Multistable Slit Caps

Multistable shells are structures that have more than one stable state of self-stress. We demonstrate for the first time that an initially stress-free, hemispherical cap with isotropic behaviour can gain at least three additional stable shapes and, hence, states of self-stress, if it is sliced partially along a given axi-symmetrical meridian. The usual initial and inverted configurations are only slightly affected by slicing. The other configurations are elicited by extra deformations about the inverted shape, which now performs a pre-stressing role. The experimental results are confirmed by finite-element simulations, and it is shown that initially rotationally symmetric structures can gain three stable configurations. Motivated by this, a simplified analytical approach using Foppl-von Karman plate theory is undertaken to analyse the bistable properties of shallow spherical segments. It is shown that the boundary conditions have a dominating influence on the occurrence of multistability.Friedrich Ebert Foundatio

The Role of the Faith Community Nurse in Fostering Spirituality in those with Alzheimer\u27s Disease

Alzheimer ’s disease (AD) strips individuals of memories and abilities that have defined them as productive adults throughout their life. While the decline in memory is real and results in a ‘loss of self’ this does not equate to a ‘loss of soul.’ AD patients continue to have spiritual needs throughout their life as do the family, and/or caregivers. This article explores the spiritual needs and care of AD patients and families and the unique opportunity faith community nurses have to help the AD patient and their support system. The Reisberg Functional Assessment Staging System is used to explain the expected functional and cognitive decline and guide in specific nursing interventions at each stage of the disease. Music, prayer, singing, reading from the Bible, the Torah or other books significant to the individual are among the interventions introduced to help the individual continue to make the spiritual connection necessary for transition to end-of-life. Resources are suggested to increase caregiver resiliency throughout the illness and after the death of the family member

Nonlinear Growing Caps

Engineers capture growth strains in two ways, reflecting the inherent bending-stretching nature of shells: by a strain gradient through the thickness or by an average in-plane value. We analyse their interaction by assuming a uniform displacement and growth-strain field in shells with elastic spring supports and a radial force applied to their outer boundary. The increased degree of statical indeterminancy enriches the variety of existing solutions and we distinguish two in-plane actuation modes which can induce Gaussian curvature via radially varying quadratic expansions in either the circumferential or radial direction. Using a Rayleigh-Ritz approach, we find closed-form solutions of the Föppl-von Kármán shell equations for the buckling thresholds, bistable limits and the post-buckled shape, which show good agreement with finite element reference solutions and available results from the literature. Moreover, we show that ‘natural’ growth modes, which evoke a change of shape without incurring elastic strain energy, can be achieved by employing quadratic radial expansions only. Additionally, we study unsupported shells subjected to higher-order actuation distributions, which give rise to natural growth modes with varying wavenumbers. Our approach dramatically simplifies an otherwise non-trivial general solution, and may be applied in novel generations of smart materials with actively tunable material properties.Friedrich-Ebert-Foundatio

Integration of the Audio-Visual Moylan Assessment of Progressive Aggression Tool (MAPAT) in a USA State Wide Training Program of Mental Health Workers

Aggressive and violent behavior toward health care workers in psychiatric hospital settings is a long recognized occupational hazard with significant psychological, physical and economic costs (U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Hunter. Carmel 1992). Numerous professional publications highlight the problem and emphasize the need for formalized staff training (one of many clinical and occupational approaches) to reduce the risk of violence and the related rate and severity of staff injuries (Infantino and Musingo 1985; Lehman, Medilla and Clark1983, Carmel and Hunter 1990, American Psychiatric Association Task Force on Clinician Safety (Task Force Report 33, Beech and Leather 2006). Training programs are widely used and options include private (e.g. Non-violent Crisis Intervention, Crisis Prevention Institute) and public sector developed (States of NY, CT, et al) programs. In the United States, staff that work in psychiatric hospital settings, where restraints and seclusion are used, must meet the training requirements set forth by regulatory and accrediting bodies [Center for Medicare/Medicaid Services CFR Part 482 (CMS), The Joint Commission (TJC)]. Hospital policies and state laws (e.g., Connecticut General Statute 814e, Sec 46-154) typically include training requirements. The requirements include who should be trained (direct care staff that work in settings where restraints and seclusion are used), at what intervals (orientation and subsequent periodic reviews) and what the content must include. Competence in the theoretical knowledge as well as physical skill knowledge are commonly used measures

Adjusting for COPD severity in database research: developing and validating an algorithm

Purpose: When comparing chronic obstructive lung disease (COPD) interventions in database research, it is important to adjust for severity. Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines grade severity according to lung function. Most databases lack data on lung function. Previous database research has approximated COPD severity using demographics and healthcare utilization. This study aims to derive an algorithm for COPD severity using baseline data from a large respiratory trial (UPLIFT).Methods: Partial proportional odds logit models were developed for probabilities of being in GOLD stages II, III and I V. Concordance between predicted and observed stage was assessed using kappa-statistics. Models were estimated in a random selection of 2/3 of patients and validated in the remainder. The analysis was repeated in a subsample with a balanced distributio

The burden of cough in idiopathic pulmonary fibrosis and other interstitial lung diseases:a systematic evidence synthesis

Background: Cough remains a persistent symptom in patients with idiopathic pulmonary fibrosis (IPF) and other interstitial lung diseases (ILDs). To inform future research, treatment and care models, we conducted the first systematic synthesis of evidence on its associated burden. Methods: A literature search was performed for articles published between January 2010 and October 2023 using databases including Embase, MEDLINE and the Cochrane Library. Studies in patients with IPF and other ILDs reporting cough-related measures were eligible for inclusion. Included studies were categorised based on the types of ILD they examined and their design. Study details, patient characteristics and outcomes were extracted, and the risk of bias was assessed. A narrative synthesis approach was employed to interpret the findings. Results: Sixty-one studies were included: 33 in IPF, 18 in mixed-ILDs, six in connective tissue disease-associated-ILDs and four in sarcoidosis. Across the studies, a range of tools to assess cough and its impact were used. The most frequently used measures of cough were cough severity visual analogue scale (VAS) and objective cough counts, whereas the most frequently used health-related quality of life (HRQoL)/impact measures were the St. George’s Respiratory Questionnaire (SGRQ) and Leicester Cough Questionnaire (LCQ). In IPF, studies consistently reported correlations between various cough and HRQoL measures, including between cough VAS scores and objective cough counts, LCQ scores and SGRQ scores. Similar correlations were observed in studies in other ILDs, but data were more limited. Qualitative studies in both IPF and other ILDs consistently highlighted the significant cough-related burden experienced by patients, including disruption of daily activities, fatigue and social embarrassment. Although there were no studies specifically investigating the economic burden of cough, one study in patients with fibrotic ILD found cough severity was associated with workplace productivity loss. Conclusions: Our study underscores the heterogeneity in assessing cough and its impact in IPF and other ILDs. The findings confirm the negative impact of cough on HRQoL in IPF and suggest a comparable impact in other ILDs. Our synthesis highlights the need for standardised assessment tools, along with dedicated studies, particularly in non-IPF ILDs and on the economic burden of cough.</p

Preferred reporting items for animal studies in endodontology (PRIASE): a development protocol

The regulated use of animals in endodontic research is often necessary to investigate the biological mechanisms of endodontic diseases and to measure the preclinical efficacy, biocompatibility, toxicology and safety of new treatments, biomaterials, sealers, drugs, disinfectants, irrigants, devices and instruments. Animal testing is most crucial in situations when research on humans is not ethical, practical or has unknown health risks. Currently, there is a wide variability in the quality of manuscripts that report the results of animal studies. Towards the goal of improving the quality of publications, guidelines for preventing disability, pain, and suffering to animals, and enhanced reporting requirements for animal research have been developed. These guidelines are referred to as Animals in Research: Reporting In Vivo Experiments (ARRIVE). Henceforth, causing any form of animal suffering for research purposes is not acceptable and cannot be justified under any circumstances. The present report describes a protocol for the development of welfare and reporting guidelines for animal studies conducted in the specialty of Endodontology: the Preferred Reporting Items for Animal Studies in Endodontology (PRIASE) guidelines. The PRIASE guidelines will be developed by adapting and modifying the ARRIVE guidelines and the Clinical and Laboratory Images in Publication (CLIP) principles. The development of the new PRIASE guidelines will include a five‐step consensus process. An initial draft of the PRIASE guidelines will be developed by a steering committee. Each item in the draft guidelines will then be evaluated by members of a PRIASE Delphi Group (PDG) for its clarity using a dichotomous scale (yes or no) and suitability for its inclusion using a 9‐point Likert scale. The online surveys will continue until each item achieves this standard, and a set of items are agreed for further analysis by a PRIASE Face‐to‐face Consensus Meeting Group (PFCMG). Following the consensus meeting, the steering committee will finalize and confirm the PRIASE guidelines taking into account the responses and comments of the PFCMG. The PRIASE guidelines will be published and disseminated internationally and updated periodically based on feedback from stakeholders

Best Practices for OAI Data Provider Implementations and Shareable Metadata

In summer 2004, the Digital Library Federation (DLF) sponsored a meeting at the California Digital Library. DLF and the National Science Digital Library (NSDL)-affiliated data and service providers as well as other interested individuals discussed issues about OAI PMH implementations and concerns stemming from the harvesting of metadata from diverse collections. This ad hoc working group brainstormed a large list of areas that needed guidelines or best practices and agreed to establish a wiki, hosted by the NSDL, to write a set of best practices. This work was chiefly facilitated by Kat Hagedorn of the University of Michigan, Sarah L. Shreeves of the University of Illinois at Urbana- Champaign, and Jenn Riley of Indiana University. It was part of an IMLS-funded effort to establish a training program and set of resources on the implementation of the OAI PMH for data providers and DLF member institutions. The best practices work was coordinated through weekly conference calls and twice-yearly meetings held at the DLF Forums. This document presents the best practices as they existed on the wiki as of April 2007.Sponsored by the Digital Library Federation and the National Science Digital Library (through the National Science Foundation).Ope

Anti-prion drug mPPIg5 inhibits PrP(C) conversion to PrP(Sc).

Prion diseases, also known as transmissible spongiform encephalopathies, are a group of fatal neurodegenerative diseases that include scrapie in sheep, bovine spongiform encephalopathy (BSE) in cattle and Creutzfeldt-Jakob disease (CJD) in humans. The 'protein only hypothesis' advocates that PrP(Sc), an abnormal isoform of the cellular protein PrP(C), is the main and possibly sole component of prion infectious agents. Currently, no effective therapy exists for these diseases at the symptomatic phase for either humans or animals, though a number of compounds have demonstrated the ability to eliminate PrPSc in cell culture models. Of particular interest are synthetic polymers known as dendrimers which possess the unique ability to eliminate PrP(Sc) in both an intracellular and in vitro setting. The efficacy and mode of action of the novel anti-prion dendrimer mPPIg5 was investigated through the creation of a number of innovative bio-assays based upon the scrapie cell assay. These assays were used to demonstrate that mPPIg5 is a highly effective anti-prion drug which acts, at least in part, through the inhibition of PrP(C) to PrP(Sc) conversion. Understanding how a drug works is a vital component in maximising its performance. By establishing the efficacy and method of action of mPPIg5, this study will help determine which drugs are most likely to enhance this effect and also aid the design of dendrimers with anti-prion capabilities for the future