The effect of particle elongation on the strength of granular materials

It has long been recognised that the macroscopic mechanical behaviour of a granular material depends on particle shape. However, a systematic investigation into particle shape is lacking. Particle shape is commonly split into the independent categories of form, angularity and roughness. The form of a particle can be quantified using the Longest (L), Intermediate (I) and Shortest (S) dimension of an equivalent scalene ellipsoid; two independent parameters of particle form are defined, termed platyness and elongation.We use DEM simulations with the Potential Particle Method to investigate the effect of particle form on the friction angle of a granular material at critical state. It is found that deviation of particle form from that of a sphere leads to higher angles of friction at critical state. It is argued that, to some extent, the higher critical state strength exhibited by non-spherical particles is due to form suppressing particle rotation and leading to increased interparticle sliding, a mechanism that in comparison requires more energy to be expended

An investigation into the effect of particle platyness on the strength of granular materials using the discrete element method

It has long been recognised that the macroscopic mechanical behaviour of a granular material depends, to differing extents, on micro-mechanical properties such as the particle size distribution, the particle shape, the inter-particle friction angle and the particle strength. However, a systematic investigation of some of these effects is still lacking. In this paper we focus on particle shape, which is one of the fundamental characteristics of a granular material. We build on previous work that used the axes of an equivalent scalene ellipsoid to characterise particle form, one of the three aspects that define particle shape. (The other two being angularity and roughness.) We use DEM simulations to investigate the effect of particle form, and in particular of particle platyness, on the friction angle of a granular material at critical state. It is found that a deviation of particle shape from that of a sphere leads to higher angles of friction; quantities such as fabric, average rates of particle rotation and interparticle sliding are used to provide insights into the underlying micromechanics

Random mutagenesis of PDZOmi domain and selection of mutants that specifically bind the Myc proto-oncogene and induce apoptosis

peer reviewedOmi is a mammalian serine protease that is localised in the mitochondria and released to the cytoplasm in response to apoptotic stimuli. Omi induces cell death in a caspase-dependent manner by interacting with the Xchromosome linked inhibitor of apoptosis protein, as well as in a caspase-independent way that relies on its proteolytic activity. Omi is synthesized as a precursor polypeptide and is processed to an active serene protease with a unique PDZ domain. PDZ domains recognise the extreme carboxyl terminus of target proteins. Internal peptides that are able to fold into a b-finger are also reported to bind some PDZ domains. Using a modified yeast two-hybrid system, PDZOmi mutants were isolated by their ability to bind the carboxyl terminus of human Myc oncoprotein in yeast as well as in mammalian cells. One such PDZm domain (PDZ-M1), when transfected into mammalian cells, was able to bind to endogenous Myc protein and induce cell death. PDZ-M1-induced apoptosis was entirely dependent on the presence of Myc protein and was not observed when c-myc null fibroblasts were used. Our studies indicate that the PDZ domain of Omi can provide a prototype that could easily be exploited to target specifically and inactivate oncogenes by binding to their unique carboxyl terminus

Trends in US Hospital Admissions for Skin and Soft Tissue Infections

Using data from the 2000–2004 US Healthcare Cost and Utilization Project National Inpatient Sample, we found that total hospital admissions for skin and soft tissue infections increased by 29% during 2000–2004; admissions for pneumonia were largely unchanged. These results are consistent with recent reported increases in community-associated methicillin-resistant Staphylococcus aureus infections

Community Health Workers as Innovators: Methods and Results from a Tele-Education Pilot for Community Health Workers in Detroit, Michigan

Community health workers (CHWs) have played an important role in improving the health of underserved populations in resource-limited settings. CHWs are trusted in communities that they serve, and are often able to see solutions to community problems that outside persons cannot. Solutions need to be low cost and easily accessible, and address the knowledge gaps among CHWs through appropriate training. Utilizing information technology solutions can be key to increasing access to knowledge for these community agents. This paper outlines the methods and results from a pilot study of the Community Health Innovator Program performed in Detroit, Michigan with a group of community health workers in basic grant-writing training, utilizing an information technology platform. The results will be discussed as a larger response to growing issues in global health and how such platforms can be used and adapted in response to ever-evolving global health challenges

COVID-19 vaccination up-take in three districts of Nepal

Vaccine hesitancy during the COVID-19 pandemic continues to be an issue in terms of global efforts to decrease transmission rates. Despite high demand for the vaccines in Nepal, the country still contends with challenges related to vaccine accessibility, equitable vaccine distribution, and vaccine hesitancy. Study objectives were to identify: 1) up-take and intention for use of COVID-19 vaccines, 2) factors associated with vaccine up-take, and 3) trusted communication strategies about COVID-19 and the vaccines. A quantitative survey was implemented in August and September 2021 through an initiative at the Nepali Ministry of Health and Population Department of Health Services, Family Welfare Division. Data were collected from 865 respondents in three provinces (Bagmati, Lumbini, and Province 1). Ordinal multivariate logistic regression was utilized to determine relationships between vaccination status and associated factors. Overall, 62% (537) respondents were fully vaccinated and 18% (159) were partially vaccinated. Those respondents with higher education (p \u3c .001) and higher household income (p \u3c .001) were more likely vaccinated. There were also significant differences in vaccine up-take across the three provinces (p \u3c .001). Respondents who were vaccinated were significantly more likely to perceive vaccines as efficacious in terms of preventing COVID-19 (p = .004) and preventing serious outcomes (p = .010). Among both vaccinated and unvaccinated individuals, there was a high level of trust in information about COVID-19 vaccines provided through local health-care workers [e.g. nurses and physicians]. These results are consistent with other findings within the South Asia region. Targeted advocacy and outreach efforts are needed to support ongoing COVID-19 vaccination campaigns throughout Nepal

Summary of the International Patient Safety Conference, June 28-29, 2019, Kathmandu, Nepal

Globally, medical errors are associated with an estimated $42 billion in costs to healthcare systems. A variety of errors in the delivery of healthcare have been identified by the World Health Organization and it is believed that about 50% of all errors are preventable. Initiatives to improve patient safety are now garnering increased attention across a range of countries in all regions of the world. From June 28--29, 2019, the first International Patient Safety Conference (IPSC) was held in Kathmandu, Nepal and attended by over 200 healthcare professionals as well as hospital, government, and non-governmental organization leaders. During the conference, presentations describing the experience with errors in healthcare and solutions to minimize future occurrence of adverse events were presented. Examples of systems implemented to prevent future errors in patient care were also described. A key outcome of this conference was the initiation of conversations and communication among important stakeholders for patient safety. In addition, attendees and dignitaries in attendance all reaffirmed their commitment to furthering actions in hospitals and other healthcare facilities that focus on reducing the risk of harm to patients who receive care in the Nepali healthcare system. This conference provides an important springboard for the development of patient-centered strategies to improve patient safety across a range of patient care environments in public and private sector healthcare institutions

Treatment with Hydroxychloroquine, Azithromycin, And Combination in Patients Hospitalized with COVID-19

Significance: The United States is in an acceleration phase of the COVID-19 pandemic. Currently there is no known effective therapy or vaccine for treatment of SARS-CoV-2, highlighting urgency around identifying effective therapies. Objective: The purpose of this study was to evaluate the role of hydroxychloroquine therapy alone and in combination with azithromycin in hospitalized patients positive for COVID-19. Design: Multi-center retrospective observational study. Setting: The Henry Ford Health System (HFHS) in Southeast Michigan: large six hospital integrated health system; the largest of hospitals is an 802-bed quaternary academic teaching hospital in urban Detroit, Michigan. Participants: Consecutive patients hospitalized with a COVID-related admission in the health system from March 10, 2020 to May 2, 2020 were included. Only the first admission was included for patients with multiple admissions. All patients evaluated were 18 years of age and older and were treated as inpatients for at least 48 h unless expired within 24 h. Exposure: Receipt of hydroxychloroquine alone, hydroxychloroquine in combination with azithromycin, azithromycin alone, or neither. Main outcome: The primary outcome was in-hospital mortality. Results: Of 2,541 patients, with a median total hospitalization time of 6 days (IQR: 4–10 days), median age was 64 years (IQR:53–76 years), 51% male, 56% African American, with median time to follow-up of 28.5 days (IQR:3–53). Overall in-hospital mortality was 18.1% (95% CI:16.6%–19.7%); by treatment: hydroxychloroquine + azithromycin, 157/783 (20.1% [95% CI: 17.3%–23.0%]), hydroxychloroquine alone, 162/1202 (13.5% [95% CI: 11.6%–15.5%]), azithromycin alone, 33/147 (22.4% [95% CI: 16.0%–30.1%]), and neither drug, 108/409 (26.4% [95% CI: 22.2%–31.0%]). Primary cause of mortality was respiratory failure (88%); no patient had documented torsades de pointes. From Cox regression modeling, predictors of mortality were age\u3e65 years (HR:2.6 [95% CI:1.9–3.3]), white race (HR:1.7 [95% CI:1.4–2.1]), CKD (HR:1.7 [95%CI:1.4–2.1]), reduced O2 saturation level on admission (HR:1.5 [95%CI:1.1–2.1]), and ventilator use during admission (HR: 2.2 [95%CI:1.4–3.3]). Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine + azithromycin 71% compared to neither treatment (p \u3c 0.001). Conclusions and relevance: In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact