Trabecular Calcium Phosphate Scaffolds for Bone Regeneration

Bone tissue engineering represents a strategy for the repair or regeneration of damaged bone in the body. The science underlying this clinical therapy bridges the traditional fields of cell biology, materials science and mechanical engineering with the aim to identify how cells behave on physiologically relevant materials with natural mechanical stimuli. The objectives of this research were to develop and characterize calcium phosphate ceramic scaffolds matched to the local architecture of natural trabecular bone and to apply tissue engineering strategies for the study of cell behavior in both in vitro and in vivo models.The specific role of environment on cell stress pathways was evaluated on three dimensional (3-D) calcium phosphate scaffolds resembling vertebral trabecular bone. A scaffold foam dipping technique was employed in the fabrication of fully sintered hydroxyapatite and tricalcium phosphate scaffolds. Study of the early cell behavior on two dimension (2-D) controls and scaffolds was performed using human embryonic palatal mesenchyme cells (HEPM), an osteoblast precursor cell line. Cell stress signaling was identified in response to the 3-D architecture using; members of the mitogen activated protein kinase cascade, cell survival signals and adhesion dependant proteins. The application of low intensity pulsed ultrasound (LIPUS) or fluid perfusion further stimulated cell-scaffold hybrids for short and long term in vitro study. Additionally, an animal model was characterized using the scaffolds for the repair of a segmental defect in the canine mandible.Study of the cell stress signaling mechanisms identified high activation of stress pathways on 3-D materials compared to controls with a corresponding increase in anti- apoptosis signaling. Similar trends were found with LIPUS stimulation demonstrating that changes in adhesion proteins during attachment may account for the alteration in stress pathways activated by bone precursors. The absence of cell death and the activation of an anti-apoptosis signal suggest that cells are able to manage these stress levels which may be required for proper function. Supporting this theory, long term in vitro perfusion studies demonstrated that the process of cell transition into a mature bone phenotype was improved with the fluid shear forces of perfusion. Finally, the scaffolds were applied for repair of a segmental defect in the canine mandible and demonstrated extensive bone in-growth and partially-organized, lamellar collagen fiber assembly characteristic of organized bone. The open architecture of the scaffold design also allowed for substantial blood vessel infiltration.This research demonstrated the importance of architecture on bone cell response for in vitro cell study and for clinical application. The scaffold design provides a bridge between laboratory based signaling mechanisms and the development of clinical therapies in regenerative orthopedics

Health financing and family planning in the context of universal health care: Connecting the discourse in Kenya

Financing is a major challenge and concern for the future of family planning (FP) programs. As countries commit to increasing access to and quality of FP services and to universal health care (UHC), it is crucial that UHC schemes include FP and other reproductive health services. This brief aims to: 1) document trends in UHC and health financing, drawing out implications for policymakers and programmers; and 2) identify opportunities for the FP community of practice to advocate for the inclusion of quality FP services within UHC and health financing discussions. With this brief, we aim to highlight experiences in Kenya, given that there is a body of experience with health financing reforms and UHC schemes and a relatively strong national FP program. The Kenya case study is instructive for other countries with decentralized and mixed health systems as they seek to integrate FP within their own UHC initiatives and health financing reforms

Health financing and family planning in the context of Universal Health Care: Connecting the discourse

Financing is a major challenge and concern for the future of family planning (FP) programs. As countries commit to increasing access to and quality of FP services and to universal health care (UHC), it is crucial that UHC schemes include FP and other reproductive health services. While the importance of financing is recognized in relation to quality, the “how” of financing FP within the context of UHC is not well understood. This brief targets the “bridge” constituency that is coalescing between the health financing and FP communities of practice around a shared interest in making access to health services universal. With this brief, we aim to: 1) document trends in UHC and health financing, drawing out implications for policymakers and programmers; and 2) identify opportunities for the FP community of practice to advocate for the inclusion of quality FP services within UHC and health financing discussions

Being seen in your pyjamas : the relationship between fashion, class, gender and space

Over the last decade class has re-emerged as a significant concept within British sociology, with prominent academics calling for a more Bourdieuian approach which focuses on class distinctions in cultural practices and tastes. Within this discussion, several note the important role fashion plays as a means of class distinction, though few have fully explore just how the fashion-class relationship operates. Based on empirical research, carried out as part of qualitative study into fashion practices and fashion discourse, this article examines the fashion-class relationship, by considering its links to both gender and space. It argues that the way in which women judge visibility and public space differs with class status and that this in turn has significant implications for women's fashion choices, and more specifically, dressing up. Indeed, whilst middle class participants tend to view almost any space as public and one in which they are visible, for working class participants neighbourhood and local spaces are seen to constitute semi-private spaces, whose audiences' opinions and judgements do not matter. As a result, being dressed in your pyjamas is not deeply problematic for these working class women in the context of their everyday lives, while for their middle class counterparts being seen in your pyjamas is something which should be avoided, at all cost. Moreover, as the article demonstrate, the wearing of pyjamas is often considered by middle class respondents as indicative of working classness. And thus, being seen in your pyjamas is undesirable on two counts

Positioning family planning quality within health financing for UHC: Connecting the discourse

Financing is a major challenge and concern for the future of the delivery of voluntary family planning (FP) services to clients, particularly in low- and middle-income countries with high unmet need and limited method choice. As countries commit to universal health coverage (UHC), it is crucial that UHC schemes include FP and other reproductive health (RH) services. Strategic purchasing of quality FP services from public and private—including for profit and not-for-profit—health-care providers could accelerate progress toward UHC. It is increasingly recognized that the FP2020 goals will not be met without adequate attention to quality, and that a sustained focus on quality of care requires financing at the policy and program levels. While the importance of sustainable financing may be recognized, the “how” of financing for quality FP within the context of UHC is not well understood. This brief targets the “bridge” constituency that is coalescing between the health financing and FP communities of practice around a shared interest in making access to health services universal

Adenocarcinoma of the Ethmoid Sinus Presenting with Epiphora

Abstract: Low-grade non-intestinal type adenocarcinomas are rare tumors that arise from the surface epithelium of the sinonasal tract. They frequently involve the ethmoid sinus, the nasal cavity, and the maxillary sinus. These tumors present at a mean age range of 37-53 years with various non-specific symptoms including nasal obstruction and epistaxis. We report the first case of a low-grade non-intestinal type sinonasal-adenocarcinoma of the ethmoid sinus presenting with persistent unilateral epiphora. Case Presentation: A 67-year-old man presented with complaints of bloody tearing and right medial canthus swelling for several months. Examination of the area revealed a small bump beneath the skin which burst with a green mucopurulent discharge on gentle palpation. Computed tomography (CT) scans revealed a large growth in the ethmoid sinus invading into the right medial orbit and extending into the maxilla. Histopathology (H&E) demonstrated a cribriform pattern, moderately graded nuclei, and eosinophilia consistent with non-intestinal type sinonasal adenocarcinoma. The patient underwent orbital exenteration and large sinus resection. Discussion: Cancers of the paranasal sinuses are extremely uncommon and account for just 1% of all human cancers. Low-grade non-intestinal type adenocarcinoma is an extremely rare subtype that has only been reported a handful of times. Synonyms in the literature include terminal tubulus adenocarcinoma, sinonasal tubulopapillary low-grade adenocarcinoma, and sinonasal seromucinous adenocarcinoma. Microscopic analysis is key for differentiation of this tumor type from other similar sinonasal malignancies as well as for prognostication purposes. Histologically, non-ITAC is recognized by its trabecular, cribaform, or papillary growth pattern and the single layer of uniform columnar or cuboidal cells that line its glands. Pleomorphic nuclei and mitotic figures are rarely seen in this subtype. Immunohistochemically, non-ITAC is characterized by positive CK7 staining and/or negative CDX-2 and CK-20 staining. Differential diagnoses to consider include intestinal type adenocarcinoma (ITAC), acinic cell carcinoma, and oncocytic Schneiderian papilloma. ITAC is an aggressive malignancy that is differentiated from non-ITAC on the basis of its resemblance to the mucosa found in the small and large intestine, its high-grade histologic appearance, and cellular expression of CDX-2. Distinguishing the two tumors types is of crucial clinical importance given that low-grade non-ITAC has not, to date, displayed metastatic behavior while several instances of low-grade ITAC metastases have been reported. Rarely, non-intestinal type adenocarcinoma may be confused with oncocytic Schneiderian papillomas. However, the epithelium of oncocytic Schneiderian papillomas are multilayered and lack glandular lumina. The presenting clinical symptoms of non-ITAC vary, however the most common reported symptoms are nasal obstruction and epistaxis. In our case, the patient presented with persistent unilateral epiphora which has not, to date, been reported in association with this tumor subtype. The mainstay in treatment of low-grade non-ITAC includes surgery followed by radiation therapy. Overall, the prognosis of patients with non-ITAC is good and rarely does death occur due to the disease.https://scholarlycommons.henryford.com/merf2020caserpt/1125/thumbnail.jp

Soil Structure Interaction Analysis of a Deeply Embedded Reactor Silo

This paper reviews the seismic soil structure interaction (SSI) analysis performed for the Modular High Temperature Gas-cooled Reactor (MHTGR). The large depth to diameter ratio of the silo requires proper modeling of embedment and silo flexibility when evaluating the response of the structure to seismic loads. The carputer program SASSI was used to perform the three dimensional SSI analysis in order to take full advantage of embedment in reducing seismic response. Acceleration response spectra were computed for three soil sites at various points in the silo walls and internal vessels. The results demonstrated the effectiveness of embedment in reducing the seismic response. In general, the lowest silo and vessel accelerations occurred in the softest site where the SSI effects are the most pronounced. For a rock site, embedment eliminated the problem faced by structures founded at grade of amplification at the structure\u27s fundamental modes

Reading women in the medieval information age: the life of Elizabeth of Spalbeek and the book of Margery Kempe

In fifteenth-century England, information about the natural and supernatural worlds came to be broadly distributed in texts that circulated well beyond the institutional contexts in which this knowledge was first produced. Vernacular texts that deal with natural philosophy, medicine, and science, alongside a range of religious topics, were created in record numbers for a widening audience. Many of these testify to intensified interest in all aspects of the human body. Religious works written by, about, and for women participate in this ferment of ideas and information, crossing the boundaries between secular and transcendent themes and concerns. Because religious women were understood to have a special relationship to forms of physical piety, their vitae served as important vehicles for the production and dissemination of thinking about corporeality. The radical asceticism of the thirteenth-century Low Countries visionary Elizabeth of Spalbeek, as detailed in an important Middle English collection from the 1420s, Oxford, Bodleian Library, MS Douce 114, can be read as an investigation of the possibilities of the fleshly, this-worldly human body to materialize divine truth, and thus by extension as participating in local and intimate ways in the distribution and deinstitutionalization of knowledge. The Book of Margery Kempe, a work often seen as taking up the conventions of affective piety, [End Page 253] similarly participates in a current discourse concerning the materiality of the divine. As the work's complex treatment of the spirit as breath, fire, inspiration, or pneuma suggests, the Book is at once a contributor to and a product of the late medieval information era.Published versio