This case study describes an adult patient whose brachial plexus injury was treated with various modalities and exercise. The participant of this study was a 76 year old female who sustained a brachial plexus injury during an elective reverse total shoulder arthroplasty. The initial evaluation reported only passive range of motion with 90 degrees shoulder flexion, 85 degrees abduction, and 30 degrees external rotation. Muscle testing yielded significantly limited wrist and digit extension strength. Testing of sensation found diminished protective sensation along the median nerve distribution, including the thumb, index finger, and middle finger. Occupational therapy was initiated for postoperative treatment of the shoulder as well as treatment of the brachial plexus palsy. Therapy consisted of static splinting for healing structures and sensory reeducation through massage, finding objects with the eyes occluded, and fluidotherapy. Additionally, various exercises and modalities for improving motion and strength were initiated, including proprioceptive neuromuscular reeducation, passive/active assist/active exercises, dynamic splinting, muscle stimulation, kinesio tape, functional activities, and tendon glides. After five months, active range of motion in the shoulder, elbow, and wrist was finally achieved and median nerve sensation had improved. After nine months, elbow motion was within normal limits and wrist motion had significantly improved. Upon muscle testing, the elbow, forearm, wrist, and hand had made significant gains in strength. However, shoulder strength and motion was still limited. Overall, treatment made a significant improvement in the patient’s functionality.

Laminated composites are increasingly being used in various industries including <br/>automotive and aerospace. Under a variety of extreme loading conditions such as low and <br/>high-velocity impacts and crash, laminated composites delaminate. To understand how and<br/>when delamination occurs, two types of laboratory tests are conducted - End-notched <br/>Flexure (ENF) test and Double Cantilever Beam (DCB) test. The ENF test is designed to <br/>find the mode II interlaminar fracture toughness, and the DCB test, the mode I interlaminar <br/>fracture toughness. In this thesis, thermopressed Honeywell Spectra Shield® 5231 <br/>composite specimens made of ultra-high molecular weight polyethylene (UHMWPE), <br/>manufactured under two different pressures (3000 psi and 6000 psi), are tested in the <br/>laboratory to find its delamination properties. The test specimen preparation, experimental <br/>procedures, and data reduction to determine the mode I and mode II interlaminar fracture <br/>properties are discussed. The ENF test results show a 15.8% increase in strain energy <br/>release rate for the 6000 psi specimens when compared to the 3000 psi specimens. <br/>Conducting the DCB tests proved to be challenging due to the low compressive strength <br/>of the material and hence required modifications to the test specimens. An estimate of the <br/>mode I interlaminar fracture toughness was found for only two of the 6000 psi specimens.

Within the pediatric hospitalization experience, fear and anxiety are two emotions commonly felt by children of all ages. Hospitalized children can greatly benefit from interventions designed to help them cope with these emotions throughout their medical experiences. This study draws on each of our clinical experiences as volunteers at Phoenix Children’s Hospital, and uses a qualitative analysis of three semi-structured interviews with currently employed Child Life Specialists to understand and analyze the use of medical play, a form of play intervention with a medical theme or medical equipment. We explore the goals and benefits of medical play for hospitalized pediatric patients, the process of using medical play as an intervention, including the activity design process, the assessments and adjustments made throughout the child’s hospitalization, and the considerations and limitations to implementing medical play activities. Ultimately, we found that the element of fun that defines play can be channeled into medical play activities implemented by skilled Child Life Specialists, who are experts in their field, in clinical settings to promote several different and beneficial goals, including pediatric patient coping.

Background: The purpose of this study was to assess the efficacy of a lifestyle intervention on cardiorespiratory fitness in Latino youth with obesity and prediabetes. <br/>Methods: Participants (n=50) in this study were taken from a larger randomized controlled trial (n=180, BMI ≥ 95th percentile). Youth participated in a 6-month lifestyle intervention that included physical activity (60 minutes, 3x/week) and nutrition and wellness classes (60 minutes, 1x/week) delivered to families at the Lincoln Family YMCA in Downtown Phoenix. The primary outcome was cardiorespiratory fitness measured at baseline and post-intervention.<br/>Results: The mean BMI for the sample was 33.17 ± 4.54 kg/m2, which put the participants in the 98.4th percentile. At baseline, the mean VO2max was 2737.02 ± 488.89 mL/min. The mean relative VO2max was 30.65 ± 3.87 mL/kg/min. VO2max values significantly increased from baseline to post-intervention (2737.022 ± 483.977 mL/min vs 2932.654 ± 96.062 mL/min, p<0.001). <br/>Conclusion: Culturally-grounded, family-focused lifestyle interventions are a promising approach for improving cardiorespiratory fitness in high-risk youth at risk for diabetes.

Long distance travel around the globe can potentially be revolutionized with the use of an intercontinental rocket that uses low earth orbit as its medium. This transport system can increase growth in many new businesses like tourism travel between the continents. This research evaluates the technical and non-technical possibilities of using a double-stage reusable rocket, where the second stage is also a reusable, rocket-powered passenger vehicle using a low earth orbit space journey with a stabilized re-entry method that ensures passenger comfortability. A potential network of spaceports spanning the globe is postulated within a range of 4,000 km to 8,000 km(2,160 nm to 4,320 nm) of each other, and each located within an hour by any other means of ground transport to population hubs greater than four million. This will help further connect the world as the journey from one major city to another would take at most an hour, and no point on the habited continents would be more than 4,000 km(2,160 nm) from a spaceport. It is assumed that the costs of an international first class flight ticket are in the thousands of dollars range showing how there is a potential market for this type of travel network. The reasoning and analysis, through a literature review, for an intercontinental rocket vehicle is presented along with the various aspects of the possibility of this kind of travel network coming to fruition in the near future.

A novel concept for integration of flame-assisted fuel cells (FFC) with a gas turbine is analyzed in this paper. Six different fuels (CH4, C3H8, JP-4, JP-5, JP-10(L), and H2) are investigated for the analytical model of the FFC integrated gas turbine hybrid system. As equivalence ratio increases, the efficiency of the hybrid system increases initially then decreases because the decreasing flow rate of air begins to outweigh the increasing hydrogen concentration. This occurs at an equivalence ratio of 2 for CH4. The thermodynamic cycle is analyzed using a temperature entropy diagram and a pressure volume diagram. These thermodynamic diagrams show as equivalence ratio increases, the power generated by the turbine in the hybrid setup decreases. Thermodynamic analysis was performed to verify that energy is conserved and the total chemical energy going into the system was equal to the heat rejected by the system plus the power generated by the system. Of the six fuels, the hybrid system performs best with H2 as the fuel. The electrical efficiency with H2 is predicted to be 27%, CH4 is 24%, C3H8 is 22%, JP-4 is 21%, JP-5 is 20%, and JP-10(L) is 20%. When H2 fuel is used, the overall integrated system is predicted to be 24.5% more efficient than the standard gas turbine system. The integrated system is predicted to be 23.0% more efficient with CH4, 21.9% more efficient with C3H8, 22.7% more efficient with JP-4, 21.3% more efficient with JP-5, and 20.8% more efficient with JP-10(L). The sensitivity of the model is investigated using various fuel utilizations. When CH4 fuel is used, the integrated system is predicted to be 22.7% more efficient with a fuel utilization efficiency of 90% compared to that of 30%.

The following paper explores the various effects of stress on the endocrine system. Many understand that being stressed can jeopardize maintaining adequate health, but what specifically happens when humans are stressed? Why does stress affect human health? This paper delves into background information, previous research, and the depths to which stress negatively affects the body. The effects stress has on the endocrine system, specifically on the hypothalamic-pituitary-thyroid axis (HPT) and hypothalamic-pituitary-adrenal axis (HPA), is discussed, and additionally, at home de-stressing methods are researched. The study included a set of participants at Arizona State University. The method took place over the course of 2 weeks: one normal week, and the other with the implementation of a de-stressing method. The normal week involved the participants living their daily lives with the addition of a stress-measuring survey, while the second week involved implementing a de-stressing method and stress-measuring survey. The purpose of this study was to discover if there was a correlation between performing these relaxation activities and decreasing stress levels in ASU students. The results found that students reported they felt more relaxed and calm after the activities. Overall, this thesis provides information and first hand research on the effects of stress and stress-reducing activities and discusses the importance of maintaining lower stress levels throughout everyday life.