Search results for: lower back
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7091

Search results for: lower back

6371 Skin-Dose Mapping for Patients Undergoing Interventional Radiology Procedures: Clinical Experimentations versus a Mathematical Model

Authors: Aya Al Masri, Stefaan Carpentier, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

Abstract:

Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis and ulceration to appear. In order to prevent these deterministic effects, an accurate calculation of the patient skin-dose mapping is essential. For most machines, the 'Dose Area Product (DAP)' and fluoroscopy time are the only information available for the operator. These two parameters are a very poor indicator of the peak skin dose. We developed a mathematical model that reconstructs the magnitude (delivered dose), shape, and localization of each irradiation field on the patient skin. In case of critical dose exceeding, the system generates warning alerts. We present the results of its comparison with clinical studies. Materials and methods: Two series of comparison of the skin-dose mapping of our mathematical model with clinical studies were performed: 1. At a first time, clinical tests were performed on patient phantoms. Gafchromic films were placed on the table of the IR machine under of PMMA plates (thickness = 20 cm) that simulate the patient. After irradiation, the film darkening is proportional to the radiation dose received by the patient's back and reflects the shape of the X-ray field. After film scanning and analysis, the exact dose value can be obtained at each point of the mapping. Four experimentation were performed, constituting a total of 34 acquisition incidences including all possible exposure configurations. 2. At a second time, clinical trials were launched on real patients during real 'Chronic Total Occlusion (CTO)' procedures for a total of 80 cases. Gafchromic films were placed at the back of patients. We performed comparisons on the dose values, as well as the distribution, and the shape of irradiation fields between the skin dose mapping of our mathematical model and Gafchromic films. Results: The comparison between the dose values shows a difference less than 15%. Moreover, our model shows a very good geometric accuracy: all fields have the same shape, size and location (uncertainty < 5%). Conclusion: This study shows that our model is a reliable tool to warn physicians when a high radiation dose is reached. Thus, deterministic effects can be avoided.

Keywords: clinical experimentation, interventional radiology, mathematical model, patient's skin-dose mapping.

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6370 Iterative Reconstruction Techniques as a Dose Reduction Tool in Pediatric Computed Tomography Imaging: A Phantom Study

Authors: Ajit Brindhaban

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Background and Purpose: Computed Tomography (CT) scans have become the largest source of radiation in radiological imaging. The purpose of this study was to compare the quality of pediatric Computed Tomography (CT) images reconstructed using Filtered Back Projection (FBP) with images reconstructed using different strengths of Iterative Reconstruction (IR) technique, and to perform a feasibility study to assess the use of IR techniques as a dose reduction tool. Materials and Methods: An anthropomorphic phantom representing a 5-year old child was scanned, in two stages, using a Siemens Somatom CT unit. In stage one, scans of the head, chest and abdomen were performed using standard protocols recommended by the scanner manufacturer. Images were reconstructed using FBP and 5 different strengths of IR. Contrast-to-Noise Ratios (CNR) were calculated from average CT number and its standard deviation measured in regions of interest created in the lungs, bone, and soft tissues regions of the phantom. Paired t-test and the one-way ANOVA were used to compare the CNR from FBP images with IR images, at p = 0.05 level. The lowest strength value of IR that produced the highest CNR was identified. In the second stage, scans of the head was performed with decreased mA(s) values relative to the increase in CNR compared to the standard FBP protocol. CNR values were compared in this stage using Paired t-test at p = 0.05 level. Results: Images reconstructed using IR technique had higher CNR values (p < 0.01.) in all regions compared to the FBP images, at all strengths of IR. The CNR increased with increasing IR strength of up to 3, in the head and chest images. Increases beyond this strength were insignificant. In abdomen images, CNR continued to increase up to strength 5. The results also indicated that, IR techniques improve CNR by a up to factor of 1.5. Based on the CNR values at strength 3 of IR images and CNR values of FBP images, a reduction in mA(s) of about 20% was identified. The images of the head acquired at 20% reduced mA(s) and reconstructed using IR at strength 3, had similar CNR as FBP images at standard mA(s). In the head scans of the phantom used in this study, it was demonstrated that similar CNR can be achieved even when the mA(s) is reduced by about 20% if IR technique with strength of 3 is used for reconstruction. Conclusions: The IR technique produced better image quality at all strengths of IR in comparison to FBP. IR technique can provide approximately 20% dose reduction in pediatric head CT while maintaining the same image quality as FBP technique.

Keywords: filtered back projection, image quality, iterative reconstruction, pediatric computed tomography imaging

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6369 Sustainable Upgrade of Existing Heritage Infrastructure - Strengthening and Rehabilitation of The LH Ford Bridge

Authors: Vince Scolaro, Lakshman Prasad, Ted Polley, Sanjivan Deshpande

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The LH Ford Bridge, built in the 1960s, comprises 28 spans, is 800m long and crosses the Macquarie River at Dubbo, NSW. The main bridge spans comprise three spans with a 63m center span (25m drop-in section) supported by halving joints from the main cantilevers and back spans of 28m. The main bridge spans were built using complex construction staging (the first of this type in NSW). They comprise twin precast boxes, in-situ reinforced concrete infills, and cantilevered outriggers stressed both longitudinally and transversely. Since construction, this bridge has undergone significantly increased design vehicle loads and showed signs of excessive shrinkage and creep leading to significant sagging of the centre span with evidence of previous failure and remediation of the halving joints. A comprehensive load rating assessment was undertaken taking account of the original complex construction staging. Deficiencies identified included inadequate capacity of the halving joints, failure of the bearings at the halving joints, inadequate shear capacity of the girder webs and inadequate girder flexural capacity to carry B-Double design vehicles. A unique strengthening system comprising two new piers (under each of the halving joints), new bearings and installation of external prestressing to the soffit of both drop-in-span and back spans was adopted. A portion of the dead load had to be transferred from the superstructure to the new piers via innovative soft/stiff bearing combinations to reduce new locked-in stresses resulting from the new pier supports. Significant temporary works comprised a precast concrete shell beam forming the pile cap/pier structure, addition of a temporary suspended scaffold (without overstressing the existing superstructure) and the installation of jacking stays for new bearing top and bottom plates. This paper presents how this existing historic and socially important bridge was strengthened and updated to increase its design life without the need for replacement.

Keywords: strengthening, creep, construction, box girder

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6368 Application of Chinese Remainder Theorem to Find The Messages Sent in Broadcast

Authors: Ayubi Wirara, Ardya Suryadinata

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Improper application of the RSA algorithm scheme can cause vulnerability to attacks. The attack utilizes the relationship between broadcast messages sent to the user with some fixed polynomial functions that belong to each user. Scheme attacks carried out by applying the Chinese Remainder Theorem to obtain a general polynomial equation with the same modulus. The formation of the general polynomial becomes a first step to get back the original message. Furthermore, to solve these equations can use Coppersmith's theorem.

Keywords: RSA algorithm, broadcast message, Chinese Remainder Theorem, Coppersmith’s theorem

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6367 Semi-Natural Meadows of Natura 2000 Habitats – Conservation and Renewable Energy Source

Authors: Mateusz Meserszmit, Mariusz Chrabąszcz, Adriana Trojanowska-Olichwer, Zygmunt Kącki

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Semi-natural meadows are valuable communities from the point of view of biodiversity, but their survival is strongly related to human activity. Unfortunately, the current status of preservation of extensively used meadows in Europe is frequently assessed as “unfavorable”. This is due to agricultural activity, in particular the lack of appropriate conservation procedures such as the cutting of meadows or livestock grazing. However, for more effective protective measures, the preservation of the biological diversity of meadows requires an interdisciplinary approach from both scientists and practitioners from many fields. Our research aimed to present the possibility of conservation of semi-natural meadows using cut biomass for the production of bioenergy – biogas, taking into consideration the botanical characteristics of the studied habitat and the chemical properties of biomass. A field study was conducted in Poland, within an area covered by the European Union's nature conservation programme. The samples were collected on four dates (May 24th, July 1st, July 23rd, and September 1st) from a study site established within a Molinion meadow. The biomass collected at the earliest date mostly consisted of plants with flowers in bud or fully open flowers. At the later harvest dates, most plants were at the fruiting or seed shed stage. An earlier stage of plant growth contributed to a lower biomass yield, which also resulted in a lower methane yield per hectare. The methane yield per hectare was at the end of May 482 m3 CH4 ha-1, at the beginning of July 867 m3 CH4 ha-1, at the end of July 759 m3 CH4 ha-1 and at the beginning of September 730 m3 CH4 ha-1. The biomass harvested in May demonstrated a significantly higher content of the elements: N, P, and K, but a lower Ca content compared to later harvested biomass, which may affect the biogas production process. The use of hay as a source of renewable energy can become an important element of conservation adapted for this type of habitat.

Keywords: nature conservation, biomass, bioenergy, grassland

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6366 Subjective Well-Being, Emotional Regulation and Motivational Orientation of Competition Athletes

Authors: Cristina Costa-Lobo, Priscila Martins, Silvia Amado Cordeiro, Ana Campina

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Behavior directed toward high levels of sports performance and excellence implies task-focused processes, processes of cognitive and emotional regulation. This research aims to understand if subjective well-being, emotional regulation, and motivational orientation influence the performance of competitive athletes. The sample of this study is a non-probabilistic convenience sample, consisting of 50 male athletes, aged 14 to 15 years, who belong to training teams integrated in the pedagogical department of a sports club in the North of Portugal. In terms of performance, the distinction between team A and team B is due to the championships in which the respective athletes participate. Team A participates in national championships where the levels of demand and challenge are more pronounced and the team B only participates in championships at the district level. Was verified the internal consistency of the subjective happiness scale, the emotional regulation scale, and the motivational orientation questionnaire. SPSS, version 22.0, was used in the data treatment. When comparing the dimensions of emotional regulation with performance, it can be seen that athletes with lower sports scores have higher levels of emotional control and emotional self-awareness. As far as situational responsiveness is concerned, only the emotional self-control dimension and the emotional self-awareness dimension show an influence on the income, although, contrary to what would be expected, they appear to be associated with lower incomes. When comparing the motivational orientation with the athletic performance, it is verified that the athletes with the highest performance present an ego-oriented motivation, evidencing the athletes with a lower performance athletic tendency towards the task orientation. Only the ego-oriented dimension seems to be associated with high sport performance. The motivational orientation for the ego and the dimensions emotional control and emotional self-awareness are presented in this study as having influence on sports performance. Following these studies that have shown concern with the characterization of the best athletes and the promotion of higher sports performances, this work contributes to the signaling of psychological variables associated with high sports income.

Keywords: subjective well-being, emotional regulation, motivational orientation, sports performance

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6365 Pupils´ Questions at School Attendance Beginning and Teachers´ Teaching Strategy

Authors: Marie Pavelková, Hana Lukášová

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Pupils´ inquisitiveness at the beginning of their school attendance is reflected by characteristics of the questions they ask. Clearly most of the classroom communication sequences are initiated by the teacher. But the teaching process also includes questions initiated by pupils in the need to satisfy their need for knowledge. The purpose of our research is to present the results of our pre-research strategy of occurrence of pupil-initiated questions in math lessons at the lower elementary school level, and to reveal the extent to which they are influenced by the teacher´s teaching strategy. We used the research methods of direct and indirect observations of fifth year classes in primary school. We focused on questions asked by the pupils in their math lessons. Our research sample for the pre-research observation method was a collection of video recordings available online. We used them for analysing the nature of pupils´ questions identified there. On the basis of the analysis, we hereby present the results concerning the nature of pupils´ questions asked in math lessons on the lower elementary school level. The interpretation of the collected results will be the starting point for the selection of research strategies in the next research stages concerning pupils’ questions in the future.

Keywords: beginning of schooling, pre-research, questions of pupils, teaching strategy

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6364 Ultrasound Therapy: Amplitude Modulation Technique for Tissue Ablation by Acoustic Cavitation

Authors: Fares A. Mayia, Mahmoud A. Yamany, Mushabbab A. Asiri

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In recent years, non-invasive Focused Ultrasound (FU) has been utilized for generating bubbles (cavities) to ablate target tissue by mechanical fractionation. Intensities >10 kW/cm² are required to generate the inertial cavities. The generation, rapid growth, and collapse of these inertial cavities cause tissue fractionation and the process is called Histotripsy. The ability to fractionate tissue from outside the body has many clinical applications including the destruction of the tumor mass. The process of tissue fractionation leaves a void at the treated site, where all the affected tissue is liquefied to particles at sub-micron size. The liquefied tissue will eventually be absorbed by the body. Histotripsy is a promising non-invasive treatment modality. This paper presents a technique for generating inertial cavities at lower intensities (< 1 kW/cm²). The technique (patent pending) is based on amplitude modulation (AM), whereby a low frequency signal modulates the amplitude of a higher frequency FU wave. Cavitation threshold is lower at low frequencies; the intensity required to generate cavitation in water at 10 kHz is two orders of magnitude lower than the intensity at 1 MHz. The Amplitude Modulation technique can operate in both continuous wave (CW) and pulse wave (PW) modes, and the percentage modulation (modulation index) can be varied from 0 % (thermal effect) to 100 % (cavitation effect), thus allowing a range of ablating effects from Hyperthermia to Histotripsy. Furthermore, changing the frequency of the modulating signal allows controlling the size of the generated cavities. Results from in vitro work demonstrate the efficacy of the new technique in fractionating soft tissue and solid calcium carbonate (Chalk) material. The technique, when combined with MR or Ultrasound imaging, will present a precise treatment modality for ablating diseased tissue without affecting the surrounding healthy tissue.

Keywords: focused ultrasound therapy, histotripsy, inertial cavitation, mechanical tissue ablation

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6363 Improved Hydrogen Sorption Kinetics of Compacted LiNH₂-LiH Based Small Hydrogen Storage Tank by Doping with TiF₄ and MWCNTs

Authors: Chongsutthamani Sitthiwet, Praphatsorn Plerdsranoy, Palmarin Dansirima, Priew Eiamlamai, Oliver Utke, Rapee Utke

Abstract:

Hydrogen storage tank containing compacted LiNH2-LiH is developed by doping with TiF₄ and multi-walled nanotubes (MWCNTs) to study kinetic properties. Transition metal-based catalyst (TiF₄) provides the catalytic effect on hydrogen dissociation/recombination, while MWCNTs benefit thermal conductivity and hydrogen permeability during de/rehydrogenation process. The Enhancement of dehydrogenation kinetics is observed from the single-step reaction at a narrower and lower temperature range of 150-350 ºC (100 ºC lower than the compacted LiNH₂-LiH without additives) as well as long plateau temperature and constant hydrogen flow rate (50 SCCM) up to 30 min during desorption. Besides, Hydrogen contents de/absorbed during 5-6 cycles increase from 1.90-2.40 to 3.10-4.70 wt. % H₂ (from 29 to up to 80 % of theoretical capacity). In the process, Li₅TiN₃ is detected upon cycling probably absorbs NH₃ to form Li₅TiN₃(NH₃)x, which is favoring hydrogen sorption properties of the LiNH₂-LiH system. Importantly, the homogeneous reaction mechanisms and performances are found at all positions inside the tank of compacted LiNH₂-LiH doped with TiF₄ and MWCNTs.

Keywords: carbon, hydride, kinetics, dehydrogenation

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6362 Applying WILSERV in Measuring Visitor Satisfaction at Sepilok Orangutan Rehabilitation Centre (SORC)

Authors: A. H. Hendry, H. S. Mogindol

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There is an increasing worldwide demand on the field of interaction with wildlife tourism. Studies pertaining to the service quality within the sphere of interaction with wildlife tourism are plentiful. However, studies on service quality in wildlife attractions, especially on semi-captured wildlife tourism are still limited. The Sepilok Orangutan Rehabilitation Centre (SORC) in Sandakan, Sabah, Malaysia is one good example of a semi-captured wildlife attraction and a renowned attraction in Sabah. This study presents a gap analysis by measuring the perception and expectation of service quality at SORC through the use of a modified SERVQUAL, referred to as WILSERV. A survey questionnaire was devised and administered to 190 visitors who visited SORC. The study revealed that all the means of the six dimensions for perceived perceptions were lower than the expectations. The highest gap was from the dimension of reliability (-0.21), followed by tangible (-0.17), responsiveness (-0.11), assurance, (-0.11), empathy (-0.11) and wild-tangible (-0.05). Similarly, the study also showed that all six dimensions for perceived perceptions means were lower than the expectations for both local and foreign visitors.

Keywords: importance performance analysis, service quality, WIL-SERV, wildlife tourism

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6361 Pre-Implementation of Total Body Irradiation Using Volumetric Modulated Arc Therapy: Full Body Anthropomorphic Phantom Development

Authors: Susana Gonçalves, Joana Lencart, Anabela Gregório Dias

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Introduction: In combination with chemotherapy, Total Body Irradiation (TBI) is most used as part of the conditioning regimen prior to allogeneic hematopoietic stem cell transplantation. Conventional TBI techniques have a long application time but non-conformality of beam-application with the inability to individually spare organs at risk. Our institution’s intention is to start using Volumetric Modulated Arc Therapy (VMAT) techniques to increase homogeneity of delivered radiation. As a first approach, a dosimetric plan was performed on a computed tomography (CT) scan of a Rando Alderson antropomorfic phantom (head and torso), using a set of six arcs distributed along the phantom. However, a full body anthropomorphic phantom is essential to carry out technique validation and implementation. Our aim is to define the physical and chemical characteristics and the ideal manufacturing procedure of upper and lower limbs to our anthropomorphic phantom, for later validate TBI using VMAT. Materials and Methods: To study the better fit between our phantom and limbs, a CT scan of Rando Alderson anthropomorphic phantom was acquired. CT was performed on GE Healthcare equipment (model Optima CT580 W), with slice thickness of 2.5 mm. This CT was also used to access the electronic density of soft tissue and bone through Hounsfield units (HU) analysis. Results: CT images were analyzed and measures were made for the ideal upper and lower limbs. Upper limbs should be build under the following measures: 43cm length and 7cm diameter (next to the shoulder section). Lower limbs should be build under the following measures: 79cm length and 16.5cm diameter (next to the thigh section). As expected, soft tissue and bone have very different electronic density. This is important to choose and analyze different materials to better represent soft tissue and bone characteristics. The approximate HU values of the soft tissue and for bone shall be 35HU and 250HU, respectively. Conclusion: At the moment, several compounds are being developed based on different types of resins and additives in order to be able to control and mimic the various constituent densities of the tissues. Concurrently, several manufacturing techniques are being explored to make it possible to produce the upper and lower limbs in a simple and non-expensive way, in order to finally carry out a systematic and appropriate study of the total body irradiation. This preliminary study was a good starting point to demonstrate the feasibility of TBI with VMAT.

Keywords: TBI, VMAT, anthropomorphic phantom, tissue equivalent materials

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6360 Atypical Familial Amyotrophic Lateral Sclerosis Secondary to Superoxide Dismutase 1 Gene Mutation With Coexistent Axonal Polyneuropathy: A Challenging Diagnosis

Authors: Seraj Makkawi, Abdulaziz A. Alqarni, Himyan Alghaythee, Suzan Y. Alharbi, Anmar Fatani, Reem Adas, Ahmad R. Abuzinadah

Abstract:

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a neurodegenerative disease that involves both the upper and lower motor neurons. Familial ALS, including superoxide dismutase 1 (SOD1) mutation, accounts for 5-10% of all cases of ALS. Typically, the symptoms of ALS are purely motor, though coexistent sensory symptoms have been reported in rare cases. In this report, we describe the case of a 47- year-old man who presented with progressive bilateral lower limb weakness and numbness for the last four years. A nerve conduction study (NCS) showed evidence of coexistent axonal sensorimotor polyneuropathy in addition to the typical findings of ALS in needle electromyography. Genetic testing confirmed the diagnosis of familial ALS secondary to the SOD1 genetic mutation. This report highlights that the presence of sensory symptoms should not exclude the possibility of ALS in an appropriate clinical setting.

Keywords: Saudi Arabia, polyneuropathy, SOD1 gene mutation, familial amyotrophic lateral sclerosis, amyotrophic lateral sclerosis

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6359 The Relationship Between Cultural Factors and Dividend Payouts of the Banks in Some Middle East Countries

Authors: Benjamin Bae, Mahdy Elhusseiny, Sherif El-Halaby

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This study investigates the relationship between some cultural factors and the level of dividend payouts of banks in a number of Muslim countries. We examine whether cultural factors play any role in determining dividend payout policy in banks. The results suggest that banks in high masculinity countries tend to pay higher dividends than low masculinity countries. The results also show that banks in high uncertainty avoidance (UA) countries tend to pay lower dividends than high UA countries. Additionally, the results of this study indicate that banks in high long-term orientation (LTO) countries tend to pay lower dividends than low LTO countries. However, two other cultural factors of power distance (PD) and individualism do not have any incremental explanatory power on the dividend payouts. Overall, this research adds to our understanding of the bank’s dividend payout policies. First, evidence on the relationship between the cultural factors and bank’s level of dividend payouts should be useful to investors. Second, the findings of this study provide financial statement users with useful information about the bank’s dividend payout levels. Third, in general, it also adds to the accounting and finance literature on dividends.

Keywords: cultural factor, dividend payout, Hofstede index, bank industry

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6358 Application of Ground-Penetrating Radar in Environmental Hazards

Authors: Kambiz Teimour Najad

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The basic methodology of GPR involves the use of a transmitting antenna to send electromagnetic waves into the subsurface, which then bounce back to the surface and are detected by a receiving antenna. The transmitter and receiver antennas are typically placed on the ground surface and moved across the area of interest to create a profile of the subsurface. The GPR system consists of a control unit that powers the antennas and records the data, as well as a display unit that shows the results of the survey. The control unit sends a pulse of electromagnetic energy into the ground, which propagates through the soil or rock until it encounters a change in material or structure. When the electromagnetic wave encounters a buried object or structure, some of the energy is reflected back to the surface and detected by the receiving antenna. The GPR data is then processed using specialized software that analyzes the amplitude and travel time of the reflected waves. By interpreting the data, GPR can provide information on the depth, location, and nature of subsurface features and structures. GPR has several advantages over other geophysical survey methods, including its ability to provide high-resolution images of the subsurface and its non-invasive nature, which minimizes disruption to the site. However, the effectiveness of GPR depends on several factors, including the type of soil or rock, the depth of the features being investigated, and the frequency of the electromagnetic waves used. In environmental hazard assessments, GPR can be used to detect buried structures, such as underground storage tanks, pipelines, or utilities, which may pose a risk of contamination to the surrounding soil or groundwater. GPR can also be used to assess soil stability by identifying areas of subsurface voids or sinkholes, which can lead to the collapse of the surface. Additionally, GPR can be used to map the extent and movement of groundwater contamination, which is critical in designing effective remediation strategies. the methodology of GPR in environmental hazard assessments involves the use of electromagnetic waves to create high of the subsurface, which are then analyzed to provide information on the depth, location, and nature of subsurface features and structures. This information is critical in identifying and mitigating environmental hazards, and the non-invasive nature of GPR makes it a valuable tool in this field.

Keywords: GPR, hazard, landslide, rock fall, contamination

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6357 The Role of Metacognitive Strategy Intervention through Dialogic Interaction on Listeners’ Level of Cognitive Load

Authors: Ali Babajanzade, Hossein Bozorgian

Abstract:

Cognitive load plays an important role in learning in general and L2 listening comprehension in particular. This study is an attempt to investigate the effect of metacognitive strategy intervention through dialogic interaction (MSIDI) on L2 listeners’ cognitive load. A mixed-method design with 50 participants of male and female Iranian lower-intermediate learners between 20 to 25 years of age was used. An experimental group (n=25) received weekly interventions based on metacognitive strategy intervention through dialogic interaction for ten sessions. The second group, which was control (n=25), had the same listening samples with the regular procedure without a metacognitive intervention program in each session. The study used three different instruments: a) a modified version of the cognitive load questionnaire, b) digit span tests, and c) focused group interviews to investigate listeners’ level of cognitive load throughout the process. Results testified not only improvements in listening comprehension in MSIDI but a radical shift of cognitive load rate within this group. In other words, listeners experienced a lower level of cognitive load in MSIDI in comparison with their peers in the control group.

Keywords: cognitive load theory, human mental functioning, metacognitive theory, listening comprehension, sociocultural theory

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6356 Experimental Analysis on the Thermal Performance of Vacuum Membrane Distillation Module Using Polyvinylidene Fluoride Hollow Fiber Membrane

Authors: Hong-Jin Joo, Hee-Yoel Kwak

Abstract:

Vacuum Membrane Distillation (VMD) uses pressure lower than the atmospheric pressure. The feed seawater is capable of producing more vapor at the same temperature than Direct Contact Membrane Distillation (DCMD), Air Gap Membrane Distillation (AGMD) or Sweep Gas Membrane Distillation (SGMD). It is advantageous because it is operable at a lower temperature than other membrane distillations. However, no commercial product is available that uses the VMD method, as it is still in the study stage. In this study, therefore, thermal performance test according to the feed water conditions was performed prior to both construction of the demonstration plant, which uses VMD module of the capacity of 400m³/d in South Korea, and commercialization of VMD module with hollow fiber membrane. Such study was performed by designing and constructing the VMD module of the capacity of 2 m³/day which utilizes the polyvinylidene fluoride (PVDF) hollow fiber membrane. The results obtained from the VMD module manufactured by ECONITY Co., Ltd in South Korea, showed that the maximum performance ratio (PR) value of 0.904, feed water temperature of 75 ℃, and the flow rate of 8 m3/h. As the temperature of and flow rate of the feed water increased, the PR value of the VMD module also increased.

Keywords: membrane distillation, vacuum membrane distillation, hollow fiber membrane, desalination

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6355 Examining the Association of Demographic Factors and Arab Women’s Investment Behavior

Authors: Razan Salem

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Men and women are different, and so their investment behaviors may also vary. To the author’s best knowledge, women's investment behavior and its association with demographic factors have not been explored directly in the behavioral finance literature, however, particularly in respect to the Arab region. Thus, this study extends the literature by focusing on examining the association of demographic factors (age, annual income, and education) with Arab women’s investment behavior. To achieve the study’s aim, the researcher distributed 600 close-ended online questionnaires to a sample of Arab male and female individual investors in both Saudi Arabia and Jordan; using Kruskal-Wallis H Test and the Mann-Whitney U Test to analyze the data. The findings reveal that age, education, and level of income are associated with Arab women’s investment behavior. Educational level and level of income are positively associated with Arab women investment confidence level. On the contrary, age is negatively associated with Arab women financial risk tolerance. According to annual income, Arab women with lower incomes have lower confidence and investment literacy levels. Overall, the study concludes that age, income, and education are important demographic factors that must be considered when investigating the investment behavior of women in the Arab region.

Keywords: Arab region, demographic factors, investment behavior, women investors

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6354 Restoring Total Form and Function in Patients with Lower Limb Bony Defects Utilizing Patient-Specific Fused Deposition Modelling- A Neoteric Multidisciplinary Reconstructive Approach

Authors: Divya SY. Ang, Mark B. Tan, Nicholas EM. Yeo, Siti RB. Sudirman, Khong Yik Chew

Abstract:

Introduction: The importance of the amalgamation of technological and engineering advances with surgical principles of reconstruction cannot be overemphasized. With earlier detection of cancer, consequences of high-speed living and neglect, like traumatic injuries and infection, resulting in increasingly younger patients with bone defects. This may result in malformations and suboptimal function that is more noticeable and palpable in the younger, active demographic. Our team proposes a technique that encapsulates a mesh of multidisciplinary effort, tissue engineering and reconstructive principles. Methods/Materials: Our patient was a young competitive footballer in his early 30s who was diagnosed with submandibular adenoid cystic carcinoma with bony involvement. He was thus counselled for a right hemi mandibulectomy, the floor of mouth resection, right selective neck dissection, tracheostomy, and free fibular flap reconstruction of his mandible and required post-operative radiotherapy. Being young and in his prime sportsman years, he was unable to accept the morbidities associated with using his fibula to reconstruct his mandible despite it being the gold standard reconstructive option. The fibula is an ideal vascularized bone flap because it’s reliable and easily shaped with relatively minimal impact on functional outcomes. The fibula contributes to 30% of weightbearing and is the attachment for the lateral compartment muscles; it is stronger in footballers concerning lateral bending. When harvesting the fibula, the distal 6-8cm and up to 10% of the total length is preserved to maintain the ankle’s stability, thus, minimizing the impact on daily activities. There are studies that have noted gait variability post-operatively. Therefore, returning to a premorbid competitive level may be doubtful. To improve his functional outcomes, the decision was made to try and restore the fibula's form and function. Using the concept of Fused Deposition Modelling (FDM), our team comprising of Plastics, Otolaryngology, Orthopedics and Radiology, worked with Osteopore to design a 3D bioresorbable implant to regenerate the fibula defect (14.5cm). Bone marrow was harvested via reaming the contralateral hip prior to the wide resection. 30mls of his blood was obtained for extracting platelet rich plasma. These were packed into the Osteopore 3D-printed bone scaffold. This was then secured into the fibula defect with titanium plates and screws. The flexor hallucis longus and soleus were anchored along the construct and intraosseous membrane, done in a single setting. Results: He was reviewed closely as an outpatient over 10 months post operatively. He reported no discernable loss or difference in ankle function. He is satisfied and back in training and our team has video and photographs that substantiate his progress. Conclusion: FDM allows regeneration of long bone defects. However, we aimed to also restore his eversion and inversion that is imperative for footballers and hence reattached his previously dissected muscles along the length of the Osteopore implant. We believe that the reattachment of the muscle stabilizes not only the construct but allows optimum muscle tensioning when moving his ankle. This is a simple but effective technique in restoring complete function and form in a young patient whose minute muscle control is imperative to life.

Keywords: fused deposition modelling, functional reconstruction, lower limb bony defects, regenerative surgery, 3D printing, tissue engineering

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6353 An Econometric Analysis of the Flat Tax Revolution

Authors: Wayne Tarrant, Ethan Petersen

Abstract:

The concept of a flat tax goes back to at least the Biblical tithe. A progressive income tax was first vociferously espoused in a small, but famous, pamphlet in 1848 (although England had an emergency progressive tax for war costs prior to this). Within a few years many countries had adopted the progressive structure. The flat tax was only reinstated in some small countries and British protectorates until Mart Laar was elected Prime Minister of Estonia in 1992. Since Estonia’s adoption of the flat tax in 1993, many other formerly Communist countries have likewise abandoned progressive income taxes. Economists had expectations of what would happen when a flat tax was enacted, but very little work has been done on actually measuring the effect. With a testbed of 21 countries in this region that currently have a flat tax, much comparison is possible. Several countries have retained progressive taxes, giving an opportunity for contrast. There are also the cases of Czech Republic and Slovakia, which have adopted and later abandoned the flat tax. Further, with over 20 years’ worth of economic history in some flat tax countries, we can begin to do some serious longitudinal study. In this paper we consider many economic variables to determine if there are statistically significant differences from before to after the adoption of a flat tax. We consider unemployment rates, tax receipts, GDP growth, Gini coefficients, and market data where the data are available. Comparisons are made through the use of event studies and time series methods. The results are mixed, but we draw statistically significant conclusions about some effects. We also look at the different implementations of the flat tax. In some countries there are equal income and corporate tax rates. In others the income tax has a lower rate, while in others the reverse is true. Each of these sends a clear message to individuals and corporations. The policy makers surely have a desired effect in mind. We group countries with similar policies, try to determine if the intended effect actually occurred, and then report the results. This is a work in progress, and we welcome the suggestion of variables to consider. Further, some of the data from before the fall of the Iron Curtain are suspect. Since there are new ruling regimes in these countries, the methods of computing different statistical measures has changed. Although we first look at the raw data as reported, we also attempt to account for these changes. We show which data seem to be fictional and suggest ways to infer the needed statistics from other data. These results are reported beside those on the reported data. Since there is debate about taxation structure, this paper can help inform policymakers of change the flat tax has caused in other countries. The work shows some strengths and weaknesses of a flat tax structure. Moreover, it provides beginnings of a scientific analysis of the flat tax in practice rather than having discussion based solely upon theory and conjecture.

Keywords: flat tax, financial markets, GDP, unemployment rate, Gini coefficient

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6352 The Comparative Electroencephalogram Study: Children with Autistic Spectrum Disorder and Healthy Children Evaluate Classical Music in Different Ways

Authors: Galina Portnova, Kseniya Gladun

Abstract:

In our EEG experiment participated 27 children with ASD with the average age of 6.13 years and the average score for CARS 32.41 and 25 healthy children (of 6.35 years). Six types of musical stimulation were presented, included Gluck, Javier-Naida, Kenny G, Chopin and other classic musical compositions. Children with autism showed orientation reaction to the music and give behavioral responses to different types of music, some of them might assess stimulation by scales. The participants were instructed to remain calm. Brain electrical activity was recorded using a 19-channel EEG recording device, 'Encephalan' (Russia, Taganrog). EEG epochs lasting 150 s were analyzed using EEGLab plugin for MatLab (Mathwork Inc.). For EEG analysis we used Fast Fourier Transform (FFT), analyzed Peak alpha frequency (PAF), correlation dimension D2 and Stability of rhythms. To express the dynamics of desynchronizing of different rhythms we've calculated the envelope of the EEG signal, using the whole frequency range and a set of small narrowband filters using Hilbert transformation. Our data showed that healthy children showed similar EEG spectral changes during musical stimulation as well as described the feelings induced by musical fragments. The exception was the ‘Chopin. Prelude’ fragment (no.6). This musical fragment induced different subjective feeling, behavioral reactions and EEG spectral changes in children with ASD and healthy children. The correlation dimension D2 was significantly lower in autists compared to healthy children during musical stimulation. Hilbert envelope frequency was reduced in all group of subjects during musical compositions 1,3,5,6 compositions compared to the background. During musical fragments 2 and 4 (terrible) lower Hilbert envelope frequency was observed only in children with ASD and correlated with the severity of the disease. Alfa peak frequency was lower compared to the background during this musical composition in healthy children and conversely higher in children with ASD.

Keywords: electroencephalogram (EEG), emotional perception, ASD, musical perception, childhood Autism rating scale (CARS)

Procedia PDF Downloads 280
6351 Factors Affecting Harvested Rain Water Quality and Quantity in Yatta Area, Palestine

Authors: Nibal Al-Batsh, Issam Al-Khatib, Subha Ghannam

Abstract:

Yatta is the study area for this research, located 9 km south of Hebron City in the West Bank in Palestine. It has been connected to a water network since 1974 serving nearly 85% of the households. The water network is old and inadequate to meet the needs of the population. The water supply made available to the area is also very limited, estimated to be around 20 l/c.d. Residents are thus forced to rely on water vendors which supply water with a lower quality compared to municipal water while being 400% more expensive. As a cheaper and more reliable alternative, rainwater harvesting is a common practice in the area, with the majority of the households owning at least one cistern. Rainwater harvesting is of great socio-economic importance in areas where water sources are scarce or polluted. The quality of harvested rainwater used for drinking and domestic purposes in the Yatta area was assessed throughout a year long period. A total of 100 water samples were collected from (50 rainfed cisterns) with an average capacity of 69 m3, adjacent to cement-roof catchment with an average area of 145 m2. Samples were analyzed for a number of parameters including: pH, Alkalinity, Hardness, Turbidity, Total Dissolved Solids (TDS), NO3, NH4, chloride and salinity. Microbiological contents such as Total Coliforms (TC) and Fecal Coliforms (FC) bacteria were also analyzed. Results showed that most of the rainwater samples were within WHO and EPA guidelines set for chemical parameters while revealing biological contamination. The pH values of mixed water ranged from 6.9 to 8.74 with a mean value of 7.6. collected Rainwater had lower pH values than mixed water ranging from 7.00 to 7.57 with a mean of 7.21. Rainwater also had lower average values of conductivity (389.11 µScm-1) compared to that of mixed water (463.74 µScm-1) thus indicating lower values of salinity (0.75%). The largest TDS value measured in rainwater was 316 mg/l with a mean of 199.86 mg /l. As far as microbiological quality is concerned, TC and FC were detected in 99%, 52% of collected rainwater samples, respectively. The research also addressed the impact of different socio-economic attributes on rainwater harvesting using information collected through a survey from the area. Results indicated that the majority of homeowners have the primary knowledge necessary to collect and store water in cisterns. Most of the respondents clean both the cisterns and the catchment areas. However, the research also arrives at a conclusion that cleaning is not done in a proper manner. Results show that cisterns with an operating capacity of 69 m3 would provide sufficient water to get through the dry summer months. However, the catchment area must exceed 146 m2 to produce sufficient water to fill a cistern of this size in a year receiving average precipitation.

Keywords: rainwater harvesting, runoff coefficient, water quality, microbiological contamination

Procedia PDF Downloads 280
6350 Stress Evaluation at Lower Extremity during Walking with Unstable Shoe

Authors: Sangbaek Park, Seungju Lee, Soo-Won Chae

Abstract:

Unstable shoes are known to strengthen lower extremity muscles and improve gait ability and to change the user’s gait pattern. The change in gait pattern affects human body enormously because the walking is repetitive and steady locomotion in daily life. It is possible to estimate the joint motion including joint moment, force and inertia effect using kinematic and kinetic analysis. However, the change of internal stress at the articular cartilage has not been possible to estimate. The purpose of this research is to evaluate the internal stress of human body during gait with unstable shoes. In this study, FE analysis was combined with motion capture experiment to obtain the boundary condition and loading condition during walking. Motion capture experiments were performed with a participant during walking with normal shoes and with unstable shoes. Inverse kinematics and inverse kinetic analysis was performed with OpenSim. The joint angle and muscle forces were estimated as results of inverse kinematics and kinetics analysis. A detailed finite element (FE) lower extremity model was constructed. The joint coordinate system was added to the FE model and the joint coordinate system was coincided with OpenSim model’s coordinate system. Finally, the joint angles at each phase of gait were used to transform the FE model’s posture according to actual posture from motion capture. The FE model was transformed into the postures of three major phases (1st peak of ground reaction force, mid stance and 2nd peak of ground reaction force). The direction and magnitude of muscle force were estimated by OpenSim and were applied to the FE model’s attachment point of each muscle. Then FE analysis was performed to compare the stress at knee cartilage during gait with normal shoes and unstable shoes.

Keywords: finite element analysis, gait analysis, human model, motion capture

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6349 Experimental Investigation of Folding of Rubber-Filled Circular Tubes on Energy Absorption Capacity

Authors: MohammadSadegh SaeediFakher, Jafar Rouzegar, Hassan Assaee

Abstract:

In this research, mechanical behavior and energy absorption capacity of empty and rubber-filled brazen circular tubes under quasi-static axial loading are investigated, experimentally. The brazen tubes were cut out of commercially available brazen circular tubes with the same length and diameter. Some of the specimens were filled with rubbers with three different shores and also, an empty tube was prepared. The specimens were axially compressed between two rigid plates in a quasi-static process using a Zwick testing machine. Load-displacement diagrams and energy absorption of the tested tubes were extracted from experimental data. The results show that filling the brazen tubes with rubber causes those to absorb more energy and the energy absorption of specimens are increased by increasing the shore of rubbers. In comparison to the empty tube, the first fold for the rubber-filled tubes occurs at lower load and it can be concluded that the rubber-filled tubes are better energy absorbers than the empty tubes. Also, in contrast with the empty tubes, the tubes that were filled with lower rubber shore deform asymmetrically.

Keywords: axial compression, quasi-static loading, folding, energy absorbers, rubber-filled tubes

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6348 Designing Information Systems in Education as Prerequisite for Successful Management Results

Authors: Vladimir Simovic, Matija Varga, Tonco Marusic

Abstract:

This research paper shows matrix technology models and examples of information systems in education (in the Republic of Croatia and in the Germany) in support of business, education (when learning and teaching) and e-learning. Here we researched and described the aims and objectives of the main process in education and technology, with main matrix classes of data. In this paper, we have example of matrix technology with detailed description of processes related to specific data classes in the processes of education and an example module that is support for the process: ‘Filling in the directory and the diary of work’ and ‘evaluation’. Also, on the lower level of the processes, we researched and described all activities which take place within the lower process in education. We researched and described the characteristics and functioning of modules: ‘Fill the directory and the diary of work’ and ‘evaluation’. For the analysis of the affinity between the aforementioned processes and/or sub-process we used our application model created in Visual Basic, which was based on the algorithm for analyzing the affinity between the observed processes and/or sub-processes.

Keywords: designing, education management, information systems, matrix technology, process affinity

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6347 A Review of Atomization Mechanisms Used for Spray Flash Evaporation: Their Effectiveness and Proposal of Rotary Bell Atomizer for Flashing Application

Authors: Murad A. Channa, Mehdi Khiadani. Yasir Al-Abdeli

Abstract:

Considering the severity of water scarcity around the world and its widening at an alarming rate, practical improvements in desalination techniques need to be engineered at the earliest. Atomization is the major aspect of flashing phenomena, yet it has been paid less attention to until now. There is a need to test efficient ways of atomization for the flashing process. Flash evaporation together with reverse osmosis is also a commercially matured desalination technique commonly famous as Multi-stage Flash (MSF). Even though reverse osmosis is massively practical, it is not economical or sustainable compared to flash evaporation. However, flashing evaporation has its drawbacks as well such as lower efficiency of water production per higher consumption of power and time. Flash evaporation is simply the instant boiling of a subcooled liquid which is introduced as droplets in a well-maintained negative environment. This negative pressure inside the vacuum increases the temperature of the liquid droplets far above their boiling point, which results in the release of latent heat, and the liquid droplets turn into vapor which is collected to be condensed back into an impurity-free liquid in a condenser. Atomization is the main difference between pool and spray flash evaporation. Atomization is the heart of the flash evaporation process as it increases the evaporating surface area per drop atomized. Atomization can be categorized into many levels depending on its drop size, which again becomes crucial for increasing the droplet density (drop count) per given flow rate. This review comprehensively summarizes the selective results relating to the methods of atomization and their effectiveness on the evaporation rate from earlier works to date. In addition, the reviewers propose using centrifugal atomization for the flashing application, which brings several advantages viz ultra-fine droplets, uniform droplet density, and the swirling geometry of the spray with kinetically more energetic sprays during their flight. Finally, several challenges of using rotary bell atomizer (RBA) and RBA Sprays inside the chamber have been identified which will be explored in detail. A schematic of rotary bell atomizer (RBA) integration with the chamber has been designed. This powerful centrifugal atomization has the potential to increase potable water production in commercial multi-stage flash evaporators, where it would be preferably advantageous.

Keywords: atomization, desalination, flash evaporation, rotary bell atomizer

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6346 Effects of Harmful Alcohol Consumption and Gender on Academic and Personal-Emotional Adjustment in First Year University Students in Spain

Authors: M. F. Páramo, F. Cadaveira, M. S. Rodríguez

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The first year at university is a critical period for personal-emotional and academic adjustment in emerging adults. Moreover, some studies show that alcohol consumption increases in young adults on transition to university. The main purpose of this study was to analyze the impact of hazardous alcohol consumption and gender on adjustment to university, understood as a multidimensional construct involving an array of demands. A sample of 300 first year students in Spain completed the Student Adaptation to College Questionnaire (SACQ) and the Alcohol Use Disorders Identification Test (AUDIT). Examination of the data by analysis of variance revealed that adjustment to university was lower in the students undertaking hazardous alcohol consumption than in the other students. Surprisingly, the personal-emotional adjustment of students with hazardous alcohol consumption was not lower than in the other students. Analysis of the gender effect revealed that levels of personal-emotional adjustment were higher in males than in females. This is our first study examining the influence of alcohol consumption on university adjustment. Future research should examine this relationship more closely, with the aim of designing public health strategies focused on limiting abusive consumption of alcohol in university students.

Keywords: alcohol consumption, first year university students, gender, SACQ

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6345 (De)Criminalising Sex Toys in Thailand: A Law and Economics Approach

Authors: Piyanee Khumpao

Abstract:

Under the Thai Penal Code and Customs Act, sex toys are criminalized and completely prohibited through the legal interpretation as obscene objects by law enforcement, despite there is no explicit legal sanction against them. The purpose of preventing people from accessing sex toys is to preserve public morals. However, sex toys are still available, exposed, and sold publicly in main cities throughout Thailand. They are easily observed by people of any age. This paper argues that sexuality is human nature and human right. Human deserves sexual pleasure as long as getting sexual pleasure does not inflict any harm on others. Using sex toys in private (individually and/or as a couple with mutual consent) does not constitute any harm nor degrade public moral. Therefore, the complete ban of sex toys shall be lifted and decriminalized. Nevertheless, the economic analysis illustrates that criminalization and prohibition of sex toys would lead to its black market – higher price and lower quantity. Although it is socially desirable to have fewer sex toys in the market, there will usually be high demand for them because sexual pleasure is natural and, hence, people have a lower price elasticity of demand for such things, including pornography. Thus, its deterrent effect is not very effective. Moreover, sex toys vendors still always exist because higher price incentivizes them to act illegally and may gain benefits from selling low-quality sex toys. Consequently, consumers do not have a choice to select high-quality sex toys at a reasonable price. Then, they are forced to purchase low quality sex toys at a higher price. They also may suffer from health issues as well as other harms from its dangerous/toxic substances since lower quality products are manufactured poorly to save costs. A law and economics approach supports the decriminalization of sex toys in Thailand. Other measures to control its availability shall be adopted to protect the vulnerable, such as children. Options are i) zoning or regulation on-premises selling sex toys as in Singapore, Japan, and China, ii) regulations of sex toys as medical apparatus like in the state of Alabama, and iii) the prevention of sex toys exposure in the real (physical) appearance (i.e., allowing virtual exposure of sex toys) like in India.

Keywords: human nature, law and economics approach, sex toys, sexual pleasure

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6344 Olive Stone Valorization to Its Application on the Ceramic Industry

Authors: M. Martín-Morales, D. Eliche-Quesada, L. Pérez-Villarejo, M. Zamorano

Abstract:

Olive oil is a product of particular importance within the Mediterranean and Spanish agricultural food system, and more specifically in Andalusia, owing to be the world's main production area. Olive oil processing generates olive stones which are dried and cleaned to remove pulp and olive stones fines to produce biofuel characterized to have high energy efficiency in combustion processes. Olive stones fine fraction is not too much appreciated as biofuel, so it is important the study of alternative solutions to be valorized. Some researchers have studied recycling different waste to produce ceramic bricks. The main objective of this study is to investigate the effects of olive stones addition on the properties of fired clay bricks for building construction. Olive stones were substituted by volume (7.5%, 15%, and 25%) to brick raw material in three different sizes (lower than 1 mm, lower than 2 mm and between 1 and 2 mm). In order to obtain comparable results, a series without olive stones was also prepared. The prepared mixtures were compacted in laboratory type extrusion under a pressure of 2.5MPa for rectangular shaped (30 mm x 60 mm x 10 mm). Dried and fired industrial conditions were applied to obtain laboratory brick samples. Mass loss after sintering, bulk density, porosity, water absorption and compressive strength of fired samples were investigated and compared with a sample manufactured without biomass. Results obtained have shown that olive stone addition decreased mechanical properties due to the increase in water absorption, although values tested satisfied the requirements in EN 772-1 about methods of test for masonry units (Part 1: Determination of compressive strength). Finally, important advantages related to the properties of bricks as well as their environmental effects could be obtained with the use of biomass studied to produce ceramic bricks. The increasing of the percentage of olive stones incorporated decreased bulk density and then increased the porosity of bricks. On the one hand, this lower density supposes a weight reduction of bricks to be transported, handled as well as the lightening of building; on the other hand, biomass in clay contributes to auto thermal combustion which involves lower fuel consumption during firing step. Consequently, the production of porous clay bricks using olive stones could reduce atmospheric emissions and improve their life cycle assessment, producing eco-friendly clay bricks.

Keywords: clay bricks, olive stones, sustainability, valorization

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6343 A Multidisciplinary Team Approach for Limb Salvage in a Rare Case of Pyoderma Gangrenosum in a Significant Circumferential Lower Extremity Wound Complicated by Diabetes and End-stage Renal Disease

Authors: Jenee Gooden, Kevin Vasquez-monterroso, Lady Paula Dejesus, Sandra Wainwright, Daniel Kim, Mackenzie Walker

Abstract:

Introduction: Pyoderma gangrenosum (PG) is a rare, rapidly progressive, neutrophilic ulcerative colitis condition with an incidence of 3 to 10 cases per year ¹ ². Due to the similar appearance, PG is often misdiagnosed as a diabetic ulcer in diabetic patients. Though they may clinically appear similar in appearance, the treatment protocol and diagnostic criteria differ. Also, end-stage renal disease (ESRD) is often a condition seen in diabetic patients, which can have a significant impact on wound healing due to the wide range of uremic toxins³. This case study demonstrates a multidisciplinary team and multimodal treatment approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine for an uncontrolled diabetic with pyoderma gangrenosum of a significant circumferential wound, covering almost the entire right lower extremity. Methods:56 y.o male presents with multiple PG ulcerations, including the chest, right posterior lower extremity and sacrum. All ulcerations were previously managed by the same wound care specialist. His chief complaint was worsening PG ulcerations accompanied by a fever of 103 °F . This case study focuses on the wound to his RLE. Past medical history significant for diabetes mellitus type 2 with hemoglobin A1c of 10% and end stage renal disease (ESRD) on hemodialysis. A multidisciplinary team approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine was successfully used to perform right lower extremity limb salvage. The patient was managed by rheumatology for the continuation of prior medication, as well as the mutual agreement with wound care for the addition of dapsone. A coronary CT angiogram was performed by interventional cardiology, but no significant disease was noted, and no further vascular workup was necessary. Multiple surgical sharp wide excisional debridements with application of allografts and split thickness skin grafts for the circumferential ulceration that encompassed almost the entire right lower extremity were performed by both podiatric surgery and general surgery. Wound cultures and soft tissue biopsies were performed, and infectious disease managed antibiotic therapy. Hyperbaric oxygen therapy and wound vac therapy by wound care were also completed as adjunct management. Results: Prevention of leg amputation by limb salvage of the RLE was accomplished by a multidisciplinary team approach, with the wound size decreasing over a total of 29 weeks from 600 cm² to 12.0 x 3.5 x 0.2 cm. Our multidisciplinary team included podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine. Discussion: Wound healing, in general, can have its challenges, and those challenges are only magnified when accompanied by multiple systemic illnesses. Though the negative impact of diabetes on wound healing is well known, the compound impact of being a diabetic with ESRD and having pyoderma gangrenosum is not. This case demonstrates the necessity for a multidisciplinary team approach with a wide array of treatment modalities to optimize wound healing and perform limb salvage with prevention of lower extremity amputation.

Keywords: diabetes, podiatry, pyoderma gangrenosum, end stage renal disease

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6342 In Search of Zero Beta Assets: Evidence from the Sukuk Market

Authors: Andrea Paltrinieri, Alberto Dreassi, Stefano Miani, Alex Sclip

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The financial crises caused a collapse in prices of most asset classes, raising the attention on alternative investments such as Sukuk, a smaller, fast growing but often misunderstood market. We study diversification benefits of Sukuk, their correlation with other asset classes and the effects of their inclusion in investment portfolios of institutional and retail investors, through a comprehensive comparison of their risk/return profiles during and after the financial crisis. We find a beneficial performance adjusted for the specific volatility together with a lower correlation especially during the financial crisis. The distribution of Sukuk returns is positively skewed and leptokurtic, with a risk/return profile similarly to high yield bonds. Overall, our results suggest that Sukuk present diversification opportunities, a significant volatility-adjusted performance and lower correlations especially during the financial crisis. Our findings are relevant for a number of institutional investors. Long term investors, such as life insurers would benefit from Sukuk’s protective features during financial crisis yet keeping return and growth opportunities, whereas banks would gain due to their role of placers, advisors, market makers or underwriters.

Keywords: sukuk, zero beta asset, asset allocation, sukuk market

Procedia PDF Downloads 475