Search results for: long bone
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6547

Search results for: long bone

6157 The Impact of the Great Irish Famine on Irish Mass Migration to the United States at the Turn of the Twentieth Century

Authors: Gayane Vardanyan, Gaia Narciso, Battista Severgnini

Abstract:

This paper investigates the long-run impact of the Great Irish Famine on emigration from Ireland at the turn of the twentieth century. To do it we combine the 1901 and the 1911 Irish Census data sets with the Ellis Island Administrative Records on Irish migrants to the United States. We find that the migrants were more likely to be Catholic, literate, unmarried, young and Gaelic speaking compared to the ones that stay. Running individual level specifications, our preliminary findings suggest that being born in a place where the Famine was more severe increases the probability of becoming a migrant in the long-run. We also intend to explore the mechanisms through which this impact occurs.

Keywords: Great Famine, mass migration, long-run impact, mechanisms

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6156 Research on Integrating Adult Learning and Practice into Long-Term Care Education

Authors: Liu Yi Hui, Chun-Liang Lai, Jhang Yu Cih, He You Jing, Chiu Fan-Yun, Lin Yu Fang

Abstract:

For universities offering long-term care education, the inclusion of adulting learning and practices in professional courses as appropriate based on holistic design and evaluation could improve talent empowerment by leveraging social capital. Moreover, it could make the courses and materials used in long-term care education responsive to real-life needs. A mixed research method was used in the research design. A quantitative study was also conducted using a questionnaire survey, and the data were analyzed by SPSS 22.0 Chinese version. The qualitative data included students’ learning files (learning reflection notes, course reports, and experience records).

Keywords: adult learning, community empowerment, social capital, mixed research

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6155 Long-Term Mechanical and Structural Properties of Metakaolin-Based Geopolymers

Authors: Lenka Matulova

Abstract:

Geopolymers are alumosilicate materials that have long been studied. Despite this fact, little is known about the long-term stability of geopolymer mechanical and structural properties, so crucial for their successful industrial application. To improve understanding, we investigated the effect of four different types of environments on the mechanical and structural properties of a metakaolin-based geopolymer (MK GP). The MK GP samples were stored in laboratory conditions (control samples), in water at 20 °C, in water at 80 °C, and outside exposed to the weather. Compressive and tensile strengths were measured after 28, 56, 90, and 360 days. In parallel, structural properties were analyzed using XRD, SEM, and mercury intrusion porosimetry. Whereas the mechanical properties of the samples in laboratory conditions and in 20 °C water were stable, the mechanical properties of the outdoor samples and the samples 80 °C water decreased noticeably after 360 days. Structural analyses were focused on changes in sample microstructure (developing microcrack network, porosity) and identifying zeolites, the presence of which would indicate detrimental processes in the structure that can change it from amorphous to crystalline. No zeolites were found during the 360-day period in MK GP samples, but the reduction in mechanical properties coincided with a developing network of microcracks and changes in pore size distribution.

Keywords: geopolymer, long-term properties, mechanical properties, metakaolin, structural properties

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6154 Long-Term Structural Behavior of Resilient Materials for Reduction of Floor Impact Sound

Authors: Jung-Yoon Lee, Jongmun Kim, Hyo-Jun Chang, Jung-Min Kim

Abstract:

People’s tendency towards living in apartment houses is increasing in a densely populated country. However, some residents living in apartment houses are bothered by noise coming from the houses above. In order to reduce noise pollution, the communities are increasingly imposing a bylaw, including the limitation of floor impact sound, minimum thickness of floors, and floor soundproofing solutions. This research effort focused on the specific long-time deflection of resilient materials in the floor sound insulation systems of apartment houses. The experimental program consisted of testing nine floor sound insulation specimens subjected to sustained load for 45 days. Two main parameters were considered in the experimental investigation: three types of resilient materials and magnitudes of loads. The test results indicated that the structural behavior of the floor sound insulation systems under long-time load was quite different from that the systems under short-time load. The loading period increased the deflection of floor sound insulation systems and the increasing rate of the long-time deflection of the systems with ethylene vinyl acetate was smaller than that of the systems with low density ethylene polystyrene.

Keywords: resilient materials, floor sound insulation systems, long-time deflection, sustained load, noise pollution

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6153 MiR-103 Inhibits Osteoblast Proliferation Mainly through Suppressing Cav 1.2 Expression in Simulated Microgravity

Authors: Zhongyang Sun, Shu Zhang, Manjiang Xie

Abstract:

Emerging evidence indicates that microRNAs (miRNAs) play important roles in modulating osteoblast function and bone formation. However, the influence of miRNA on osteoblast proliferation and the possible mechanisms underlying remain to be defined. In this study, we aimed to investigate whether miR-103 regulates osteoblast proliferation under simulated microgravity condition through regulating Cav1.2, the primary subunit of L-type voltage sensitive calcium channels (LTCCs). We first investigated the effect of simulated microgravity on osteoblast proliferation and the outcomes clearly demonstrated that the mechanical unloading inhibits MC3T3-E1 osteoblast-like cells proliferation. Using quantitative Real-Time PCR (qRT-PCR), we provided data showing that miR-103 was up-regulated in response to simulated microgravity. In addition, we observed that up-regulation of miR-103 inhibited and down-regulation of miR-103 promoted osteoblast proliferation under simulated microgravity condition. Furthermore, knocking-down or over-expressing miR-103, respectively, up- or down-regulated the level of Cav1.2 expression and LTCCs currents, suggesting that miR-103 acts as an endogenous attenuator of Cav1.2 in osteoblasts under the condition of simulated microgravity. More importantly, we showed that the effect of miR-103 on osteoblast proliferation was diminished in simulated microgravity, when co-transfecting miR-103 mimic or inhibitor with Cav1.2 siRNA. Taken together, our data suggest that miR-103 inhibits osteoblast proliferation mainly through suppression of Cav1.2 expression under simulated microgravity condition. This work may provide a novel mechanism of microgravity-induced detrimental effects on osteoblast, identifying miR-103 as a novel possible therapeutic target in bone remodeling disorders in this mechanical unloading.

Keywords: microRNA, osteoblasts, cell proliferation, Cav1.2, simulated microgravity

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6152 Production, Characterization and In vitro Evaluation of [223Ra]RaCl2 Nanomicelles for Targeted Alpha Therapy of Osteosarcoma

Authors: Yang Yang, Luciana Magalhães Rebelo Alencar, Martha Sahylí Ortega Pijeira, Beatriz da Silva Batista, Alefe Roger Silva França, Erick Rafael Dias Rates, Ruana Cardoso Lima, Sara Gemini-Piperni, Ralph Santos-Oliveira

Abstract:

Radium-²²³ dichloride ([²²³Rₐ]RₐCl₂) is an alpha particle-emitting radiopharmaceutical currently approved for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease. [²²³Rₐ]RₐCl₂ is bone-seeking calcium mimetic that bonds into the newly formed bone stroma, especially osteoblastic or sclerotic metastases, killing the tumor cells by inducing DNA breaks in a potent and localized manner. Nonetheless, the successful therapy of osteosarcoma as primary bone tumors is still a challenge. Nanomicelles are colloidal nanosystems widely used in drug development to improve blood circulation time, bioavailability, and specificity of therapeutic agents, among other applications. In addition, the enhanced permeability and retention effect of the nanosystems, and the renal excretion of the nanomicelles reported in most cases so far, are very attractive to achieve selective and increased accumulation in tumor site as well as to increase the safety of [²²³Rₐ]RₐCl₂ in the clinical routine. In the present work, [²²³Rₐ]RₐCl₂ nanomicelles were produced, characterized, in vitro evaluated, and compared with pure [²²³Rₐ]RₐCl2 solution using SAOS2 osteosarcoma cells. The [²²³Rₐ]RₐCl₂ nanomicelles were prepared using the amphiphilic copolymer Pluronic F127. The dynamic light scattering analysis of freshly produced [²²³Rₐ]RₐCl₂ nanomicelles demonstrated a mean size of 129.4 nm with a polydispersity index (PDI) of 0.303. After one week stored in the refrigerator, the mean size of the [²²³Rₐ]RₐCl₂ nanomicelles increased to 169.4 with a PDI of 0.381. Atomic force microscopy analysis of [223Rₐ]RₐCl₂ nanomicelles exhibited spherical structures whose heights reach 1 µm, suggesting the filling of 127-Pluronic nanomicelles with [²²³Rₐ]RₐCl₂. The viability assay with [²²³Rₐ]RₐCl₂ nanomicelles displayed a dose-dependent response as it was observed using pure [²²³Rₐ]RₐCl2. However, at the same dose, [²²³Rₐ]RₐCl₂ nanomicelles were 20% higher efficient in killing SAOS2 cells when compared with pure [²²³Rₐ]RₐCl₂. These findings demonstrated the effectiveness of the nanosystem validating the application of nanotechnology in targeted alpha therapy with [²²³Ra]RₐCl₂. In addition, the [²²³Rₐ]RaCl₂nanomicelles may be decorated and incorporated with a great variety of agents and compounds (e.g., monoclonal antibodies, aptamers, peptides) to overcome the limited use of [²²³Ra]RₐCl₂.

Keywords: nanomicelles, osteosarcoma, radium dichloride, targeted alpha therapy

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6151 An Experimental Study on the Positive Streamer Leader Propagation under Slow Front Impulse Voltages in a 10m Rod-Plane Air Gap

Authors: Wahab Ali Shah, Junjia He

Abstract:

In this work, we performed a large-scale investigation into leader development in a 10 m rod-plane gap under a long front positive impulse. To describe the leader propagation under slow front impulse voltages, we recorded the leader propagation with a high-speed charge coupled device (CCD) camera. It is important to figure out this phenomenon to deepen our understanding of leader discharge. The observation results showed that the leader mechanism is a very complex physical phenomenon; it could be categorized into two types of leader process, namely, continuous and the discontinuous leader streamer-leader propagation. Furthermore, we studied the continuous leader development parameters, including two-dimensional (2-D) leader length, injected charge, and final jump stage, as well as leader velocity for rod–plane configuration. We observed that the discontinuous leader makes an important contribution to the appearance of channel re-illuminations of the positive leader. The comparative study shows better results in terms of standard switch impulse and long front positive impulse. Finally, the results are presented with a view toward improving our understanding of propagation mechanisms related to restrike phenomena, which are rarely reported. To clarify the above doubts under long front cases, we carried out extensive experiments in this study.

Keywords: continuous and discontinuous leader, high-speed photographs, long air gap, positive long front impulse, restrike phenomena

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6150 An Analysis of the Impact of Government Budget Deficits on Economic Performance. A Zimbabwean Perspective

Authors: Tafadzwa Shumba, Rose C. Nyatondo, Regret Sunge

Abstract:

This research analyses the impact of budget deficits on the economic performance of Zimbabwe. The study employs the autoregressive distributed lag (ARDL) confines testing method to co-integration and long-run estimation using time series data from 1980-2018. The Augmented Dick Fuller (ADF) and the Granger approach were used to testing for stationarity and causality among the factors. Co-integration test results affirm a long term association between GDP development rate and descriptive factors. Causality test results show a unidirectional connection between budget shortfall to GDP development and bi-directional causality amid debt and budget deficit. This study also found unidirectional causality from debt to GDP growth rate. ARDL estimates indicate a significantly positive long term and significantly negative short term impact of budget shortfall on GDP. This suggests that budget deficits have a short-run growth retarding effect and a long-run growth-inducing effect. The long-run results follow the Keynesian theory that posits that fiscal deficits result in an increase in GDP growth. Short-run outcomes follow the neoclassical theory. In light of these findings, the government is recommended to minimize financing of recurrent expenditure using a budget deficit. To achieve sustainable growth and development, the government needs to spend an absorbable budget deficit focusing on capital projects such as the development of human capital and infrastructure.

Keywords: ARDL, budget deficit, economic performance, long run

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6149 3D Printing of Polycaprolactone Scaffold with Multiscale Porosity Via Incorporation of Sacrificial Sucrose Particles

Authors: Mikaela Kutrolli, Noah S. Pereira, Vanessa Scanlon, Mohamadmahdi Samandari, Ali Tamayol

Abstract:

Bone tissue engineering has drawn significant attention and various biomaterials have been tested. Polymers such as polycaprolactone (PCL) offer excellent biocompatibility, reasonable mechanical properties, and biodegradability. However, PCL scaffolds suffer a critical drawback: a lack of micro/mesoporosity, affecting cell attachment, tissue integration, and mineralization. It also results in a slow degradation rate. While 3D-printing has addressed the issue of macroporosity through CAD-guided fabrication, PCL scaffolds still exhibit poor smaller-scale porosity. To overcome this, we generated composites of PCL, hydroxyapatite (HA), and powdered sucrose (PS). The latter serves as a sacrificial material to generate porous particles after sucrose dissolution. Additionally, we have incorporated dexamethasone (DEX) to boost the PCL osteogenic properties. The resulting scaffolds maintain controlled macroporosity from the lattice print structure but also develop micro/mesoporosity within PCL fibers when exposed to aqueous environments. The study involved mixing PS into solvent-dissolved PCL in different weight ratios of PS to PCL (70:30, 50:50, and 30:70 wt%). The resulting composite was used for 3D printing of scaffolds at room temperature. Printability was optimized by adjusting pressure, speed, and layer height through filament collapse and fusion test. Enzymatic degradation, porogen leaching, and DEX release profiles were characterized. Physical properties were assessed using wettability, SEM, and micro-CT to quantify the porosity (percentage, pore size, and interconnectivity). Raman spectroscopy was used to verify the absence of sugar after leaching. Mechanical characteristics were evaluated via compression testing before and after porogen leaching. Bone marrow stromal cells (BMSCs) behavior in the printed scaffolds was studied by assessing viability, metabolic activity, osteo-differentiation, and mineralization. The scaffolds with a 70% sugar concentration exhibited superior printability and reached the highest porosity of 80%, but performed poorly during mechanical testing. A 50% PS concentration demonstrated a 70% porosity, with an average pore size of 25 µm, favoring cell attachment. No trace of sucrose was found in Raman after leaching the sugar for 8 hours. Water contact angle results show improved hydrophilicity as the sugar concentration increased, making the scaffolds more conductive to cell adhesion. The behavior of bone marrow stromal cells (BMSCs) showed positive viability and proliferation results with an increasing trend of mineralization and osteo-differentiation as the sucrose concentration increased. The addition of HA and DEX also promoted mineralization and osteo-differentiation in the cultures. The integration of PS as porogen at a concentration of 50%wt within PCL scaffolds presents a promising approach to address the poor cell attachment and tissue integration issues of PCL in bone tissue engineering. The method allows for the fabrication of scaffolds with tunable porosity and mechanical properties, suitable for various applications. The addition of HA and DEX further enhanced the scaffolds. Future studies will apply the scaffolds in an in-vivo model to thoroughly investigate their performance.

Keywords: bone, PCL, 3D printing, tissue engineering

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6148 Dividend Initiations and IPO Long-Run Performance

Authors: Nithi Sermsiriviboon, Somchai Supattarakul

Abstract:

Dividend initiations are an economically significant event that has important implications for a firm’s future financial capacity. Given that the market’s expectation of a consistent payout, managers of IPO firms must approach the initial dividend decision cautiously. We compare the long run performance of IPO firms that initiated dividends with those of similarly matched non-payers. We found that firms which initiated dividends perform significantly better up to three years after the initiation date. Moreover, we measure investor reactions by 2-day around dividend announcement date cumulative abnormal return. We evidence no statistically significant differences between cumulative abnormal returns (CAR) of IPO firms and cumulative abnormal returns of Non-IPO firms, indicating that investors do not respond to dividend announcement of IPO firms more than they do to the dividend announcement of Non-IPO firms.

Keywords: dividend, initial public offerings, long-run performance, finance

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6147 Accounting and Prudential Standards of Banks and Insurance Companies in EU: What Stakes for Long Term Investment?

Authors: Sandra Rigot, Samira Demaria, Frederic Lemaire

Abstract:

The starting point of this research is the contemporary capitalist paradox: there is a real scarcity of long term investment despite the boom of potential long term investors. This gap represents a major challenge: there are important needs for long term financing in developed and emerging countries in strategic sectors such as energy, transport infrastructure, information and communication networks. Moreover, the recent financial and sovereign debt crises, which have respectively reduced the ability of financial banking intermediaries and governments to provide long term financing, questions the identity of the actors able to provide long term financing, their methods of financing and the most appropriate forms of intermediation. The issue of long term financing is deemed to be very important by the EU Commission, as it issued a 2013 Green Paper (GP) on long-term financing of the EU economy. Among other topics, the paper discusses the impact of the recent regulatory reforms on long-term investment, both in terms of accounting (in particular fair value) and prudential standards for banks. For banks, prudential and accounting standards are also crucial. Fair value is indeed well adapted to the trading book in a short term view, but this method hardly suits for a medium and long term portfolio. Banks’ ability to finance the economy and long term projects depends on their ability to distribute credit and the way credit is valued (fair value or amortised cost) leads to different banking strategies. Furthermore, in the banking industry, accounting standards are directly connected to the prudential standards, as the regulatory requirements of Basel III use accounting figures with prudential filter to define the needs for capital and to compute regulatory ratios. The objective of these regulatory requirements is to prevent insolvency and financial instability. In the same time, they can represent regulatory constraints to long term investing. The balance between financial stability and the need to stimulate long term financing is a key question raised by the EU GP. Does fair value accounting contributes to short-termism in the investment behaviour? Should prudential rules be “appropriately calibrated” and “progressively implemented” not to prevent banks from providing long-term financing? These issues raised by the EU GP lead us to question to what extent the main regulatory requirements incite or constrain banks to finance long term projects. To that purpose, we study the 292 responses received by the EU Commission during the public consultation. We analyze these contributions focusing on particular questions related to fair value accounting and prudential norms. We conduct a two stage content analysis of the responses. First, we proceed to a qualitative coding to identify arguments of respondents and subsequently we run a quantitative coding in order to conduct statistical analyses. This paper provides a better understanding of the position that a large panel of European stakeholders have on these issues. Moreover, it adds to the debate on fair value accounting and its effects on prudential requirements for banks. This analysis allows us to identify some short term bias in banking regulation.

Keywords: basel 3, fair value, securitization, long term investment, banks, insurers

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6146 Business Buyers’ Expectations in Buyer-Seller Encounters

Authors: Pia I. Hautamäki

Abstract:

Sales has changed. Selling has taken on aspects of relationship marketing and sales force play a critical role in developing long-term relationships between buyers and sellers which is seen to serve the company’s targets and create success for a long run. The purpose of this study was to examine what really matters in buyer-seller encounters and determine what expectations business buyers have. We studied 17 business buyers by a qualitative interview. We found that buyers appreciate encounters where the salesperson face the buyer as a way he or she is as a person, identificate the real needs to improve buyers’ business and build up cooperation for long-term relationship. This study show that personality matters are a key elements when satisfying business buyers’ expectations.

Keywords: business buyer-seller encounters, customer expectations, perceived similarity, personal selling, personality types

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6145 IPO Price Performance and Signaling

Authors: Chih-Hsiang Chang, I-Fan Ho

Abstract:

This study examines the credibility of the signaling as explanation for IPO initial underpricing. Findings reveal the initial underpricing and the long-term underperformance of IPOs in Taiwan. However, we only find weak support for signaling as explanation of IPO underpricing.

Keywords: signaling, IPO initial underpricing, IPO long-term underperformance, Taiwan’s stock market

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6144 A Generative Pretrained Transformer-Based Question-Answer Chatbot and Phantom-Less Quantitative Computed Tomography Bone Mineral Density Measurement System for Osteoporosis

Authors: Mian Huang, Chi Ma, Junyu Lin, William Lu

Abstract:

Introduction: Bone health attracts more attention recently and an intelligent question and answer (QA) chatbot for osteoporosis is helpful for science popularization. With Generative Pretrained Transformer (GPT) technology developing, we build an osteoporosis corpus dataset and then fine-tune LLaMA, a famous open-source GPT foundation large language model(LLM), on our self-constructed osteoporosis corpus. Evaluated by clinical orthopedic experts, our fine-tuned model outperforms vanilla LLaMA on osteoporosis QA task in Chinese. Three-dimensional quantitative computed tomography (QCT) measured bone mineral density (BMD) is considered as more accurate than DXA for BMD measurement in recent years. We develop an automatic Phantom-less QCT(PL-QCT) that is more efficient for BMD measurement since no need of an external phantom for calibration. Combined with LLM on osteoporosis, our PL-QCT provides efficient and accurate BMD measurement for our chatbot users. Material and Methods: We build an osteoporosis corpus containing about 30,000 Chinese literatures whose titles are related to osteoporosis. The whole process is done automatically, including crawling literatures in .pdf format, localizing text/figure/table region by layout segmentation algorithm and recognizing text by OCR algorithm. We train our model by continuous pre-training with Low-rank Adaptation (LoRA, rank=10) technology to adapt LLaMA-7B model to osteoporosis domain, whose basic principle is to mask the next word in the text and make the model predict that word. The loss function is defined as cross-entropy between the predicted and ground-truth word. Experiment is implemented on single NVIDIA A800 GPU for 15 days. Our automatic PL-QCT BMD measurement adopt AI-associated region-of-interest (ROI) generation algorithm for localizing vertebrae-parallel cylinder in cancellous bone. Due to no phantom for BMD calibration, we calculate ROI BMD by CT-BMD of personal muscle and fat. Results & Discussion: Clinical orthopaedic experts are invited to design 5 osteoporosis questions in Chinese, evaluating performance of vanilla LLaMA and our fine-tuned model. Our model outperforms LLaMA on over 80% of these questions, understanding ‘Expert Consensus on Osteoporosis’, ‘QCT for osteoporosis diagnosis’ and ‘Effect of age on osteoporosis’. Detailed results are shown in appendix. Future work may be done by training a larger LLM on the whole orthopaedics with more high-quality domain data, or a multi-modal GPT combining and understanding X-ray and medical text for orthopaedic computer-aided-diagnosis. However, GPT model gives unexpected outputs sometimes, such as repetitive text or seemingly normal but wrong answer (called ‘hallucination’). Even though GPT give correct answers, it cannot be considered as valid clinical diagnoses instead of clinical doctors. The PL-QCT BMD system provided by Bone’s QCT(Bone’s Technology(Shenzhen) Limited) achieves 0.1448mg/cm2(spine) and 0.0002 mg/cm2(hip) mean absolute error(MAE) and linear correlation coefficient R2=0.9970(spine) and R2=0.9991(hip)(compared to QCT-Pro(Mindways)) on 155 patients in three-center clinical trial in Guangzhou, China. Conclusion: This study builds a Chinese osteoporosis corpus and develops a fine-tuned and domain-adapted LLM as well as a PL-QCT BMD measurement system. Our fine-tuned GPT model shows better capability than LLaMA model on most testing questions on osteoporosis. Combined with our PL-QCT BMD system, we are looking forward to providing science popularization and early morning screening for potential osteoporotic patients.

Keywords: GPT, phantom-less QCT, large language model, osteoporosis

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6143 An Unusual Case of Wrist Pain: Idiopathic Avascular Necrosis of the Scaphoid, Preiser’s Disease

Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

Abstract:

We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

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6142 Screening of Osteoporosis in Aging Populations

Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

Abstract:

Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

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6141 Chronic Renal Failure Associated with Heavy Metal Contamination of Drinking Water in Hail, Kingdom of Saudi Arabia

Authors: Elsayed A. M. Shokr, A. Alhazemi, T. Naser, Talal A. Zuhair, Adel A. Zuhair, Ahmed N. Alshamary, Thamer A. Alanazi, Hosam A. Alanazi

Abstract:

The main threats to human health from heavy metals are associated with exposure to Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. is mainly via intake of drinking water being the most important source in most populations. These metals have been extensively studied and their effects on human health regularly reviewed by international bodies such as the WHO. Heavy metals have been used by humans for thousands of years. Although several adverse health effects of heavy metals have been known for a long time, exposure to heavy metals continues, and is even increasing in some parts of the world, in particular in less developed countries, though emissions have declined in most developed countries over the last 100 years. A strong relationship between contaminated drinking water with heavy metals from some of the stations of water shopping in Hail, KSA and chronic diseases such as renal failure, liver cirrhosis, and chronic anemia has been identified in this study. These diseases are apparently related to contaminant drinking water with heavy metals such as Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. Renal failure is related to contaminate drinking water with lead and cadmium, liver cirrhosis to copper and molybdenum, and chronic anemia to copper and cadmium. Recent data indicate that adverse health effects of cadmium exposure may occur at lower exposure levels than previously anticipated, primarily in the form of kidney damage but possibly also bone effects and fractures. The general population is primarily exposed to mercury via drinking water being a major source of methyl mercury exposure, and dental amalgam. During the last century lead, cadmium, zinc, iron and arsenic is mainly via intake of drinking water being the most important source in most populations. Long-term exposure to lead, cadmium, zinc, iron and arsenic in drinking-water is mainly related to primarily in the form of kidney damage. Studies of these diseases suggest that abnormal incidence in specific areas is related to toxic materials in the groundwater and thereby led to the contamination of drinking water in these areas.

Keywords: heavy metals, liver functions, kidney functions and chronic renal failure, hail, renal, water

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6140 Reliability of Dry Tissues Sampled from Exhumed Bodies in DNA Analysis

Authors: V. Agostini, S. Gino, S. Inturri, A. Piccinini

Abstract:

In cases of corpse identification or parental testing performed on exhumed alleged dead father, usually, we seek and acquire organic samples as bones and/or bone fragments, teeth, nails and muscle’s fragments. The DNA analysis of these cadaveric matrices usually leads to identifying success, but it often happens that the results of the typing are not satisfactory with highly degraded, partial or even non-interpretable genetic profiles. To aggravate the interpretative panorama deriving from the analysis of such 'classical' organic matrices, we must add a long and laborious treatment of the sample that starts from the mechanical fragmentation up to the protracted decalcification phase. These steps greatly increase the chance of sample contamination. In the present work, instead, we want to report the use of 'unusual' cadaveric matrices, demonstrating that their forensic genetics analysis can lead to better results in less time and with lower costs of reagents. We report six case reports, result of on-field experience, in which eyeswabs and cartilage were sampled and analyzed, allowing to obtain clear single genetic profiles, useful for identification purposes. In all cases we used the standard DNA tissue extraction protocols (as reported on the user manuals of the manufacturers such as QIAGEN or Invitrogen- Thermo Fisher Scientific), thus bypassing the long and difficult phases of mechanical fragmentation and decalcification of bones' samples. PCR was carried out using PowerPlex® Fusion System kit (Promega), and capillary electrophoresis was carried out on an ABI PRISM® 310 Genetic Analyzer (Applied Biosystems®), with GeneMapper ID v3.2.1 (Applied Biosystems®) software. The software Familias (version 3.1.3) was employed for kinship analysis. The genetic results achieved have proved to be much better than the analysis of bones or nails, both from the qualitative and quantitative point of view and from the point of view of costs and timing. This way, by using the standard procedure of DNA extraction from tissue, it is possible to obtain, in a shorter time and with maximum efficiency, an excellent genetic profile, which proves to be useful and can be easily decoded for later paternity tests and/or identification of human remains.

Keywords: DNA, eye swabs and cartilage, identification human remains, paternity testing

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6139 Long Term Variability of Temperature in Armenia in the Context of Climate Change

Authors: Hrachuhi Galstyan, Lucian Sfîcă, Pavel Ichim

Abstract:

The purpose of this study is to analyze the temporal and spatial variability of thermal conditions in the Republic of Armenia. The paper describes annual fluctuations in air temperature. Research has been focused on case study region of Armenia and surrounding areas, where long–term measurements and observations of weather conditions have been performed within the National Meteorological Service of Armenia and its surrounding areas. The study contains yearly air temperature data recorded between 1961-2012. Mann-Kendal test and the autocorrelation function were applied to detect the change trend of annual mean temperature, as well as other parametric and non-parametric tests searching to find the presence of some breaks in the long term evolution of temperature. The analysis of all records reveals a tendency mostly towards warmer years, with increased temperatures especially in valleys and inner basins. The maximum temperature increase is up to 1,5 °C. Negative results have not been observed in Armenia. The patterns of temperature change have been observed since the 1990’s over much of the Armenian territory. The climate in Armenia was influenced by global change in the last 2 decades, as results from the methods employed within the study.

Keywords: air temperature, long-term variability, trend, climate change

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6138 A Cross-Sectional Study on the Nutritional Status of School Going Children From Urban and Rural Populations of Pakistan

Authors: Aftab Ahmed, Farhan Saeed, Muhammad Afzaal, Shinawar Waseem Ali, Ali Imran, Sadaf Munir

Abstract:

Malnutrition is a globally increasing public health concern among children; it affects number of school children influencing their growth, development and academic performance. The tenet of the current cross sectional study was to assess the nutritional biomarkers of school going children of age 12-15 years resulting in stunting, underweight, overweight, bone deformities and other health disparities in nutritionally deprived urban and rural populations of Pakistan. A sample size comprising of 180 school going children was stipulated from the targeted urban and rural populations. The fallouts of investigation unveiled that both rural and urban populations were experiencing nutritional challenges however; on account of awareness paucity the rustic population was nutritionally more compromised. Hematological tests elucidated 16.7% and 7.8% cases for high glucose level, 35.6% and 27.8% cases for low hemoglobin levels, 14.4% and 15.6% cases for low calcium indices, 12.2% and 4.4% high white blood cell count (WBC), 20% and 14.4% low red blood cell count, 76.7% and 74.4% low hematocrit (HCT) values, among the rural and urban populations respectively. The above mentioned outcomes can serve as a way forward for policy and law maker institutions to curb the possible barricades in the way of healthy nutritional status in these areas

Keywords: malnutrition, hematological study, child nutrition, bone mineral density, calcium, RBC

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6137 Long Run Estimates of Population, Consumption and Economic Development of India: An ARDL Bounds Testing Approach of Cointegration

Authors: Sanjay Kumar, Arumugam Sankaran, Arjun K., Mousumi Das

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The amount of domestic consumption and population growth is having a positive impact on economic growth and development as observed by the Harrod-Domar and endogenous growth models. The paper negates the Solow growth model which argues the population growth has a detrimental impact on per capita and steady-state growth. Unlike the Solow model, the paper observes, the per capita income growth never falls zero, and it sustains as positive. Hence, our goal here is to investigate the relationship among population, domestic consumption and economic growth of India. For this estimation, annual data from 1980-2016 has been collected from World Development Indicator and Reserve Bank of India. To know the long run as well as short-run dynamics among the variables, we have employed the ARDL bounds testing approach of cointegration followed by modified Wald causality test to know the direction of causality. The conclusion from cointegration and ARDL estimates reveal that there is a long run positive and statistically significant relationship among the variables under study. At the same time, the causality test shows that there is a causal relationship that exists among the variables. Hence, this calls for policies which have a long run perspective in strengthening the capabilities and entitlements of people and stabilizing domestic demand so as to serve long run and short run growth and stability of the economy.

Keywords: cointegration, consumption, economic development, population growth

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6136 Long-Term Otitis Media with Effusion and Related Hearing Loss and Its Impact on Developmental Outcomes

Authors: Aleema Rahman

Abstract:

Introduction: This study aims to estimate the prevalence of long-term otitis media with effusion (OME) and hearing loss in a prospective longitudinal cohort studyand to study the relationship between the condition and educational and psychosocial outcomes. Methods: Analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) will be undertaken. ALSPAC is a longitudinal birth cohort study carried out in the UK, which has collected detailed measures of hearing on ~7000 children from the age of seven. A descriptive analysis of the data will be undertaken to estimate the prevalence of OME and hearing loss (defined as having average hearing levels > 20dB and type B tympanogram) at 7, 9, 11, and 15 years as well as that of long-term OME and hearing loss. Logistic and linear regression analyses will be conducted to examine associations between long-term OME and hearing loss and educational outcomes (grades obtained from standardised national attainment tests) and psychosocial outcomes such as anxiety, social fears, and depression at ages 10-11 and 15-16 years. Results: Results will be presented in terms of the prevalence of OME and hearing loss in the population at each age. The prevalence of long-term OME and hearing loss, defined as having OME and hearing loss at two or more time points, will also be reported. Furthermore, any associations between long-term OME and hearing loss and the educational and psychosocial outcomes will be presented. Analyses will take into account demographic factors such as sex and social deprivation and relevant confounders, including socioeconomic status, ethnicity, and IQ. Discussion: Findings from this study will provide new epidemiological information on the prevalence of long-term OME and hearing loss. The research will provide new knowledge on the impact of OME for the small group of children who do not grow out of condition by age 7 but continue to have hearing loss and need clinical care through later childhood. The study could have clinical implications and may influence service delivery for this group of children.

Keywords: educational attainment, hearing loss, otitis media with effusion, psychosocial development

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6135 Manufacturing and Characterization of Bioresorbable Self-Reinforced PLA Composites for Bone Applications

Authors: Carolina Pereira Lobato Costa, Cristina Pascual-González, Monica Echeverry, Javier LLorca, Carlos Gonzáléz, Juan Pedro Fernández-Bláquez

Abstract:

Although the potential of PLA self-reinforced composites for bone applications, not much literature addresses optimal manufacturing conditions. In this regard, this paper describes the woven self-reinforced PLA composites manufacturing processes: the commingling of yarns, weaving, and hot pressing and characterizes the manufactured laminates. Different structures and properties can be achieved by varying the hot compaction process parameters (pressure, holding time, and temperature). The specimens manufactured were characterized in terms of thermal properties (DSC), microstructure (C-scan optical microscope and SEM), strength (tensile test), and biocompatibility (MTT assays). Considering the final device, 155 ℃ for 10 min at 2 MPa act as the more appropriate hot pressing parameters. The laminate produced with these conditions has few voids/porosity, a tensile strength of 30.39 ± 1.21 MPa, and a modulus of 4.09 ± 0.24 GPa. Subsequently to the tensile testing was possible to observe fiber pullout from the fracture surfaces, confirming that this material behaves as a composite. From the results, no single laminate can fulfill all the requirements, being necessary to compromise in function of the priority property. Further investigation is required to improve materials' mechanical performance. Subsequently, process parameters and materials configuration can be adjusted depending on the place and type of implant to suit its function.

Keywords: woven fabric, self-reinforced polymer composite, poly(lactic acid), biodegradable

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6134 An Analysis of the Impact of Immunosuppression upon the Prevalence and Risk of Cancer

Authors: Aruha Khan, Brynn E. Kankel, Paraskevi Papadopoulou

Abstract:

In recent years, extensive research upon ‘stress’ has provided insight into its two distinct guises, namely the short–term (fight–or–flight) response versus the long–term (chronic) response. Specifically, the long–term or chronic response is associated with the suppression or dysregulation of immune function. It is also widely noted that the occurrence of cancer is greatly correlated to the suppression of the immune system. It is thus necessary to explore the impact of long–term or chronic stress upon the prevalence and risk of cancer. To what extent can the dysregulation of immune function caused by long–term exposure to stress be controlled or minimized? This study focuses explicitly upon immunosuppression due to its ability to increase disease susceptibility, including cancer itself. Based upon an analysis of the literature relating to the fundamental structure of the immune system alongside the prospective linkage of chronic stress and the development of cancer, immunosuppression may not necessarily correlate directly to the acquisition of cancer—although it remains a contributing factor. A cross-sectional analysis of the survey data from the University of Tennessee Medical Center (UTMC) and Harvard Medical School (HMS) will provide additional supporting evidence (or otherwise) for the hypothesis of the study about whether immunosuppression (caused by the chronic stress response) notably impacts the prevalence of cancer. Finally, a multidimensional framework related to education on chronic stress and its effects is proposed.

Keywords: immune system, immunosuppression, long–term (chronic) stress, risk of cancer

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6133 Inventory Control for Purchased Part under Long Lead Time and Uncertain Demand: MRP vs Demand-Driven MRP Approach

Authors: M. J. Shofa, A. Hidayatno, O. M. Armand

Abstract:

MRP as a production control system is appropriate for the deterministic environment. Unfortunately, most production systems such as customer demands are stochastic. Demand-Driven MRP (DDMRP) is a new approach for inventory control system, and it deals with demand uncertainty. The objective of this paper is to compare the MRP and DDMRP work for a long lead time and uncertain demand in terms of on-hand inventory levels. The evaluation is conducted through a discrete event simulation using purchased part data from an automotive company. The result is MRP gives 50,759 pcs / day while DDMRP gives 34,835 pcs / day (reduce 32%), it means DDMRP is more effective inventory control than MRP in terms of on-hand inventory levels.

Keywords: Demand-Driven MRP, long lead time, MRP, uncertain demand

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6132 Characteristics of the Long-Term Regional Tourism Development in Georgia

Authors: Valeri Arghutashvili, Mari Gogochuri

Abstract:

Tourism industry development is one of the key priorities in Georgia, as it has positive influence on economic activities. Its contribution is very important for the different regions, as well as for the national economy. Benefits of the tourism industry include new jobs, service development, and increasing tax revenues, etc. The main aim of this research is to review and analyze the potential of the Georgian tourism industry with its long-term strategy and current challenges. To plan activities in a long-term development, it is required to evaluate several factors on the regional and on the national level. Factors include activities, transportation, services, lodging facilities, infrastructure and institutions. The major research contributions are practical estimates about regional tourism development which plays an important role in the integration process with global markets.

Keywords: regional tourism, tourism industry, tourism in Georgia, tourism benefits

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6131 Serum Granulocyte Colony Stimulating Factor is a Potent Stimulator of Hematopoeitic Progenitor Cells Mobilization in Trauma Hemorrhagic Shock

Authors: Manoj Kumar, Sujata Mohanty, D. N. Rao, Arul Selvi, Sanjeev K. Bhoi

Abstract:

Background: Hematopoietic progenitor cells (HPC) mobilized from bone marrow to peripheral blood has been observed in severe trauma and hemorrhagic shock patients. Granulocyte-colony stimulating factor (G-CSF) is a potent stimulator that mobilized HPC from bone marrow to peripheral blood. Objective: Our aim of the study was to investigate the serum G-CSF levels and correlate with HPC and outcome. Methods: Peripheral blood sample from 50 hemorrhagic shock patients was collected on arrival for determination of G-CSF and peripheral blood HPC (PBHPC) and compared with healthy control (n=15). Determination of serum levels of G-CSF by sandwich ELISA and PBHPC by Sysmex XE-2100. Data were categorized by age, sex, Injury Severity Score (ISS), and laboratory data was prospectively collected. Data are expressed as mean±SD and median (min, max). Results: Significantly increased the serum level of G-CSF (264.8 vs. 79.1 pg/ml) and peripheral blood HPC (0.1 vs. 0.01 %) in the T/HS patients when compared with control group. Conclusions: Our studies suggest serum G-CSF elevated in T/HS patients. The elevated in G-CSF was also associated with mobilization of HPC from BM to peripheral blood HPC. Increased the levels of G-CSF in T/HS may play a significant role in the alteration of the hematopoietic compartment.

Keywords: granulocyte colony stimulating factor, G-CSF, hematopoietic progenitor cells, HPC, trauma hemorrhagic shock, T/HS, outcome

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6130 Histopathological and Biochemical Evaluation of Hydroxyurea-Induced Hepato-Pulmonary Toxicity and Lymphoid Necrosis in Rats

Authors: Samah Oda, Asmaa Khafaga, Mohammed Hashim, Asmaa Khamis

Abstract:

Toxicity of hydroxyurea (HU), a treatment for certain tumors, polycythemia, and thrombocytosis, was evaluated in rats in one-month toxicity study. Sixty male albino rats were equally classified into four groups. Rats received daily oral gavage of HU in 0, 250, 500, and 750 mg/kg b.wt. Chemical and histopathological assessment of liver, lung, spleen, and bone marrow was performed at 10, 20, and 30 days of the experiment. No significant change was reported in alanine aminotransferase (ALT), aspartate aminotransferase (AST), globulin, and albumin/ globulin ratio during the experiment. Significant decreases in alkaline phosphatase (ALP) and total albumin were reported in rats received 500 and 750 mg/kg b.wt of HU. In addition, total cholesterol level increased significantly after 10 days; however, it significantly decreased after 20 and 30 days of the experiment. Moreover, hepatocytic vacuolation and necrosis with portal inflammatory infiltrates were reported along experimental periods. Pulmonary congestion, hemorrhage, interstitial mononuclear infiltration, peribronchitis, and bronchial epithelial necrosis were also reported. Severe lymphocytic necrosis in spleen and severe loss of hematopoietic cells and replacement with corresponding adipose tissue in bone marrow tissues was demonstrated. In conclusion, HU could be able to induce severe dose and time-dependent hepato-pulmonary toxicity and lymphoid depression in rats.

Keywords: hydroxyurea, hepato-pulmonary toxicity, lymphoid depression, histopathology

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6129 Information Technology and Communications in Management of the Imperial Citadel of Thang Long-A World Heritage Site

Authors: Ngo the Bach

Abstract:

Information technology and communications are growing strongly and penetrated almost the entire Vietnamese economy and society. The article presents an overview of information technology and application communications in the management the Central Sector of the Imperial Citadel of Thang Long (Hanoi, Vietnam) - A World Heritage Site. The author also points out the opportunities and challenges of the information technology and communications in the sectors of culture and heritage; the use of information technology as an effective tool to develop mass and interactive communications. The article emphasizes on the advantage of information technology and communications in supporting effectively the management reform with respect to the Imperial Citadel of Thang Long in particular and the management of world heritage sites in Vietnam in general.

Keywords: information technology, communications, management, culture, heritage

Procedia PDF Downloads 300
6128 The Descending Genicular Artery Perforator Free Flap as a Reliable Flap: Literature Review

Authors: Doran C. Kalmin

Abstract:

The descending genicular artery (DGA) perforator free flap provides an alternative to free flap reconstruction based on a review of the literature detailing both anatomical and clinical studies. The descending genicular artery (DGA) supplies skin, muscle, tendon, and bone located around the medial aspect of the knee that has been used in several pioneering reports in reconstructing defects located in various areas throughout the body. After the success of the medial femoral condyle flap in early studies, a small number of studies have been published detailing the use of the DGA in free flap reconstruction. Despite early success in the use of the DGA flap, acceptance within the Plastic and Reconstructive Surgical community has been limited due primarily to anatomical variations of the pedicle. This literature review is aimed at detailing the progression of the DGA perforator free flap and its variations as an alternative and reliable free flap for reconstruction of composite defects with an exploration into both anatomical and clinical studies. A literature review was undertaken, and the progression of the DGA flap is explored from the early review by Acland et al. pioneering the saphenous free flap to exploring modern changes and studies of the anatomy of the DGA. An extensive review of the literature was undertaken that details the anatomy and its variations, approaches to harvesting the flap, the advantages, and disadvantages of the DGA perforator free flap as well as flap outcomes. There are 15 published clinical series of DGA perforator free flaps that incorporate cutaneous, osteoperiosteal, cartilage, osteocutaneous, osteoperiosteal and muscle, osteoperiosteal and subcutaneous and tendocutatenous. The commonest indication for using a DGA free flap was for non-union of bone, particularly that of the scaphoid whereby the medial femoral condyle could be used. In the case series, a success rate of over 90% was established, showing that these early studies have had good success with a wide range of tissue transfers. The greatest limitation is the anatomical variation of the DGA and therefore, the challenges associated with raising the flap. Despite the variation in anatomy and around 10-15% absence of the DGA, the saphenous artery can be used as well as the superior medial genicular artery if the vascular bone is required as part of the flap. Despite only a handful of anatomical and clinical studies describing the DGA perforator free flap, it ultimately provides a reliable flap that can include a variety of composite structure used for reconstruction in almost any area throughout the body. Although it has limitations, it provides a reliable option for free flap reconstruction that can routinely be performed as a single-stage procedure.

Keywords: anatomical study, clinical study, descending genicular artery, literature review, perforator free flap reconstruction

Procedia PDF Downloads 123