There has been a rise of innovative parametric insurance solutions in recent years covering a wide range of risks and serving clients from individuals, to businesses, and to governments. These ...parametric insurance products cover risks that are otherwise uninsured or underinsured, by simplifying product design and reducing transaction costs. This paper offers a comprehensive review of parametric insurance including a classification of the types of contract and an overview of market practices. We outline the benefits and concerns of parametric insurance in comparison with indemnity insurance, and discuss the legal principle and regulatory compliance matters. We then survey the current global market and identify areas where insurance and reinsurance companies can play important roles in offering or supporting parametric insurance operations. Lastly, we offer a case study on a type of parametric insurance designed to cover earthquake risk in California.
An ultrafast electrochromic display is fabricated based upon well defined nanotube arrays of poly(3,4‐ethylenedioxythiophene), PEDOT (see Figure). The thin nature of the nanotube walls (10 – 20 nm) ...offers a short ion‐diffusion distance, which results in an ultrafast switching rate (color‐switching time < 10 ms). The arrayed long nanotube structure furnishes strong coloration.
Two-stage revision for infected shoulder arthroplasty Buchalter, Daniel B., BA; Mahure, Siddharth A., MD, MBA; Mollon, Brent, MD, FRCSC ...
Journal of shoulder and elbow surgery,
06/2017, Letnik:
26, Številka:
6
Journal Article
Recenzirano
Background Periprosthetic shoulder infections (PSIs) are challenging to treat and often result in significant patient morbidity. Without a standardized treatment protocol, PSIs are often managed ...similarly to periprosthetic hip and knee infections. Because 2-stage revision is the gold standard for treating periprosthetic hip and knee infections, we performed a case series and literature review to determine its effectiveness in PSIs. Methods We identified 19 patients (14 men) from our institution who were treated with a 2-stage revision after presenting with a PSI. Mean patient age was 63 ± 9 years, and average body mass index was 30.8 ± 5.8. The average time from the index arthroplasty to treatment was 40 months, 8 of 13 positive cultures were Propionibacterium acnes , and 9 of 19 patients had multiple shoulder operations before presenting with infection. Minimum follow-up for all patients was 2 years. Results After a mean follow-up of 63 months (range, 25-184 months), 15 of 19 patients in our study were successfully treated for PSI. Average postoperative American Shoulder and Elbow Surgeons (ASES) Shoulder Assessment score was 69 (range, 32-98) and average postoperative forward elevation was significantly increased from 58° to 119° ( P < .001). The incidence of recurrent infection was 26%. The rate of noninfection complications was 16%, for a total complication rate of 42%. Conclusion In patients with PSIs, especially those with intractable, chronic infections, a 2-stage revision represents a viable treatment option for eradicating infection and restoring function. However, it is important to recognize the risk of recurrent infection and postoperative complications in this challenging patient population.
Microfluidics have been applied to filtration of rare tumor cells from the blood as liquid biopsies. Processing is highly limited by low flow rates and device clogging due to a single function of ...fluidic paths. A novel method using multifunctional hybrid functional microposts was developed. A swift by-passing route for non-tumor cells was integrated to prevent very common clogging problems. Performance was characterized using microbeads (10 µm) and human cancer cells that were spiked in human blood. Design-I showed a capture efficiency of 96% for microbeads and 87% for cancer cells at 1 ml/min flow rate. An improved Design-II presented a higher capture efficiency of 100% for microbeads and 96% for cancer cells. Our method of utilizing various microfluidic functions of separation, bypass and capture has successfully guaranteed highly efficient separation of rare cells from biological fluids.
The vestibulospinal tract (VST) is involved in balance control and gait function. No research has identified the VST in the human brain. In the current study, we attempted to identify the medial and ...lateral VST in the human brain, using diffusion tensor tractography (DTT).
We recruited 40 healthy volunteers for this study. For reconstruction of the medial VST, a seed region of interest (ROI) was placed on the medial vestibular nuclei in the pons and target ROI on the posteromedial medulla. For reconstruction of the lateral VST, a seed ROI was placed on the lateral vestibular nuclei of pons and the target ROI on the posterolateral medulla. Values of fractional anisotropy (FA), mean diffusivity (MD), and tract volume of the medial and lateral VST were measured.
The medial VST, which originates from the medial vestibular nuclei, descends through the posteromedial medulla, and terminates at the anterior funiculus of the cervical spinal cord. The lateral VST originates from the lateral vestibular nuclei, and terminates in the anterior portion of lateral funiculus, through the posterolateral medulla. The FA value of medial VST was significantly higher than that of lateral VST. In contrast, the MD value and tract volume were significantly lower than those of lateral VST (
< 0.05).
We identified the medial and lateral VST in the human brain using DTT and investigated the anatomical characteristics of the medial and lateral VST. The methodology and results of this study could be helpful to both clinicians and researchers in the neuroscience field.
A series of experimental studies were conducted for cylindrical structures subjected to underwater shock loading to understand their dynamic responses and failure characteristics. All tests were ...performed inside an anechoic water tank. The submerged test cylinders were freely suspended, and an underwater shock loading was generated by the Compressed Air Shock Pipe Underwater Release (CASPUR) system. Cylinders were made of two different materials. The first group of cylinders was fabricated from carbon fiber and resin using the filament winding technique. The winding angles were ± 45° resulting in the same properties along axial and hoop directions. The second group of cylinders was constructed using a 3-D printer with polylactic acid (PLA) material. The 3-D printed cylinders had an orthotropic material property with different values in the axial and hoop directions. Both single-wall and double-wall cylindrical structures were tested. The latter consisted of two concentric cylinders of different diameters with uniform spacing between them. In addition, within the single-wall cylinders and the annuli of double-wall cylinders, the water fill was varied at 0%, 50%, or 100%. Pressure and strain gages were used to measure the shock pressure and deformation of the cylinders. The number of cylinders such as single-wall or double-wall and the internal water resulted in significant effects on the measured dynamic response (i.e., strain gage response) as well as the failure loading and failure characteristics including major failure locations. Internal water reduced the strain on the cylinders and made them withstand greater shock loading for both single-wall and double-wall cylinders.
The purpose of this study was to examine the association between bisphosphonate exposure and osteonecrosis of the jaw (ONJ) in Korean patients with osteoporosis. A nested case-control study was ...performed using the claims database during 2002 to 2010 provided by the National Health Insurance Service. We identified a cohort of individuals with diagnosis of osteoporosis during 2002 to 2010. Cases and controls were identified during 2004 to 2010, and the date of potential cases of ONJ was defined as the index date. Bisphosphonate exposure was evaluated during 2 y prior to the index date. The association between bisphosphonate exposure and ONJ was tested by performing a conditional logistic regression analysis for matched data, and odds ratios (ORs) with 95% confidence intervals (CIs) were presented. Subjects were classified as nonuser, recent user, past user, or continuous user, depending on the prescription of bisphosphonates in 2 periods (1 to 2 y and 0 to 1 y prior to the index date). Continuous users were defined as patients who were exposed to bisphosphonate in both periods. We also examined the impact of bisphosphonate medication compliance by measuring the cumulative duration of exposure (CDE) on the risk of ONJ. A total of 212 cases with ONJ and 2,120 controls matched by sex, age, income level, and insurance type were identified among 109,787 patients with osteoporosis out of 1,025,340 enrollees in the sample cohort. The odds of having ONJ after adjusting for patient comorbidities significantly increased in continuous users of bisphosphonates (OR, 3.9; 95% CI, 2.4 to 6.2) compared to nonusers. Increased odds of ONJ were observed as CDE increased. The adjusted OR in patients with 1.5 y < CDE ≤ 2 y prior to the index date was 7.8 (95% CI, 4.0 to 15.5) versus nonusers. Our study results support significantly increased occurrences of potential ONJ in patients with osteoporosis who were exposed to bisphosphonates compared to those without exposure.
We present high spatial resolution observations of the continuum emission from the young multiple star system UZ Tau at frequencies from 6 to 340 GHz. To quantify the spatial variation of dust ...emission in the UZ Tau E circumbinary disk, the observed interferometric visibilities are modeled with a simple parametric prescription for the radial surface brightnesses at each frequency. We find evidence that the spectrum steepens with radius in the disk, manifested as a positive correlation between the observing frequency and the radius that encircles a fixed fraction of the emission (Reff ∝ 0.34 0.08). The origins of this size-frequency relation are explored in the context of a theoretical framework for the growth and migration of disk solids. While that framework can reproduce a similar size-frequency relation, it predicts a steeper spectrum than that observed. Moreover, it comes closest to matching the data only on timescales much shorter (≤1 Myr) than the putative UZ Tau age (∼2-3 Myr). These discrepancies are direct consequences of the rapid radial drift rates predicted by models of dust evolution in a smooth gas disk. One way to mitigate that efficiency problem is to invoke small-scale gas pressure modulations that locally concentrate drifting solids. If such particle traps reach high-continuum optical depths at 30-340 GHz with a ∼30%-60% filling fraction in the inner disk (r 20 au), they can also explain the observed spatial gradient in the UZ Tau E disk spectrum.
Summary
The actin‐related protein 2/3 (Arp2/3) complex is critical for regulation of actin polymerization, which is associated with sperm motility and capacitation status. However, the function of ...the Arp2/3 complex in male fertility has not yet been fully elucidated. Therefore, this study was designed to investigate the role of the Arp2/3 complex in different processes in spermatozoa and its consequences on fertilization and early embryonic development. In this in vitro study, mouse spermatozoa were incubated with different concentrations (10, 100, and 500 μm) of CK‐636, an Arp2/3 complex antagonist. Our results demonstrated that inhibition of the Arp2/3 complex by high concentrations (100 and 500 μm) of CK‐636 induced hyper‐activated motility and acrosomal reaction, whereas intracellular calcium and tyrosine phosphorylation levels in spermatozoa were inhibited. Moreover, exposure of spermatozoa to the highest concentration of CK‐636 reduced fertilization and embryo development. Interestingly, fertilization was significantly increased after treatment with 100 μm CK‐636, whereas embryonic development was significantly decreased. Therefore, we conclude that the Arp2/3 complex plays a decisive role in regulation of sperm function and male fertility via actin polymerization. We anticipate that the Arp2/3 complex may have clinical application as marker for male fertility and male contraceptive targeting.
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