Preliminary design and test of high enthalpy device

Addition of kinetic energy to supersonic exhaust of shock tunnel by reversing flow direction with high speed piston - high enthalpy devic

Unpacking the Ontogeny of Gesture Understanding: How Movement Becomes Meaningful Across Development

Gestures, hand movements that accompany speech, affect children\u27s learning, memory, and thinking (e.g., Goldin‐Meadow, 2003). However, it remains unknown how children distinguish gestures from other kinds of actions. In this study, 4‐ to 9‐year‐olds (n = 339) and adults (n = 50) described one of three scenes: (a) an actor moving objects, (b) an actor moving her hands in the presence of objects (but not touching them), or (c) an actor moving her hands in the absence of objects. Participants across all ages were equally able to identify actions on objects as goal directed, but the ability to identify empty‐handed movements as representational actions (i.e., as gestures) increased with age and was influenced by the presence of objects, especially in older children

The quest for sustained multiple morbidity reduction in very low-birth-weight infants: the Antifragility project.

OBJECTIVE: Can a comprehensive, explicitly directive evidence-based guideline for all therapies that might affect the major morbidities of very low-birth-weight (VLBW) infants help a neonatal intensive care unit (NICU) further improve generally favorable morbidity rates? Can Antifragility principles of provider adaptive growth from stressors, enhanced infant risk assessment and adherence to effective therapies minimize unproven treatments and reduce all morbidities? STUDY DESIGN: Prospectively planned observational trial in VLBW infants: control group born October 2011 to September 2013 and study group October 2013 to September 2015. Multi-disciplinary evidence-based review assigned all NICU treatments into one of four distinct categories: (1) always employ this therapy for VLBW infants, (2) never use this therapy, (3) employ this questionable therapy thoughtfully, only in certain circumstances and (4) this therapy has insufficient evidence of efficacy and safety. Extensive staff education emphasized evidence-based potentially better practice (PBP) selection with compliance checks, appreciation of intertwined co-morbidities and prioritizing infant risk reduction strategies. RESULTS: Control included 221 infants, mean (s.d.) age 29 (2.6) weeks, birth weight 1129 (257) g and Study included 197 infants, 29 (2.7) weeks, 1093 (292) g. One hundred and four distinct therapies were placed into categories 1 to 4, with 32 specific compliance checks. Overall mean compliance with the process checks during the second era was 70%, high: 100% (exclusive breast milk use), low: 24% (correct pulse oximetry alarm settings). Morbidity and mortality rates did not significantly change during the second era. CONCLUSIONS: In our NICU with favorable morbidity rates, an expanded effort using a comprehensive therapy guideline for VLBW infants did not further improve outcomes. We need deeper understanding of continuous quality improvement (CQI) fundamentals, therapy compliance, co-morbidity relationships and enhanced sensitivity of risk assessment. Our innovative Antifragility PBP guideline could be useful to other NICUs seeking improvement in VLBW infant morbidities, as we offer a reasoned and concise template of a broad array of therapies categorized efficiently for transparency and review, designed to enhance responsible CQI decision-making

The Esophageal Pressure-Guided Ventilation 2 (EPVent2) trial protocol: a multicentre, randomised clinical trial of mechanical ventilation guided by transpulmonary pressure

Introduction: Optimal ventilator management for patients with acute respiratory distress syndrome (ARDS) remains uncertain. Lower tidal volume ventilation appears to be beneficial, but optimal management of positive end-expiratory pressure (PEEP) remains unclear. The Esophageal Pressure-Guided Ventilation 2 Trial (EPVent2) aims to examine the impact of mechanical ventilation directed at maintaining a positive transpulmonary pressure (PTP) in patients with moderate-to-severe ARDS. Methods and analysis EPVent2 is a multicentre, prospective, randomised, phase II clinical trial testing the hypothesis that the use of a PTP-guided ventilation strategy will lead to improvement in composite outcomes of mortality and time off the ventilator at 28 days as compared with a high-PEEP control. This study will enrol 200 study participants from 11 hospitals across North America. The trial will utilise a primary composite end point that incorporates death and days off the ventilator at 28 days to test the primary hypothesis that adjusting ventilator pressure to achieve positive PTP values will result in improved mortality and ventilator-free days. Ethics and dissemination Safety oversight will be under the direction of an independent Data and Safety Monitoring Board (DSMB). Approval of the protocol was obtained from the DSMB prior to enrolling the first study participant. Approvals of the protocol as well as informed consent documents were also obtained from the Institutional Review Board of each participating institution prior to enrolling study participants at each respective site. The findings of this investigation, as well as associated ancillary studies, will be disseminated in the form of oral and abstract presentations at major national and international medical specialty meetings. The primary objective and other significant findings will also be presented in manuscript form. All final, published manuscripts resulting from this protocol will be submitted to PubMed Central in accordance with the National Institute of Health Public Access Policy. Trial registration number ClinicalTrials.gov under number NCT01681225

Evaluation of ground information with respect to EPB tunnelling for the Thessaloniki metro, Greece

Ο Μητροπολιτικός σιδηρόδρομος της Θεσσαλονίκης αποτελείται από δύο παράλληλες σήραγγες διαμέτρου ~6 m και μήκους ~8 km η κάθε μία και περιλαμβάνει 13 σταθμούς. Η γεωλογία του πολεοδομικού συγκροτήματος της Θεσσαλονίκης χαρακτηρίζεται από την παρουσία νεογενών και τεταρτογενών αποθέσεων. Ο κύριος σχηματισμός της περιοχής του έργου είναι μία σειρά πολύ στιφρών έως σκληρών ερυθρών αργίλων ανωμειοκαινικής-πλειοκαινικής ηλικίας. Σχηματισμοί του Τεταρτογενούς που έχουν αποτεθεί πάνω σε αυτές τις αργίλους συνίστανται από αργιλώδεις-ιλυώδεις άμμους ή/και χάλικες. Το πρόγραμμα γεωερευνητικών εργασιών περιελάμβανε έναν σημαντικό αριθμό δειγματοληπτικών γεωτρήσεων, επί τόπου και εργαστηριακών δοκιμών. Τα στοιχεία του γεωερευνητικού προγράμματος αξιολογήθηκαν ώστε να κατανοηθεί καλύτερα το γεωλογικό προσομοίωμα της περιοχής του έργου και να διακριτοποιηθούν ζώνες με βάση τη συμπεριφορά των γεωυλικών κατά τη διάνοιξη της σήραγγας με μηχάνημα ολομέτωπης κοπής (ΤΒΜ). Όσον αφορά το μηχάνημα διάνοιξης, η επιλογή ενός μηχανήματος εδαφικής εξισορροπητικής πίεσης (ΕΡΒΜ) φαίνεται να είναι εύλογη τόσο από πλευράς ευστάθειας όσο και από πλευράς ρυθμού προχώρησης. Η επιλογή αυτή υπαγορεύεται από τα χαρακτηριστικά του εδάφους για την κάλυψη όλων των αντικειμενικών σκοπών όπως ο έλεγχος των καθιζήσεων και εδαφικών μετακινήσεων, η διατήρηση της στάθμης του υπόγειου νερού αλλά και η ικανοποιητική προχώρηση των σηράγγωνThe Thessaloniki Metropolitan Railway comprises two separate ~6 m diameter parallel tunnels with an ~8 km stretch each and 13 stations. The geology of the urban area of Thessaloniki is characterised by the presence of Neogene and Quaternary deposits. The base formation for the project area is a very stiff to hard red clay, dating to Upper Miocene-Pliocene. Upon this formation, Quaternary sediments have been deposited, most of which comprise sand and/or gravel in a clay-silt dominated matrix, covered in places by anthropogenic fill. Ground investigation campaigns incorporated a significant number of sampling boreholes and in situ and laboratory testing. This information was elaborated in order to obtain a better geological understanding and a geotechnical zonation of the ground with respect to mechanized tunnelling. EPB M appears to be the reasonable choice for the project in all aspects of tunnel safety and tunnelling performance. The characteristics and parameters of the soils and the hydrogeological regime directed towards this selection and it is expected that all the objectives, such as settlement and ground movements control, water table level maintenance and adequate performance, will be met by an EPBM provided it is properly operate

Some simple thin-layer chromatographic systems for the separation of purines and purine nucleosides

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/33914/1/0000179.pd

There is More to Gesture Than Meets the Eye: Visual Attention to Gesture’s Referents Cannot Account for Its Facilitative Effects During Math Instruction

Teaching a new concept with gestures – hand movements that accompany speech – facilitates learning above-and-beyond instruction through speech alone (e.g., Singer & GoldinMeadow, 2005). However, the mechanisms underlying this phenomenon are still being explored. Here, we use eye tracking to explore one mechanism – gesture’s ability to direct visual attention. We examine how children allocate their visual attention during a mathematical equivalence lesson that either contains gesture or does not. We show that gesture instruction improves posttest performance, and additionally that gesture does change how children visually attend to instruction: children look more to the problem being explained, and less to the instructor. However looking patterns alone cannot explain gesture’s effect, as posttest performance is not predicted by any of our looking-time measures. These findings suggest that gesture does guide visual attention, but that attention alone cannot account for its facilitative learning effects