of tools to perform calculations and to aid in the design process. For example, engineers designing gas turbines, specifically the aerodynamicists, use a combination of hand calculations, experimental data, and complex numerical codes to simulate air flow around each blade. Aerodynamicists designing gas turbines must predict the locations of the shocks to locate inefficiencies in the flow. In this thesis, three methods of calculating the shock angles are compared: analytical, experimental, and computational. Three different airfoil shapes are tested: a rectangular flat plate, a supersonic diamond, and a turbine airfoil. Cascade tests of the airfoil shapes were also performed. Hand calculations using the compressible flow theory with shock analysis are performed on simplified single airfoil cases. The experimental rig used is a water table apparatus that simulates compressible flow. The different airfoils and configurations were tested in the water table and photographs were taken. ANSYS Fluent, a commercial Computational Fluid Dynamics (CFD) code, is run on each case. Due to the complex nature of the flow, hand calculations, experimental data, and CFD results are only compared for the flat plate and supersonic diamond single airfoil cases. The results from each method are compared and the percent error is taken to determine the accuracy of each method. All three methods produced results that were in an acceptable range of error for the flat plate. The analytical and computational for the supersonic diamond cases matched up within acceptable error, but the experimental results were off by a maximum of about 40%

Feasibility Study of Custom Manufacturing of Ionic Polymer-Metal Composite Sensors

The ability to create an ion exchange membrane with any shape or thickness through custom manufacturing techniques is highly desirable in ionic polymer-metal composite (IPMC) research. This is caused by the poor selection and limited availability of certain thicknesses of commercial ion exchange membranes. The objective of this study is to determine the feasibility of manufacturing custom ion exchange membranes for IPMC sensors. The manufacturing methods used in this study are extrusion, injection molding, and hot pressing. A commercial membrane from Golden Energy Fuel Cells (GEFC) is used as a comparison. After the membranes are fabricated, certain properties of the membranes are tested throughout each processing stage to determine if they are suitable to be developed into IPMCs. The three processing stages are pre-activation, activation (hydrated and dehydrated), and IPMC. It was observed that the stiffness of the membranes increased from pre-activation to activation and decreased from activation to IPMC. A more flexible membrane in an IPMC allows for larger cation displacement within the membrane. The extruded and injection molded membranes showed the most potential with having the lowest stiffness of all the samples; however, they were not able to be made into IPMCs due to repeated membrane failures in the primary plating process. Gas accumulated between the layers that formed in the membranes due to the extrusion and injection molding cooling process during manufacturing. The hot pressed membrane was the only custom manufactured membrane to be fully processed into an IPMC. The hot pressed and GEFC IPMC sensors were operated at 1 Hz, 5 Hz, and 10 Hz frequencies with the GEFC IPMC producing the strongest output voltage signal. While the extruded and injection molded membranes showed potential to become IPMCs with their high water uptake percentage, high ion exchange capacity, and low stiffness, more development is needed within the manufacturing process to make a uniform sample that does not fail during chemical processing

Isocitrate Dehydrogenase Mutation in \u3ci\u3eVibrio anguillarum\u3c/i\u3e Results in Virulence Attenuation and Immunoprotection in Rainbow Trout (\u3ci\u3eOncorhynchus mykiss\u3c/i\u3e)

Background Vibrio anguillarum is an extracellular bacterial pathogen that is a causative agent of vibriosis in finfish and crustaceans with mortality rates ranging from 30% to 100%. Mutations in central metabolism (glycolysis and the TCA cycle) of intracellular pathogens often result in attenuated virulence due to depletion of required metabolic intermediates; however, it was not known whether mutations in central metabolism would affect virulence in an extracellular pathogen such as V. anguillarum. Results Seven central metabolism mutants were created and characterized with regard to growth in minimal and complex media, expression of virulence genes, and virulence in juvenile rainbow trout (Oncorhynchus mykiss). Only the isocitrate dehydrogenase (icd) mutant was attenuated in virulence against rainbow trout challenged by either intraperitoneal injection or immersion. Further, the icd mutant was shown to be immunoprotective against wild type V. anguillarum infection. There was no significant decrease in the expression of the three hemolysin genes detected by qRT-PCR. Additionally, only the icd mutant exhibited a significantly decreased growth yield in complex media. Growth yield was directly related to the abundance of glutamate. A strain with a restored wild type icd gene was created and shown to restore growth to a wild type cell density in complex media and pathogenicity in rainbow trout. Conclusions The data strongly suggest that a decreased growth yield, resulting from the inability to synthesize α-ketoglutarate, caused the attenuation despite normal levels of expression of virulence genes. Therefore, the ability of an extracellular pathogen to cause disease is dependent upon the availability of host-supplied nutrients for growth. Additionally, a live vaccine strain could be created from an icd deletion strain

Cost analysis of large-scale implementation of the ‘Helping Babies Breathe’ newborn resuscitation-training program in Tanzania

Background: Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania. Methods: We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the target regions. Activity-cost centers included administrative, initial training (including resuscitation equipment), and follow-up training expenses. Sensitivity analysis was utilized to project cost scenarios incurred to achieve countrywide expansion of the program across all mainland regions of Tanzania and to model costs of program maintenance over one and five years following initiation. Results: Total costs for the Mbeya Region were $202,240, with the highest proportion due to initial training and equipment (45.2$4,000,000 (around $600 per facility). Following sensitivity analyses, the estimated total for all Tanzania initial rollout lies between$2,934,793 to $4,309,595. In order to maintain the program nationally under the current model, it is estimated it would cost$2,019,115 for a further one year and $5,640,794 for a further five years of ongoing program support. Conclusion: HBB implementation is a relatively low-cost intervention with potential for high impact on perinatal mortality in resource-poor settings. It is shown here that nationwide expansion of this program across the range of health provision levels and regions of Tanzania would be feasible. This study provides policymakers and investors with the relevant cost-estimation for national rollout of this potentially neonatal life-saving intervention

Geographic Variation in Salt Marsh Structure and Function for Nekton: a Guide to Finding Commonality Across Multiple Scales

Coastal salt marshes are distributed widely across the globe and are considered essential habitat for many fish and crustacean species. Yet, the literature on fishery support by salt marshes has largely been based on a few geographically distinct model systems, and as a result, inadequately captures the hierarchical nature of salt marsh pattern, process, and variation across space and time. A better understanding of geographic variation and drivers of commonalities and differences across salt marsh systems is essential to informing future management practices. Here, we address the key drivers of geographic variation in salt marshes: hydroperiod, seascape configuration, geomorphology, climatic region, sediment supply and riverine input, salinity, vegetation composition, and human activities. Future efforts to manage, conserve, and restore these habitats will require consideration of how environmental drivers within marshes affect the overall structure and subsequent function for fisheries species. We propose a future research agenda that provides both the consistent collection and reporting of sources of variation in small-scale studies and collaborative networks running parallel studies across large scales and geographically distinct locations to provide analogous information for data poor locations. These comparisons are needed to identify and prioritize restoration or conservation efforts, identify sources of variation among regions, and best manage fisheries and food resources across the globe

Relationship of Race With Functional and Clinical Outcomes With the REHAB-HF Multidomain Physical Rehabilitation Intervention for Older Patients With Acute Heart Failure

Background The REHAB‐HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) randomized trial demonstrated that a 3‐month transitional, tailored, progressive, multidomain physical rehabilitation intervention improves physical function, frailty, depression, and health‐related quality of life among older adults with acute decompensated heart failure. Whether there is differential intervention efficacy by race is unknown. Methods and Results In this prespecified analysis, differential intervention effects by race were explored at 3 months for physical function (Short Physical Performance Battery [primary outcome], 6‐Minute Walk Distance), cognition, depression, frailty, health‐related quality of life (Kansas City Cardiomyopathy Questionnaire, EuroQoL 5‐Dimension‐5‐Level Questionnaire) and at 6 months for hospitalizations and death. Significance level for interactions was P≤0.1. Participants (N=337, 97% of trial population) self‐identified in near equal proportions as either Black (48%) or White (52%). The Short Physical Performance Battery intervention effect size was large, with values of 1.3 (95% CI, 0.4–2.1; P=0.003]) and 1.6 (95% CI, 0.8–2.4; P\u3c0.001) in Black and White participants, respectively, and without significant interaction by race (P=0.56). Beneficial effects were also demonstrated in 6‐Minute Walk Distance, gait speed, and health‐related quality of life scores without significant interactions by race. There was an association between intervention and reduced all‐cause rehospitalizations in White participants (rate ratio, 0.73 [95% CI, 0.55–0.98]; P=0.034) that appears attenuated in Black participants (rate ratio, 1.06 [95% CI, 0.81–1.41]; P=0.66; interaction P=0.067). Conclusions The intervention produced similarly large improvements in physical function and health‐related quality of life in both older Black and White patients with acute decompensated heart failure. A future study powered to determine how the intervention impacts clinical events is required. REGISTRATION URL: https://www.clinicaltrials.gov. Identifier: NCT02196038

Barriers to access to psychiatric medications in Missouri county jails

Introduction Objectives of this study were to characterize barriers to receiving psychiatric medications for people who are incarcerated, to compare barriers before competency restoration to those after competency restoration, and to characterize psychiatric medication formularies. Methods A survey of county jails in Missouri was completed between October 2021 and February 2022. Survey questions were answered by medical department personnel, nurses, or a person responsible for medication oversight. Formularies were requested. Results Of 97 jails contacted, 51 completed the survey (53%). Most jails allowed patients to supply their own medications and reported they were “often” or “always” able to continue home medications. Inability to provide home medications was frequently attributed to cost. Notably, only 57% of jails were able to provide long-acting injectable antipsychotics (LAIA), 22% charged a fee for administration of medications, and 31% would not adjust medication times based on food requirements. No major differences existed precompetency and postcompetency for any question. Discussion Jail policies varied; thus, medication access for patients should be approached at the individual level. Potential areas to target to improve access are medication administration times, LAIA access, and removal of medication administration fees

Assessing the understandability, actionability, and quality of online resources for the self-management of bipolar disorder

Introduction: This study aims to assess the understandability, actionability, and quality of online resources for the self-management (SM) of bipolar spectrum disorders in adults. Methods: An online search using Google, Bing, and Yahoo! search engines was conducted to identify resources for bipolar disorder. Those that were published in English, discussed at least 1 method directed at improving an SM task, and were within the first 25 nonadvertisement results for each search were included. Resources directed specifically at adolescents were excluded. Understandability and actionability of the online resources were evaluated using the Patient Education Materials Assessment Tool (PEMAT). Quality of the online resources was evaluated using the DISCERN instrument. The number of SM tasks each resource discussed was also evaluated. Overall mean appropriateness was calculated by averaging the percentage scores of understandability, actionability, and quality. Results: Fifty-two resources were included. The mean sample scores were 8.4 (SD, 2.1; range, 2-13; maximum, 15) for understandability, 2.2 (SD, 1.2; range, 0-4; maximum, 5) for actionability, and 46.1 (SD, 8.9; range, 30-57; maximum, 75) for quality. The overall mean appropriateness percentage was 53.5% (SD, 11.7%; range, 18%-77%), with a goal of at least 70%. Included resources addressed a mean of 7.1 tasks (SD, 2.5; range, 1-14; maximum, 20). Discussion: Most online resources for the SM of bipolar disorder scored poorly for understandability and actionability based on PEMAT scores and had low to moderate scores for quality using the DISCERN instrument. Future online resources should be designed with the goal of increasing appropriateness for patients

Publication rates and characteristics of PGY2 psychiatric pharmacy resident research projects

Introduction: To describe the publication rates and characteristics of PGY2 psychiatric pharmacy residency projects presented as a poster presentation at the annual meetings of the College of Psychiatric and Neurologic Pharmacists (CPNP) from 2002 to 2018. (As of 2022 the organization is under the name, American Association of Psychiatric Pharmacists.) Methods: CPNP abstracts from even years were strategically searched in PubMed, Ovid MEDLINE, and Google Scholar. If a publication was identified, additional data were collected for characterization, including study information, journal information, author information, institutional affiliation, publication year, and time to publication. Results: A total of 348 abstracts were evaluated. Publication in a journal was achieved for 60 projects (17.2%), with publication rates decreasing from 2012 to 2018. The mean time to publication was 17.3 months after completion of the residency, with most projects published at 8 months. More than half (51.7%) of these projects were published in a psychiatric pharmacy journal affiliated with CPNP. Study designs were predominantly retrospective, observational, cohort studies with a focus on evaluation of a drug therapy outcome. The PGY2 resident was the first author in 90% of the publications. Forty percent included other health care professionals outside of pharmacy as a coauthor. PGY2 residencies affiliated with academic institutions had overall higher publications rates. Discussion: Publication rates for PGY2 psychiatric pharmacy residency projects are low and are decreasing over time despite an increasing number of PGY2 psychiatric pharmacy residency programs. This publication rate is lower than that reported in the literature for PGY2 critical care residency programs. The downward trend of publication rates for PGY2 psychiatric pharmacy residency projects is concerning

Antipsychotic factors related to time to competency for forensic inpatients in a state psychiatric facility

Introduction: A defendant who is deemed incompetent to stand trial may go through competency restoration consisting of mental health treatment and legal education. Antipsychotics are often used in treatment; however, there is little data examining their role. Methods: This retrospective study included subjects opined competent to stand trial from July 2016 to February 2020 and prescribed an antipsychotic. The primary outcome was difference in time to competency between antipsychotics. Secondary outcomes included difference in time to competency between groups of antipsychotics, difference in length of stay after opined competent based on medication availability in jail, individual antipsychotics, and formulations. Results: There were 117 subjects included for analysis. There were no differences in time to competency between individual antipsychotics, first- and second-generation antipsychotics, or formulations. Length of stay after opined competent was significantly longer for subjects who were prescribed a long-acting injectable antipsychotic (103 days vs 56 days), who were not able to receive their antipsychotic in jail (104 days vs 54 days), or who were prescribed any formulation of paliperidone compared with olanzapine (88 days vs 35 days). Discussion: Since there were no differences in time to competency, patient-specific factors should be used to choose an agent for competency restoration. Length of stay differences are likely related to the antipsychotic access differences between jails and state psychiatric facilities. Therefore, policies related to antipsychotic access should better align between state psychiatric facilities and jails to improve the capacity of the system and provide better care