The cost and time effectiveness of osseointegration compared to the traditional socket prosthesis

Individuals with limb amputation fitted with conventional socket-suspended prostheses often experience socket related discomfort leading to a significant decrease in quality of life.[1-14] Most of these concerns can be overcome with osseointegration, a direct skeletal fixation method where the prosthetic componentry are directly attached to the fixation, resulting in the redundancy of the traditional socket system. There are two stages of osseointegration; Stage one, a titanium implant is inserted into the marrow space of residual limb bone and Stage two, a titanium extension is attached to the fixture. This surgical procedure is currently blooming worldwide, particularly within Queensland. Whilst providing improvements in quality of life, this new method also has potential to minimise the cost required for an amputee to ambulate during daily living. Thus, the aim of this project was to compare the differences in mean cost of services, cost of componentry and labour hours when using osseointegration compared to traditional socket-based prostheses. Data were extracted from Queensland Artificial Limb Services (QALS) database to determine cost of services, type of services and labour hours required to maintain a prosthetic limb. Five trans-femoral amputee male participants (age 46.4±10.1 yrs; height 175.4±16.3 cm; mass 83.8±14.0 kg; time since second stage 22.0± 8.1 mths) met inclusion criteria which was patient had to be more than 12 months post stage two osseointegration procedure. The socket and osseointegration prosthesis variables examined were the mean hours of labour, mean cost of services and mean cost of prosthetic componentry. Statistical analyses were conducted using an ANOVA. The results identified that there were only significant differences in the number of labour hours (p = 0.005) and cost of services (p = 0.021) when comparing the socket and osseointegration prosthetic type. These results identified that the cost of componentry were comparable between the two methods.

Effects of the Cessation of Sewage Sludge Dumping at the 12-Mile Site: Proceedings of the 12-Mile Dumpsite Symposium, Ocean Place Hilton Hotel, Long Branch, New Jersey, 18-19 June 1991

This study owes its inception to the wisdom and experience of the staff of the Northeast Fisheries Science Center who, after several decades of surveys in the New York Bight, recognized a unique opportunity to capitalize on the decision to stop ocean dumping of sewage sludge and designed an innovative field study to evaluate effects on living marine resources and their habitats. For decades ocean dumping was viewed as a cheap and effective means for disposal of wastes generated by urbanized coastal areas. Even after the 12-mile site was closed, sewage sludge continued to be dumped at Deepwater Dumpsite 106. The 6-mile site off the NewJersey coast is still used as a dumpsite for dredged material from New York Harbor areas. Discussions continue on the propriety of using the deep ocean spaces for disposal of a variety of material including low level radioactive wastes. Consequently, managers are still faced with critical decisions in this area. It is to be hoped that the results from the 12-mile study will provide the necessary information on which these managers can evaluate future risks associated with ocean waste disposal. (PDF file contains 270 pages.)

History of the Fisheries of Raritan Bay, New York and New Jersey

Raritan Bay is the body of water bounded by New York and New Jersey and lying immediately south of New York City (Fig. 1). It has close proximity to the most concentrated urban and industrial area in the United States. Its history has been one of extensive multiple use by the surrounding human population. Dating from the precolonial and colonial periods, people have employed many types of gear to catch and gather its once abundant fishes and shellfishes. Its beaches were once popular for sun bathing and swimming, but after the 1940's they were essentially abandoned because the water became too polluted. Another large use has been for pleasure boating and the transit and dockage of merchant, passenger, and military vessels. Channels and basins were dug in the bay, bulkheads and jetties were constructed along its shores, and it was a donor source of sand and gravel for construction projects. It has also been a receptor for large quantities of domestic and industrial wastes and, mainly for this reason, it is one ofthe most deteriorated estuaries in the United States.

Habitat and diet overlap of 4 piscivorous fishes: variation on the inner continental shelf off New Jersey

Piscivorous fishes, many of which are economically valuable, play an important role in marine ecosystems and have the potential to affect fish and invertebrate populations at lower trophic levels. Therefore, a quantitative understanding of the foraging ecology of piscivores is needed for ecosystem-based fishery management plans to be successful. Abundance and stomach contents of seasonally co-occurring piscivores were examined to determine overlap in resource use for Summer Flounder (Paralichthys dentatus; 206–670 mm total length [TL]), Weakfish (Cynoscion regalis; 80–565 mm TL), Bluefish (Pomatomus saltatrix; 55–732 mm fork length [FL]), and Striped Bass (Morone saxatilis; 422–920 mm FL). We collected samples from monthly, fishery-independent trawl surveys conducted on the inner continental shelf (5–27 m) off New Jersey from June to October 2005. Fish abundances and overlaps in diet and habitat varied over this study period. A wide range of fish and invertebrate prey was consumed by each species. Diet composition (determined from 1997 stomachs with identifiable contents) varied with ontogeny (size) and indicated limited overlap between most of the species size classes examined. Although many prey categories were shared by the piscivores examined, different temporal and spatial patterns in habitat use seemed to alleviate potential competition for prey. Nevertheless, the degree of overlap in both fish distributions and diets increased severalfold in the fall as species left estuaries and migrated across and along the study area. Therefore, the transitional period of fall migration, when fish densities are higher than at other times of the year, may be critical for unraveling resource overlap for these seasonally migrant predators.

Recruitment of larval Atlantic menhaden (Brevoortia tyrannus) to North Carolina and New Jersey estuaries: evidence for larval transport northward along the east coast of the United States

Age, size, abundance, and birthdate distributions were compared for larval Atlantic menhaden (Brevoortia tyrannus) collected weekly during their estuarine recruitment seasons in 1989–90, 1990–91, and 1992–93 in lower estuaries near Beaufort, North Carolina, and Tuckerton, New Jersey, to determine the source of these larvae. Larval recruitment in New Jersey extended for 9 months beginning in October but was discontinuous and was punctuated by periods of no catch that were associated with low water temperatures. In North Carolina, recruitment was continuous for 5–6 months beginning in November. Total yearly larval density in North Carolina was higher (15–39×) than in New Jersey for each of the 3 years. Larvae collected in North Carolina generally grew faster than larvae collected in New Jersey and were, on average, older and larger. Birthdate distributions (back-calculated from sagittal otolith ages) overlapped between sites and included many larvae that were spawned in winter. Early spawned (through October) larvae caught in the New Jersey estuary were probably spawned off New Jersey. Larvae spawned later (November–April) and collected in the same estuary were probably from south of Cape Hatteras because only there are winter water temperatures warm enough (≥16°C) to allow spawning and larval development. The percentage contribution of these late-spawned larvae from south of Cape Hatteras were an important, but variable fraction (10% in 1992–93 to 87% in 1989–90) of the total number of larvae recruited to this New Jersey estuary. Thus, this study provides evidence that some B. tyrannus spawned south of Cape Hatteras may reach New Jersey estuarine nurseries.

The life of John Brainerd, the brother of David Brainerd, and his successor as missionary to the Indians of New Jersey ... By Rev. Thomas Brainerd.

http://name.umdl.umich.edu/ABB4262

A new performance based method for design and maintenance of reinforced concrete structures

Best concrete research paper by a student - Research has shown that the cost of managing structures puts high strain on the infrastructure budget, with
estimates of over 50% of the European construction budget being dedicated to repair and maintenance. If reinforced concrete
structures are not suitably designed and adequately maintained, their service life is compromised, resulting in the full economic
value of the investment not realised. The issue is more prevalent in coastal structures as a result of combinations of aggressive
actions, such as those caused by chlorides, sulphates and cyclic freezing and thawing.
It is a common practice nowadays to ensure durability of reinforced concrete structures by specifying a concrete mix and a
nominal cover at the design stage to cater for the exposure environment. This in theory should produce the performance required
to achieve a specified service life. Although the European Standard EN 206-1 specifies variations in the exposure environment,
it does not take into account the macro and micro climates surrounding structures, which have a significant influence on their
performance and service life. Therefore, in order to construct structures which will perform satisfactorily in different exposure
environments, the following two aspects need to be developed: a performance based specification to supplement EN 206-1
which will outline the expected performance of the structure in a given environment; and a simple yet transferrable procedure
for assessing the performance of structures in service termed KPI Theory. This will allow the asset managers not only to design
structures for the intended service life, but also to take informed maintenance decisions should the performance in service fall
short of what was specified. This paper aims to discuss this further.

Development of a new cellular model for the visualization and study of GFAP oligomerization in living cells

Tese de mestrado, Neurociências, Faculdade de Medicina, Universidade de Lisboa, 2016

Dinocyst biochronology and palynofacies : inferred systems tract character of Miocene sequences from New Jersey mid-Atlantic transect (ODP legs 174A and 174AX) /

One of the main objectives of the mid-Atlantic transect is to improve dating resolution of sequences and unconfonnity surfaces. Dinoflagellate cysts from two Ocean Drilling Program boreholes, the onshore Leg 174AX Ocean View Site and Leg 174A continental shelf Site 1071, are used to provide age estimates for sequences and unconfonnities fonned on the New Jersey continental margin during the Miocene epoch. Despite the occasional lack of dinocysts in barren and oxidized sections, dinocyst biochronology still offers greater age control than that provided by other microfossils in marginal marine environments. An early Miocene to late Miocene chronology based on ages detennined for the two study sites is presented. In addition, .palynofacies are used to unravel the systems tract character of the Miocene sequences and provide insight into the effects of taphonomy and preservation of palynomorphs in marginal marine and shelf environments under different ~ea level conditions. More precise placement of maximum flooding surfaces is possible through the identification of condensed sections and palynofacies shifts can also reveal subaerially exposed sections and surfaces not apparent in seismic or lithological analyses. The problems with the application of the pollen record in the interpretation of Miocene climate are also discussed. Palynomorphs provide evidence for a second-order lowering of sea level during the Miocene, onto which higher order sea level fluctuations are super-imposed. Correlation of sequences and unconfonnities is attempted between onshore boreholes and from the onshore Ocean View borehole to offshore Site 1071.

Natural resource windfalls and efficiency of local government expenditures: evidence from Peru

We study the role of natural resource windfalls in explaining the efficiency of public expenditures. Using a rich dataset of expenditures and public good provision for 1,836 municipalities in Peru for period 2001-2010, we estimate a non-monotonic relationship between the efficiency of public good provision and the level of natural resource transfers. Local governments that were extremely favored by the boom of mineral prices were more efficient in using fiscal windfalls whereas those benefited with modest transfers were more inefficient. These results can be explained by the increase in political competition associated with the boom. However, the fact that increases in efficiency were related to reductions in public good provision casts doubts about the beneficial effects of political competition in promoting efficiency.

An illustration of the modelling of cost and efficacy data from a clinical trial

Health care providers, purchasers and policy makers need to make informed decisions regarding the provision of cost-effective care. When a new health care intervention is to be compared with the current standard, an economic evaluation alongside an evaluation of health benefits provides useful information for the decision making process. We consider the information on cost-effectiveness which arises from an individual clinical trial comparing the two interventions. Recent methods for conducting a cost-effectiveness analysis for a clinical trial have focused on the net benefit parameter. The net benefit parameter, a function of costs and health benefits, is positive if the new intervention is cost-effective compared with the standard. In this paper we describe frequentist and Bayesian approaches to cost-effectiveness analysis which have been suggested in the literature and apply them to data from a clinical trial comparing laparoscopic surgery with open mesh surgery for the repair of inguinal hernias. We extend the Bayesian model to allow the total cost to be divided into a number of different components. The advantages and disadvantages of the different approaches are discussed. In January 2001, NICE issued guidance on the type of surgery to be used for inguinal hernia repair. We discuss our example in the light of this information. Copyright © 2003 John Wiley & Sons, Ltd.

Finite element analysis and fracture resistance testing of a new intraradicular post

Objectives: The objective of the present study was to evaluate a prefabricated intraradicular threaded pure titanium post, designed and developed at the Sao Jose dos Campos School of Dentistry - UNESP, Brazil. This new post was designed to minimize stresses observed with prefabricated post systems and to improve cost-benefits. Materials and and methods: Fracture resistance testing of the post/core/root complex, fracture analysis by microscopy and stress analysis by the finite element method were used for post evaluation. The following four prefabricated metal post systems were analyzed: group 1, experimental post; group 2, modification of the experimental post; group 3, Flexi Post, and group 4, Para Post. For the analysis of fracture resistance, 40 bovine teeth were randomly assigned to the four groups (n=10) and used for the fabrication of test specimens simulating the situation in the mouth. The test specimens were subjected to compressive strength testing until fracture in an EMIC universal testing machine. After fracture of the test specimens, their roots were sectioned and analyzed by microscopy. For the finite element method, specimens of the fracture resistance test were simulated by computer modeling to determine the stress distribution pattern in the post systems studied. Results: The fracture test presented the following averages and standard deviation: G1 (45.63 +/- 8.77), G2 (49.98 +/- 7.08), G3 (43.84 +/- 5.52), G4 (47.61 +/- 7.23). Stress was homogenously distributed along the body of the intraradicular post in group 1, whereas high stress concentrations in certain regions were observed in the other groups. These stress concentrations in the body of the post induced the same stress concentration in root dentin. Conclusions: The experimental post (original and modified versions) presented similar fracture resistance and better results in the stress analysis when compared with the commercial post systems tested (08/2008PA/CEP).

Advanced morphological 3D magnetic resonance observation of cartilage repair tissue (MOCART) scoring using a new isotropic 3D proton-density, turbo spin echo sequence with variable flip angle distribution (PD-SPACE) compared to an isotropic 3D steady-state free precession sequence (True-FISP) and standard 2D sequences

To evaluate a new isotropic 3D proton-density, turbo-spin-echo sequence with variable flip-angle distribution (PD-SPACE) sequence compared to an isotropic 3D true-fast-imaging with steady-state-precession (True-FISP) sequence and 2D standard MR sequences with regard to the new 3D magnetic resonance observation of cartilage repair tissue (MOCART) score.