Investigation of wheelhouse flow interaction and the influence of lateral wheel displacement

The aim of this research was to improve the understanding of the complex flow features found around a wheel and wheelhouse and to examine how the lateral displacement of the wheel affects these features and the production of exhibited pressures and forces. A bespoke rotating wheel rig and accompanying wheelhouse with a fully-pressure-tapped wheel arch was designed and manufactured at Loughborough University. Wind tunnel tests were performed where force and pressure measurements and Particle Image Velocimetry (PIV), data were obtained. The experimental data were used to validate unsteady CFD predictions where a k-ω SST Improved Delayed Detached Eddy Simulation (IDDES) turbulence model was used in STAR-CCM+. The CFD showed good agreement with all trends of the experimental results providing a validated numerical methodology. For both methodologies, a lower amount of wheelhouse drag was found generated when the wheel was rotating. However, the CFD showed that whilst this was the case, total configuration drag had increased. This was attributed to an increase of the wheel and axle drag, illustrated by the change in separation over the wheel itself when located within a wheelhouse and so overcompensating the reduction in body and stand drag. Differences in vortex locations when comparing to previously-attained results were due to differences in housing geometry, such as blockage in the cavity or housing dimensions. Experimental and computational results showed that up until a 10-mm displacement outboard of the housing, overall drag decreased. The reduction in housing drag was credited to a reduction in the size of outboard longitudinal vortex structures. This led to the lateral width of the shear layer across the housing side being narrower. Overall, this study identified that there were potential benefits to be gained when offsetting a wheel outboard of the longitudinal edge of a model housing

Experimental and computational study of the flow around a stationary and rotating isolated wheel and the influence of a moving ground plane

This study investigates the aerodynamic behavior of the flow around a rotating and stationary 60% scale isolated wheel, with and without the use of a moving ground plane. The aim of this research was to improve the understanding of the fundamental aerodynamic flow features around a wheel and to examine how rotation and moving ground planes modify these and affect the production of drag. A bespoke rotating wheel rig was designed and wind tunnel tests were performed over a range of pre to post critical Reynolds numbers. Force coefficients were obtained using balance measurements and flow field data were obtained using Particle Image Velocimetry (PIV). The unsteady flow field data generated was used to validate unsteady CFD predictions. These were performed using STARCCM+ and a k- SST Improved Delayed Detached Eddy Simulation (IDDES) turbulence model. This was seen to outperform other models by capturing an increased amount of finer detailed, high frequency vortical structures. The CFD showed good agreement with the experimental results providing, for the first time, a validated numerical methodology. Comparing stationary and rotating wheels the CFD and experimental data both illustrated large scale structural differences in the surrounding flow due to changes in separation and wake structure. The rotating model also exhibited a lower drag at post critical Reynolds numbers, which is corroborated by existing literature. Importantly, the CFD showed minimal difference between a stationary and moving ground plane simulation with a rotating wheel. This is evidence that, provided the wheel is rotating, valid experiments can be performed without the complexity of a moving ground plan

[Editorial] Specific learning difficulties in healthcare education: the meaning in the nomenclature

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The Use of Breast Cup Immobilization in Radiation Therapy and Patient Reported Outcomes on Cosmesis and Pain

Purpose/Objective(s): Breast cosmesis and pain are among the most reported outcomes in patients undergoing breast irradiation. There is variability in the degree of adverse reactions based on different patient specific characteristics. It has been found that women with large body habitus, African American race, and larger breast size tend to have an increased chance of experiencing worse toxicity from treatment. Attempts to improve cosmesis and pain have been highly explored. We explore here whether the use of a breast cup for treatment leads to worse cosmesis and pain when compared to those treated without a breast cup. This is an important topic as it is felt that the use of a breast cup would provide a significant dosimetric advantage (i.e., organ at risk dosing) during treatment. We now explore this treatment option through a retrospective analysis of patient reported outcomes experienced during and after completing post-operative radiation therapy to the breast. Materials/Methods: 645 patients undergoing adjuvant breast irradiation were evaluated from 2011 through 2019. 79 patients were treated using a breast cup. Mean heart dose was analyzed and compared between the two treatment groups and was found to be comparable in each arm. Additionally, patient reported outcomes among the entire cohort were collected via survey documentation forms during treatment, at 1 month post treatment, and at 1 year after treatment. These results were collected using the Michigan Radiation Oncology Quality Consortium (MROQC) database as each patient was consented to enroll in MROQC prior to starting treatment. The outcomes of skin changes, lymphedema, and breast pain among the two treatment groups were then compared for statistically significant differences via a logistic regression analysis. Results: Patients were evaluated at 3 time points; during treatment, 1-month post-treatment and at 1 year after treatment. Of the 79 patients treated with a breast cup, when compared to the no cup patients, grade 2 pruritus and grade 1 alteration in skin texture were not significantly different at any time point (p \u3e 0.05). With regards to lymphedema, no statistically significant difference was seen between the two groups of patients outside of the 1 month after treatment survey time point; all p values greater than 0.05 except for the 1-month mark (p value 0.03). Lastly, breast pain survey remarks at the pre-specified time points failed to show a significant difference in the symptom between the two analyzed treatment groups (p\u3e 0.05). Conclusion: From our patient\u27s perspective, the use of a breast cup during radiation therapy did not negatively impact breast cosmesis or pain when compared to patients treated without a cup. Breast cup use was also found to produce similar dosimetric coverage to the heart as non-cup patients, even in left sided breast cancers

Parents and healthcare professionals' attitudes to Kangaroo Care for preterm infants in the United Kingdom

Aim: To explore the attitudes of parents and healthcare professionals (HCPs), and facilitators and barrier to implementation of Kangaroo Care (KC) in the United Kingdom. Methods: Online cross-sectional survey; distributed via the British Association of Perinatal Medicine, Bliss (UK-based charity), social media. Results: Sixty HCPs responded. 37 (62%) were nurses/nurse practitioners. 57 (95%) regularly implement KC. The most important factor that supported KC implementation was the team's belief in benefits of KC. Increased workload, staff shortage and fear about safely of KC in unwell infants were recognised as the challenges preventing implementation. Five hundred eighteen parents responded. 421 (81%) had a preterm baby within 3 years. 338 (80%) were familiar with KC. The main facilitator was the belief that their baby enjoyed it. Excess noise and crowding on the unit were the most frequently reported barriers. Lack of opportunity and limited staff support were the main reasons why they had been unable to practice KC. Conclusion: We found that most HCPs and parents believe that KC is beneficial and would like to practice it. Lack of resources to enable effective implementation is the main barrier. Service development and implementation research is required to ensure that KC is delivered in all UK neonatal units

National Association Of Industrial Technology 2005 BETA Standards: An Evaluative Study Of The Thomas W. Reese Graphic Arts And Imaging Technology Program

The Thomas W. Reese Graphic Arts and Imaging Technology (GAIT) program of Appalachian State University has yet to pursue examination from an outside reviewer through self-assessment based on national standards. Therefore, the sixteen 2005 beta standards of the National Association of Industrial Technology (NAIT) were chosen as a tool of self-assessment for GAIT

Characterizing Sensitive Cardiac Substructure Excursion Due to Respiration

PURPOSE: Whole-heart dose metrics are not as strongly linked to late cardiac morbidities as radiation doses to individual cardiac substructures. Our aim was to characterize the excursion and dosimetric variation throughout respiration of sensitive cardiac substructures for future robust safety margin design. METHODS AND MATERIALS: Eleven patients with cancer treatments in the thorax underwent 4-phase noncontrast 4-dimensional computed tomography (4DCT) with T2-weighted magnetic resonance imaging in end-exhale. The end-exhale phase of the 4DCT was rigidly registered with the magnetic resonance imaging and refined with an assisted alignment surrounding the heart from which 13 substructures (chambers, great vessels, coronary arteries, etc) were contoured by a radiation oncologist on the 4DCT. Contours were deformed to the other respiratory phases via an intensity-based deformable registration for radiation oncologist verification. Measurements of centroid and volume were evaluated between phases. Mean and maximum dose to substructures were evaluated across respiratory phases for the breast (n = 8) and thoracic cancer (n = 3) cohorts. RESULTS: Paired t tests revealed reasonable maintenance of geometric and anatomic properties (P \u3c .05 for 4/39 volume comparisons). Maximum displacements \u3e5 mm were found for 24.8%, 8.5%, and 64.5% of the cases in the left-right, anterior-posterior, and superior-inferior axes, respectively. Vector displacements were largest for the inferior vena cava and the right coronary artery, with displacements up to 17.9 mm. In breast, the left anterior descending artery D(mean) varied 3.03 ± 1.75 Gy (range, 0.53-5.18 Gy) throughout respiration whereas lung showed patient-specific results. Across all patients, whole heart metrics were insensitive to breathing phase (mean and maximum dose variations \u3c0.5 Gy). CONCLUSIONS: This study characterized the intrafraction displacement of the cardiac substructures through the respiratory cycle and highlighted their increased dosimetric sensitivity to local dose changes not captured by whole heart metrics. Results suggest value of cardiac substructure margin generation to enable more robust cardiac sparing and to reduce the effect of respiration on overall treatment plan quality

All You Need Is Fats—for Seizure Control: Using Amoeba to Advance Epilepsy Research

Since the original report of seizure control through starvation in the 1920s, the ketogenic diet has been considered an energy-related therapy. The diet was assumed to be functioning through the effect of reduced carbohydrate intake regulating cellular energy state, thus giving rise to seizure control. From this assumption, the generation of ketones during starvation provided an attractive mechanism for this altered energy state; however, many years of research has sought and largely failed to correlate seizure control and ketone levels. Due to this focus on ketones, few studies have examined a role for free fatty acids, as metabolic intermediates between the triglycerides provided in the diet and ketones, in seizure control. Recent discoveries have now suggested that the medium-chain fats, delivered through the medium-chain triglyceride (MCT) ketogenic diet, may provide a key therapeutic mechanism of the diet in seizure control. Here we describe an unusual pathway leading to this discovery, beginning with the use of a tractable non-animal model—Dictyostelium, through to the demonstration that medium-chain fats play a direct role in seizure control, and finally the identification of a mechanism of action of these fats and related congeners leading to reduced neural excitability and seizure control

Dyspraxia in medical education: a collaborative autoethnography

In this paper we adopt an autoethnographic approach to explore the lived experiences of a UK medical student with dyspraxia within the current culture of UK medical education. An initial review of the literature revealed that there is now growing evidence regarding the difficulties experienced by, and support needed for medical students and doctors with dyslexia. However, no research has been conducted concerning dyspraxia on its own in medical education. Here we seek to provide an in-depth account of a UK undergraduate medical student with dyspraxia. It is hoped that this will have three outcomes: to support both students and staff across multiple disciplines, who have had similar experiences; to inform educators; and to promote further interest and research into this important area