Comparative empirical analysis of temporal relationships between construction investment and economic growth in the United States

The majority of policymakers believe that investments in construction infrastructure would boost the economy of the United States (U.S.). They also assume that construction investment in infrastructure has similar impact on the economies of different U.S. states. In contrast, there have been studies showing the negative impact of construction activities on the economy. However, there has not been any research attempt to empirically test the temporal relationships between construction investment and economic growth in the U.S. states, to determine the longitudinal impact of construction investment on the economy of each state. The objective of this study is to investigate whether Construction Value Added (CVA) is the leading (or lagging) indicator of real Gross Domestic Product (real GDP) for every individual state of the U.S. using empirical time series tests. The results of Granger causality tests showed that CVA is a leading indicator of state real GDP in 18 states and the District of Columbia; real GDP is a leading indicator of CVA in 10 states and the District of Columbia. There is a bidirectional relationship between CVA and real GDP in 5 states and the District of Columbia. In 8 states and the District of Columbia, not only do CVA and real GDP have leading/lagging relationships, but they are also cointegrated. These results highlight the important role of the construction industry in these states. The results also show that leading (or lagging) lengths vary for different states. The results of the comparative empirical analysis reject the hypothesis that CVA is a leading indicator of real GDP in the states with the highest shares of construction in the real GDP. The findings of this research contribute to the state of knowledge by quantifying the temporal relationships between construction investment and economic growth in the U.S. states. It is expected that the results help policymakers better understand the impact of construction investment on the economic growth in various U.S. states

Zusammenhang zwischen CT-proET-1, TNF-α und IL-6 mit der hepatischen Dysfunktion bei Sepsis

Sepsis ist eine lebensbedrohliche Organdysfunktion als Folge einer systemisch dysregulierten Inflammationsreaktion auf eine Infektion. Im Rahmen der Sepsis kommt es innerhalb weniger Stunden zu einer Einschränkung der hepatischen Funktion. Die Leber nimmt eine zentrale Rolle ein bei der Regulierung des Immunsystems und Bekämpfung der Krankheitserreger. Durch die Aktivierung des Immunsystems im Rahmen der Sepsis kommt es zur Freisetzung zahlreicher Zytokine und Mediatoren. Hierzu gehören Tumornekrosefaktor-α, Interleukin-6 und Endothelin-1. Ziel der vorliegenden klinisch- prospektiven Studie ist es, den Zusammenhang zwischen den genannten Zytokinen und der Leberfunktion, gemessen mit dem LiMAx-Test, bei septischen Patienten zu untersuchen. Des Weiteren sind die unterschiedlichen Verläufe dieser Zytokine in Abhängigkeit des Schweregrades der Sepsis und deren Assoziation mit der Prognose der Patienten analysiert worden. Methode 28 Patienten wurden innerhalb von 24 Stunden nach Beginn der Sepsis in die Studie eingeschlossen. Als Kontrollgruppe dienten fünf Patienten mit einem postoperativen systemischen inflammatorischen Response-Syndrom. Der LiMAx-Test wurde unmittelbar nach Einschluss in die Studie sowie an den Tagen 2, 5 und 10 durchgeführt. Zu denselben Zeitpunkten wurde zur Bestimmung der Serumkonzentrationen von Tumornekrosefaktor-α, Interleukin-6 und C-Terminal-pro-Endothelin-1 (Spaltprodukt von Endothelin-1) Blut abgenommen. Der Verlauf der LiMAx-Werte und der Zytokine wurde bei allen Studienteilnehmern analysiert. In der Sepsis-Gruppe wurde die Höhe der Zytokine mit dem LiMAx-Wert korreliert. Zusätzlich wurden innerhalb der Sepsis-Gruppe folgende Untergruppen hinsichtlich der Konzentration der Zytokine miteinander verglichen: • Patienten mit einem LiMAx-Wert von ≥100μg/kg/h und <100μg/kg/h • Patienten mit einem Acute Physiologiy and Chronic Health Evaluation II Score (APACHE-II-Score) ≥20 und <20 • Patienten mit einem positiven Verlauf und mit einem negativen Verlauf Ergebnisse: Innerhalb von 24 Stunden nach Eintritt der Sepsis kam es zu einer signifikanten Einschränkung der hepatischen Funktion. Die Serumkonzentrationen von C-Terminal-pro-Endothelin-1, Tumornekrosefaktor-α und Interleukin-6 waren an allen Tagen erhöht. Es konnte eine negative Korrelation zwischen der Höhe der Zytokine und der Leberfunktion nachgewiesen werden. Patienten mit einer hochgradigen Einschränkung der Leberfunktion (LiMAx <100μg/kg/h) zeigten vor allem im späteren Verlauf der Sepsis höhere Konzentrationen von C-Terminal-pro-Endothelin-1 und Tumornekrosefaktor-α als Patienten mit einer geringer eingeschränkten Leberfunktion. Patienten mit einem APACHE-II-Score ≥20 zeigten eine stärker eingeschränkte Leberfunktion und höhere Konzentrationen aller drei Zytokine als Patienten mit einem APACHE-II-Score <20. Patienten mit einem negativen Verlauf zeigten höhere Werte von C-Terminal-pro-Endothelin-1, Tumornekrosefaktor-α und Interleukin-6 als Patienten mit einem positiven Verlauf. Schlussfolgerung: Bei septischen Patienten korreliert das Ausmaß der hepatischen Dysfunktion, der Schweregrad der Sepsis und der Krankheitsverlauf mit der Höhe und dem V erlauf der Zytokine Tumornekrosefaktor-α, Interleukin-6 und Endothelin-1.Sepsis is a life-threatening organ dysfunction as a result of a dysregulated systemic inflammation response to an infection. This condition involves a hepatic dysfunction which already begins within a short time after the onset of sepsis. The liver has a crucial role in the regulation of the immune system and protection of the body against pathogens. During sepsis a great number of cytokines and mediators such as tumor necrosis factor-α, interleukin-6 and endothelin-1 are released. The aim of the present clinical prospective study was to investigate the relationship between the abovementioned mediators and the hepatic dysfunction, measured for the first time by the LiMAx-Test, in septic patients. Furthermore, the association of these mediators with the severity of sepsis and the outcome of patients was analysed. Methods 28 Patients were admitted to the study within 24 hours after the onset of sepsis. 5 patients with a post-operative systemic inflammatory response syndrome were admitted as control group. The LiMAx-test and blood sample collection for the measurement of tumor necrosis factor-α, interleukin-6 and C-terminal-pro-endothelin-1 (precursor fragment of endothelin-1) plasma levels were performed at baseline (within 24 hours after the onset of sepsis) and on 2nd, 5th, and 10th day. The dynamic of the liver function and the cytokines was analysed. In the sepsis group a correlation between the LiMAx-value and the levels of cytokines was established. In addition, the septic patients were dived in to the following sub-groups for further analyzes: LiMAx-value of ≥100μg/kg/h and <100μg/kg/h, APACHE-II-Score of ≥20 and <20, favorable and adverse outcome. Results: In the sepsis group the liver function was impaired within a short time after the onset of sepsis. The levels of tumor necrosis factor-α, interleukin-6 and C-terminal-pro-endothelin-1 were elevated on all days. There was a negative correlation between the levels of these cytokines and the liver function. Patients with a LiMAx-value of <100μg/kg/h revealed higher levels of tumor necrosis factor-α and C-terminal-pro-endothelin-1. APACHE-II-Score of ≥20 and adverse outcome both were associated with higher cytokines levels. The severity of liver dysfunction was higher in patients with an APACHE-II-score of ≥20. Conclusion: The Plasma levels of tumor necrosis factor-α, interleukin-6 and endothelin-1 during sepsis are associated with the hepatic dysfunction, outcome and the severity of illness

Silver and Gold Nanoparticles for Antimicrobial Purposes against Multi-Drug Resistance Bacteria

Several pieces of research have been done on transition metal nanoparticles and their nanocomplexes as research on their physical and chemical properties and their relationship to biological features are of great importance. Among all their biological properties, the antibacterial and antimicrobial are especially important due to their high use for human needs. In this article, we will discuss the different synthesis and modification methods of silver (Ag) and gold (Au) nanoparticles and their physicochemical properties. We will also review some state-of-art studies and find the best relationship between the nanoparticles’ physicochemical properties and potential antimicrobial activity. The possible antimicrobial mechanism of these types of nanoparticles will be discussed in-depth as well

A Critical review of surgical logbook applications for the android and iOS platforms in the Australian setting

BackgroundSmartphones have become pervasive in all aspects of modern life and the health care industry is not immune. Currently smartphone applications (apps) are used by 85–87 per cent of physicians. Surgical logbooks are a mandatory part of training and time consuming to maintain.AimsWe conducted a critical review of available logbooks apps in the Australian market for Android and iPhone and reported our findings.Methods A critical search through the Google Play Store's (Android) and Apple’s App Store's (iOS) Australian marketplace was conducted with keywords of “logbook” and other suitable variations in January 2017. Apps were critically reviewed and against the Royal Australasian College of Surgeons’ Minimum Dataset (MDS) and Extended Dataset (EDS). Apps were included if they could be utilised to record clinical procedures.Results Seven apps were available and fit the criteria of our search: Surgeons Logbook, eLogbook, LogBox Academic, SurgCase, T-Res 2, Surgeon Log Book Free, and SurgiLog. None of the apps completely satisfied the requirements of maintaining a surgical logbook as stipulated by RACS. However, Surgeon’s Logbook provided ability to customise the logbook fields, which allows users to modify their logbook app to meet the requirements. Furthermore, the lack of connection to hospital electronic medical records, or RACS, limits the usability of these apps for Australian trainees.ConclusionThe current apps available in the market do not meet the requirements of Australian trainees. However, with the advancing technology and rapid progress of smartphones and their apps, this is likely to change in the future

Thyroid gland dysfunction and its effect on the cardiovascular system: a comprehensive review of the literature

There is an intimate and functional relationship between the cardiovascular system and the thyroid gland; from sharing the same embryologic origin to modulating each of the components of the heart for a normal function. Due to this relationship, patients suffering from cardiovascular diseases often undergo a thyroid function test to rule out hypo- or hyperthyroidism. The signs and symptoms of hyper- and hypothyroidism are clinically relevant and profound. The cardiac function changes can be explained through the cellular mechanism of the thyroid hormone action on the heart. Minor alteration of thyroid hormone can change vascular resistance, cardiac contractility, blood pressure, and heart rhythm, because of the presence of the thyroid hormone receptors on these tissues. A better understanding of the impact of thyroid hormones on the cardiovascular system is paramount for physicians to make a quick decision and initiate a treatment plan because it has been shown to reverse some of the cardiac changes such as systolic and diastolic dysfunction. With this literature review, we aim to describe the holistic effect of thyroid hormones on the cardiovascular system, from its effect on a cellular level to changes in cardiac functions in subclinical and overt hypo/hyperthyroidism. Additionally, we will describe the effects of the drug treatment regimen of thyroid on the cardiac function.

Clinical significancy of WNT pathway inhibition in various cancers

The tumor microenvironment (TME) plays an important role in the cell cycle. There is a correlation between the Wnt/B–catenin signaling pathway and TME. This article reviews methods of inhibiting Wnt Pathway, a useful process in the treatment of various cancers. Compounds of Wnt/β–Catenin Signaling Pathway, such as TCF–1, have an impact on the differentiation and migration of CD8+ T cells. CCL4 expression is regulated by the beta–catenin protein to recruit CD103+ dendritic cells, which enables CD8+ T cell activation. Inhibition of the Wnt/β–catenin pathway has an impact on ovarian cancer patients’ prognosis, reducing the development of ovarian cancer. Research shows that inhibition of the pathway with the use of the LGK974 inhibitor may boost immunity, especially when applied with a Paclitaxel mix. After treatment, expression of the inhibitory receptors CTLA–4, TIM3, PD–1 on CD8+ T cells decreased. The combination of LGK974 and Paclitaxel can cause the death of tumor cells and significantly inhibit their proliferation. The application of dose–dense Paclitaxel avoids toxicity related to the maximum dose needed to protect the patient's immune system by increasing CD8+ TILs.&nbsp; There are concerns regarding toxicity of the LGK 974, especially for cells dependent on the Wnt/β–catenin pathway to maintain homeostasis. Many Wnt/β–catenin pathway inhibitors are tested against colorectal cancer (CRC) with successful results. These include NSAIDs, porcupine inhibitors, tankyrase inhibitors, Wnt5A inhibitors, and disheveled protein inhibitors.The Wnt/β–catenin pathway, when expressed in Triple Negative Breast Cancer (TNBC), leads to the transition of epithelial to mesenchymal cells. In early clinical development, there are multiple inhibitors (ex. KYA1797K) targeting the Wnt/β–catenin pathway in TNBC cells, which could become a viable anticancer strategy.&nbsp

A bid/mark-up decision support model in contractor's tender strategy development phase based on project complexity measurement in the downstream sector of petroleum industry

The tender process is an inseparable step of the contract award process in the public sector, and from the other point of view, it is one of the crucial elements of the core business of construction contractors. Reviewing previous research reveals a gap in the application of a project’s detailed features and historical data to support the bid/no-bid decision and to determine the cost and time contract mark-ups. In this study, a prescriptive project complexity-based model is proposed to support the bid decision in the tender strategy development phase of a contractor for the downstream sector of the petroleum industry in Iran. For this purpose, regression analysis of historical data is adopted to configure the model and to infer from previous actual trends by exploring relationships between the contractor’s bid decision and proposed mark-ups with the project’s inherent and surrounding complexity factors. Hence, using experts’ opinions and historical data from 139 previous contracts as training and test data, a model was developed to make a decision on a bid and mark-up problem. The results of the model validation show that the credibility of the model is 74.67% and 75.36% for time and cost, respectively, and the reliability of model outputs is approximately 90% overall in predicting the bid mark-ups in accordance with the project complexity index (PCI). The main contribution of this research to current knowledge has two aspects: utilizing the complexity concept for the tender problem in the form of a project complexity index (PCI) and considering both time and cost mark-ups (TMU–CMU) in the contractor’s bid simultaneously. In addition, the results show that the more complex the project is, the higher the bid rate is

The Effects of Propofol-Remifentanil Vs Midazolam-Remifentanil on Hemodynamic Stability during Stapedectomy: A Randomized Clinical Trial

Background: One of the essential components during stapedectomy is a good cooperation between patient and surgeon. Remifentanil is commonly used short – acting opioid to assess the results during the procedure.Purpose: The aim of this study is to investigate the effects of propofol- remifentanil and midazolam -remifentanil on hemodynamic parameters intra- Stapedectomy.Methods: In this randomized, double-blinded trial, 36 patients with otosclerosis were evaluated in two equal groups, which received propofol- remifentanil and midazolam- remifentanil each. We recorded cardio-respiratory parameters, side effects and intra-operative cooperation of the patients.Results: There was a statistically significant difference in blood pressure reduction between two groups. The severity of the bleeding and desirable cooperation of patients in midazolam- based regimen was better than propofol- based regimen (p- value= 0.01 and 0.02 respectively). The average operative time in patients who received propofol was about 15 minutes more than the other group (p- value=0.01).Conclusion: The midazolam - remifentanil is more appropriate sedative, because it provides hemodynamic stability and a better cooperation of patient intra - stapedectomy

Investigation the integration of heliostat solar receiver to gas and combined cycles by energy, exergy, and economic point of views

Due to the high amount of natural gas resources in Iran, the gas cycle as one of the main important power production system is used to produce electricity. The gas cycle has some disadvantages such as power consumption of air compressors, which is a major part of gas turbine electrical production and a considerable reduction in electrical power production by increasing the environment temperature due to a reduction in air density and constant volumetric airflow through a gas cycle. To overcome these weaknesses, several methods are applied such as cooling the inlet air of the system by different methods and integration heat recovery steam generator (HRSG) with the gas cycle. In this paper, using a heliostat solar receiver (HSR) in gas and combined cycles are investigated by energy, exergy, and economic analyses in Tehran city. The heliostat solar receiver is used to heat the pressurized exhaust air from the air compressor in gas and combined cycles. The key parameter of the three mentioned analyses was calculated and compared by writing computer code in MATLAB software. Results showed the use of HSR in gas and combined cycles increase the annual average energy efficiency from 28.4% and 48.5% to 44% and 76.5%, respectively. Additionally, for exergy efficiency, these increases are from 29.2% and 49.8% to 45.2% and 78.5%, respectively. However, from an economic point of view, adding the HRSG increases the payback period (PP) and it decreases the net present value (NPV) and internal rate of return (IRR)