Galileo lithium/SO2

The current status of the Galileo lithium SO2 battery is described. The following general requirements of the battery are discussed: (1) electrical characteristics, (2) storage, (3) reliability, and (4) performance

Perceptual versus motoric attention : an fMRI investigation of the speed-accuracy tradeoff in decision-making

iii, 126 leaves : ill. (some col.) ; 29 cm.Includes abstract.Includes bibliographical references (leaves 80-93).Selectively attending to either the sensory qualities of a stimulus or the response required by a task can influence the speed and accuracy of performance. Prior fMRI studies have identified medial and lateral prefrontal regions to play a critical role in accommodating speed instructions; however, no neural regions that accommodate improvements in accuracy have been identified. Here event-related fMRI was used to investigate when brain regions respond to speed-accuracy tradeoff manipulations and whether there are distinct brain regions for achieving greater accuracy or greater speed. First, visual-attention regions had greater activation when emphasizing accuracy rather than speed. Secondly, the pre-supplementary motor area increased activation during response preparation when emphasizing speed over accuracy. Lastly, the lentiform nucleus increased activation just prior to the execution of a response when emphasizing speed. Trading speed for accuracy may involve shifting the balance of neural activation between systems that prepare for action and those involved with visuo-spatial attention

Characterisation of fabric deformation mechanisms during preform manufacture

The use of composites for structural applications in the automotive industry has become more attractive due to the possible weight savings and part integration. Liquid moulding processes, where the reinforcement is prepared separately from the moulding operation, have been suggested as a suitable production method. However there are several obstacles to overcome before they can meet the high production volumes required. Whilst forming the preform, defects such as wrinkling and tearing can occur which can prevent successful moulding. This thesis addresses problems in the design and production of preforms. Current preform manufacturing processes and modelling techniques are reviewed. A model based on kinematic principles to predict fibre architectures for biaxial fabrics draped over arbitrary surfaces is described. A technique based on grid strain analysis was used to measure the deformation of various stitch bonded fabrics, and compared to the kinematic drape model results. The pure shear assumptions of the kinematic drape model assume the fabric has zero resistance to shear. Experimental measurements of fabric in-plane shear resistance were undertaken and compared for a range of fabrics. This highlighted some important criteria in fabric selection and possible problems in the kinematic modelling approach. The results from the in-plane shear tests were compared with those from the grid strain analysis to determine which fabric variables were important to fabric formability. Problems in the application of constraints within the kinematic model were discovered, and methods for overcoming them were suggested. Criteria which must be considered when selecting suitable fabrics for high drape preforms are discussed

In search of consensus on aphasia management.

Morag Bixley and colleagues discuss their analysis of current UK aphasia practice

Aphasia management in an acute setting, what are we doing and why?

TITLE OF PAPER: APHASIA MANAGEMENT IN AN ACUTE SETTING, WHAT ARE WE DOING AND WHY? KEYWORDS: THERAPY, RATIONALES, EXPERTS • WHY THE STUDY WAS UNDERTAKEN The Specific Interest Group in Aphasia Therapy has been involved with two projects looking into what Speech and Language Therapists (SLTs) do for people with aphasia in the acute setting. In the first phase of their research Bixley et al (2011) collated the different activities reported by 86 SLTs from 55 different adult trusts. This research suggested that therapist activity could be divided into five categories. A follow up study (Bixley et al, 2013) asked SLTs to confirm these groups, estimate the amount of time spent on each activity and provide a rationale for why this therapy intervention was important. Twenty two therapists confirmed that their activities could be categorised into the five different types. Eight of these therapists were able to estimate the amount of time spent on each type of activity. These activities were: 1) Assessment - 32% 2) Multidisciplinary team working (MDT) - 26% 3) Therapy choices - 23% 4) SLT administration - 13% and 5) Support training and education (STE) - 6%. This paper expands on this research by presenting a grounded theme analysis of the rationales for intervention for people with aphasia in the acute setting. • HOW THE STUDY WAS DONE Therapists were asked to complete a short questionnaire that had been distributed opportunistically through the SIG network. Twenty two SLTs from 14 different NHS trusts participated in this research. Twenty one participants (95%) estimated that they spent an average of 43% of their time in work providing aphasia management. Typically they worked in departments of three therapists providing 17 sessions of acute aphasia care. Eleven therapists (50%) had less than five years SLT experience and typically were on pay scale 5 or 6. Four very experienced therapists (18%) who had worked for ten to twenty years were paid at band 8. • WHAT WAS FOUND AND IMPLICATIONS FOR FUTURE POLICY AND PRACTICE Rationales were provided for each of the five management options. Assessment: Words used to describe reasons for assessment activities (basis, develop, establish, estimate, focus, gain, guide, indicate, inform, make, plan, provide and suggest) indicate that assessment is an active, ongoing, reflective process. Assessment was linked to both therapist belief and recommended practice (Royal College of Physicians, 2012 and National Institute for Health and Clinical Excellence, 2013). MDT: Therapists reported that the role of MDT working was goal setting for the benefit of the client management. However some therapists were not employed as part of an MDT and found it difficult to influence this decision making process. Therapy: SLTs thought that impairment, functional and psychological therapies were equally important. They acknowledged that this was challenging in the acute sector where clients were discharged quickly and were not always well enough to engage fully with rehabilitation. 19/22 therapists (86%) suggested they would like more time to provide SLT input. This paper presents a consensus of current SLT expert opinion. Despite the small sample size this research could be used to guide targets for future SLT intervention in the acute sector and it could be used as a focus for discussion about intervention choices within the SLT profession. REFERENCES Bixley, M., Blagdon, B., Dean, M., Langley, J. & Stanton, D. (2013) Best practice for aphasia in the acute sector: a consensus of expert opinions. British Aphasiology Society Biennial International Conference Book of Abstracts, 8-9. Bixley, M., Blagdon, B., Dean, M., Langley, J. & Stanton, D. (2011) In search of consensus on aphasia management. Royal College of Speech and Language Therapists Bulletin, October, 18-20. Intercollegiate Stroke Working Party. (2012) National clinical guideline for stroke, 4th edition. London: Royal College of Physicians. National Institute For Health And Clinical Excellence. (2013) Stroke rehabilitation: 2nd guideline consultation

Ward based feeding and swallowing training.

Conference posterTITLE OF PAPER: WARD BASED FEEDING AND SWALLOWING TRAINING KEYWORDS: DYSPHAGIA, EVIDENCE BASE WHY THE STUDY WAS UNDERTAKEN This paper summarises the findings of the Northamptonshire Healthcare (NH) Feeding and Swallowing Training programme initiative. The results of the pilot study for this programme were presented at the Royal College of Speech and Language Therapists Conference in 2012. Speech and Language Therapists (SLTs) in the acute setting spend half of their time involved in providing feeding and swallowing care (Bixley, Blagdon, Dean, Langley & Stanton, 2011). As part of the multidisciplinary team, the overall aim of feeding and swallowing intervention is to help clients to meet their nutritional need. A recent Care Quality Commission (2011) report suggested that 51% of hospital trusts were not achieving this standard. Hospital based policies such as protected mealtimes highlight the importance of feeding within the acute sector. Inter professional guidelines (Boaden, 2006) and the evidence base for dysphagia management (Magnus, 2001) also support the use of specific feeding and swallowing training. However delivering comprehensive training within large hospitals is difficult using classroom based packages. Especially in environments where ward teams are large, staff teams change regularly and releasing staff for off ward training is difficult. The Northamptonshire feeding and swallowing programme was introduced to provide a sustainable swallowing training package that could overcome some of these difficulties, by providing training to nursing staff on the ward HOW THE STUDY WAS DONE The NHSLT team evaluated the impact of their innovative feeding and swallowing project by comparing the results of three ward based measures: B1, B2 and B3. The research was carried out on four acute wards, one after another. It was conducted during the hospital wide, one hour protected lunchtime slot. In each of the wards observational and questionnaire measurements (B1) were taken before implementation of a two week, eight day, training package. After the ward based training had occurred two further evaluations were conducted, one immediately after the training package had been delivered (B2) and one two weeks after the programme had been completed (B3). Observational measures were qualitative and recorded general impressions of the feeding practise on the ward. Questionnaire measurements were both quantitative and qualitative and were designed to identify what ward staff understood about feeding and swallowing difficulties. WHAT WAS FOUND Over the course of the ten month research project, twenty four hours of training was provided for fifty four people, on four different wards. Training was provided to 31 health care assistants, 17 nurses, 3 student nurses and 2 assistants and 2 others .Statistical analysis of the ward based knowledge questionnaires suggested that there was a significant difference between the scores obtained in B1 and B2 and B3 (Kruskal Wallis H (2) = 15.537, p=0.014 with a mean rank of 18.64 for B1, 34.83 for B2 and 37.78 for B3). These findings suggest that the feeding training programme had resulted in a measurable difference in ward staff knowledge and this difference was evident after the training programme had been completed. IMPLICATIONS FOR FUTURE POLICY AND PRACTICE The results of this study suggest that ward based feeding programmes are an effective way to deliver training. This type of training targets people who do not normally attend swallowing training courses because they cannot be released from their work. It also means that training can be individualised to the needs of different wards and staff members. This type of training delivery may be a valuable supplement or alternative to classroom based teaching programmes. • REFERENCES Blagdon, B., Bixley, M., Levis, N., Bird, L., Hood, G. & Murphy, K. (2012). Taking dysphagia management out of the classroom: A ward based feeding and swallowing project. Royal College of Speech and Language Therapists Conference, Driving transformation Using Evidence Based Practice, 52. Bixley, M., Blagdon, B., Dean, M., Langley, J. & Stanton, D. (2011). In search of consensus on aphasia management. Royal College of Speech and Language Therapists Bulletin, October, 18-20. Boaden, E. & Davies, S., Storey, L., & Watkins, C. (2006). Interprofessional Dysphagia Framework. www.uclan.aca.uk/facs/health/nursing/research/groups/stroke Care Quality Commission (2011). Dignity and Nutrition Inspection Programme. Newcastle upon Tyne: Care Quality Commission. Magnus, V. (2001). Dysphagia training for nurses in an acute hospital setting – a pragmatic approach. International Journal of Language and Communication Disorders, 36, 375-378

Broad Neutralization of SARS-CoV-2 Variants, Including Omicron, following Breakthrough Infection with Delta in COVID-19-Vaccinated Individuals

Numerous studies have shown that a prior SARS-CoV-2 infection can greatly enhance the antibody response to COVID-19 vaccination, with this so called "hybrid immunity" leading to greater neutralization breadth against SARS-CoV-2 variants of concern. However, little is known about how breakthrough infection (BTI) in COVID-19-vaccinated individuals will impact the magnitude and breadth of the neutralizing antibody response. Here, we compared neutralizing antibody responses between unvaccinated and COVID-19-double-vaccinated individuals (including both AZD1222 and BNT162b2 vaccinees) who have been infected with the Delta (B.1.617.2) variant. Rapid production of spike-reactive IgG was observed in the vaccinated group, providing evidence of effective vaccine priming. Overall, potent cross-neutralizing activity against current SARS-CoV-2 variants of concern was observed in the BTI group compared to the infection group, including neutralization of the Omicron (B.1.1.529) variant. This study provides important insights into population immunity where transmission levels remain high and in the context of new or emerging variants of concern

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.