A bifurcation study to guide the design of a landing gear with a combined uplock/downlock mechanism

This paper discusses the insights that a bifurcation analysis can provide when designing mechanisms. A model, in the form of a set of coupled steady-state equations, can be derived to describe the mechanism. Solutions to this model can be traced through the mechanism's state versus parameter space via numerical continuation, under the simultaneous variation of one or more parameters. With this approach, crucial features in the response surface, such as bifurcation points, can be identified. By numerically continuing these points in the appropriate parameter space, the resulting bifurcation diagram can be used to guide parameter selection and optimization. In this paper, we demonstrate the potential of this technique by considering an aircraft nose landing gear, with a novel locking strategy that uses a combined uplock/downlock mechanism. The landing gear is locked when in the retracted or deployed states. Transitions between these locked states and the unlocked state (where the landing gear is a mechanism) are shown to depend upon the positions of two fold point bifurcations. By performing a two-parameter continuation, the critical points are traced to identify operational boundaries. Following the variation of the fold points through parameter space, a minimum spring stiffness is identified that enables the landing gear to be locked in the retracted state. The bifurcation analysis also shows that the unlocking of a retracted landing gear should use an unlock force measure, rather than a position indicator, to de-couple the effects of the retraction and locking actuators. Overall, the study demonstrates that bifurcation analysis can enhance the understanding of the influence of design choices over a wide operating range where nonlinearity is significant

Modified Early Warning Scores (MEWS) to support ambulance clinicians’ decisions to transport or treat at home

Introduction Modified Early Warning Scores (MEWS), calculated from patients’ vital signs, are used in hospital to identify patients who may benefit from admission or intensive care: higher MEWS indicates greater clinical risk. We aimed to evaluate MEWS to support paramedics’ decisions to transport patients to hospital or treat and leave them at home. Methods We used an interrupted time series design. We trained 19 volunteer paramedics to use MEWS to support decisions to transport or treat and leave at home. We used linear regression to evaluate differences in weekly transportation rates (percentage of patients attended and transported to hospital) and revisit rates (percentage of patients attended, treated at home and subsequently revisited within 7 days), comparing trends in rates 17 weeks prior (pre-MEWS) and 17 weeks post implementation of MEWS. Auto-calculated scores retrospectively applied to all data provided pre-MEWS and were compared with paramedic calculated scores post-MEWS. Results Of the 4140 patients attended, 2208 were excluded owing to missing values (n=1897), recording errors (n=21) or excluded clinical complaints (n=290). From the remaining data (n=1932) there were no significant differences in transportation rates (pre=55±6%; post=63±11%) by catering for the existing increasing trends where the confidence intervals of the regression slopes overlap (pre=0.15; 95%CI -0.51 to 0.80 vs. post=0.54; -0.58 to 1.65). Similarly, there were no significant difference in revisit rates (pre=4±4%; post=2±4%) catering for the similar trends (pre=-0.13; -0.53 to 0.27 vs. post=0.08; -0.33 to 0.49). Paramedic scores were incorrect 39% of the time (n=622). Conclusion MEWS had a minimal effect on transportation or revisit rates. Scores were frequently not calculated or recorded, or incorrectly calculated. Opportunities for ongoing training, clinical support and feedback were limited. A larger study, ensuring adequate ongoing support, is recommended before implementing MEWS on a wider scale

Absolute quantification of the host-to-parasite DNA ratio in Theileria parva-infected lymphocyte cell lines

Theileria parva is a tick-transmitted intracellular apicomplexan pathogen of cattle in sub-Saharan Africa that causes East Coast fever (ECF). ECF is an acute fatal disease that kills over one million cattle annually, imposing a tremendous burden on African small-holder cattle farmers. The pathology and level of T. parva infections in its wildlife host, African buffalo (Syncerus caffer), and in cattle are distinct. We have developed an absolute quantification method based on quantitative PCR (qPCR) in which recombinant plasmids containing single copy genes specific to the parasite (apical membrane antigen 1 gene, ama1) or the host (hypoxanthine phosphoribosyltransferase 1, hprt1) are used as the quantification reference standards. Our study shows that T. parva and bovine cells are present in similar numbers in T. parva-infected lymphocyte cell lines and that consequently, due to its much smaller genome size, T. parva DNA comprises between 0.9% and 3% of the total DNA samples extracted from these lines. This absolute quantification assay of parasite and host genome copy number in a sample provides a simple and reliable method of assessing T. parva load in infected bovine lymphocytes, and is accurate over a wide range of host-to-parasite DNA ratios. Knowledge of the proportion of target DNA in a sample, as enabled by this method, is essential for efficient high-throughput genome sequencing applications for a variety of intracellular pathogens. This assay will also be very useful in future studies of interactions of distinct host-T. parva stocks and to fully characterize the dynamics of ECF infection in the field

Trends during development of Scottish salmon farming: An example of sustainable intensification?

Commercial farming of Atlantic salmon in Scotland started in 1969 and has since expanded to produce >179,000 t year-1. A government department has published annual statistics and information on the seawater and freshwater sub-sectors of the Scottish salmon farming industry since 1979, and this review collates and discusses metrics covering aspects of production, farm sites and systems, fish performance, socio-economics and environmental pressures. Trends illustrated in this case study of aquaculture development include: initial increases in numbers of farms and companies, followed by decreases due to industry consolidation; increases in average farm size, and productivity of systems and employees; increases in survival, size at age and productivity of fish (yield per smolt, ova per broodstock); reduced dependence on wild stocks for ova. This case study also illustrates the importance of disease management, control of biological processes to overcome natural seasonality (i.e. production of out-of-season smolt), and the international nature of aquaculture. Improvements in fish survival, growth and productivity are attributed to progress in vaccination and health management (including fallowing), husbandry, system design, feed formulation and provision, and introduction of technology and mechanisation. Salmon farming is discussed in relation to the challenging strategy of ``sustainable intensification{''}. Improved growth and survival over a period of increasing rearing unit size, farm size and output and decreasing relative staff input counters the common assumption that intensification compromises animal welfare. The value of capturing time series data on industry wide metrics is illustrated as it enables identification of trends, underperformance and bench-marking, as well as assessment of resource use efficiency, environmental pressures, and ultimately sustainability. Crown Copyright (C) 2016 Published by Elsevier B.V.

Protection against discrimination in national dementia guideline recommendations: A systematic review

BACKGROUND: National dementia guidelines provide recommendations about the most effective approaches to diagnosis and interventions. Guidelines can improve care, but some groups such as people with minority characteristics may be disadvantaged if recommended approaches are the same for everyone. It is not known if dementia guidelines address specific needs related to patient characteristics. The objectives of this review are to identify which countries have national guidelines for dementia and synthesise recommendations relating to protected characteristics, as defined in the UK Equality Act 2010: age, disability, gender identity, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation. METHODS AND FINDINGS: We searched CINAHL, PsycINFO, and Medline databases and the Guideline International Network library from inception to March 4, 2020, for dementia guidelines in any language. We also searched, between April and September 2020, Google and the national health websites of all 196 countries in English and in each country’s official languages. To be included, guidelines had to provide recommendations about dementia, which were expected to be followed by healthcare workers and be approved at a national policy level. We rated quality according to the iCAHE guideline quality checklist. We provide a narrative synthesis of recommendations identified for each protected characteristic, prioritising those from higher-quality guidelines. Forty-six guidelines from 44 countries met our criteria, of which 18 were rated as higher quality. Most guidelines (39/46; 85%) made at least one reference to protected characteristics, and we identified recommendations relating to age, disability, race (or culture, ethnicity, or language), religion, sex, and sexual orientation. Age was the most frequently referenced characteristic (31/46; 67%) followed by race (or culture, ethnicity, or language; 25/46; 54%). Recommendations included specialist investigation and support for younger people affected by dementia and consideration of culture when assessing whether someone had dementia and providing person-centred care. Guidelines recommended considering religion when providing person-centred and end-of-life care. For disability, it was recommended that healthcare workers consider intellectual disability and sensory impairment when assessing for dementia. Most recommendations related to sex recommended not using sex hormones to treat cognitive impairment in men and women. One guideline made one recommendation related to sexual orientation. The main limitation of this study is that we only included national guidelines applicable to a whole country meaning guidelines from countries with differing healthcare systems within the country may have been excluded. CONCLUSIONS: National guidelines for dementia vary in their consideration of protected characteristics. We found that around a fifth of the world’s countries have guidelines for dementia. We have identified areas of good practice that can be considered for future guidelines and suggest that all guidelines provide specific evidence-based recommendations for minority groups with examples of how to implement them. This will promote equity in the care of people affected by dementia and help to ensure that people with protected characteristics also have high-quality clinical services

Results Following Three Modalities of Periodontal Therapy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141627/1/jper0522.pd

Longitudinal Study of Periodontal Therapy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142010/1/jper0066.pd

New and improved demonstrations, each illustrating a single scientific paper

Thesis (Ed.M.)--Boston Universit

Numerical continuation analysis of a dual-sidestay main landing gear mechanism

A model of a three-dimensional dual-sidestay landing gear mechanism is presented and employed in an investigation of the sensitivity of the downlocking mechanism to attachment point deflections. A motivation for this study is the desire to understand the underlying nonlinear behavior, which may prevent a dual-sidestay landing gear from downlocking under certain conditions. The model formulates the mechanism as a set of steady-state constraint equations. Solutions to these equations are then continued numerically in state and parameter space, providing all state parameter dependencies within the model from a single computation. The capability of this analysis approach is demonstrated with an investigation into the effects of the aft sidestay angle on retraction actuator loads. It was found that the retraction loads are not significantly affected by the sidestay plane angle, but the landing gear’s ability to be retracted fully is impeded at certain sidestay plane angles. This result is attributed to the landing gear’s geometry, as the locklinks are placed under tension and cause the mechanism to lock. Sidestay flexibilities and attachment point deflections are then introduced to enable the downlock loads to be investigated. The investigation into the dual sidestay’s downlock sensitivity to attachment point deflections yields an underlying double-hysteresis loop, which is highly sensitive to these deflections. Attachment point deflections of a few millimeters were found to prevent the locklinks from automatically downlocking under their own weight, hence requiring some external force to downlock the landing gear. Sidestay stiffness was also found to influence the downlock loads, although not to the extent of attachment point deflection