Ohio University

The thermoforming mold or tool has many purposes. First and foremost it defines the geometry of the part being formed. In addition it may provide part texture, lettering, logos and other molded in details. The mold also acts as a heat exchanger to draw heat from the formed part to reduce cooling time. It may also provide locations for part trimming or even perform the trimming operation during the forming process know as in-mold trimming.

Forming plastics during the thermoforming process is basically a stress/strain issue. As the material is heated, the amount of force, stress, needed to deform the part, strain, is reduced.

The thermoforming process is considered secondary process in the plastics industry as the input materials, plastics sheet and film, must first be created. This sheet and film are typically produced using extrusion, casting and calendaring processes.

Prior to discussing part design specifics, the first question to resolve is whether a part should be thermoformed. There are many sources for these questions as well as differing opinions as to their answers. The following represent a select set of design issues that need to be considered. Many of these will be further discussed in this chapter as well as the following chapter on tool design.

Plastics have been the focus of many environmental discussions over the years. Some of the issues are justified while others are not. For example, disposable plastics packaging is often cited as an environmental issue since it does not break down and it is filling landfills to capacity.

The control of quality is key to the success of any business. Thermoforming is no exception. Since thermoforming is a secondary process requiring sheet material to be produced first, one critical area of concern is the quality of the incoming materials. As the old saying goes: “You cannot make a silk purse out of a sow's ear”. Supplier quality will be discussed in the following categories: material source, material variation, orientation, moisture and cosmetics.

The intent of this chapter is to provide a brief overview of plastics as an industrial material as it relates to thermoforming rather than a study of polymer science. Today’s industrial plastics are synthetic, organic, hydrocarbons made primarily from petroleum.

Introduction Preterm birth and small for gestational age (SGA) are significant public health concerns in the United States, with pronounced disparities across racial and ethnic groups. Traditional prenatal care adequacy indices have limitations in fully capturing their multifaceted nature. Our study introduces the Comprehensive Prenatal Care Index (CPCI) to provide a more holistic assessment of prenatal care by integrating key elements of prenatal counseling and health promotion. Methods This cross‐sectional study used the Pregnancy Risk Assessment Monitoring System 2016‐2021 data. The CPCI was developed based on a comprehensive literature review, incorporating components such as timing, frequency, and content of prenatal visits. The index was validated using Item Response Theory (IRT) and compared with the Kotelchuck and Kessner Indices. Results The study included 139,181 pregnant women. The CPCI demonstrated strong internal consistency (Cronbach's α, 0.75; ω total, 0.81). IRT analysis confirmed the index's ability to capture variability in the quality of prenatal care, with item difficulty parameters ranging from −2.93 to +2.10. CPCI scores were significantly associated with reduced odds of adverse birth outcomes. Adequate CPCI care was linked to a 63% reduction in the odds of preterm birth among non‐Hispanic White women, with similar reductions observed in Hispanic women (odds ratio [OR], 0.59) and Asian women (OR, 0.38). For SGA, adequate care was protective among non‐Hispanic White (OR, 0.86) and Hispanic women (OR, 0.82) but showed mixed results in other groups. Discussion The CPCI provides a more inclusive measure of the quality of prenatal care compared with traditional indices. The study's findings suggest a significant role of comprehensive prenatal care in reducing adverse birth outcomes and addressing racial and ethnic disparities. Future research should focus on refining the CPCI and exploring its applicability in diverse populations to inform targeted and culturally sensitive prenatal care strategies.

System reliability is a critical factor in designing complex engineering systems. Redundancy allocation problem (RAP) has attracted more interest owing to its wide scope of industrial applications for system reliability optimization. RAPs for binary‐state and multistate systems have been extensively studied. However, the redundancy allocation for continuous‐state systems composed of degrading components has not yet been fully explored. This study attempts to build the RAP for the continuous‐state parallel‐series system consisting of identical, independent, and nonrepairable components under active and cold‐standby redundancy strategies. The degradation of individual components in a system is continuous and modeled by the gamma process. The degradation at the system level is derived according to a deterministic structure function that relates the system degradation to the degradation of its components. Genetic algorithm and exhaustive search method are used to find the cost‐optimal redundancy design while satisfying a system reliability requirement. Series‐parallel lithium‐ion battery pack systems for electric vehicles (EVs) are used as an illustrative example to validate the proposed RAP and optimization model.

Objective To evaluate the effectiveness of a radio campaign involving serial 10-minute drama episodes, 10-minute on air discussion of each episode by trained community health workers and 30-minute phone-ins from listeners in improving mothers’ nutrition- and health-related attitudes (HNRAs) and children’s minimum acceptable diet (MAD). Design A two-arm quasi-experimental trial with a pre-post design was used to quantify the effect of a radio campaign on nutrition before and immediately after the 6-month intervention. Difference-in-difference (DID) analysis was performed to assess the intervention’s effect. Setting Saboba district (intervention) and Central Gonja (comparison district) of northern region of Ghana. Participants At baseline, a total of 598 mothers with children aged 6–22 months were randomly selected from the intervention ( n 298) and control ( n 300) districts. At endline (6 months post-intervention), 252 mother–child dyads in the intervention district and 275 mother–child dyads in the control district were followed up. Results The radio campaign was significantly and positively associated with a change in health- and nutrition-related attitudes (HNRA) over time, with DID in mean attitudes significantly improving more over time in the intervention district than the control (DID = 1·398, P < 0·001). Also, the prevalence of MAD over time in the intervention district was significantly higher than the control district (DID = 16·1 percentage points, P = 0·02) in the presence of food insecurity. Conclusions The study indicates that a radio campaign on nutrition is associated with improved mothers’ HNRA and children’s MAD. Communication interventions on child nutrition targeting low-resource settings should consider this innovative approach.

Bacterial and viral cutaneous infections pose a great risk of serious complications in combat athletes and contribute to a significant amount of time lost in practice and competition. Although these infections can be treated with standard antimicrobials, the rise in resistance of Staphylococcus aureus and dermatophytes calls for updated treatment recommendations. Methicillin-resistant S. aureus (MRSA) is becoming a highly prevalent culprit of impetigo, folliculitis, and cellulitis and must be managed correctly to eradicate infection effectively. In addition, the increased prevalence of tinea incognito and terbinafine-resistant Trichophyton tonsurans makes dermatophyte infections difficult to handle. Limited studies provide evidence for a nuanced approach when treating athletes who engage in weight cycling or rapid weight loss, but adjusted dosing and treatment guidelines remain important.

Being dismissed or disparaged by medical professionals can be shocking and demoralizing for patients, leading to unnecessary harms (e.g., avoidance of medical treatment; depression; shame). This difficulty is further compounded when patients are also the target of wide-ranging stigmatization due to the nature of the medical and behavioral diagnoses they carry, and/or the social identities attributed to them by medical providers. Incorporating both clinical psychology and medical ethics perspectives, two clinical cases are presented demonstrating the insidious nature of the harms incurred to patients from traumatic medical experiences like those described above. Both cases are shown to illustrate the role that a particular form of gaslighting– medical gaslighting– plays in creating the conditions that result in a form of medical trauma. The term “medical gaslighting” currently lacks a clear and stable definition in the larger literature; the authors develop and establish a definition here. The case of Alex is offered, illustrating a standard form of medical trauma recognized in the literature, and the significance of epistemic injustice in preparing the grounds for medical gaslighting. Next, the case of Kiara is considered, in order to demonstrate how medical gaslighting becomes the vehicle for a more subtle form of medical trauma, not currently captured in standard diagnostic criteria. The claims presented here are testable, and the authors suggest that further work expanding the conceptual reach of medical trauma, and incorporating the concept of medical gaslighting into standard practice, is warranted.

The use of nicotinamide cofactors in cell-free biocatalytic systems is necessitated by the high specificity that these enzymes show for their natural redox mediators. Unfortunately, isolation and use of natural cofactors is costly, which suggests that enhancing their stability is key to enabling their use in industrial processes. This study details NAD+ and NADH stability in three buffer systems (sodium phosphate, HEPES, and Tris) at 19 °C and 25 °C and for up to 43 d. In Tris, both NADH and NAD+ were found to be highly stable. NADH degradation rates of 4 μM/d (19 °C) and 11 μM/d (25 °C) were observed in Tris buffer, corresponding to >90% and 75% remaining after 43 d, respectively. Higher degradation rates (up to 34 μM/d) were observed when sodium phosphate or HEPES buffers were used. The effect of a mild increase in temperature was determined to be significant for long-term stability, and it was shown that degradation under these conditions can be easily monitored via UV–Vis, because the degradation proceeds via the oxidation/de-aromatization of the dihydropyridine ring. Overall, this work emphasizes that the choice of buffer system is consequential for bioreactor systems employing natural nicotinamide cofactors for extended periods of time.