Influence of Connector Design on Displacement and Micromotion in Tooth-Implant Fixed Partial Dentures Using Different Lengths and Diameters: A Three-Dimensional Finite Element Study.

The literature presents insufficient data evaluating the displacement and micromotion effects resulting from the combined use of tooth-implant connections in fixed partial dentures. Analyzing the biomechanical behavior of tooth-implant fixed partial denture (FPD) prothesis is vital for achieving an optimum design and successful clinical implementation. The objective of this study was to determine the relative significance of connector design on the displacement and micromotion of tooth-implant-supported fixed dental prostheses under occlusal vertical loading. A unilateral Kennedy class I mandibular model was created using a 3D reconstruction from CT scan data. Eight simulated designs of tooth-implant fixed partial dentures (FPDs) were split into two groups: Group A with rigid connectors and Group B with non-rigid connectors. The models were subjected to a uniform vertical load of 100 N. Displacement, strain, and stress were computed using finite element analysis. The materials were defined as isotropic, homogeneous, and exhibiting linear elastic properties. This study focused on assessing the maximum displacement in various components, including the bridge, mandible, dentin, cementum, periodontal ligament (PDL), and implant. Displacement values were predominantly higher in Group B (non-rigid) compared to Group A (rigid) in all measured components of the tooth-implant FPDs. Accordingly, a statistically significant difference was observed between the two groups at the FPD bridge (p value = 0.021 *), mandible (p value = 0.021 *), dentin (p value = 0.043 *), cementum (p value = 0.043 *), and PDL (p value = 0.043 *). Meanwhile, there was an insignificant increase in displacement values recorded in the distal implant (p value = 0.083). This study highlighted the importance of connector design in the overall stability and performance of the prosthesis. Notably, the 4.7 mm × 10 mm implant in Group B showed a displacement nearly 92 times higher than its rigid counterpart in Group A. Overall, the 5.7 mm × 10 mm combination of implant length and diameter showcased the best performance in both groups. The findings demonstrate that wider implants with a proportional length offer greater resistance to displacement forces. In addition, the use of rigid connection design provides superior biomechanical performance in tooth-implant fixed partial dentures and reduces the risk of micromotion with its associated complications such as ligament overstretching and implant overload, achieving predictable prognosis and enhancing the stability of the protheses.

Choice of needleless connector technology as a risk reduction strategy for catheter related bloodstream infection, mortality, and cost: A secondary data analysis.

OBJECTIVE: To compare relative risk (RR) of central line-associated bloodstream infection (CLABSI) between hospitals using Clave needleless connector technologies (NCT) and comparator hospitals using non-Clave NCT. And, to estimate avoided CLABSIs, mortality, and cost savings. BACKGROUND: Needleless connectors, while protective against needlestick injury, have long been implicated as a potential risk for CLABSI. Significant RR reduction of CLABSI among the many NCT has not been clinically demonstrated. METHODS: The U.S. Healthcare-Associated Infections database was accessed for CLABSI data for calendar year 2019 via the Centers for Medicare and Medicaid Services website. This dataset was merged with the Clave NCT manufacturer's 2019 database to identify hospitals purchasing Clave NCT (MicroClave™, NanoClave™, Clave Neutron™, Clave™, Microclave™ Clear) and non-Clave NCT comparator hospitals. Sub-analysis of Clave NCT hospitals included: (1) Clave NCT mixed-use and (2) Clave high-volume use hospitals. The standardized infection ratio (SIR) was generated to estimate CLABSI RR after adjusting for intern/resident-to-bed-ratio (IRB), care location, and hospital demographics. Using the RR, avoided CLABSIs, mortality, and cost savings were calculated. RESULTS: A total of 2987 eligible hospitals (1288 Clave NCT, 1699 non-Clave NCT) with 17,452,575 central line-days were evaluated. All three Clave NCT hospital groups showed a statistically significant reduction in RR compared to the non-Clave NCT hospitals. The RR in Clave NCT hospitals was 0.93, a 7% decrease in CLABSI risk (p = 0.02). In the Clave NCT subgroups, mixed-use hospitals RR was 0.93, a 7% reduction (p = 0.04), while the Clave NCT high-volume hospitals experienced a 19% reduction, RR 0.81 (p = 0.04). An estimated 563 CLABSIs and 84 related deaths were avoided with use of Clave NCT and $27,095,231 in cost savings. CONCLUSION: The use of the Clave NCT, in and of itself, is an effective risk reduction strategy for CLABSI prevention, reduced mortality, and substantial cost savings.

Shear Performance Study of Sleeved Stud Connectors in Continuous Composite Girder.

In order to reveal the mechanism of sleeved stud connectors, 15 push-out specimens were designed, and static loading tests were conducted to evaluate the mechanical performance. The shear performance differences between the novel sleeved studs and conventional welded studs were compared. Referring to the experimental results, an Abaqus nonlinear finite element model was established to study the shear mechanism of sleeved stud connectors. Parametric analysis was conducted to investigate the effects of stud height, sleeve filling material, and sleeve diameter on the mechanical performance of the connectors. The experimental and finite element analysis results indicated that the ultimate shear bearing capacity and shear stiffness of the sleeved stud connectors were higher than those of ordinary welded studs, and the maximum slip was relatively small. Compared to conventional welded studs, the ultimate bearing capacity of sleeved studs increased by 4% to 8%, and the shear stiffness increased by 25% to 35%. Since the shear behavior of sleeved studs mainly occurred at the base of the studs, the influence of stud height on shear performance was relatively small. However, sleeve and stud diameter have a great influence on bearing capacity and stiffness. As the Ultra-High Performance Concrete (UHPC) near the base of the stud effectively enhanced the shear carrying capacity of the sleeved stud connectors, the shear carrying capacity and shear stiffness increased with the increase in the sleeve diameter.

Experimental and Numerical Investigation of the Use of Ultrasonic Waves to Assist Laser Welding.

This study evaluates the enhancement of laser welding using ultrasonic waves aimed at reorganising the intermetallic position in such a fashion that leads to increased mechanical properties of welds in battery pack assemblies for electric vehicles. The experiment employed 20 kHz and 40 kHz High-Power Ultrasound Transducers (HPUTs) in both contact and contactless modes. A simplified experimental configuration is suggested to represent conditions similar to those found in electric vehicle battery pack assemblies. Measurements of vibration transmission to aluminium alloy 1050 plates revealed more than a 1000-fold increase in acceleration amplitude in contact mode compared to contactless mode. The 20 kHz transducer in contactless mode demonstrated superior performance, showing a 10% increase in load and 27% increase in extension compared to welding without ultrasonic assistance. On the other hand, the 40 kHz transducer, while still improved over non-ultrasonic methods, showed less pronounced benefits. This suggests that lower-frequency ultrasonic assistance (20 kHz) is more effective in this specific context. The study explores ultrasonic assistance in laser welding copper (Cu101) to aluminium alloy 1050 using 20 kHz and 40 kHz HPUTs, showing that both transducers enhance microstructural integrity by reducing copper homogenisation into aluminium, with the 20 kHz frequency proving more effective in this context. A numerical simulation was conducted to evaluate the transmission of pressure into the molten pool of the weld, correlated with the vibration results obtained from the 20 kHz transducer. The numerical simulation confirms that no cavitation is initiated in the molten pool area, and all improvements are solely due to the ultrasonic waves.

Experimental and numerical study on the shear performance of stainless steel-GFRP connectors for use in precast concrete sandwich panels.

Precast Concrete Sandwich Panel (PCSP) is composed of concrete load-bearing panels, thermal insulation panels, and decorative panels, which are assembled through connectors, integrating load-bearing, thermal insulation, and decorative functions. The connector bears the main shear force between the wall panels, and the shear resistance and insulation performance of the connector largely determine the mechanical stability and insulation effect of the wall panels, which is a key component in PCSPs. The current common practice is to cross assemble stainless steel insulation (SSI) connectors and Glass-Fiber-Reinforced Plastic (GFRP) connectors into PCSPs, which can reduce building energy consumption and save resources while meeting strength and insulation requirements. A large-scale pull-out test on a PCSP with intersecting SSI-GFRP connectors was conducted in this paper. The damage process and damage pattern of PCSP were observed and the shear performance of SSI-GFRP connectors was analyzed. Secondly, a numerical analysis model of the test PCSP was built using ABAQUS finite element software and its validity was verified through the test data. In addition, parameters such as connector diameter, connector number ratio and concrete strength were analyzed for their effect on the shear performance of SSI-GFRP connectors and it was found that connector diameter and connector number ratio had a significant effect. Finally, it is found that there are some differences between the classical theory for calculating the shear performance of SSI-GFRP connectors and the actual results. A theoretical correction factor (ζ) is given to improve the accuracy of the calculation of the classical theory, and its influencing factors and changing rules are investigated.

Patients' and caregivers' perspective on challenges and outcomes with tube feeding: Analysis of home enteral nutrition survey data.

BACKGROUND: Given the growing use of home enteral nutrition (HEN), assessing the experience of consumers and caregivers is crucial to understanding the real-world subjective and objective challenges of administering HEN. METHODS: After obtaining institutional review board approval, a survey was distributed to HEN consumers and caregivers between January 16, 2020, and July 16, 2021. Data collected included information regarding demographics, primary diagnosis, tube and connectors, HEN regimen, and overall HEN experience. RESULTS: A total of 884 individuals responded to the survey: 673 (76.1%) responses by caregivers and 211 (23.9%) responses by patients. The study cohort included 566 (64%) children and 318 (36%) adults. The leading primary diagnosis of participants was developmental delay and motility disorder for children and adults, respectively. Low-profile gastric tubes were the most used (75.7% of children and 30.3% of adults). Notably, legacy connectors were utilized for more patients (46.7% children, 52.6% adults) compared to ISO-80369-3 connectors (38.9% children, 29.7% adults). HEN complications were prevalent, including enteral tube site infections and other tube-related complications, including clogging and kinking. CONCLUSION: This real-world data reveals that HEN complications remain prevalent. Additionally, despite introducing ISO-80369-3 connectors many years ago, most patients continue to use legacy tubes with a significant lack of knowledge about ISO-80369-3 connectors. The survey results guide HEN providers to focus on several areas to reduce complications.

The influence of needleless connectors and inserted catheters on flow rates through vascular introducer sheaths.

SummaryA vascular introducer sheath is often used for rapid volume replacement. However, common manipulations such as the addition of needleless connectors to infusion ports and the insertion of catheters or other devices through the introducer sheath may impede flow. In this study we utilised a rapid infuser to deliver room-temperature normal saline through two introducer sheath configurations with and without the addition of needleless connectors and the placement of catheters through the introducer sheaths. The maximal flow rate delivered by the rapid infuser was 1000 mL/min, which was observed with both introducer sheath sizes tested without additional resistive elements. However, with the addition of a needleless connector, flow rates through the introducer sheaths were substantially lower (64 (standard deviation (SD) 6) mL/min and 61 (SD 7) mL/min for the 8.5 Fr and 9 Fr introducers, respectively). Flow rates were also reduced when catheters were placed within the sheaths (298 (SD 9) mL/min with the 7 Fr catheter and 74 (SD 9) mL/min with the 8 Fr catheter placed in an 8.5 Fr sheath; 649 (SD 6) mL/min with the 7 Fr catheter and 356 (SD 14) mL/min with the 8 Fr catheter placed in the 9 Fr sheath). These findings indicated that both needleless connectors and the placement of catheters through vascular introducer sheaths substantially reduced potential flow rates. Even 'large' vascular introducer sheaths capable of delivering high flow rates could be rendered minimally effective for rapid fluid administration when used in this way. Clinicians should consider these impediments to flow when rapid fluid administration is required, and obtain alternative vascular access if necessary.

Performance of angle shear connectors for U-shaped steel concrete infilled composite beams.

The current design codes i.e. AISC 360-16, CSA-S16-19, EC-04 etc. provide empirical relationships to estimate the capacity of shear connectors which were developed based on pushout tests of headed studs and channels connectors in exposed type sections. Therefore, these equations may result inaccurate predictions for strength of connectors in infilled-type sections. This study presents a detailed experimental study investigating the performance of angle connectors in composite sections. The testing program consisted two series of pushout tests. A total of 36 specimens were tested, considering the influence of several important parameters i.e. the length (Lc), height (hc), and web-thickness (tw) of angle connector, length of the weld (w) and the direction of shear connector (forward/backward) etc. The tests results demonstrated that with increasing connector height hs, and thickness, the maximum load Pmax and slip δu were increased. The connector direction didn't change much the load-slip behavior. The prediction accuracy of the existing shear capacity models was evaluated by comparing the predictions with experimental results. The current equations were noticed to be highly inconsistent in predicting the shear capacity of angle connectors, especially in case of infilled type sections. When the entire length of connector was taken as the effective length, the models overestimated the shear capacity. While in case when the welding length was taken as effective length in calculations, the models underestimated the shear strength of angle connectors.

Disinfectant caps in vitro effectiveness.

Background: Catheter-related bloodstream infections (CRBSIs) are a major cause of morbidity and mortality among hospitalized patients. Different studies suggest that the use of disinfectant caps (DCs) significantly reduces the rate of CRBSIs. The first purpose of this study is to analyze, through an in-vitro-model, the antiseptic effect of DCs produced by two manufacturers; the second aim is to assess potential differences in terms of effectiveness between the two manufacturers' products. Methods: A know concentration of thirteen different microorganisms was incubated with the sponge drenched in antimicrobial fluid inside DCs and cultured through several assays to investigate the disinfectant effectiveness of some commercially available caps. Disinfectant properties were evaluated under two different conditions: baseline (DCs placed on the needle-free connectors (NFCs) and stress test (DCs directly applied to the catheter hub). Results: Both manufacturers overcame the basal tests (fourteen different assays). Regarding stress tests: the only significant bacterial load was found for Serratia marcescens (104 CFU/mL in ICU Medical™), both at 90 and 180 minutes after incubation; due to the low load, MDR Acinetobacter baumannii was not considered significant (<103 CFU/mL in BD PureHub™). Conclusions: Our results confirm what was reported in BD PureHub™ datasheet and add data not previously shown by ICU Medical™. Moreover, no difference was observed between the two manufacturers products: the use of both DCs on NFCs was able to reclaim the catheter lumen. These findings support the routine use of DCs with NFCs, as part of a structured bundle of interventions, to reduce the incidence of CRBSIs.

Study on the Shear Resistance Performance of Grouped Stud Connectors.

In order to further investigate the grouped stud effect on the force properties of stud connectors, based on the premise that the correctness of the finite element simulation method, in this paper, a finite element model of grouped stud connectors was developed, and the grouped stud effect and its sensitivity factors were analyzed in order to validate the recommended formula for calculating the shear capacity of grouped stud connectors. Results show that the number of grouped stud rows and stud row spacing have a significant influence on the grouped stud effect, and the unevenness coefficient of grouped stud force is negatively correlated with the number of grouped stud rows as well as the grouped stud row spacing. Grouped stud connectors with commonly used concrete grades greater than C50 and height-to-diameter ratios of greater than 4 in steel-concrete composite structural bridges are insensitive to changes in the concrete strength grades and the length of the studs. The direction of force transmission for grouped stud changes with the change in loading angle and the unevenness coefficient of force for the grouped stud will therefore be reduced. By comparing the results of the 62 existing groups of grouped stud connectors push-out tests, the mean of the tested to calculated value ratio was found to be 1.12, the variance was 0.023, the dispersion was small, and it was shown that the recommended formula has a high degree of accuracy. The results of this paper can be used as a theoretical basis for the study of the shear stress performance of grouped stud connectors.

The compassionate communities connectors program: effect on healthcare usage.

Background: Public health approaches to palliative and end-of-life care focus on enhancing the integration of services and providing a comprehensive approach that engages the assets of local communities. However, few studies have evaluated the relative costs and benefits of providing care using these service models. Objectives: To assess the effect on healthcare usage of a community-based palliative care program ('Compassionate Communities Connectors') where practical and social support was delivered by community volunteers to people living with advanced life-limiting illnesses in regional Western Australia. Design: Controlled before-and-after study/Cost-consequence analysis. Methods: A total of 43 community-based patients participated in the program during the period 2020-2022. A comparator population of 172 individuals with advanced life-limiting illnesses was randomly selected from usage data from the same set of health services. Results: Relative to controls, the intervention group had lower hospitalizations per month [Incidence rate ratio (IRR): 0.37; 95% CI: 0.18-0.77, p = 0.007], less hospital days per month (IRR: 0.23; 95% CI: 0.11-0.49, p < 0.001) and less emergency presentations (IRR: 0.56; 95% CI: 0.34-0.94, p = 0.028. The frequency of outpatient contacts overall was two times higher for the intervention group (IRR: 2.07; 95% CI: 1.11-3.86, p = 0.022), indicating the Connector program may have shifted individuals away from the hospital system and toward community-based care. Estimated net savings of $AUD 518,701 would be achieved from adopting the Connector program, assuming enrollment of 100 patients over an average 6-month participation period. Conclusion: This combined healthcare usage and economic analysis of the 'Compassionate Communities Connectors' program demonstrates the benefits of optimizing palliative care services using home-based and community-centered interventions, with gains for the health system through improved patient outcomes and reduced total healthcare costs (including fewer hospitalizations and readmissions). These findings, coupled with the other published results, suggest that investment in the Connectors program has the capacity to reduce net health sector expenditure while also improving outcomes for people with life-limiting illnesses. Trial Registration: Australian and New Zealand Clinical Trial Registry: ACTRN12620000326998.

Shear Behaviour and Calculation Methods of Bearing-Shear Connectors for Prefabricated Steel-Concrete Composite Beams.

The bearing-shear connector (B-SC) is a newly developed connector that exhibits excellent shear behaviour and is easy to process. However, research on the application of B-SCs as substitutes for grouped studs in prefabricated steel-concrete composite beams is rare, and systematically studying their shear behaviour is necessary. Thus, a refined numerical model was developed to study the shear behaviour of the B-SCs. The numerical model, validated by push-out tests, was conducted to analyse the stress of the B-SCs and concrete slab during loading and to explore the failure mechanism of B-SCs. Then, a parametric study was performed to identify the key factors influencing the shear behaviour of the B-SCs. The concrete strength, and the thickness and the tensile strength of the shear plate were found to significantly influence the shear behaviour of B-SCs. According to the experiments and numerical analysis, calculation formulae for the ultimate shear resistance and slip modulus were proposed.

Palliative and End-of-Life Care for People Living with Motor Neurone Disease: Ongoing Challenges and Necessity for Shifting Directions.

Although the progressive clinical trajectory of motor neurone disease (MND) is widely understood, multiple challenges remain preventing optimal end-of-life care for this population with unique needs from the patient, carer and service provider perspectives. This paper reports on the experiences, gaps in service and unmet needs of MND patients and family carers and explores public health palliative care approaches that would facilitate coordinated and integrated care to respond to their changing needs. This is a qualitative study of responses to questions in an online consumer survey (353 respondents) in Western Australia (2020), focusing on a subset of 29 current and bereaved carers of people with MND who have used health services in the last five years. The analysis identified themes, highlighting the insufficient integration of services across health and social care; poor and unequal access to coordinated palliative care; significant gaps in the knowledge base of the workforce and a failure to meet the consumer expectations of person-centred care. For palliative care to be accessible to those living with MND and other under-served conditions, there needs to be a shift to more comprehensive, inclusive and sustainable options, such as the public health approach to palliative/end-of-life care that engages the assets of local communities in partnership with health services, one example being the "Compassionate Communities Connectors" model of care. Further considerations include advocacy for policy changes, fostering partnerships and developing indicators for evaluating the impact of the proposed models of care. The end result is not only better care but substantial savings for the health system.

Out-of-Plane Flexural Behavior of Insulated Wall Panels Constructed with Large Insulation Thicknesses.

Insulated concrete sandwich wall panels (ICSWPs) are gaining popularity as energy regulations become stricter worldwide. ICSWPs are now being constructed with thinner wythes and thicker insulation to keep up with the changing market, which is reducing material costs and increasing thermal and structural efficiency. However, there is a need for adequate experimental testing to validate the current design methods for these new panels. This research aims to provide that validation by comparing the predictions of four different methods with experimental data obtained from six large-scale panels. The study found that while current design methods adequately predict the behavior of thin wythe and thick insulation ICSWPs within the elastic region, they do not accurately predict their ultimate capacity.

Effect of non-rigid connector on the stress distribution of tooth-implant supported fixed prostheses using different implant length and diameter: A comparative 3D finite element study.

PURPOSE: To investigate the significance of the connector type on stress dissemination within the tooth-implant-supported fixed dental prostheses in the mandibular posterior region with different combinations of implant diameter and length by means of finite element analysis (FEA). MATERIALS AND METHODS: Six models of different designs for tooth-implant fixed dental prosthesis (FDPs) were simulated and divided into two main groups. Implant lengths were 10, 11.5, and 13 mm while implant diameters were 3.7, 4.7, and 5.7 mm. The main difference between the groups was the connector type. Models were evaluated using 3D FEA (Solidworks Premium 2018 × 64 Edition). Group A tooth-implant FDPs (5.7 mm × 10 mm) had a mesial and distal rigid connector while group B tooth-implant FDPs (3.7 mm × 10 mm, 3.7 mm × 11.5 mm, 3.7 mm × 13 mm, 4.7 mm × 10 mm and 5.7 mm × 10 mm) had a mesial non-rigid connector in their design between the pontic and the tooth. Models were analyzed to determine the magnitude of von Misses Stresses at six specific zones (fixed dental prosthesis, bone around distal implant, bone around tooth, cementum, periodontal ligament, implant) under vertical occlusal loading of 100 N after meshing and assigning the material properties. RESULTS: Stress values around the supporting bone were significantly higher in Group B (tooth-implant FDP with non-rigid connection) when compared to Group A (tooth-implant FDP with rigid connection). Also, the stresses measured at the FDP level showed that the rigid connection group (5.7 mm × 10 mm) exhibited 26% lower stress values when compared to the non-rigid group (5.7 mm × 10 mm). CONCLUSIONS: Implant-tooth FDPs with rigid connector design using the combination of implant diameter and length (5.7 mm × 10 mm) demonstrated a better design modality thus predicting a higher success rate and more longevity than using the non-rigid connection option.

Leveraging African American family connectors for Alzheimer's disease genomic studies.

INTRODUCTION: The underrepresentation of African Americans (AAs) in Alzheimer's disease (AD) research may limit potential benefits from translational applications. This article describes an approach to recruit AA families into an AD genomic study and characteristics of seeds (family connectors) used to overcome recruitment barriers of AA families into AD research. METHODS: A four-step outreach and snowball sampling approach relying on family connectors was used to recruit AA families. Descriptive statistics of a profile survey were gathered to understand the demographic and health characteristics of family connectors. RESULTS: Twenty-five AA families (117 participants) were enrolled in the study via family connectors. Most family connectors self-identified as female (88%), were 60 years of age or older (76%), and attained post-secondary education (77%). DISCUSSION: Community-engaged strategies were essential to recruit AA families. Relationships between study coordinators and family connectors build trust early in the research process among AA families. HIGHLIGHTS: Community events were most effective for recruiting African American families. Family connectors were primarily female, in good health, and highly educated. Systematic efforts by researchers are necessary to "sell" a study to participants.

The Compassionate Communities Connectors programme: experiences of supported families and referring healthcare providers.

Background and Aim: Comprehensive evaluations that include the experience of patients and service providers are vital if interventions are to be translated into the standard practice of health services and allow formal networks to work as partners with informal community networks. However, published evaluations are limited in the palliative care volunteering literature. The objective of the study is to explore the experiences and views of both patients and their family carers who received support and their referring healthcare providers concerning their participation in the Compassionate Communities Connectors programme, in the south-west region of Western Australia. Connectors identified and addressed gaps in community and healthcare provision by accessing resources and mobilising social networks of people with life-limiting illnesses. The perspectives of patients, carers and service providers concerning the feasibility and acceptability of the intervention were sought. Methods: Semistructured interviews were undertaken with 28 patients/families and 12 healthcare providers, resulting in 47 interviews in total (March 2021-April 2022). An inductive content analysis was used in analysing interview transcripts to identify key themes. Results: Families greatly appreciated the support and enablement received from the Connectors. Healthcare providers were impressed with the high level of resourcefulness exhibited by the Connectors and perceived a great need for the programme, particularly for those socially isolated. Three themes captured the patients'/families' perspectives: connector as an advocate, increasing social connectedness and taking the pressure off families. Healthcare providers' perspectives were captured in three themes: reducing social isolation, filling a gap in service provision and building the capacity of the service. Conclusions: Perspectives of patients/families and healthcare providers demonstrated the mediating role of Connectors. Each group saw the Connectors' contribution through the lens of their particular interests or needs. However, there were indications that the connection was shifting the way each group understood and practised care, encouraging or restoring agency to families and reminding healthcare providers that collaborating beyond the boundaries of their roles actually enhances the whole ecology of care. Using a Compassionate Communities approach to mobilise health and community sectors has the potential to develop a more holistic approach that addresses the social, practical and emotional domains of care.

Micromechanical BEoL robustness evaluation methods enabling loading condition customization and acoustic emission damage monitoring.

For micromechanical robustness evaluation methods, it is advantageous if the mechanical loading conditions applied can be controlled as precisely as possible. For microchips, this is required to determine the robustness under specific conditions, e.g. during assembly or characteristic application/usage scenarios. In this work, three different micromechanical BEoL (Back End of Line) robustness evaluation methods are presented which should enable a more precise and flexible mechanical load induction and damage identification. They have been subsequently developed. Three main aspects characterize the customization of the developed approaches:•The design and testing of customized micro-tools to precisely apply mechanical load to individual Cu-pillars.•The implementation of an AE (Acoustic Emission) monitoring approach to detect minor damages during mechanical loading. This strategy also enabled the development of sub-critical loading experiments for which AE signals served as a damage indicator and mechanical loading was aborted upon the detection of AE events.•The development of a new measurement setup and approach to enable the solder attach of individual Cu-pillars to a mechanical testing system. The applications of these approaches should enable the induction of customized mechanical loading conditions and the identification of failure modes and damage initiation locations.

Experimental and Theoretical Study on the Fatigue Crack Propagation in Stud Shear Connectors.

Steel-concrete composite girder bridges are subjected to reciprocal cyclic loading from vehicles, and the stud shear connectors are the key components for transmitting shear forces. Thus, it is necessary to study the fatigue performance of the stud shear connectors. At present, there are few studies on the fatigue crack propagation process of studs, and the variation curve of the crack depth of studs with the number of fatigue loading cycles is not clear. In this study, the degradation law of fatigue properties and the fatigue crack propagation law of stud shear connectors in steel-concrete composite structures are examined under fatigue loading. The fatigue properties, i.e., failure mode, the dynamic slip-fatigue number curve, cross-sectional characteristics, and the residual bearing capacity of the stud specimens, are first systematically studied through ten standard push-out specimen tests. The test results show that the relative value of the fatigue crack extension area increases, while the relative value of the residual bearing capacity of the studs decreases approximately linearly. Then, the expression of the relationship between the fatigue crack depth and the residual load-bearing capacity of the stud is proposed, based on the fatigue crack theory of fracture mechanics. Finally, combined with the ABAQUS and FRANC3D software, a fatigue crack propagation finite element analysis (FEA) model of the stud is established. The FEA results showed that the trends in the number of cyclic loads and the fatigue crack depth of studs are basically the same for the simulation curve, test curve and theoretical calculation curve.

[NRFit: A new standard to prevent wrong-route medication errors]. / NRFit : une nouvelle norme de connexion pour prévenir les erreurs médicamenteuses concernant les voies d'administration.

Wrong route medication errors due to tubing misconnections can lead to serious adverse events, especially when they concern the neuraxial and perineural routes. It has been favoured by the use of the universal Luer connector for medical devices with a risk of confusion with the intravenous route. The prevention of these errors is based on passive measures such as using specific small-bore connectors, and active measures such as reading Specific labelling which must be systematically affixed to the routes. NRFit connectors are a type of small-bore connector specifically intended for neuraxial and perineural applications. They are based on the International Organization for Standardization (ISO) standard 80369-6. They are physically incompatible with other small-bore connectors, like the Luer connectors used for intra-venous and enteral medication administration, and thus help prevent inadvertent misconnections. While some countries have already implemented this standard, France is behind schedule in implementing the NRFit connectors due to the absence of strong recommendations or obligations from the authorities. However, NRFit connectors represents real progress for the prevention of medication errors.