Experimental characterisation of fatigue damage in single Z-pins

Z-pins have been shown to significantly improve delamination resistance and impact strength of carbon fibre reinforced (CFRP) composites. In this paper, an experimental investigation of the influence of different fatigue parameters (mean opening/sliding displacement, amplitude, frequency, number of cycles) on the through-thickness reinforcement (TTR) is presented. For mode I, it is shown that the degradation on pin behaviour during fatigue is mostly affected by the applied displacement amplitude. The degradation is primarily caused by surface wear. Due to the brittleness of the Z-pins, mode II fatigue does not have a significant effect for very small sliding displacements. Exceeding a critical displacement causes the pin to rupture within the very first cycles

Micro-mechanical finite element analysis of Z-pins under mixed-mode loading

© 2015 Elsevier Ltd. All rights reserved.This paper presents a three-dimensional micro-mechanical finite element (FE) modelling strategy for predicting the mixed-mode response of single Z-pins inserted in a composite laminate. The modelling approach is based upon a versatile ply-level mesh, which takes into account the significant micro-mechanical features of Z-pinned laminates. The effect of post-cure cool down is also considered in the approach. The Z-pin/laminate interface is modelled by cohesive elements and frictional contact. The progressive failure of the Z-pin is simulated considering shear-driven internal splitting, accounted for using cohesive elements, and tensile fibre failure, modelled using the Weibulls criterion. The simulation strategy is calibrated and validated via experimental tests performed on single carbon/BMI Z-pins inserted in quasi-isotropic laminate. The effects of the bonding and friction at the Z-pin/laminate interface and the internal Z-pin splitting are discussed. The primary aim is to develop a robust numerical tool and guidelines for designing Z-pins with optimal bridging behaviour

Illness reporting and demand for medical care in rural Burkina Faso

This is the post-print version of the final paper published in Social Science & Medicine. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2010 Elsevier B.V.The issue of illness reporting in modelling demand for health care in low- and middle-income countries can be handled according to either of two conceptually-different constructs: (a) considering illness reporting behaviour as endogenous to demand; or (b) considering demand itself as the outcome of a sample selection phenomenon. In this paper, we take the second viewpoint and estimate the demand for medical care with an estimator that uses Heckman-type. Empirical estimates based on household survey data from rural Burkina Faso suggest that there are some implications of illness reporting behaviour for modelling the demand for medical care.German Science Foundatio

Political Parties and Political Foundations in Italy. Their Changing Landscape of Structure and Financing

This book, published with research funds from the University of Rome La Sapienza, aims at disseminating knowledge about the Italian system of political parties and political foundations among non-Italian scholars, in the light of the recent legislative reforms in this field. Due to their nature as free associations of citizens under art. 49 Cost., political parties are supposed to enjoy a full autonomy in determining their own purposes, internal organisation and financial management. However, the recent regulation on the funding of political parties contains provisions aimed at influencing the contents of party statutes, imposing upon them several organisational obligations. Moreover, some draft laws concerning the internalfunding have been proposed, with the idea of making intra-party democracy not only a prerequisite for obtaining funds, but also for competing in elections. However, many argue that a law should be the least invasive possible, and parties should instead proceed to self-reformation. The stronger the erosion process of party organisations and of political cultures is, the more strongly affirmed will be the personalised models of political organisation, in which even the funding of the organisation’s own public viability is managed autonomously. This is why ever more frequently some political leaders make use of think tanks for fund-raising, by virtue of the broad degree of autonomy that they enjoy

5% lidocaine medicated plaster double effect in a case of orofacial localized neuropathic pain

Roberto Casale,1,2 Yuriy Romanenko,2,3 Massimo Allegri4–6 1Department of Clinical Neurophysiology and Pain Rehabilitation Unit, Foundation "Salvatore Maugeri", Research and Care Institute, IRCCS, Pavia, Italy; 2EFIC Montescano Pain School, Montescano, Italy; 3Department of Neurology, Lugansk City Hospital 4, Lugansk, Ukraine; 4Department of Clinical, Surgical, Diagnostic and Pediatric Sciences University of Pavia, Pavia, Italy; 5Pain Therapy Service Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 6SIMPAR group, Pavia, Italy Abstract: Localized neuropathic pain (LNP) is a type of neuropathic pain that is characterized by “consistent and limited area(s) of maximum pain associated with negative or positive sensory signs and/or spontaneous symptoms characteristic of neuropathic pain”. This definition encompasses a huge number of neuropathic orofacial pain syndromes. We present a case report of a patient who was affected with sleep apnea syndrome treated with nocturnal oxygen mask delivery, in whom orofacial LNP hampered the wearing of a mask due to unbearable burning and throbbing pain. The application of 5% lidocaine medicated plaster during the night led to an impressive reduction of both the pain level and the size of the painful area due to the plaster's pharmacological mechanisms, which were associated with a secondary benefit due to its mechanical protective action. This case report shows how these two factors could be of clinical value and have to be considered more systematically in the treatment of LNP in reducing pain and the size of the painful area. Keywords: trigeminal pain, localized neuropathic pain, topical treatment, 5% lidocaine medicated plaste

Step-wedge cluster-randomised community-based trials: An application to the study of the impact of community health insurance

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.BACKGROUND: We describe a step-wedge cluster-randomised community-based trial which has been conducted since 2003 to accompany the implementation of a community health insurance (CHI) scheme in West Africa. The trial aims at overcoming the paucity of evidence-based information on the impact of CHI. Impact is defined in terms of changes in health service utilisation and household protection against the cost of illness. Our exclusive focus on the description and discussion of the methods is justified by the fact that the study relies on a methodology previously applied in the field of disease control, but never in the field of health financing. METHODS: First, we clarify how clusters were defined both in respect of statistical considerations and of local geographical and socio-cultural concerns. Second, we illustrate how households within clusters were sampled. Third, we expound the data collection process and the survey instruments. Finally, we outline the statistical tools to be applied to estimate the impact of CHI. CONCLUSION: We discuss all design choices both in relation to methodological considerations and to specific ethical and organisational concerns faced in the field. On the basis of the appraisal of our experience, we postulate that conducting relatively sophisticated trials (such as our step-wedge cluster-randomised community-based trial) aimed at generating sound public health evidence, is both feasible and valuable also in low income settings. Our work shows that if accurately designed in conjunction with local health authorities, such trials have the potential to generate sound scientific evidence and do not hinder, but at times even facilitate, the implementation of complex health interventions such as CHI

A novel model of delamination bridging via Z-pins in composite laminates

AbstractA new micro-mechanical model is proposed for describing the bridging actions exerted by through-thickness reinforcement on delaminations in prepreg based composite materials, subjected to a mixed-mode (I–II) loading regime. The model applies to micro-fasteners in the form of brittle fibrous rods (Z-pins) inserted in the through-thickness direction of composite laminates. These are described as Euler–Bernoulli beams inserted in an elastic foundation that represents the embedding composite laminate. Equilibrium equations that relate the delamination opening/sliding displacements to the bridging forces exerted by the Z-pins on the interlaminar crack edges are derived. The Z-pin failure meso-mechanics is explained in terms of the laminate architecture and the delamination mode. The apparent fracture toughness of Z-pinned laminates is obtained from as energy dissipated by the pull out of the through-thickness reinforcement, normalised with respect to a reference area. The model is validated by means of experimental data obtained for single carbon/BMI Z-pins inserted in a quasi-isotropic laminate

ES8 COST-EFFECTIVENESS OF DARUNAVIR/R IN HIGHLY TREATMENT-EXPERIENCED HIV/AIDS PATIENTS IN DIFFERENT EUROPEAN HEALTH CARE SETTINGS

Large-scale molecular interaction data sets have the potential to provide a comprehensive, system-wide understanding of biological function. Although individual molecules can be promiscuous in terms of their contribution to function, molecular functions emerge from the specific interactions of molecules giving rise to modular organisation. As functions often derive from a range of mechanisms, we demonstrate that they are best studied using networks derived from different sources. Implementing a graph partitioning algorithm we identify subnetworks in yeast protein-protein interaction (PPI), genetic interaction and gene co-regulation networks. Among these subnetworks we identify cohesive subgraphs that we expect to represent functional modules in the different data types. We demonstrate significant overlap between the subgraphs generated from the different data types and show these overlaps can represent related functions as represented by the Gene Ontology (GO). Next, we investigate the correspondence between our subgraphs and the Gene Ontology. This revealed varying degrees of coverage of the biological process, molecular function and cellular component ontologies, dependent on the data type. For example, subgraphs from the PPI show enrichment for 84%, 58% and 93% of annotated GO terms, respectively. Integrating the interaction data into a combined network increases the coverage of GO. Furthermore, the different annotation types of GO are not predominantly associated with one of the interaction data types. Collectively our results demonstrate that successful capture of functional relationships by network data depends on both the specific biological function being characterised and the type of network data being used. We identify functions that require integrated information to be accurately represented, demonstrating the limitations of individual data types. Combining interaction subnetworks across data types is therefore essential for fully understanding the complex and emergent nature of biological function

Factors influencing variation in implementation outcomes of the redesigned community health fund in the Dodoma region of Tanzania: a mixed-methods study

INTRODUCTION: Micro-health insurance (MHI) has been identified as a possible interim solution to foster progress towards Universal Health Coverage (UHC) in low- and middle- income countries (LMICs). Still, MHI schemes suffer from chronically low penetration rates, especially in sub-Saharan Africa. Initiatives to promote and sustain enrolment have yielded limited effect, yet little effort has been channelled towards understanding how such initiatives are implemented. We aimed to fill this gap in knowledge by examining heterogeneity in implementation outcomes and their moderating factors within the context of the Redesigned Community Health Fund in the Dodoma region in Tanzania. METHODS: We adopted a mixed-methods design to examine implementation outcomes, defined as adoption and fidelity of implementation (FOI) as well as their moderating factors. A survey questionnaire collected individual level data and a document review checklist and in-depth interview guide collected district level data. We relied on descriptive statistics, a chi square test and thematic analysis to analyse our data. RESULTS: A review of district level data revealed high adoption (78%) and FOI (77%) supported also by qualitative interviews. In contrast, survey participants reported relatively low adoption (55%) and FOI (58%). Heterogeneity in adoption and FOI was observed across the districts and was attributed to organisational weakness or strengths, communication and facilitation strategies, resource availability (fiscal capacity, human resources and materials), reward systems, the number of stakeholders, leadership engagement, and implementer's skills. At an individual level, heterogeneity in adoption and FOI of scheme components was explained by the survey participant's level of education, occupation, years of stay in the district and duration of working in the scheme. For example, the adoption of job description was statistically associated with occupation (p = 0.001) and wworking in the scheme for more than 20 months had marginal significant association with FOI (p = 0.04). CONCLUSION: The study demonstrates that assessing the implementation processes helps to detect implementation weaknesses and therefore address such weaknesses as the interventions are implemented or rolled out to other settings. Attention to contextual and individual implementer elements should be paid in advance to adjust implementation strategies and ensure greater adoption and fidelity of implementation