Initial Point Of Contact Research Articles

Study on issues of hydrodynamics of the roll squeezing process

The laws of distribution of hydrodynamic pressure and changes in extracted fluid in the pressing area are developed; they take into account the phenomena of contact interaction in the roll pair of the pressing machine. Hydraulic pressure in the compression zone increases from zero at the initial point of contact to a maximum value at a point lying on the line of centers. The distribution of hydraulic pressure in the recovery zone depends on the position of the water division point. It was revealed that the pattern of change of the removed fluid in the recovery zone depends on the position of the water division point. At the beginning of the recovery zone and up to the point of water division, the fluid flows from the coating into the material, and beyond this point, fluid is reabsorbed from the roll coating, and the amount of fluid removed from the material in the recovery zone is greater than the amount of absorbed fluid.

О некоторых особенностях разрушения высокоскоростных частиц на гофрированных противометеорных сеточных экранах

This paper studies the impact of high-speed particles on corrugated metal mesh shields. Numerical solutions to a number of problems on high-speed interaction at different corrugation angles and positions of the initial contact point of the shield and impactor are solved using the grid Wilkins Lagrangian method in a three-dimensional formulation. The parameters of the behind-the-barrier cloud of destruction products are compared for various problems with the same distance traveled by the particle perforating the shield. Thus, the optimal inclination angle of the corrugation is revealed.

"NUMERICAL SIMULATION OF ELASTIC-PLASTIC CONTACT WITH ISOTROPIC HARDENING "

The contacts of mechanical components transmit loads that lead to subsurface stresses developing in the contacting bodies. In an efficient tribological design, these stresses are expected to remain under the yield strength of the softer contacting material. When this condition is not met, plastic flow occurs in the softer body. Under the assumption of isotropic hardening, the yield strength increases with the development of additional plastic strains. As plastic flow processes are dissipative and therefore path dependent, the elastic-plastic problem is unsolvable through analytical endeavours, but can be approached with a numerical algorithm capable of simulating the loading history. The Betti’s reciprocal theorem provides the theoretical framework for the application of superposition principle to elastic-plastic stresses and displacement. An algorithm consisting in three nested loops is assembled from the solutions of simpler problems: (1) the purely elastic rough contact problem, (2) the inclusion problem and (3) the problem of the plastic strain increment. The numerical simulations suggest that the residual stresses decrease the intensity of the total stresses, thus delaying additional plastic flow. With increasing load, the heart-shaped plastic strain volume advances toward the surface, enveloping a plastic core near the initial point of contact. Compared to the purely elastic case, the elastic-plastic pressure shows a flatter distribution, while the contact radius is increased.

The IL-20RB receptor and the IL-20 signaling pathway in regulating host defense in oral mucosal candidiasis.

Pseudomembranous candidiasis (thrush), erythematous candidiasis, and fungal esophagitis are infections of the barrier mucosa of the upper gastrointestinal tract. The majority of these infections are caused by Candida albicans, an opportunistic fungal pathogen that frequently exists as a harmless commensal on mucosal surfaces lining the gastrointestinal tract. Oral infections are initiated in the superficial stratified squamous epithelium, in which keratinocytes are the most abundant host cells and are the initial points of contact with C. albicans present in saliva. Intrinsic features of oral keratinocytes are likely to play important roles in host defense and tissue homeostasis in oral candidiasis. One understudied pathway that may be important for modulating oral candidiasis is the IL-20 cytokine signaling pathway that employs keratinocyte IL-20RB receptors as ligands for IL-19, IL-20, and IL-24. We report that production of human oral keratinocyte il24 mRNA and protein are stimulated during co-culture with C. albicans. To test the role of the IL-20 family signaling pathway in oral candidiasis, Il20rb-/- mice (lacking the IL-20RB receptor) were compared to wild-type mice in a murine model of oropharyngeal candidiasis. Fungal burdens and percent loss in body weight were determined. Despite comparable fungal burdens, the Il20rb-/- mice exhibited less weight loss over the course of their infection compared to the B6 mice, suggestive of reduced overall disease consequences in the mutant mice. Interference with IL-20 family cytokine signaling may be useful for augmenting the ability of the host to defend itself against pathogens.

Museum Tour Guide Performance: A Visitor Perspective

Tour guide performance has been a hotly debated academic topic, owing to the critical role they play in facilitating a variety of tourist experiences. Similarly, museum tour guides are the initial point of contact for tourists and have a substantial impact on the total visitor experience, but their performance is far less investigated. Visitors’ satisfaction and behavior intentions are inextricably linked to museum guide performances in this case. The purpose of this research was to implement and test a well-established scale for assessing tour guide performance in the museum context. Moreover, the aim was also to single out and discuss museum guide types based on their performances. The research was conducted during May and June 2021 on a sample of 255 visitors from five museums in Serbia. The data were processed by SPSS, R and RStudio. The results indicate the existence of five museum guide types: Classic Professional, Agile Empath, Operational Erudite, Trustworthy Caretaker, and Passionate Socializer. The study explores sociodemographic differences in visitors’ evaluations of tour guide performances and gives theoretical and managerial implication for each museum guide type.

Video Analysis of Pectoralis Major Injuries in Professional Australian Football Players.

Background:There is little evidence regarding the mechanisms of pectoralis major (PM) injury and player outcomes in Australian Football League (AFL) players.Purposes/Hypothesis:The study aims were to investigate (1) the mechanisms of PM muscle injury in elite AFL players via video analysis and (2) the player profile, method of management, and clinical outcomes of the PM injuries sustained. We hypothesized that the majority of PM tears would occur in outer-range PM positions (hyperextension of the glenohumeral joint).Study Design:Case series; Level of evidence, 4.Methods:We analyzed video of the precipitating event for traumatic PM injuries during AFL competition or training over a 20-year period (2002-2021). The footage was analyzed by 4 experienced assessors, and the following were evaluated: mechanism of injury, injury variables (arm position, initial contact point, visual awareness, and use of taping), player characteristics (age at the time of injury, hand dominance, and history of injury), injury profile (location and size of tear), method of management (operative vs nonoperative), patient outcomes (time to return to full senior training/match play), and complication rates.Results:The mean ± standard deviation age of the players was 26.5 ± 3.1 years (range, 21-32 years). Overall, 22 PM injuries were identified in the AFL injury database for a rate of 1.1 per year; 16 of these injuries had accompanying video footage. We identified 3 mechanisms for PM injury: horizontal hyperextension (62.5%), hyperflexion-abduction (25.0%), and horizontal adduction (sustained tackling; 12.5%). The most common site of the tear was the insertion point of the sternocostal head (91.0%). Twenty players (91.0%) required surgical repair, with 75% undergoing surgery within 1 week (range, 0-26 weeks). The mean return to competition for the surgical repair group was 11.1 weeks (range, 8-15 weeks). The rerupture rate was 5.0% (1 repair; <4 weeks postoperatively in 2004).Conclusion:PM tears in elite male AFL players were due to 1 of 3 distinct mechanisms: horizontal hyperextension, hyperflexion-abduction, and horizontal adduction (sustained tackling). Players returned to play on average 11 weeks after injury. Knowledge regarding mechanisms of injury, player profile, and return-to-sport timelines is important for appropriate medical management and provides potential areas to target for prevention of PM injuries.

Public awareness, expectations, and views on community pharmacist’s roles and practices in the Philippines

Community pharmacists have been identified as an accessible source of drug information for both patients and other healthcare professionals. Over the years, the role and practices of community pharmacists have developed from drug-based activities to patient-centered healthcare. Although most patients have considered community pharmacists the initial point of contact for their medication-related concerns, they remain underutilized healthcare professionals who have become almost invisible to the public despite their efforts. This study was conducted to ascertain the public's awareness, expectations, and views of the roles and practices of community pharmacists in the Philippines. A descriptive quantitative and qualitative cross-sectional research design was employed; a self-made questionnaire was utilized among the 315 respondents selected through non-probability convenience sampling. For data analysis, descriptive statistics and the Chi-square approach were employed. Significant associations were defined as those with p &lt; 0.05. Most of the respondents visit a community pharmacy 2-3 times a month (39.58%) to buy prescription medicines (73.02%) due to its reasonable price (74.60%). The majority (x̅=3.765) agreed that they had considered community pharmacists as an integral part of the healthcare system and expected them to respond to drug-related questions (x̅ =3.686) and view them to be knowledgeable enough to attend to their concerns (x̅ =3.613). The educational attainment of the respondents and their expectations on the roles and practices of community pharmacists were found to be significantly associated with the study (p=0.026). The public has presented an overall positive awareness, expectations, and views toward the roles and practices of community pharmacists.

Drag on a circular intruder traversing a shape-heterogeneous granular mixture.

The main aim of our work is to explore the effect of particle shape heterogeneity on the dynamics of an intruder moving through a two-dimensional mixture of dumbbells and disks. In spite of similar physical conditions (the mass of the dumbbell is the same as that of the disk) and the same area fraction, we noticed a significant difference in the drag experienced by the intruder as the mixture concentration varies. The propagation of stress from the intruder to the granular grains manifests in the form of force chains, and interestingly these force chains can vary significantly depending on the shape of the grains. These differences, however, appear to be suppressed in the frictionless case where the force chains cannot extend very far from the initial point of contact. Apart from particle shape, the effect of the area fraction of the system and the size of the intruder have also been explored. As the area fraction increases, the drag force on the intruder increases owing to the increase in the contact forces. Finally, we present the velocity and stress fields at different dumbbell fractions and for various intruder diameters to show the effect of the moving intruder on its surrounding particles.

Atomic Force Microscopy of Polymer Brushes: Insights into Controversies

Atomic force microscopes (AFM) and nanoindenters have been used for decades to evaluate mechanical properties of thin films at the nanoscale. It is argued that the elastic solutions to the indentation problem, which are most often associated with the names of Galin or Sneddon, may be used for extracting elastic contact modulus of bulk samples and continual films, while their application to contact between an AFM probe and a polymer brush is a priori questionable. This is because the character of compression of a polymer brush is drastically different from the response of an elastic half-space to indentation. In the present paper, a number of controversial issues related to the interpretation of the AFM data obtained for polymer brushes tested with a rigid probe are studied. In particular, a correct relation has been established between the constitutive equation for a single polymer brush in compression with a bare rigid surface and the constitutive equation for two identical polymer brushes in compression under the assumption of lack of interpenetration of compressed brushes. It is shown that the so-called apparent elastic modulus of a polymer brush introduced based on the Hertzian force-displacement relation depends on the indenter radius and, thus, may not serve as a characteristic of polymer brush. Also, the Derjaguin’s approximation-based method of identifying the point of initial contact is given in opposition to controversial methods, which are broadly based on the Hertzian contact mechanics.

When to suspect dementia

With global dementia cases approaching 50 000 000, the importance of early and accurate diagnosis is crucial. Primary care clinicians are often the initial point of contact for people, their family and caregivers when dementia is first suspected. People who suspect they, or their loved one, may have dementia often experience significant fear and distress. Timely and accurate diagnosis, with an honest but compassionate discussion of dementia and its prognosis, may alleviate some distress by reducing time to diagnosis. Timely diagnosis may also enable opportunities to use disease-limiting treatments, reduce unnecessary testing and investigations and provides an opportunity to undertake advance care planning.

Touchless Sanitizer Dispenser

The main aim to develop “TOUCHLESS SANITIZER DISPENSER” is to reduce spread of corona virus. Initial point of contact with germs is often from the hand. Our designed touchless sanitizer dispenser can be commercially used to develop a good sanitization approach toward a community. When compared to liquid soap or solid soap, they is very necessary of water to wash off since it is vaporizes and we can instantly apply to hands. In project an Arduino microcontroller as the main control, A human will hand detect by infrared sensor, and a solenoid valve as an actuator that will activate the automatic dispense without touching.

An update to a retrospective comparison of results between the National Breast and Cervical Cancer Early Detection Program and NCI cancer center based early detection program with evidenced based patient navigation and social work support.

e18572 Background: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) through the CDC has provided uninsured women access to breast and cervical cancer screening/diagnostic services. The uninsured face obstacles which include fear, lack of access and trust in the system, financial and logistical barriers to accessing health care services (Natale-Pereira, et.al, 2011) Disparities in access to screening and diagnostic testing, cancer treatment and survivorship is well documented for medically vulnerable populations that impact stage of diagnosis and mortality (Guadagnolo, Dohan &amp; Raich 2011). The Jefferson's program participates in the NBCCEDP program and uses other private resources which incorporate Social Work core competencies that provide assistance to address barriers. The program navigates along the continuum of cancer care (e.g, prevention, screening, treatment and survival). We have found in a comparative analysis that TJUH’s program has higher rates of diverse racial and ethnic participation of key medically underserved demographics than the National Program. Methods: TJUH's program employs a clinical model, Clinical Patient Navigation with a Licensed Clinical Social Worker operating from a strengths based framework to direct care with administrative support. The program utilizes best practices for working with the at risk population: translation services for the Limited English Proficient, appointment confirmation, transportation assistance and psychosocial support from initial point of contact through final diagnosis. Program staff coordinate internal and external referrals from multiple providers. Results: The study population includes 3144 participants who received breast and cervical cancer screening services through the program from 2012 through 2020. 13.9% were white, 41.7% were African-American, 24.5% were Asian and 19.1% Latinx participated in the program, Table. The age of the participants was slightly younger than the National program as well with 15% under 40, 46% between the ages of 40-49. Conclusions: TJUH’s program provides comprehensive psychosocial support to address barriers along the continuum of screening and diagnostic services leading with increased participation among at risk populations. This further reduces no show rates and participants being lost to follow up. TJUH’s program screens a larger proportion of African American and Asian and younger women compared to the NBCCED program. Additionally, we serviced a slightly younger population than the national program. TJUH’s program addresses health disparities and inequity in access to cancer screening services as shown by the data of the diversity of the participants.

Efficiency of primary spine care as compared to conventional primary care: a retrospective observational study at an Academic Medical Center

BackgroundPrimary Spine Care (PSC) is an innovative model for the primary management of patients with spine-related disorders (SRDs), with a focus on the use of non-pharmacological therapies which now constitute the recommended first-line approach to back pain. PSC clinicians serve as the initial or early point of contact for spine patients and utilize evidence-based spine care pathways to improve outcomes and reduce escalation of care (EoC; e.g., spinal injections, diagnostic imaging, hospitalizations, referrals to a specialist). The present study examined 6-month outcomes to evaluate the efficiency of care for patients who received PSC as compared to conventional primary care. We hypothesized that patients seen by a PSC clinician would have lower rates of EoC compared to patients who received usual care by a primary care (PC) clinician.MethodsThis was a retrospective observational study. We evaluated 6-month outcomes for two groups seen and treated for an SRD between February 01, 2017 and January 31, 2020. Patient groups were comprised of N = 1363 PSC patients (Group A) and N = 1329 PC patients (Group B). We conducted Pearson chi-square and logistic regression (adjusting for patient characteristics that were unbalanced between the two groups) to determine associations between the two groups and 6-month outcomes.ResultsWithin six months of an initial visit for an SRD, a statistically significantly smaller proportion of PSC patients utilized healthcare resources for spine care as compared to the PC patients. When adjusting for patient characteristics, those who received care from the PSC clinician were less likely within 6 months of an initial visit to be hospitalized (OR = .47, 95% CI .23–.97), fill a prescription for an opioid analgesic (OR = .43; 95% CI .29–.65), receive a spinal injection (OR = .56, 95% CI .33–.95), or have a visit with a specialist (OR = .48, 95% CI .35–.67) as compared to those who received usual primary care.ConclusionsPatients who received PSC in an academic primary care clinic experienced significantly less escalation of their spine care within 6 months of their initial visit. The PSC model may offer a more efficient approach to the primary care of spine problems for patients with SRDs, as compared to usual primary care.

Running gait biomechanics in female runners with sacroiliac joint pain.

[Purpose] To identify running gait biomechanics associated with sacroiliac (SI) joint pain in female runners compared to healthy controls. [Participants and Methods] In this case-control study, treadmill running gait biomechanics of female runners diagnosed SI joint pain, (by ultrasound-guided diagnostic SI joint injection and/or ≥2 positive SI physical exam maneuvers) were compared with age, height, mass, and BMI matched healthy female runners. Sagittal and coronal plane treadmill running video angles were measured and compared. [Results] Eighteen female runners with SI pain, and 63 matched controls, were analyzed. There was no difference in age, height, mass, or BMI between groups. At the point of initial contact, runners with SI joint pain demonstrated less knee flexion, greater tibial overstride, and greater ankle dorsiflexion, compared to controls. In midstance, runners with SI pain had greater contralateral pelvic drop compared to controls. For unilateral SI joint pain cases (N=15), greater contralateral pelvic drop was observed when loading their affected side compared to the unaffected side. [Conclusion] Female runners with SI joint pain demonstrated greater contralateral pelvic drop during midstance phase; along with less knee flexion, greater “tibial overstride”, and greater ankle dorsiflexion at initial contact compared to controls.

Knowledge, attitude, and practices toward tobacco control among rural community health care workers of primary subcenters in Belagavi district, Karnataka.

ABSTRACTContext:Tobacco is the common cause to a number of illnesses affecting millions of individuals all over the world. Primary care physicians are the initial point of contact for tobacco users, yet reaching everyone is impossible. Therefore, it is important to understand community health workers attitude to render community services in tobacco cessation counseling.Aim:To assess knowledge, attitude, practices, and occupational barriers toward tobacco control among community health care workers in Belagavi district, Karnataka.Settings and Design:This cross-sectional study was conducted in various subcenters of Belagavi district, Karnataka.Methods and Material:Simple random sampling technique was employed and 220 participants were interviewed using an interviewer administered questionnaire comprising of 22 close ended questions. Reliability of the questionnaire assessed with Cronbach’s a value of 0.85, face validity 84%, and content validity ratio 0.78.Statistical Analysis Used:The data were analyzed using descriptive analysis, chi square analysis, correlation, and regression.Results:The mean knowledge score among Accredited Social Health Activist (ASHA) workers was 4.77 ± 2.11 and it was lower in Anganwadi workers 2.93 ± 2.55. There was a statistically significant difference in the attitude scores (P < 0.05) between the community health workers. The majority of the ASHA workers would spread awareness, on the other hand, Anganwadi workers did not take any specific step which showed statistically significant difference with a P value of 0.018.Conclusion:ASHA workers had been superior to Anganwadi workers with regard to knowledge and attitude toward tobacco control. However, knowledge regarding tobacco and its ill effects was below optimal level among community health workers which desires to thoroughly educate in the aspects of oral health and disorders as part of their training.

Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation

BackgroundInadequate assessment of the severity and urgency of health problems is one of the factors contributing to unnecessary emergency department visits. A software-based instrument for standardized initial assessment (SmED) aims to support healthcare professionals and steer patients to the appropriate source of care. The aim of this study was to evaluate the implementation process of SmED based on the point of view of users in order to facilitate sustainable implementation.MethodsA quantitative process evaluation on the basis of a paper-based questionnaire was carried out alongside the implementation of SmED in 26 outpatient emergency care services within 11 federal states in Germany. Healthcare professionals who worked with SmED either at the joint contact points of the outpatient emergency care service and the emergency departments of hospitals ("Joint Counter", German “Gemeinsamer Tresen”) or at the initial telephone contact points of the outpatient emergency care service (116117) were invited to participate in the survey.Results200 users of SmED completed the questionnaire comprising the five scales: Intervention effectiveness/efficacy, Interprofessional context/occupational Interest, Individual Context, Organisational Framework Conditions, and Medical Context. Several individual characteristics were related to the implementation process of SmED. Female and younger healthcare professionals and participants with less than five years of professional experience tended to evaluate the implementation process as more positive. Factors related to the Individual Context and to the Medical Context were associated with the reported use of SmED (p = 0.004 and 0.041, respectively).ConclusionThe involvement of healthcare professionals, particularly more experienced professionals, in the implementation of SmED may help to facilitate sustainable implementation. In addition, training of potential user prior and during the implementation process and the adaption of Organisational Context factors are crucial.Trial registration The study was registered at the German Clinical Trials Register prior to the start of the study (DRKS00017014).

Subjective Experiences of Mental Health Crisis Care in Emergency Departments: A Narrative Review of the Qualitative Literature.

Mental health presentations to the emergency department (ED) have increased, and the emergency department has become the initial contact point for people in a mental health crisis. However, there is mounting evidence that the ED is not appropriate nor effective in responding to people in mental health crises. Insufficient attention has been paid to the subjective experience of people seeking support during a mental health crisis. This review aims to describe the qualitative literature involving the subjective experiences of people presenting to the ED during a mental health crisis. The method was guided by Arksey and O’Malley’s framework for scoping studies and included keyword searches of PsycINFO, CINAHL, Medline and Embase. A narrative analysis, drawing on the visual tool of journey mapping, was applied to summarise the findings. Twenty-three studies were included. The findings represent the experience of accessing EDs, through to the impact of treatment. The review found points of opportunity that improve people’s experiences and characteristics associated with negative experiences. The findings highlight the predominance and impact of negative experiences of the ED and the incongruence between the expectations of people presenting to the ED and the experience of treatment.

Numerical study on surface-heterogeneity-induced anisotropic impact dynamics of droplet

Droplet impact on flat surfaces with heterogeneity is expected to trigger unusual impact dynamics, such as anisotropic spreading and directional rebounding, which in turn could be utilized in the control of droplet motion in many industrial processes. The present work illustrates a numerical study on droplet impact on a flat superhydrophobic substrate coated with a heterogeneous rectangle area, the influence of different positions and wettability of this heterogeneous area on the impact dynamics is investigated. The simulation results show the wettability of the heterogeneous area can impose significant influence on the spreading, retracting, and bouncing processes, especially when the heterogeneous area is located on a site other than the initial contact point, the bouncing of droplet is more likely to happen, and the contact time also becomes shorter. The clear pictures and analysis of the impact dynamics could advance the knowledge of how to control droplet motion by surface coatings.

Substance use, mental health, chronic medical conditions and criminal justice contact in a nationally representative sample

PurposeThe amount of overlap between criminal justice practices and public health is growing and more research is needed to guide new initiatives. This study was designed to assess the relationships between various chronic medical conditions, substance use severity, mental health indicators and criminal justice contact using the National Survey on Drug Use and Health.Design/methodology/approachAnalyses were conducted in three stages to comprehensively examine the relationships between various indicators of physical health, mental health, substance use severity and criminal justice contact.FindingsResults demonstrate indicators of substance use severity surpass physical and mental health conditions as stronger determinants of any criminal justice contact, as well as repeated interactions with police. In addition, combinations of multiple conditions increase the likelihood of criminal justice involvement, but substance use remains a consistent factor contributing to the strongest associations. These findings highlight the importance of capitalizing on the initial point of criminal justice contact to address substance use to prevent further and subsequent involvement in the system.Research limitations/implicationsCriminal justice initiatives based on least harm solutions require evidence to support public health-oriented approaches. The unique approach to examining the intersection of criminal justice practices and health provided in this study can be used to inform alternates to arrest.Practical implicationsThe least harmful practices should be adopted to address health conditions at the time of criminal justice contact. These practices should focus heavily on injection drug use as a primary factor associated with the prior arrest. Practices designed to divert arrestees with health conditions away from jails are needed. Law enforcement practices can significantly benefit from public health-oriented approaches.Originality/valueCriminal justice initiatives based on least harm solutions require evidence to support public health-oriented approaches. The unique approach to examining the intersection of criminal justice practices and health provided in this study can be used to inform alternates to arrest.

Disruptive Power Of CTCA In A DGH’s Endeavour Towards Value Based Health Care

Introduction: In 2016, NICE CG 95 was revised to recommend CT coronary angiography (CTCA) as the first line test for angina or non-anginal chest pain with ECG abnormalities. Additional capacity modelling, to deliver this guideline, performed by the British Society of Cardiac Imaging, demonstrated a mismatch with current capacity. There is an additional disparity between a district general hospital (DGH) and tertiary centres to deliver CTCA in England. The initial point of contact for patients will be their local DHG. 5 years on, we sought to assess the local impact CTCA has had; to establish if it truly has offered an acceptable alternative to invasive coronary angiography (ICA) in our population of approximately 800,000, and to predict its fiscal impact.