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The SUbsonic Single Aft eNgine (SUSAN) Electrofan is a National Aeronatics and Space Administration (NASA) concept transport aircraft representative of technology anticipated for a 2040 entry-into-service date. The powertrain consists of a single thrust-producing geared turbofan engine with generators driving a series/parallel partial hybrid power/propulsion system. The architecture includes 16 underwing contrarotating fans, eight on each side. The distributed fans can be used by the flight control system to augment or replace the rudder function. This paper sets up the optimal control problem of setpoint determination for individual wingfans in the distributed propulsion system, accounting for electrical string efficiencies, saturations, and failures. The solution minimizes power consumption while maintaining thrust and torque on the airframe for maneuvering. Additionally, thrust that would have been lost due to temporary fan speed or power saturation is optimally redistributed to maintain overall desired thrust and torque on the aircraft. A simulation of a coordinated turn utilizing the distributed electric propulsion for yaw rate control in a multiple wingfan failure scenario demonstrates the robustness of the powertrain design to failures and helps define its limitations. [ABSTRACT FROM AUTHOR]

This study aims to characterize participation of neonatal intensive care unit (NICU) graduates in early intervention (EI). We used data from the National Early Intervention Longitudinal Study. We fit models of days from referral to Individualized Family Service Plan creation (plan time), days from referral to initiation of services (service time), and parent-reported effort to enroll their child with clinical and sociodemographic predictors. The sample of 1,188 NICU graduates had median birth weight 1,942 g, gestational age 33.4 weeks, and maternal age 27.4 years. Plan time was shorter for those with health insurance (2.5 weeks, p = 0.04) and living in high-providing states (3.3 weeks, p = 0.005). Service time was shorter for those with global delay (8 days, p = 0.02) and health insurance (11 days, p = 0.03) and longer for those with single parents (24 days, p = 0.009). Single parents and parents of children with higher birth weight, congenital problems, and non-White race reported greater effort finding services. Single parents and parents of female and higher birth weight infants reported greater effort initiating services. These findings document disparities in enrollment timing and service provision by disability types, single parenthood, and being of non-White race. Further elucidation of such disparities could lead to improved enrollment and access to prescribed services.

The article focuses on the necessity of adopting a systems-centered approach for achieving equitable and integrated care for children, especially those facing health disparities due to structural barriers. It mentions the shortcomings of individual-centered strategies, such as the family-centered medical home model, and advocates for a paradigm shift towards addressing systemic issues to enhance the quality, value, and equity of pediatric care.

Aim: To test whether poor childhood pulmonary function explains the relationship between extremely preterm (EP) birth and attention‐deficit/hyperactivity disorder (ADHD) symptoms in young adulthood. Methods: EPICure birth cohort participants include children born <26 weeks' gestation in the United Kingdom and Ireland in 1995 and their term‐born classmates. Predictor was EP birth. Outcomes were inattention/hyperactivity subscale z‐scores at 19 years. Forced expiratory volume (FEV1) z‐scores in childhood and young adulthood were mediators. We used recursive path analysis to determine the direct effect of EP birth on inattention/hyperactivity and its indirect effect through pulmonary function. Results: Ninety EP and 47 term‐born participants had pulmonary function testing at 11 and 19 years. Inattention z‐scores were higher in the EP group (mean difference 0.55 [95% CI 0.11, 0.99]) but not hyperactivity. Compared to term‐born peers, EP participants had lower FEV1 z‐scores at 11 (mean difference−1.35 [95% CI −1.72, −0.98]) and 19 (mean difference−1.29 [95% CI −1.65, −0.92]). Path models revealed that childhood pulmonary function explained the relationship between EP birth and inattention. Conclusions: Extremely preterm young adults have increased risk for inattention compared to term‐born peers. Poor pulmonary function appears to underlie this risk. The mechanisms responsible remain unclear and warrant further study. [ABSTRACT FROM AUTHOR]