Challenges for reducing inequities in health and healthcare for the 21st Century

Human life expectancy during the time of the Roman Empire was approximately 28 years. In 1990, global life expectancy had increased to 65 years. The advances in life expectancy in the 20th century were remarkable by any standard. Although many factors contributed to this enhanced life expectancy, including medical technologies, by far the largest proportion of the increase occurred as a consequence of economic growth, rising living standards and nutrition. Despite the large improvements in terms of life expectancy, significant health variations still remain between countries and across different socioeconomic classes with in countries. As the 20th century proceeded, a growing dichotomy existed between those who are healthy and have access to medical care and those who are not healthy and do not have access to such services. Moreover, evidence shows that such inequities in health and healthcare are increasing. The present paper will analyze the dynamics of shifts in health profile during the early period of the last century and describe the major determinants of inequities in health and healthcare at the international level. Challenges facing the reduction in inequalities in health and healthcare will be discussed

Influence of Z-pin embedded length on the interlaminar traction response of multi-directional composite laminates

The work in this paper investigated the performance of composites through-thickness reinforcing Z-pins as a function of their embedded length in pre-preg laminates. Single Z-pins were inserted into multidirectional carbon fibre laminates with increasing thicknesses, corresponding to embedded lengths from 1 mm to 10 mm and tested through a range of mixed mode displacement ratios to investigate their interlaminar bridging traction response. Detailed analysis of the tests revealed a non-linear tangential friction response and its strong dependence on the embedded length of the Z-pin. Using a new power law empirical relationship for the tangential friction force per unit length, a modified Z-pin bridging traction analytical model was proposed, giving good predictions of the full mixed mode bridging mechanics of a CFRP Z-pin in a multidirectional composite laminate of varying thickness. Several characteristics of the model are discussed and their influence on predicting the Z-pin bridging energy response have been analysed

Cohesive element formulation for z-pin delamination bridging in fibre reinforced laminates

Z-pins are an effective method of reinforcing laminated composite materials for resisting the propagation of delamination. In this paper, a novel numerical method combines the classical cohesive finite element (FE) method with a semi-analytical z-pin crack bridging model. Special purpose cohesive elements, in which the generalized traction-displacement characteristics are provided by the semi-analytical model z-pin bridging map, are implemented in macro-scale FE models. This cohesive element offers the flexibility to employ two cohesive laws concurrently for prediction of delamination propagation, for both the pinned and unpinned behaviour. Its efficacy is evaluated by the simulation of double cantilever beam (DCB), mixed-mode bend (MMB), and pure mode II End-Loaded Split (ELS) fracture tests at 2% z-pin areal density. The numerical results in terms of load-deflection predictions agree well with experiments. The different simulations were all performed using a single set of input parameters derived from single z-pin tests with no fitting factors

Strain rate dependence of mode II delamination resistance in through thickness reinforced laminated composites

A thorough experimental procedure is presented in which the mode II delamination resistance of a laminated fibre reinforced plastic (FRP) composite with and without Z-pins is characterised when subjected to increasing strain rates. Standard three-point End Notched Flexure (3ENF) specimens were subjected to increasing displacement loading rates from quasi-static (∼0 m/s) to high velocity impact (5 m/s) using a range of test equipment including drop weight impact tower and a Modified Hopkinson Bar apparatus for dynamic three-point bending tests. The procedure outlined uses compliance based approach to calculate the fracture toughness which was shown to produce acceptable values of GIIC for all loading rates. Using detailed high resolution imaging relationships between delamination velocities, apparent fracture toughness, longitudinal and shear strain rates were measured and compared. Confirming behaviours observed in literature, the thermosetting brittle epoxy composite showed minor increase in GIIC with increase in strain rate. However, the Z-pinned specimens showed a significant increase in the apparent GIIC with loading rate. This highlights the need to consider the strain rate dependency of the Z-pinned laminates when designing Z-pinned structures undergoing impact

Initial Study for Cost-Effectiveness of Joint/Crack Sealing

The sealing and resealing of joints and cracks in PCC, HMA, and composite pavements is assumed to be an important component of pavement maintenance. Recently this practice has been challenged by research indicating that sealing may not be cost-effective. The Indiana Department of Transportation currently spends approximately four million dollars annually to perform joint/crack sealing. The primary objective of the research presented in this report is to investigate the costeffectiveness of joint/crack sealing in relation to pavement performance. The results of a mail survey showed that most states, including Indiana, do not have quantitative justification for sealing policies, nor do they know the cost-effectiveness of the operations. Based on the experimental design for this research, nineteen test sites were selected in Indiana, each site having one sealed section and one unsealed section. Collected data including falling weight deflectometer measurements, pavement roughness, visual condition surveys, and core samples were used to evaluate the pavement performance between sealed and unsealed sections. A three-dimensional finite element pavement model was developed to evaluate the test location effect on the load transfer measurements. The temperature effect was evaluated by statistical analyses and a temperature correction factor for deflections on asphalt pavement is provided. A statistical model was developed to compare the pavement performance between sealed and unsealed sections for three pavement types, PCC, HMA and composite. The results indicated that there appears to be no significant differences between the performance of sealed and unsealed sections regardless of pavement type, drainage condition and road classification

Coronavirus Disease 2019: Knowledge, Attitude, Practice, and Perceived Barriers among Health care Workers at Cairo University Children Hospital, Egypt

BACKGROUND: Insufficient knowledge and negative attitude toward coronavirus disease 2019 (COVID-19) among health care workers (HCWs) could lead to faulty practices resulting in delayed diagnosis and spread of the disease. AIM: this study was conducted to assess the knowledge, attitude, practice, and perceived barriers to infection control toward COVID-19 among Egyptian HCWs. METHODS: A cross-sectional study was conducted in Cairo University Children Hospital, with 537 HCWs (doctors and nurses) enrolled. RESULTS: HCWs had an overall good knowledge level about COVID-19 where 61% had a knowledge score of ≥18 points (out of 23). Doctors were more knowledgeable than nurses. About 64% of HCWs were considered as having positive attitude (scored ≥10 out of 13 points), with a significantly higher positive attitude among nurses. The mean practice score of HCWs was 1.0 ± 2.0 with a significantly higher good practice among nurses. Younger age, being a doctor, and higher qualification were the significant positive predictors of acquiring knowledge about the disease. The most commonly perceived barriers for applying infection control measures in hospitals were overcrowdings in health-care facilities (78.2%) and insufficient infection control policies (62.6%). CONCLUSION: HCWs in general expressed good knowledge, positive attitude, and good practice toward COVID-19 despite some gaps that were detected in specific items. Proper planning of educational programs that are directed according to the needs of different groups of HCWs is crucial. Effective policies should be established to overcome the barriers for applying infection control in health facilities

Geostationary Operational Environmental Satellite (GOES)-8 mission flight experience

The Geostationary Operational Environmental Satellite (GOES)-8 spacecraft was launched on April 13, 1994, at 06:04:02 coordinated universal time (UTC), with separation from the Atlas-Centaur launch vehicle occurring at 06:33:05 UTC. The launch was followed by a series of complex, intense operations to maneuver the spacecraft into its geosynchronous mission orbit. The Flight Dynamics Facility (FDF) of the Goddard Space Flight Center (GSFC) Flight Dynamics Division (FDD) was responsible for GOES-8 attitude, orbit maneuver, orbit determination, and station acquisition support during the ascent phase. This paper summarizes the efforts of the FDF support teams and highlights some of the unique challenges the launch team faced during critical GOES-8 mission support. FDF operations experience discussed includes: (1) The abort of apogee maneuver firing-1 (AMF-1), cancellation of AMF-3, and the subsequent replans of the maneuver profile; (2) The unexpectedly large temperature dependence of the digital integrating rate assembly (DIRA) and its effect on GOES-8 attitude targeting in support of perigee raising maneuvers; (3) The significant effect of attitude control thrusting on GOES-8 orbit determination solutions; (4) Adjustment of the trim tab to minimize torque due to solar radiation pressure; and (5) Postlaunch analysis performed to estimate the GOES-8 separation attitude. The paper also discusses some key FDF GOES-8 lessons learned to be considered for the GOES-J launch which is currently scheduled for May 19, 1995

A Panel of Ancestry Informative Markers for the Complex Five-Way Admixed South African Coloured Population

Admixture is a well known confounder in genetic association studies. If genome-wide data is not available, as would be the case for candidate gene studies, ancestry informative markers (AIMs) are required in order to adjust for admixture. The predominant population group in the Western Cape, South Africa, is the admixed group known as the South African Coloured (SAC). A small set of AIMs that is optimized to distinguish between the five source populations of this population (African San, African non-San, European, South Asian, and East Asian) will enable researchers to cost-effectively reduce false-positive findings resulting from ignoring admixture in genetic association studies of the population. Using genome-wide data to find SNPs with large allele frequency differences between the source populations of the SAC, as quantified by Rosenberg et. al's -statistic, we developed a panel of AIMs by experimenting with various selection strategies. Subsets of different sizes were evaluated by measuring the correlation between ancestry proportions estimated by each AIM subset with ancestry proportions estimated using genome-wide data. We show that a panel of 96 AIMs can be used to assess ancestry proportions and to adjust for the confounding effect of the complex five-way admixture that occurred in the South African Coloured population.Department of HE and Training approved lis

Crystal structure of potassium [4-amino-5-(benzo[d]thia-zol-2-yl)-6-(methyl-sulfan-yl)pyrimidin-2-yl](phenyl-sulfon-yl)aza-nide di-methyl-formamide monosolvate hemihydrate

The title compound, K+·C18H14N5O2S3 -·C3H7NO·0.5H2O, was obtained in a reaction designed to deliver a neutral 2-pyrimidylbenzo-thia-zole. The anion is deprotonated at the sulfonamide nitro-gen. The asymmetric unit of the title compound contains two potassium cations, two anions, two mol-ecules of DMF and one of water. The anions display some conformational differences but each contains an intra-molecular N-H⋯Nbenzo-thia-zole hydrogen bond. The potassium ions both display a highly irregular six-coordination, different for each potassium ion. The anions, together with the DMF and water mol-ecules, are linked by four classical hydrogen bonds to form chains parallel to the b-axis direction

Improving Glass Walls Thermal Resistance In Air-Conditioned Buildings

The solar radiation through an air conditioned building depends on what is called the building envelope. Building envelope consists of the surfaces that separate the inside from the building outdoors. Area, direction, and specifications of glass walls; as one of envelope surfaces; has an important impact on solar radiation. Design and construction of glass walls have significant effects on building comfort and energy consumption. This paper describes methods of improving glass walls thermal resistance in air conditioned buildings. Effect of glass wall radiation temperature on the indoor temperature distribution of building rooms is also investigated. Heat gain through various types of glass is discussed. Optimization and testing of these types are carried out theoretically and experimentally as well. A series of experiments on different types of glass with special strips is performed