Common Services Research Articles

SDN-Based Secure Common Emergency Service for Railway and Road Co-Existence Scenarios

In the near future, there will be a greater emphasis on sharing network resources between roads and railways to improve transportation efficiency and reduce infrastructure costs. This could enable the development of global Cooperative Intelligent Transport Systems (C-ITSs). In this paper, a software-defined networking (SDN)-based common emergency service is developed and validated for a railway and road telecommunication shared infrastructure. Along with this, the developed application is capable of reducing the chances of distributed denial-of-service (DDoS) situations. A level-crossing scenario is considered to demonstrate the developed solution where railway tracks are perpendicular to the roads. Two cases are considered to validate and analyze the developed SDN application for common emergency scenarios. In case 1, no cross-communication is available between the road and railway domains. In this case, emergency message distribution is carried out by the assigned emergency servers with the help of the SDN controller. In case 2, nodes (cars and trains) are defined with two wireless interfaces, and one interface is reserved for emergency data communication. To add the DDoS resiliency to the developed system the messaging behavior of each node is observed and if an abnormality is detected, packets are dropped to avoid malicious activity.

32 Hypermobile Ehlers-Danlos Syndrome: Phenotypic Presentation, Comorbidity Risk, and Medical Service Utilization in the United States

OBJECTIVES/GOALS: Hypermobile Ehlers-Danlos syndrome (hEDS) is a heritable connective tissue disorder with no known genetic etiology. Its complex phenotypic presentation with multi-system involvement delays proper diagnosis and treatment, especially for females. This study examines the risk for common hEDS comorbidities and medical service utilization. METHODS/STUDY POPULATION: Electronic health records from over 150 million patients across 92 American healthcare servers were queried using the TriNetX database to determine phenotypic presentation of hEDS and risk of receiving comorbid diagnoses. Contingency tables were created with hEDS as the condition and postural orthostatic tachycardia syndrome (POTS) or gastroparesis as the grouping variables. Advanced analytics were conducted to compare outcomes of two cohorts: (1) patients diagnosed with hEDS and both POTS and gastroparesis, and (2) patients with a sole diagnosis of hEDS. After propensity score matching, differences in medical service utilization and mental health diagnoses were assessed between these two cohorts. All analyses restricted age (12-70 years) and employed established exclusion criteria (e.g., diabetes). RESULTS/ANTICIPATED RESULTS: TriNetX national health records (N = 1,968) reveal that hEDS predominantly affects females (87%) and is diagnosed at a mean of 35 years of age. People diagnosed with hEDS have a high prevalence of comorbid nervous system (81%), mental health (76%), and digestive system (69%) disorders. They are 29.7 times more likely to be diagnosed with POTS [95% CI: 27.1, 32.6] and 66.3 times more likely to be diagnosed with gastroparesis [95% CI: 56.5, 77.9], compared to people without hEDS. After propensity score matching for sex, race, and ethnicity, people diagnosed with hEDS and both POTS and gastroparesis have significantly greater service utilization (72.2% vs. 56.7%; z = 2.18, p < .05) but not a greater incidence of mental health disorders (34.4% vs. 24.4%; z = 1.47, p = .14) than people diagnosed with hEDS alone. DISCUSSION/SIGNIFICANCE: This study reveals the phenotypic presentation of hEDS and the elevated risk of co-occurring POTS and/or gastroparesis diagnosis. hEDS and its comorbidities are associated with more frequent medical encounters but not with a greater incidence of mental illness. Findings have implications for both clinical practice guidelines and further research.

Optimization of Inventory and Capacity in Large-Scale Assembly Systems Using Extreme-Value Theory

High-tech systems are typically produced in two stages: (1) production of components using specialized equipment and staff and (2) system assembly/integration. Component production capacity is subject to fluctuations, causing a high risk of shortages of at least one component, which results in costly delays. Companies hedge this risk by strategic investments in excess production capacity and in buffer inventories of components. To optimize these, it is crucial to characterize the relation between component shortage risk and capacity and inventory investments. We suppose that component production capacity and produce demand are normally distributed over finite time intervals, and we accordingly model the production system as a symmetric fork-join queueing network with N statistically identical queues with a common arrival process and independent service processes. Assuming a symmetric cost structure, we subsequently apply extreme value theory to gain analytic insights into this optimization problem. We derive several new results for this queueing network, notably that the scaled maximum of N steady-state queue lengths converges in distribution to a Gaussian random variable. These results translate into asymptotically optimal methods to dimension the system. Tests on a range of problems reveal that these methods typically work well for systems of moderate size. Funding: This work is part of the research program Complexity in High-Tech Manufacturing, (partly) financed by the Dutch Research Council (NWO) [Grant 438.16.121]. The research is also supported by the NWO programs MEERVOUD to M. Vlasiou [Grant 632.003.002] and Talent VICI to B. Zwart [Grant 639.033.413].

The Free-Riding Issue in Contemporary Organizations: Lessons from the Common Good Perspective

Free riding involves benefiting from common resources or services while avoiding contributing to their production and maintenance. Few studies have adequately investigated the propensity to overestimate the prevalence of free riding. This is a significant omission, as exaggeration of the phenomenon is often used to justify control and coercion systems. To address this gap, we investigate how the common good approach may mitigate the flaws of a system excessively focused on free-riding risk. In this conceptual paper featuring illustrative vignettes, we argue that the common good perspective is realistic and effective in preventing this excessive attention by promoting trust as an unconditional gift and a response to vulnerability. We discuss the common good perspective’s originality over the dominant approaches and propose a set of ethical and managerial recommendations that may be the best protection against this excessive focus and maybe even against free riding itself.

Abstract 6301: Mapping survivor-specific supportive care resources: A digital landscape analysis of NCI-designated cancer centers

Abstract Background: Optimal care for cancer survivors requires a comprehensive array of supportive care services to address the multitude of physical, psychological, social, financial, and health promotion needs of this population. To understand options to address their unique needs, survivors and their caregivers may seek information from online sources. Although National Cancer Institute-Designated Cancer Centers (NCIDCCs) serve as leaders in cancer treatment and care delivery, as well as credible sources for survivors to receive information on their recovery, no study has characterized the digital landscape of survivorship offerings on their website. This study aims to characterize the supportive care services offered to cancer survivors on NCIDCCs. Methods: Of the 72 NCIDCCs, 65 provide clinical care. We reviewed the webpage of each to identify supportive care offerings. Services were categorized based on the four domains of the quality-of-life model: (1) physical well-being, (2) psychological well-being, (3) social well-being, and (4) spiritual well-being. Supportive care services were classified as survivor-specific if the online description included information that specifically catered to cancer survivors. Results: Of the 65 clinical NCIDCC websites, 100% offer supportive care services and 54% offer supportive care services specific to survivors (Table). The most common supportive care service offered was nutrition (90.6%) and the least commonly offered was caregiver support (7.9%). Behavioral medicine was offered most frequently for survivors (28.3%) and caregiver support was offered the least (0%). Out of the four domains of the quality-of-life model, spiritual well-being services were offered the least at NCIDCCs. Conclusion: More than half of the NCIDCC websites provided survivor-specific supportive care services. Supportive care services on websites of NCI-Designated or Comprehensive Cancer Centers (N = 65) Supportive Care Service (n) % Supportive Care Service Specific to Cancer Survivors (n) % Physical Well Being Services Nutrition 58 90.6 14 24.1 Genetics 53 82.8 5 9.4 Pain and Palliative Care 52 81.3 8 15.4 Complementary and Alternative Medicine 49 75.4 6 12.2 Integrative Medicine 47 73.4 9 19.1 Occupational Therapy 45 70.3 6 13.3 Fertility Preservation 43 66.2 6 14 Tobacco Cessation 38 58.5 6 15.8 Speech 36 56.3 3 8.3 Exercise 29 45.3 5 17.2 Primary Care 6 9.2 3 50 Psychological Well-Being Services Behavioral Medicine 53 81.5 15 28.3 Recreational Therapy 36 58.1 5 13.9 Social Well-Being Services Oncology Social Work 56 87.5 5 8.9 Patient Navigation 33 51.6 3 9.1 Financial Counseling 32 50 4 12.5 Self-Image 27 41.5 3 11.1 Reproductive and Sexual Health 22 33.8 5 22.7 Caregiver Support 5 7.9 0 0 Spiritual Well-Being Services Pastoral Services 49 75.4 5 10.2 Citation Format: Alexis Taylor, Katherine Sterba, Evan Graboyes. Mapping survivor-specific supportive care resources: A digital landscape analysis of NCI-designated cancer centers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6301.

Abstract 4972: Bioinformatic analysis of an annotated genomic database is clinically useful in a private cancer center

Abstract Background: Sequencing of patient solid tumor tissue is not a common service provided by community cancer centers. Our community cancer center has collected and sequenced over 5,000 tumor tissue samples from patients with various types of cancer. Since April 2019, we have conducted whole-exome and whole-transcriptome sequencing and stored this data in an internal genomics database. To analyze large patient cohorts, we must first optimize bioinformatic workflows on a smaller scale, which can then be applied to studies of larger populations. Previous studies have shown BRAF mutations are associated with an increased activation of the mitogen-activated protein kinase (MAPK) pathway. We analyzed transcriptomes of a cohort of 30 patients with thyroid cancer, 15 with V600E BRAF mutations and 15 wild-type for BRAF, for MAPK Pathway Activation Scores (MPAS). MPAS serves as a transcriptomic measure of the activation state of the MAPK pathway and has been shown to be a reliable prognostic biomarker of MAPK activity. Method: We conducted a retrospective analysis of data from FFPE tumor samples sent to a commercial CLIA-certified laboratory from April 2019 to October 2023. Samples were profiled by whole exome, whole transcriptome sequencing and immunohistochemistry (IHC). Whole transcriptome sequencing (WTS) was executed using Illumina NovaSeq along with the Agilent SureSelect Human All Exon V7 bait panel. Resulting data were reported in transcripts per million (TPM) using the Salmon expression pipeline. MPAS was calculated using the expression profile of 10 MAPK-associated genes. Results: There was no significant difference in BRAF expression levels or MAPK activation between patients with BRAF mutant and BRAF wild-type thyroid cancer (median MPAS scores: -0.09 vs. 0.11, p=0.9). This analysis workflow will be repeated with a larger patient population of patients with melanoma in the future; however, the consistency of expression between the groups, the rank-order, and the low variability per group suggest that expression changes related to this BRAF mutation may occur upstream or via differential regulation of an indirect pathway. Rank-order statistics and percentiles become more precise as data per tumor type grows. Conclusions: Our community cancer center began building an internal genomics database including whole-exome and whole-transcriptome sequencing since 2019. This resource facilitates analysis of patient samples for tumor mutational burden, gene fusions, transcriptomic data, and other important characteristics which could reveal patterns or trends that inform cancer diagnosis and prognosis of other patients. Analysis of expression data for patients with advanced solid tumors who have mutations in genes of interest could inform on potential targeted treatments in the future. This study represents a single example of the potential of our internal clinically annotated genomics database. Citation Format: Carlos E. Zuazo, Sourat Darabi, David R. Braxton, Phillip Stafford, Michael J. Demeure. Bioinformatic analysis of an annotated genomic database is clinically useful in a private cancer center [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4972.

Performing exemplarity: the “two faces” of a village cadre in North China

This article investigates the practice of exemplarity in rural China through Secretary Xu’s oral narratives to provincial leaders and local villagers in a northern model village. It applies a performative narrative analysis to reveal how Xu constructs his persona, utilizing narrative structures, chronotopes, and the interplay of events to forge exemplary images suited to each audience. In presentations to leaders, Xu highlights rural development achievements, while to villagers, he emphasizes common prosperity and community service. This strategic narrative manipulation not only showcases Xu’s skill in aligning with both state and local values but also fosters cultural intimacy and community cohesion despite narrative discrepancies. The case study expands the discourse on narrative techniques and representational strategies within rural revitalization and social governance, offering a nuanced perspective on the intersection of narrative, identity, and governance.

The relationship between community social risk factors and regional hospital-reported cash, negotiated, and chargemaster prices for 14 common services

BackgroundSocial risk factors are key drivers of the geographic variation in spending in the United States but little is known how community-level social risk factors are associated with hospital prices. Our objective was to describe the relationship between regional hospital-reported prices and social risk factors by price type (chargemaster, cash, commercial, Medicare, and Medicaid).MethodsThis cross-sectional analysis used newly available hospital-reported prices from acute general hospitals in 2022. The prices were for 14 common services. Prices were winsorized at 98%, wage index-adjusted, standardized by service, and aggregated to hospital service areas (HSAs). For social risk, we used 23 measures across 5 domains of social risk (socioeconomic position; race, ethnicity, and culture; gender; social relationships; and residential and community context). Spearman’s correlation was used to estimate associations between median prices and social risk by price type.ResultsPrices were reported from 2,386 acute general hospitals in 45% (1,502 of 3,436) HSAs. Correlations between regional prices and other social risk factors varied by price type (range: -0.19 to 0.31). Chargemaster and cash prices were significantly correlated with the most community characteristics (10 of 23, 43%) followed by commercial prices (8, 35%). Medicare and Medicaid prices were only significantly correlated with 1 measure (all p < 0.01). All price types were significantly correlated with the percentage of uninsured (all p < 0.01). Chargemaster, cash, and commercial prices were positively correlated with percentage of Hispanic residents, residents with limited English proficiency, and non-citizens (all p < 0.05).ConclusionsWhile regional correlations between prices and social risk factors were weak across all prices, chargemaster, cash, and commercial prices were more like closely aligned with community-level social risk factors than the two public payers (Medicare and Medicaid). Chargemaster, cash, and commercial hospital prices appeared to be higher in socially disadvantaged communities. Further research is needed to clarify the relationship between prices and community social risk factors.

Surgical interventions and outcome in a population of canine trauma patients.

To determine signalment, injury type, trauma severity score, and outcome of canine trauma patients undergoing surgical (emergency room [ER] or operating room [OR]) and nonsurgical treatment in addition to time to surgery, specialty services involved, and cost in the OR surgery population. Retrospective evaluation of medical record and hospital trauma registry data on canine trauma cases. University teaching hospital. One thousand six hundred and thirty dogs presenting for traumatic injury between May 2017 and July 2020. None. Demographics and outcome were compared for canine trauma patients undergoing OR surgery (12.8%, 208/1630), ER surgery (39.1%, 637/1630), or no surgical intervention (48.2%, 785/1630). Among the 2 surgical groups, 98.9% (836/845) survived to discharge compared with 92.2% (724/785) of the nonsurgical group (P<0.0001). The OR surgical group had significantly higher median Animal Trauma Triage scores (2vs 1, P<0.0001) and median days in hospital (2vs<1, P<0.0001) compared with the other groups. For the OR surgical cohort, electronic medical records were reviewed to determine the specialty surgery service involved, time to and duration of anesthesia and surgery, and visit cost. The most common surgery services involved were orthopedics (45.2%, 94/208) and general surgery (26.9%, 56/208). Neurology and general surgery cases required the longest median length of stay in hospital, and ophthalmology and dentistry cases required the shortest. The median cost of visit was highest in neurology ($10,032) and lowest in ophthalmology ($2305) and dentistry ($2404). Surgical intervention in canine trauma patients appears to be associated with higher survival rates, and among the surgery groups, mortality was highest in the ER and general surgery groups. OR surgical intervention, in particular general surgery and neurology, was associated with increased length of hospitalization, increased cost, and higher Animal Trauma Triage scores.

Evaluating airflow dynamics in common vertical circulation spaces of a multi-floor apartment building for mitigating airborne infection risks: A CFD modeling study

As more people increasingly inhabit indoor spaces, the importance of interior environment design has grown significantly. The focus of this research is to assess the air flow and air change per hour (ACH) within common service vertical circulation spaces in apartment buildings, emphasizing the potential role of these spaces in mitigating airborne infections. The intricate relationships between the design parameters of these spaces and variables related to air circulation are examined. To achieve this goal, the investigation employed a simulation-based approach, utilizing computational fluid dynamics (CFD) analysis to scrutinize the prevalent design of common vertical circulation spaces. The simulation outcomes unequivocally reveal that the design of these spaces has a direct impact on air circulation patterns, often influencing suboptimal conditions. Armed with these insights, this research advocates for a reevaluation of design considerations of common service vertical circulation in forthcoming housing projects. Furthermore, this research proposes innovative design solutions and strategies aimed at enhancing natural ventilation and overall air flow within common service vertical circulation spaces while evaluating their performance.

Optimization in Territorial Partitioning to Improve the Performance of a Common Building Maintenance Service Contract: A Case Study of a Public Agency in Paraná State, Brazil

All public administration contracts must be evaluated in order to improve their performance while respecting the limits established by laws and regulations. The purpose of this article is to apply an approach to improve the performance of a common building maintenance service contract for the Paraná State Court of Justice (PRCJ), which has a total built area of ​​544 283,79 m² in 224 buildings distributed over 161 counties, by optimizing the territorial partitioning of Paraná State. To partition the state into 14 regions, a binary integer linear programming (BILP) mathematical model is applied to the facilities location problem (FLP) in three scenarios. The results show that Scenario 3 (in which the location of the 14 maintenance offices and the configuration of their areas of activity were optimized) is the best in terms of minimizing the distances traveled by maintenance teams. In this scenario, the total distance traveled would be 9 775 km per day (instead of the current 11 150 km), achieving savings of around 12,3% when compared to the current solution. With this solution, in addition to the distance, the direct and indirect costs associated with the displacement of work teams and the time spent on their corresponding trips would be minimized. Furthermore, the users of maintenance services could be served more quickly, resulting in a higher number of services and greater satisfaction for the target audience of the contract.

Effective integration of low-cost digital manufacturing systems: a reference architecture driven approach

ABSTRACT Integration involves the systematic linking of system components, functions and solutions. For digital systems comprising low-cost components, integration enables the sharing of resources and allows them to benefit from each others functionalities. However, in general integrating low-cost systems can be difficult, since data are heterogeneous and distributed over multiple sources and there is no common interface to interact with resources. This study proposes the use of reference architectures as a means of supporting such integration needs. Reference architectures are models that provide a structured template with common terminology and support integration through a systematic, repeatable framework. In this paper, we evaluate strategies to integrate digital systems formed from the same reference architecture. We first select three reference architectures and use them to conceptually design the integration of two low-cost digital systems based on different strategies. Then, the conceptually designed strategies are evaluated in terms of their effectiveness to be realised at low cost. Finally, the most effective strategy is deployed for an industrially relevant application, and validated by comparing its effectiveness to a system architecture driven integration. The evaluation results suggest that coordinators with a common service bus and virtual data integration are effective for integrating low-cost digital systems.

Adaptive channel reservation multiple access protocol based on differentiated traffic guarantee

Ad Hoc network is widely used because of its distributed flexibility, in which nodes may generate different types of traffic, and some high-priority traffic requires lower delay and other Quality of service (QoS) requirements. However, as the load of traffic increases, the probability of conflict increases significantly, which makes it difficult to guarantee the requirement of these traffic. It is significant to design the efficient multiple access protocol to ensure the quality of different kinds of traffic. Channel reservation mechanism is an important method to ensure QoS. However, the existing channel reservation mechanism does not fine-adjust reservation parameters according to the QoS when dealing with various traffic differently, and the differentiation mechanism is rough. In addition, it is difficult to ensure the performance of common services when low-latency services are met. Therefore, a differentiated service guarantee adaptive reservation mechanism (DSGARM) to solve the above problems is proposed. The core idea of the protocol is to provide differentiated services in detail according to the delay tolerance requirements of each business. Absolute reservation mechanism is used to guarantee delay-sensitive services, and relative reservation mechanism is used to service relatively delay-insensitive services. In the protocol, a model is established to design an adaptive algorithm to quantitatively calculate reservation parameters that meet the delay requirements. On the premise of prioritized reservation for various services, appropriate reservation parameters can be adjusted according to network conditions to ensure the delay tolerance requirements of each type of service. The present work can be widely applied to scenarios with differentiated business requirements. The simulation results show the advantages of the present protocol and have great practical significance.

The Effects of a Collegiate Recovery Community Psychotherapy Program Incorporating Equine Interaction during the COVID-19 Pandemic on Young Adults with Substance Abuse Disorder

While psychotherapy incorporating equine interaction (PIE) has proven to be a viable therapeutic intervention, it is not a common mental health service found on college campuses. Nevertheless, with the rise of mental health challenges on campuses after the COVID-19 pandemic, a need for effective therapeutic solutions is warranted. Therefore, the objective of this study was to determine the effect of a collegiate recovery community (CRC) PIE program for substance abuse disorder (SUD) compared to that of traditional cognitive behavioral therapy (CBT) and to determine whether physiological synchronization occurs between the human and horse during the therapy process. College-aged adults were recruited during the COVID-19 pandemic for two types of short-term SUD therapeutic interventions, CRC-PIE and CBT. Both groups completed a self-reporting survey assessing emotional safety. Vital signs measurements for human and horse participants within the CRC-PIE were collected prior to and after the first and last therapeutic sessions. Results concluded that although emotional safety did not improve significantly for PIE participants by the last therapy session (p = 0.85), emotional safety scores were significantly different between therapy types, with lower post-therapy scores for PIE (p = 0.04). As for physiological measures for PIE participants, respiratory rates (Human: p = 0.01; Horse: p = 0.01) and pain rating scores (Human: p = 0.03; Horse: p = 0.01) significantly decreased post-therapy and a strong positive correlation (R = 0.73, R2 = 0.53) associated with vital signs was observed between humans and horses. This human–horse physiological synchronization during the therapeutic intervention suggests that the horse may be a viable tool within campus CRC programs for the development of therapeutic alliances within the therapy process.

The impact of network coverage on adoption of Fintech and financial inclusion in sub-Saharan Africa

Digital finance plays a major role in improving access to, usage and quality of financial services in developing countries. The use of these platforms has been associated with a positive impact on economic growth and people’s welfare. They allow for convenient, secure, and efficient transaction and are the crucial element of e-commerce. In this paper, we analyse the effect of mobile network coverage on adoption of financial technologies and financial inclusion using a survey data of 12,735 individuals from nine sub-Saharan African countries conducted in 2017. By combining survey data with information on the proximity of mobile network towers, we estimate a two-stage model. In the first stage, consumers decide to adopt a technology device, and in the second stage, they decide whether to use digital financial services or not. Results show a significant and positive relationship between network coverage and adoption of digital financial services. Considering that the whole population lives within 2 km radius from the LTE tower, financial inclusion would increase by 6% in Mozambique and 3% in Ghana, Rwanda and Senegal. In Tanzania, where mobile money is the common financial service, investment in GSM and UMTS would have a larger impact on financial inclusion than LTE. These results show that digital financial technologies such as mobile money, mobile banking and e-wallet, that do not necessarily require consumers to be connected to the Internet have a greater impact on financial inclusion in East African countries, where financial service innovations are mobile led. However, in countries where digital financial innovations are bank led, LTE coverage have a greater impact than GSM and UMTS coverage. The findings of this study can help policy-makers to understand the issues related to the expansion of digital financial services and effective strategies to deliver these services to the poor.

Sequences of vocational rehabilitation services in Germany: a cohort study

BackgroundThis study aimed to describe sequences of vocational rehabilitation services among individuals with approved vocational rehabilitation in Germany and to identify typical service sequences.MethodsWe used administrative data on vocational rehabilitation services and questionnaire data on health and work ability to describe frequencies and sequences of vocational rehabilitation services financed by the Federal German Pension Insurance. Through sequence analysis, we were able to map the service sequences. We did cluster analyses to identify typical different service sequences.ResultsOur sample included 1,652 individuals with 2,584 services. Integration services and two-year vocational retraining were the most common services. We could identify three different service clusters around integration services: shorter ones, followed by employer benefits and without employer benefits. We found two different clusters around two-year vocational retraining: shorter and longer clusters. Two-year vocational retraining was more often initiated by preparatory services and followed by employer benefits than integration services. Longer services in both clusters were associated with better baseline data for physical health, work ability, risk of future work disability, and younger age than shorter services. People in two-year-vocational retraining reported at baseline better general health, better work ability, low risk of future work disability, and less mental illness compared to people in integration services.ConclusionsMultiple services, that is, sequences of services, were more likely to occur among individuals with more complex services like two-year vocational retraining. Utilization of complex services and longer services was influenced by health, age, risk of future work disability, and education.Trial registrationGerman Clinical Trials Register DRKS00009910, registration 25/01/2016.

Preliminary Hybrid Joint Analysis for Aircraft Structures

Metal-composite joints, or hybrid joints are prevalent in aerospace structures due to their high strength and low weight. Such structures are usually found in areas where because of the load configuration, the use of composite materials is possible. Thereby, the analysis of such areas needs to consider both components, the metallic and the composite part. In this paper a hybrid joint is analyzed, consisting of a metallic stiffener, a multilayered honeycomb composite material, and joining fasteners, which constitute the joint between the isotropic and orthotropic materials. The present article has two main purposes: the first is to illustrate a pre-design procedure aimed to evaluate the load-carrying capability of a hybrid joint structure, thereby giving an estimate if the structure can withstand the given loading conditions; the second purpose is to present two types of finite element modeling techniques, one that captures the real geometric structure of the composite material and another which uses a simplified equivalent model, based on the desired level of evaluation of the composite material part. A comparison between the two models is made, highlighting the advantages and disadvantages of the two forms of evaluations. For the metallic parts - stiffener and fasteners, both static and fatigue analyses were performed, as fatigue failure represents the common service failure mode for this type of structural components.

Impact of the COVID-19 Pandemic on Rate of Complete Treatment for Syphilis among Pregnant Women in Indochina: A Preliminary Report

Abstract Background: The COVID-19 outbreak has had a negative influence on common public health services in a number of ways. The authors of this particular study discuss the impact of the COVID-19 pandemic on antenatal care programs used to treat syphilis in pregnant women in areas where the illness is a major problem. Materials and Methods: In Southeast Asia, where syphilis is extremely prevalent, data on the treatment of syphilis among pregnant women in accordance with normal prenatal care programs are examined. Results: The total treatment rate has decreased as compared to the period before COVID-19. Conclusion: According to the regular antenatal care program, the COVID-19 pandemic had an impact on how pregnant women were treated for syphilis in the research area. The reduced coverage is a severe issue that has to be effectively addressed.

Investigating the Prevalence and Types of Clinical Services Offered by Pharmacists in Federally Qualified Health Centers in South Carolina: A Qualitative, Cross-Sectional Survey.

To investigate the prevalence and type of clinical pharmacy services offered within South Carolina Federally Qualified Health Centers (SC FQHCs) and identify existing implementation barriers. This study was a cross-sectional survey of pharmacists or Chief Medical Officers practicing in SC FQHCs. Organizations were identified utilizing the Health Resources and Services Administration (HRSA) database and were contacted to participate in a telephone survey. An electronic form was created in REDCap® software. Descriptive statistics were used to analyze and evaluate data. Twenty-two SC FQHCs were eligible for the survey, with 16 (72.7%) participating. Of the respondents, 9 (56%) offered at least 1 service. The most common services offered were chronic disease state management, diabetes self-management education and support (DSMES), and tobacco cessation (43.8%, n = 7). The least common services offered were chronic care, Hepatitis C, and HIV management (18.9%, n = 3). The most common barriers to implementation were lack of personnel and provider interest (62.5%, n = 10). The least common barrier was a lack of pharmacist interest or time (25%, n = 4). Pharmacists offered at least 1 clinical service within most SC FQHCs. Barriers were identified that prevented expansion of services and further research is needed to overcome these.

Exploring the 'citizen organization': an evaluation of a regional Australian community-based palliative care service model.

Little Haven is a rural, community-based specialist palliative care service in Gympie, Australia. Its goals are to provide highest quality of care, support and education for those experiencing or anticipating serious illness and loss. Families and communities work alongside clinical services, with community engagement influencing compassionate care and support of dying people, their families and communities. Public Health Palliative Care promotes community engagement by community-based palliative care services and is grounded in equal partnerships between civic life, community members, patients and carers, and service providers. This takes many forms, including what we have termed the 'citizen organization'. This paper reports on an evaluation of Little Haven's model of care and explores the organization's place as a 'citizen' of the community it services. A co-designed evaluation approach utilizing mixed-method design is used. Multiple data sources obtained a broad perspective of the model of care including primary qualitative data from current patients, current carers, staff, volunteers and organizational stakeholders (interviews and focus groups); and secondary quantitative survey data from bereaved carers. Thematic analysis and descriptive statistics were generated. This model of care demonstrates common service elements including early access to holistic, patient/family-centred, specialized palliative care at little or no cost to users, with strong community engagement. These elements enable high-quality care for patients and carers who describe the support as 'over and above', enabling good quality of life and care at home. Staff and volunteers perceive the built-in flexibility of the model as critical to its outcomes; the interface between the service and the community is similarly stressed as a key service element. Organizational stakeholders observed the model as a product of local activism and accountability to the community. All participant groups agree the service model enables the delivery of excellent care. The construction of a community palliative care service as a citizen organization emerged as a new concept.