Variable compliance device for a respiratory physiotherapy training simulator

Matériaux et outils pour la santéInternational audienceSemi active devices to modify the stiffness or the damping of systems received significant attention in the recent years. In this paper, two solutions of a variable compliance device to change the physiotherapists feeling of the thorax compliance of a 6-month old infant torso training simulator are presented. A first solution, using a variable orifice device which allows to change the compliance by changing the radius of a flow pipe is proposed. Another solution is to use a magnetorheological fluid damper. Both systems are presented in detail and discussed especially for their applicability to be integrated in the simulator

Aspects of Spirituality in Adolescents

This paper analyses which aspects of spirituality are valued by adolescents, and how they are interconnected with youths' life satisfaction and 'self-centeredness'. The participants were 254 adolescents (11th grade) of four different high schools from west Germany. After re-validation of the 6-factorial student's version of the ASP questionnaire (ASP-S, Cronbach's alpha = .90), we found that they appreciated most Conscious interactions, Compassion / Generosity and Aspiring for Beauty / Wisdom, while particularly Religious orientation / Prayer (Trust in God), esoteric Transcendence conviction, or Quest orientation were of lower relevance. The importance of these aspects of spirituality is known to increase with higher age. The correlation pattern between aspects of spirituality and life satisfaction dimensions differed remarkably between female and male adolescents. In particular Conscious interactions correlated with future prospects in females, while in males it correlated much better with family life and school situation. It became obvious that the non-formal aspects of spirituality in terms of relational consciousness are still vital, particularly secular humanism (i.e. Conscious interactions, Compassion / Generosity). These findings may have implications for religious educational programmes

Exhaust Nozzle for a Multitube Detonative Combustion Engine

An improved type of exhaust nozzle has been invented to help optimize the performances of multitube detonative combustion engines. The invention is applicable to both air-breathing and rocket engines used to propel some aircraft and spacecraft, respectively. In a detonative combustion engine, thrust is generated through the expulsion of combustion products from a detonation process in which combustion takes place in a reaction zone coupled to a shock wave. The combustion releases energy to sustain the shock wave, while the shock wave enhances the combustion in the reaction zone. The coupled shockwave/reaction zone, commonly referred to as a detonation, propagates through the reactants at very high speed . typically of the order of several thousands of feet per second (of the order of 1 km/s). The very high speed of the detonation forces combustion to occur very rapidly, thereby contributing to high thermodynamic efficiency. A detonative combustion engine of the type to which the present invention applies includes multiple parallel cylindrical combustion tubes, each closed at the front end and open at the rear end. Each tube is filled with a fuel/oxidizer mixture, and then a detonation wave is initiated at the closed end. The wave propagates rapidly through the fuel/oxidizer mixture, producing very high pressure due to the rapid combustion. The high pressure acting on the closed end of the tube contributes to forward thrust. When the detonation wave reaches the open end of the tube, it produces a blast wave, behind which the high-pressure combustion products are expelled from the tube. The process of filling each combustion tube with a detonable fuel/oxidizer mixture and then producing a detonation repeated rapidly to obtain repeated pulses of thrust. Moreover, the multiple combustion tubes are filled and fired in a repeating sequence. Hence, the pressure at the outlet of each combustion tube varies cyclically. A nozzle of the present invention channels the expansion of the pulsed combustion gases from the multiple combustion tubes into a common exhaust stream, in such a manner as to enhance performance in two ways: (1) It reduces the cyclic variations of pressure at the outlets of the combustion tubes so as to keep the pressure approximately constant near the optimum level needed for filling the tubes, regardless of atmospheric pressure at the altitude of operation; and (2) It maximizes the transfer of momentum from the exhaust gas to the engine, thereby maximizing thrust. The figure depicts a typical engine equipped with a nozzle according to the invention. The nozzle includes an interface section comprising multiple intake ports that couple the outlets of the combustion tubes to a common plenum. Proceeding from its upstream to its downstream end, the interface section tapers to a larger cross-sectional area for flow. This taper fosters expansion of the exhaust gases flowing from the outlets of the combustion tubes and contributes to the desired equalization of exhaust combustion pressure. The cross-sectional area for flow in the common plenum is greater than, or at least equal to, the combined cross-sectional flow areas of the combustor tubes. In the common plenum, the exhaust streams from the individual combustion tubes mix to form a single compound subsonic exhaust stream. Downstream of the common plenum is the throat that tapers to a smaller flow cross section. In this throat, the exhaust gases become compressed to form a compound sonic gas stream. Downstream of the throat is an expansion section, which typically has a bell or a conical shape. (The expansion section can be truncated or even eliminated in the case of an air-breathing engine.) After entering the expansion section, the exhaust gases expand rapidly from compound sonic to compound supersonic speeds and are then vented to the environment. The basic invention admits of numerous variations. For example, the combustion tubes can be arranged around the central axin a symmetrical or asymmetrical pattern other than the one shown in the figure. For another example, the flow cross-sectional area(s) of one or more of the intake ports in the interface section, of the common plenum, the throat, and/or the expansion section can be varied, either symmetrically or asymmetrically, to adjust dynamics of the exhaust stream or to direct the thrust vector away from the central axis

Three Conservation Applications of Astronaut Photographs of Earth: Tidal Flat Loss (Japan), Elephant Impacts on Vegetation (Botswana), and Seagrass and Mangrove Monitoring (Australia)

NASA photographs taken from low Earth orbit can provide information relevant to conservation biology. This data source is now more accessible due to improvements in digitizing technology, Internet file transfer, and availability of image processing software. We present three examples of conservation-related projects that benefited from using orbital photographs. (1) A time series of photographs from the Space Shuttle showing wetland conversion in Japan was used as a tool for communicating about the impacts of tidal flat loss. Real-time communication with astronauts about a newsworthy event resulted in acquiring current imagery. These images and the availability of other high resolution digital images from NASA provided timely public information on the observed changes. (2) A Space Shuttle photograph of Chobe National Park in Botswana was digitally classified and analyzed to identify the locations of elephant-impacted woodland. Field validation later confirmed that areas identified on the image showed evidence of elephant impacts. (3) A summary map from intensive field surveys of seagrasses in Shoalwater Bay, Australia was used as reference data for a supervised classification of a digitized photograph taken from orbit. The classification was able to distinguish seagrasses, sediments and mangroves with accuracy approximating that in studies using other satellite remote sensing data. Orbital photographs are in the public domain and the database of nearly 400,000 photographs from the late 1960s to the present is available at a single searchable location on the Internet. These photographs can be used by conservation biologists for general information about the landscape and in quantitative applications

Religious attendance after elevated depressive symptoms: is selection bias at work?

In an attempt to determine if selection bias could be a reason that religious attendance and depression are related, the predictive value of elevated depressive symptoms for a decrease in future attendance at religious services was examined in a longitudinal panel of 1,673 Dutch adults. Religious attendance was assessed yearly over five years using the single question, “how often do you attend religious gatherings nowadays?” Depressive symptoms were assessed four times within the first year using the Depression subscale of the Brief Symptom Inventory. Logistic regression models of change in attendance were created, stratifying by baseline attendance status. Attenders who developed elevated symptoms were less likely to subsequently decrease their attendance (relative risk ratio: 0.55, 95% CI [0.38–0.79]) relative to baseline as compared to those without elevated symptoms. This inverse association remained significant after controlling for health and demographic covariates, and when using multiply imputed data to account for attrition. Non-attenders were unlikely to start attending after elevated depressive symptoms. This study provides counter evidence against previous findings that church attenders are a self-selected healthier group

Treatment response and remission in a double-blind, randomized, head-to-head study of lisdexamfetamine dimesylate and atomoxetine in children and adolescents with attention-deficit hyperactivity disorder

The Author(s) 2014. This article is published with open access at Springerlink.com Objectives A secondary objective of this head-to-head study of lisdexamfetamine dimesylate (LDX) and ato-moxetine (ATX) was to assess treatment response rates in children and adolescents with attention-deficit hyperactiv-ity disorder (ADHD) and an inadequate response to methylphenidate (MPH). The primary efficacy and safety outcomes of the study, SPD489-317 (ClinicalTrials.gov NCT01106430), have been published previously. Methods In this 9-week, double-blind, active-controlled study, patients aged 6–17 years with a previous inadequate response to MPH were randomized (1:1) to dose-optimized LDX (30, 50 or 70 mg/day) or ATX (patients \70 kg: 0.5–1.2 mg/kg/day, not to exceed 1.4 mg/kg/day; patients C70 kg: 40, 80 or 100 mg/day). Treatment response was a secondary efficacy outcome and was predefined as a reduction from baseline in ADHD Rating Scale IV (ADHD-RS-IV) total score of at least 25, 30 or 50 %. Sustained response was predefined as a reduction from baseline in ADHD-RS-IV total score (C25, C30 or C50 %) or a Clinical Global Impressions (CGI)–Improvement (CGI–I) score of 1 or 2 throughout weeks 4–9. CGI– Severity (CGI–S) scores were also assessed, as an indicator of remission. Results A total of 267 patients were enrolled (LDX, n = 133; ATX, n = 134) and 200 completed the study (LDX, n = 99; ATX, n = 101). By week 9, significantly (p \ 0.01) greater proportions of patients receiving LDX than ATX met the response criteria of a reduction from baseline in ADHD-RS-IV total score of at least 25 % (90.5 vs. 76.7 %), 30 % (88.1 vs. 73.7 %) or 50 % (73.0 vs. 50.4 %). Sustained response rates were also signifi-cantly (p \ 0.05) higher among LDX-treated patient

Majority Party Agenda Setting: Picking Fights or Avoiding Them?

In legislatures such as the U.S. House of Representatives, where the majority party controls the agenda, the frequency of observed partisan disagreement is partially a function of strategic agenda‐setting choices made by that party. Do majority party leaders use their agenda control to privilege bills that accentuate disagreements with the minority party? In this paper, we develop a theoretical framework focused on the costs and benefits associated with floor consideration of partisan legislation. We test hypotheses derived from our theory on a dataset of 15,611 bills considered in House committees during the 104th–114th Congresses (1995–2016). We find that minority party opposition in committee is associated with a decreased likelihood of floor consideration, suggesting that the majority party does not use agenda setting to indiscriminately favor partisan legislation. Our findings focus attention on the costs of partisan agenda setting, and contextualize the partisan disagreement we ultimately observe on the House floor

Protocol investigating the clinical utility of an objective measure of attention, impulsivity and activity (QbTest) for optimising medication management in children and young people with ADHD ‘QbTest Utility for Optimising Treatment in ADHD’ (QUOTA): a feasibility randomised controlled trial

Introduction: Attention-deficit hyperactivity disorder (ADHD) is characterised by symptoms of inattention, hyperactivity and impulsivity. To improve outcomes, the National Institute for Health and Care Excellence ADHD guidelines recommend regular monitoring of symptoms when children commence medication. However, research suggests that routine monitoring rarely happens, and clinicians often rely on subjective information such as reports from parents and teachers to ascertain improvement. These sources can be unreliable and difficult to obtain. The addition of an objective test of attention and activity (QbTest) may improve the objectivity, reliability and speed of clinical decision-making and so reduce the time to identify the optimal medication dose. This study aims to assess the feasibility and acceptability of a QbTest medication management protocol delivered in routine healthcare services for children with ADHD. Method and analysis: This multisite feasibility randomised controlled trial (RCT) will recruit 60 young people (aged 6–17 years old), diagnosed with ADHD, and starting stimulant medication who are seen by Child and Adolescent Mental Health Services or Community Paediatric services. Participants will be randomised into one of two arms. In the experimental arm (QbTest protocol), the participant will complete a QbTest at baseline (prior to medication initiation), and two follow-up QbTests on medication (2–4 weeks and 8–10 weeks later). In the control arm, participants will receive treatment as usual, with at least two follow-up consultations. Measures of parent-, teacher- and clinician-rated symptoms and global functioning will be completed at each time point. Health economic measures will be completed. Clinicians will record treatment decision-making. Acceptability and feasibility of the protocol will be assessed alongside outcome measure completion rates. Qualitative interviews will be conducted. Ethics and dissemination: The findings will be used to inform the development of a fully powered RCT. The results will be submitted for publication in peer-reviewed journals. The study has ethical approval