Search results for: dental implant placement

Authors: E.K.K. Agyeman, P. Mousseau, A. Sarda, D. Edelin

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The uniform and controlled cooling of hot metals by the circulation of water in canals remains a challenge due to the phase change of the water and the high heat fluxes associated with the phase change. This is because, during the cooling process, the phases are not uniformly distributed along the canals with the liquid phase dominating at the entrances of the canals and the gaseous phase dominating towards the exits. The difference in thermal properties between both phases leads to a heterogeneous temperature distribution in the part being cooled. Slowing down the cooling process is also a challenge due to the high heat fluxes associated with the phase change of water. This study investigates the use of multiple water jets for the controlled and homogenous cooling of hot metal parts and the effect of gravity on the effectiveness of the cooling process with a potential application in the cooling of composite forming moulds. A hole is bored at the centre of a steel block along its length. The jets are generated from the holes of a perforated steel pipe which is placed along the centre of the hole bored in the steel block. The evolution of the temperature with respect to time on the external surface of the steel block is measured simultaneously by thermocouples and an infrared camera. Different jet positions are tested in order to identify the jet placement configuration that ensures the most homogenous cooling of the block while the cooling speed is controlled by an intermittent impingement of the jets. In order to study the effect of gravity on the cooling process, a scenario where the jets are oriented in the opposite direction to that of gravity is compared to one where the jets are aligned in the same direction as gravity. It’s observed that orienting the jets in the direction of gravity reduces the effectiveness of the cooling process on the face of the block facing the impinging jets. This is due to the formation of a deeper pool of water due to the effect gravity and of the curved surface of the canal. This deeper pool of water influences the boiling regime characterized by a slower bubble evacuation when compared to the scenario where the jets are opposed to gravity.

Keywords: cooling speed, gravity, homogenous cooling, jet impingement

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Authors: Devendra Gupta, S. P. Ambesh, P. K Singh

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Introduction: Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. Minimally invasive direct coronary artery bypass (MIDCAB) provides many anesthetic challenges including one lung ventilation (OLV), managing myocardial ischemia, and pain. We present an early and midterm result of the use of this technique with OLV. Method: We enrolled 62 patients for analysis operated between 2008 and 2012. Patients were anesthetized and left endobronchial tube was placed. During the procedure left lung was isolated and one lung ventilation was maintained through right lung. Operation was performed utilizing off pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Postoperative ventilation was done with single lumen endotracheal tube. Median follow-up is 2.5 years (6 months to 4 years). Results: Median age was 58.5 years (41-77) and all were male. Single vessel disease was present in 36, double vessel in 24 and triple vessel disease in 2 patients. All the patients had normal left ventricular size and function. In 2 cases difficulty were encounter in placement of endobronchial tube. In 1 case cuff of endobronchial tube was ruptured during intubation. High airway pressure was developed on OLV in 1 case and surgery was accomplished with two lung anesthesia with low tidal volume. Mean postoperative ventilation time was 14.4 hour (11-22). There was no perioperative and 30 day mortality. Conversion to median sternotomy to complete the operation was done in 3.23% (2 out of 62 patients). One patient had acute myocardial infarction postoperatively and there were no deaths during follow-up. Conclusion: MICABG is a safe and effective method of revascularization with OLV in low risk candidates for coronary artery bypass grafting.

Keywords: MIDCABG, one lung ventilation, coronary artery bypass grafting, endobronchial tube

Procedia PDF Downloads 420

Authors: Mohamed H. Kosba, Heba A. Ibrahim, H. Rozita

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Statement of the Problem: The life expectancy for transfusion-dependent thalassemia patients has increased dramatically with iron-chelation therapy and other modern management modalities. In these patients, the most dominant maxillofacial manifestations are protrusion of zygomatic bones and premaxilla due to the hyperplasia of bone marrow. The purpose of this study is to determine the prevalence of malocclusion and orthodontic treatment needs according to the Dental Aesthetic Index (DAI) among Malay transfusion-dependent thalassemia patients. Orientation: This is a cross-sectional study consist of 43 Malay transfusion-dependent thalassemia patients, 22 males, and 19 females with the mean age of 15.9 years old (SD 3.58). The subjects were selected randomly from patients attending Paediatrics and Internal Medicine Clinic at Hospital USM and Hospital Sultana Bahiyah. The subjects were assessed for malocclusion according to Angle’s classification, and orthodontic treatment needs using DAI. The results show that 22 of the subjects (51.1%) have class II malocclusion, 12 subjects (28%) have class І, while 9 subjects (20.9%) have class Ⅲ. The assessment of orthodontic treatment needs to reveal 22 cases (51.1%) fall in the normal/minor needs category, 12 subjects (28%) fall in the severe and very severe category, while 9 subjects (20.9%) fall in the definite category. Conclusion & Significance: Half of Malay transfusion-dependent thalassemia patients have Class Ⅱmalocclusion. About 28% had malocclusion and required orthodontic treatment. This research shows that Malay transfusion-dependent thalassemia may require orthodontic management; earlier intervention to reduce the complexity of the treatment later, suggesting functional appliance as a suitable treatment option for them, a twin block appliance together with headgear to restrict maxillary growth suggested for management. The current protocol implemented by the Malaysian Ministry of Health for the management of these patients seems to be sufficient since the result shows that about 28% require orthodontic treatment need, according to DAI.

Keywords: prevalence, DAI, thalassaemia, angle classification

Procedia PDF Downloads 138

Authors: Afshin Zahedi, Keivan Jamshidi

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This study was conducted to determine the neurotoxic effects of different doses of ACR on the thoracic axons of the spinal cord of rat. To evaluate this hypothesis in the thoracic axons, amino-cupric silver staining technique of the de Olmos was conducted to define the histopathologic characteristic (argyrophilia) of axonal damage following ACR exposure. For this purpose 60 adult male rats (Wistar, approximately 250 g) were selected. Rats were hosed in polycarbonate boxes as two per each. Randomly assigned groups of rats (10 rats per exposure group, total 5 exposure groups as A, B, C, D and E) were exposed to 0.5, 5, 50, 100 and 500 mg/kg per day×11days intraperitoneal injection (IP injection) respectively. The remaining 10 rats were housed in group (F) as control group. Control rats received daily injections of 0.9% saline (3ml/kg). As indices of developing neurotoxicity, weight gain, gait scores and landing hindlimb foot splay (LHF) were determined. Weight gains were measured daily prior to injection. Gait scoring involved observation of spontaneous open field locomotion, included evaluations of ataxia, hopping, rearing and hind foot placement, and hindlimb foot splay were determined 3-4 times per week. Gait score was assigned from 1-4. After 11 days, two rats for silver stain, were randomly selected, dissected and proper samples were collected from thoracic portion of the spinal cord of rat. Results did show no neurological behavior in groups A, B and F, whereas severe neurotoxicity was observed in groups C and D. Rats in groups E died within 1-2 hours due to severe toxemia. In histopathological studies based on the de Olmos technique no argyrophilic neurons or processes were observed in stained sections obtained from the thoracic portion of the spinal cord of rats belong to groups A, B and F, while moderate to severe argyrophilic changes were observed in different stained sections obtained from the thoracic portion of the spinal cord of rats belong to groups C and D.

Keywords: acrylamide, rat, axonopathy, argyrophily, de Olmos

Procedia PDF Downloads 338

Authors: Amerah Alsalem

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Aim: Laminate veneers are restorations which are envisioned to correct existing abnormalities, esthetic deficiencies, and discolorations. Laminate veneer restorations may be processed in two different ways: direct or indirect. Materials and methods: Direct composite laminate veneers require minimal preparation compared to indirect composite veneers, cost less and are easier to repair, so are useful in young patients. However, composites can have inherent limitations such as shrinkage, limited toughness; color instability and susceptibility to wear that reduce the lifespan of the restoration and cause postoperative complications. Every new material or method introduced to the field of dentistry aims to achieve esthetics and successful dental treatments with minimal invasiveness. Therefore, direct laminate veneer restorations have been developed for advanced esthetic problems of anterior teeth. Tooth discolorations, rotated teeth, coronal fractures, congenital or acquired malformations, diastemas, discolored restorations, palatally positioned teeth, the absence of lateral incisors, abrasions and erosions are the main indications for direct laminate veneer restorations. Result: Direct veneers, as esthetic procedures, have become treatment alternatives for patients with esthetic problems of anterior teeth in recent years. The cost, social and time factors have to be considered. Although ceramic laminate veneer restorations have some advantages like color stability and high resistance against abrasion, they have also some disadvantages, including high cost and long chair time. Moreover, they have some problems such as the necessity of an additional adhesive cement. Conclusion: Although there are still some disadvantages, especially discolorations and fragility, with the development of new composite resins, direct laminate veneer restorations can be a treatment option for patients with esthetic problems of anterior teeth, when applied judiciously with good patient hygiene motivation.

Keywords: direct, veneers, composite, anterior

Procedia PDF Downloads 278

Authors: Gulnara Galeeva

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The Analytic Hierarchy Process is widely used in the economic and financial studies, including the formation of investment portfolios. In this study, a generalized method of obtaining a vector of priorities for the case with separate pairwise comparisons of the expert opinion being presented as a set of several equal evaluations on a ratio scale is examined. The author claims that this method allows solving an important and up-to-date problem of excluding vagueness and ambiguity of the expert opinion in the decision making theory. The study describes the authentic wide pairwise comparison matrix. Its application in the formation of the efficient investment portfolio of intangible assets of a small business enterprise with limited funding is considered. The proposed method has been successfully approbated on the practical example of a functioning dental clinic. The result of the study confirms that the wide pairwise comparison matrix can be used as a simple and reliable method for forming the enterprise investment policy. Moreover, a comparison between the method based on the wide pairwise comparison matrix and the classical analytic hierarchy process was conducted. The results of the comparative analysis confirm the correctness of the method based on the wide matrix. The application of a wide pairwise comparison matrix also allows to widely use the statistical methods of experimental data processing for obtaining the vector of priorities. A new method is available for simple users. Its application gives about the same accuracy result as that of the classical hierarchy process. Financial directors of small and medium business enterprises get an opportunity to solve the problem of companies’ investments without resorting to services of analytical agencies specializing in such studies.

Keywords: analytic hierarchy process, decision processes, investment portfolio, intangible assets

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Authors: Arya Farjand

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This study delves into the Early Pleistocene fauna of the Yuanmou Basin, highlighting two significant findings. The first is the discovery of exceptionally well-preserved canid coprolites, which provide a rare glimpse into the diet and ecological niche of these ancient carnivores. The analysis of these coprolites has revealed a diet rich in diverse prey species, suggesting a complex food web and a dynamic ecological environment. This discovery not only sheds light on the dietary habits of these canids but also offers broader insights into the region's ecological dynamics during the Early Pleistocene. Additionally, the preservation of these coprolites allows for detailed study of the carnivore's role in the ecosystem, including their interactions with other species and the overall health of the environment. The second major finding is the identification of a mustelid species, Eirictis yuanmouensis, from the same fossil horizon as the coprolites. This discovery is crucial for understanding the diversity and evolution of Mustelidae in the region. The detailed analysis of cranial and dental morphology of Eirictis yuanmouensis indicates unique adaptations that suggest a specialized ecological niche. This finding, in conjunction with the coprolite analysis, provides a comprehensive view of the ecological niches occupied by both mustelids and hyenas, enhancing our understanding of their adaptations and interactions within this paleoenvironment. The study's significance is further amplified by the analysis of pollen data from the same horizon, which indicates a paleoenvironment characterized by rapid climatic changes and a dominant semiarid climate. This combination of faunal and floral data paints a detailed picture of the Early Pleistocene environment in the Yuanmou Basin, offering valuable insights into the interactions between different carnivore species and their adaptation strategies in response to changing environmental conditions.

Keywords: Yuanmou Basin, coprolite, Hyaena, eirictis yuanmouensis, early pleistocene

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Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt

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Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.

Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery

Procedia PDF Downloads 86

Authors: Pallavi Gajjar, Vinayak Malhotra

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Rockets have been known to have played a predominant role in spacecraft propulsion. The quintessential aspect of combustion-related requirements of a rocket engine is the minimization of the surrounding risks/hazards. Over time, it has become imperative to understand the combustion rate variation in presence of external energy source(s). Rocket propulsion represents a special domain of chemical propulsion assisted by high speed flows in presence of acoustics and thermal source(s). Jet noise leads to a significant loss of resources and every year a huge amount of financial aid is spent to prevent it. External heat source(s) induce high possibility of fire risk/hazards which can sufficiently endanger the operation of a space vehicle. Appreciable work had been done with justifiable simplification and emphasis on the linear variation of external energy source(s), which yields good physical insight but does not cater to accurate predictions. Present work experimentally attempts to understand the correlation between inter-energy conversions with the non-linear placement of external energy source(s). The work is motivated by the need to have better fire safety and enhanced combustion. The specific objectives of the work are a) To interpret the related energy transfer for combustion in presence of alternate external energy source(s) viz., thermal and acoustic, b) To fundamentally understand the role of key controlling parameters viz., separation distance, the number of the source(s), selected configurations and their non-linear variation to resemble real-life cases. An experimental setup was prepared using incense sticks as potential fuel and paraffin wax candles as the external energy source(s). The acoustics was generated using frequency generator, and source(s) were placed at selected locations. Non-equidistant parametric experimentation was carried out, and the effects were noted on regression rate changes. The results are expected to be very helpful in offering a new perspective into futuristic rocket designs and safety.

Keywords: combustion, acoustic energy, external energy sources, regression rate

Procedia PDF Downloads 137

Authors: Fengxia Li, Lufeng Zhang, Haibo Wang

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The tight sandstone gas reservoir in the Xujiahe Formation of the Sichuan Basin has huge reserves, but its utilization rate is low. Fracturing and stimulation are indispensable technologies to unlock their potential and achieve commercial exploitation. Slickwater is the most widely used fracturing fluid system in the fracturing and renovation of tight reservoirs. However, its viscosity is low, its sand-carrying performance is poor, and the risk of sand blockage is high. Increasing the sand carrying capacity by increasing the displacement will increase the frictional resistance of the pipe string, affecting the resistance reduction performance. The variable viscosity slickwater can flexibly switch between different viscosities in real-time online, effectively overcoming problems such as sand carrying and resistance reduction. Based on a self-developed indoor loop friction testing system, a visualization device for proppant transport, and a HAAKE MARS III rheometer, a comprehensive evaluation was conducted on the performance of variable viscosity slickwater, including resistance reduction, rheology, and sand carrying. The indoor experimental results show that: 1. by changing the concentration of drag-reducing agents, the viscosity of the slippery water can be changed between 2~30mPa. s; 2. the drag reduction rate of the variable viscosity slickwater is above 80%, and the shear rate will not reduce the drag reduction rate of the liquid; under indoor experimental conditions, 15mPa. s of variable viscosity and slickwater can basically achieve effective carrying and uniform placement of proppant. The layered fracturing effect of the JiangX well in the dense sandstone of the Xujiahe Formation shows that the drag reduction rate of the variable viscosity slickwater is 80.42%, and the daily production of the single layer after fracturing is over 50000 cubic meters. This study provides theoretical support and on-site experience for promoting the application of variable viscosity slickwater in tight sandstone gas reservoirs.

Keywords: slickwater, hydraulic fracturing, dynamic sand laying, drag reduction rate, rheological properties

Procedia PDF Downloads 70

Authors: Dana Page, Erica McClure, Kate Snider, Jenni Pollard, Tim Landrum, Jeff Valentine

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Extensive research has been conducted on students with emotional and behavioral disorders (EBD) and their rates of challenging behavior. In the past, however, less attention has been given to their academic achievement and outcomes. Recent research examining outcomes for students with EBD has indicated that these students receive lower grades, are less likely to pass classes, and experience higher rates of school dropout than students without disabilities and students with other high incidence disabilities. Given that between 2% and 20% of the school-age population is likely to have EBD (though many may not be identified as such), this is no small problem. Despite the need for increased examination of this population’s academic achievement, research on the actual performance of students with EBD has been minimal. This study reports the results of a meta-analysis of the limited research examining academic achievement of students with EBD, including effect sizes of assessment scores and discussion of moderators potentially impacting academic outcomes. Researchers conducted a thorough literature search to identify potentially relevant documents before screening studies for inclusion in the systematic review. Screening identified 35 studies that reported results of academic assessment scores for students with EBD. These studies were then coded to extract descriptive data across multiple domains, including placement of students, participant demographics, and academic assessment scores. Results indicated possible collinearity between EBD disability status and lower academic assessment scores, despite a lack of association between EBD eligibility and lower cognitive ability. Quantitative analysis of assessment results yielded effect sizes for academic achievement of student participants, indicating lower performance levels and potential moderators (e.g., race, socioeconomic status, and gender) impacting student academic performance. In addition to discussing results of the meta-analysis, implications and areas for future research, policy, and practice are discussed.

Keywords: students with emotional behavioral disorders, academic achievement, systematic review, meta-analysis

Procedia PDF Downloads 60

Authors: Masayuki Mori

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This study investigates the relationship between teachers’ perceptions of the usability of classroom space and various elements, including both physical and non-physical, of classroom environments. With the introduction of the GIGA School funding program in Japan in 2019, understanding its impact on learning in classroom space is crucial. The program enabled local educational authorities (LEA) to make it possible to provide one PC/tablet for each student of both elementary and junior high schools. Moreover, at the same time, the program also supported LEA to purchase other electronic devices for educational purposes such as electronic whiteboards, large displays, and real image projectors. A nationwide survey was conducted using random sampling methodology among 100 junior high schools to collect data on classroom space. Of those, 60 schools responded to the survey. The survey covered approximately fifty items, including classroom space size, class size, and educational electronic devices owned. After the data compilation, statistical analysis was used to identify correlations between the variables and to explore the extent to which classroom environment elements influenced teachers’ perceptions. Furthermore, decision tree analysis was applied to visualize the causal relationships between the variables. The findings indicate a significant negative correlation between class size and teachers’ evaluation of usability. In addition to the class size, the way students stored their belongings also influenced teachers’ perceptions. As for the placement of educational electronic devices, the installation of a projector produced a small negative correlation with teachers’ perceptions. The study suggests that while the GIGA School funding program is not significantly influential, traditional educational conditions such as class size have a greater impact on teachers’ perceptions of the usability of classroom space. These results highlight the need for awareness and strategies to integrate various elements in designing the learning environment of the classroom for teachers and students to improve their learning experience.

Keywords: classroom space, GIGA School, questionnaire survey, teachers’ perceptions

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Authors: W. Thepsuwan, N. Monmaturapoj

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Calcium phosphate cements (CPCs) is one of the most attractive bioceramics due to its moldable and shape ability to fill complicated bony cavities or small dental defect positions. In this study, CPCs were produced by using mixtures of tetracalcium phosphate (TTCP, Ca4O(PO4)2) and dicalcium phosphate anhydrous (DCPA, CaHPO4) in equimolar ratio (1/1) with aqueous solutions of acetic acid (C2H4O2) and disodium hydrogen phosphate dehydrate (Na2HPO4.2H2O) in combination with sodium alginate in order to improve theirs moldable characteristic. The concentrations of the aqueous solutions and sodium alginate were varied to investigate the effects of different aqueous solution and alginate on properties of the cements. The cement paste was prepared by mixing cement powder (P) with aqueous solution (L) in a P/L ratio of 1.0 g/ 0.35 ml. X-ray diffraction (XRD) was used to analyses phase formation of the cements. Setting times and compressive strength of the set CPCs were measured using the Gilmore apparatus and Universal testing machine, respectively. The results showed that CPCs could be produced by using both basic (Na2HPO4.2H2O) and acidic (C2H4O2) solutions. XRD results show the precipitation of hydroxyapatite in all cement samples. No change in phase formation among cements using difference concentrations of Na2HPO4.2H2O solutions. With increasing concentration of acidic solutions, samples obtained less hydroxyapatite with a high dicalcium phosphate dehydrate leaded to a shorter setting time. Samples with sodium alginate exhibited higher crystallization of hydroxyapatite than that of without alginate as a result of shorten setting time in basic solution but a longer setting time in acidic solution. The stronger cement was attained from samples using acidic solution with sodium alginate; however it was lower than using the basic solution.

Keywords: calcium phosphate cements, TTCP, DCPA, hydroxyapatite, properties

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Authors: Zhaopeng Zhu, Xianzhi Song, Gensheng Li

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Transports of solid particles through the drill pipe, drill string-hole annulus and hydraulically generated fractures are important dynamic processes encountered in oil and gas well drilling and completion operations. Different from particle transport in infinite space, the transports of cuttings, proppants and formation sand are hindered by a finite boundary. Therefore, an accurate description of the particle transport behavior under the bounded wall conditions encountered in drilling and hydraulic fracturing operations is needed to improve drilling safety and efficiency. In this study, the particle settling experiments were carried out to investigate the particle settling behavior in the pipe, annulus and between the parallel plates filled with power-law fluids. Experimental conditions simulated the particle Reynolds number ranges of 0.01-123.87, the dimensionless diameter ranges of 0.20-0.80 and the fluid flow behavior index ranges of 0.48-0.69. Firstly, the wall effect of the annulus is revealed by analyzing the settling process of the particles in the annular geometry with variable inner pipe diameter. Then, the geometric continuity among the pipe, annulus and parallel plates was determined by introducing the ratio of inner diameter to an outer diameter of the annulus. Further, a unified dimensionless diameter was defined to confirm the relationship between the three different geometry in terms of the wall effect. In addition, a dimensionless term independent from the settling velocity was introduced to establish a unified explicit settling velocity model applicable to pipes, annulus and fractures with a mean relative error of 8.71%. An example case study was provided to demonstrate the application of the unified model for predicting particle settling velocity. This paper is the first study of annulus wall effects based on the geometric continuity concept and the unified model presented here will provide theoretical guidance for improved hydraulic design of cuttings transport, proppant placement and sand management operations.

Keywords: wall effect, particle settling velocity, cuttings transport, proppant transport in fracture

Procedia PDF Downloads 156

Authors: Muñiz-Lino Marcos A.

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The ectomesenchymal tissues involved in tooth development and their remnants are the origin of different odontogenic lesions, including tumors and cysts of the jaws, with a wide range of clinical behaviors. A dentigerous cyst (DC) represents approximately 20% of all cases of odontogenic cysts, and it has been demonstrated that it can develop benign and malignant odontogenic tumors. DC is characterized by bone destruction of the area surrounding the crown of a tooth that has not erupted and contains liquid. The treatment of odontogenic tumors and cysts usually involves a partial or total removal of the jaw, causing important secondary co-morbidities. However, molecules implicated in DC pathogenesis, as well as in its development into odontogenic tumors, remain unknown. A cellular model may be useful to study these molecules, but that model has not been established yet. Here, we reported the establishment of a cell culture derived from a dentigerous cyst. This cell line was named DeCy-1. In spite of its ectomesenchymal morphology, DeCy-1 cells express epithelial markers such as cytokeratins 5, 6, and 8. Furthermore, these cells express the ODAM protein, which is present in odontogenesis and in dental follicles, indicating that DeCy-1 cells are derived from odontogenic epithelium. Analysis by electron microscopy of this cell line showed that it has a high vesicular activity, suggesting that DeCy-1 could secrete molecules that may be involved in DC pathogenesis. Thus, secreted proteins were analyzed by PAGE-SDS where we observed approximately 11 bands. In addition, the capacity of these secretions to degrade proteins was analyzed by gelatin substrate zymography. A degradation band of about 62 kDa was found in these assays. Western blot assays suggested that the matrix metalloproteinase 2 (MMP-2) is responsible for this protease activity. Thus, our results indicate that the establishment of a cell line derived from DC is a useful in vitro model to study the biology of this odontogenic lesion and its participation in the development of odontogenic tumors.

Keywords: dentigerous cyst, ameloblastoma, MMP-2, odontogenic tumors

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Authors: Kruti Jaruriya

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Distribution of arsenic (As) and its compound and related toxicology are serious concerns. This is particularly so since millions worldwide are suffering from toxicity due to drinking of As-contaminated groundwater. The Bengal delta plain, formed by the Ganga– Padma–Meghna–Brahmaputra river basin, covering several districts of West Bengal, India and Bangladesh is considered as the worst As affected alluvial basin. However, some equally affected, if not more, areas are emerging in upper Brahmaputra plains. The present study was carried out to examine As contamination trends in the worst affected part of Assam, India. Arsenic (As) mobilization to the groundwater of Brahmaputra floodplains was investigated in Titabor, Jorhat District, located in the North Eastern part of India. The groundwater and the aquifer geochemistry were characterized. The groundwater is characterized by high dissolved Fe, Mn, and HCO-3 and low concentrations of NO-3 and SO2-4 indicating anoxic conditions prevailing in the groundwater. Fifty groundwater samples collected from shallow and deep tubewells of Titabor, Jorhat district (Assam) were examined. Along with total As, examination of concentration levels of other key parameters, viz., pH, EC, Fe, Mn , Mg2+, Ca2+, Na+, K+, PO43- , HCO-3 , NO3- ,Cl - and SO42- was also carried out. In respect to the permissible guideline of World Health Organization (WHO: As 0.01 ppm, Fe 1.0 ppm, and Mn 0.3 ppm for potable water), the range of As concentration in the groundwater varied from 0.014 to 0.604 mg/L with mean concentration 0.184 mg/L. The present study showed that out of the 50 groundwater samples,100%, 54%, and 42% were found contaminated with higher metal contents (for total As, Fe, and Mn, respectively). The results of hydrogeochemical study revealed that the reductive dissolution of MnOOH and FeOOH represents an important mechanism of arsenic release in the study area along with major cations playing an important role in leaching of As into the groundwater. Arsenic released by oxidation of pyrite, as water levels are drawn down and air enters the aquifer, contributes negligibly to the problem of As pollution. Identification of the mechanism of As release to groundwater helps to provide a framework to guide the placement of new water wells so that they will have acceptable concentrations of As.

Keywords: arsenic, assam, brahmaputra floodplain, groundwater, hydrogeochemistry

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Authors: Allaire Eric, Hauet Pascal, Floresco Jean, Beley Sebastien, Sussman Helene, Virag Ronald

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Background: Caverno-venous leakage (CVL) is devastating, although barely known disease, the first cause of major physical impairment in men under 25, and responsible for 50% of resistances to phosphodiesterase 5-inhibitors (PDE5-I), affecting 30 to 40% of users in this medication class. In this condition, too early blood drainage from corpora cavernosa prevents penile rigidity and penetration during sexual intercourse. The role of conservative surgery in this disease remains controversial. Aim: Assess complications and results of combined open surgery and embolization for CVL. Method: Between June 2016 and September 2021, 133 consecutive patients underwent surgery in our institution for CVL, causing severe erectile dysfunction (ED) resistance to oral medical treatment. Procedures combined vein embolization and ligation with microsurgical techniques. We performed a pre-and post-operative clinical (Erection Harness Scale: EHS) hemodynamic evaluation by duplex sonography in all patients. Before surgery, the CVL network was visualized by computed tomography cavernography. Penile EMG was performed in case of diabetes or suspected other neurological conditions. All patients were optimized for hormonal status—data we prospectively recorded. Results: Clinical signs suggesting CVL were ED since age lower than 25, loss of erection when changing position, penile rigidity varying according to the position. Main complications were minor pulmonary embolism in 2 patients, one after airline travel, one with Factor V Leiden heterozygote mutation, one infection and three hematomas requiring reoperation, one decreased gland sensitivity lasting for more than one year. Mean pre-operative pharmacologic EHS was 2.37+/-0.64, mean pharmacologic post-operative EHS was 3.21+/-0.60, p<0.0001 (paired t-test). The mean EHS variation was 0.87+/-0.74. After surgery, 81.5% of patients had a pharmacologic EHS equal to or over 3, allowing for intercourse with penetration. Three patients (2.2%) experienced lower post-operative EHS. The main cause of failure was leakage from the deep dorsal aspect of the corpus cavernosa. In a 14 months follow-up, 83.2% of patients had a clinical EHS equal to or over 3, allowing for sexual intercourse with penetration, one-third of them without any medication. 5 patients had a penile implant after unsuccessful conservative surgery. Conclusion: Open surgery combined with embolization for CVL is an efficient approach to CVL causing severe erectile dysfunction.

Keywords: erectile dysfunction, cavernovenous leakage, surgery, embolization, treatment, result, complications, penile duplex sonography

Procedia PDF Downloads 142

Authors: Ava Zarif Sanayei, Sedigheh Sina

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Interventional radiology (IR) uses imaging guidance, including X-rays and CT scans, to deliver therapy precisely. Most IR procedures are performed under local anesthesia and start with a small needle being inserted through the skin, which may be called pinhole surgery or image-guided surgery. There is increasing concern about radiation exposure during interventional radiology procedures due to procedure complexity. The basic aim of optimizing radiation protection as outlined in ICRP 139, is to strike a balance between image quality and radiation dose while maximizing benefits, ensuring that diagnostic interpretation is satisfactory. This study aims to estimate the equivalent doses to the main trunk of the body for the Interventional radiologist and Superintendent using LiF: Mg, Ti (TLD-100) chips at the IR department of a hospital in Shiraz, Iran. In the initial stage, the dosimeters were calibrated with the use of various phantoms. Afterward, a group of dosimeters was prepared, following which they were used for three months. To measure the personal equivalent dose to the body, three TLD chips were put in a tissue-equivalent batch and used under a protective lead apron. After the completion of the duration, TLDs were read out by a TLD reader. The results revealed that these individuals received equivalent doses of 387.39 and 145.11 µSv, respectively. The findings of this investigation revealed that the total radiation exposure to the staff was less than the annual limit of occupational exposure. However, it's imperative to implement appropriate radiation protection measures. Although the dose received by the interventional radiologist is a bit noticeable, it may be due to the reason for using conventional equipment with over-couch x-ray tubes for interventional procedures. It is therefore important to use dedicated equipment and protective means such as glasses and screens whenever compatible with the intervention when they are available or have them fitted to equipment if they are not present. Based on the results, the placement of staff in an appropriate location led to increasing the dose to the radiologist. Manufacturing and installation of moveable lead curtains with a thickness of 0.25 millimeters can effectively minimize the radiation dose to the body. Providing adequate training on radiation safety principles, particularly for technologists, can be an optimal approach to further decreasing exposure.

Keywords: interventional radiology, personal monitoring, radiation protection, thermoluminescence dosimetry

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Authors: Laura Canagueral-Pellice, Antonio Munar-Frau, Adaia Valls-Ontanon, Joao Carames, Federico Hernandez-Alfaro, Jordi Caballe-Serrano

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Objective: Guided bone regeneration (GBR) aims to replace the missing bone with a new structure to achieve long-term stability of rehabilitations. The aim of the present systematic review and meta-analysis is to determine the effect of barrier membranes on histological outcomes after GBR procedures. Moreover, the effect of the grafting material and tissue gain were analyzed. Materials & methods: Two independent reviewers performed an electronic search in Pubmed and Scopus, identifying all eligible publications up to March 2020. Only randomized controlled trials (RCTs) assessing a histological analysis of augmented areas were included. Results: A total of 6 publications were included for the present systematic review. A total of 110 biopsied sites were analysed; 10 corresponded to vertical bone augmentation procedures, whereas 100 analysed horizontal regeneration procedures. A mean tissue gain of 3 ± 1.48mm was obtained for horizontal defects. Histological assessment of new bone formation, residual particle and sub-epithelial connective tissue (SCT) was reported. The four main barrier membranes used were natural collagen membranes, e-PTFE, polylactic resorbable membranes and acellular dermal matrix membranes (AMDG). The analysis demonstrated that resorbable membranes result in higher values of new bone formation and lower values of residual particles and SCT. Xenograft resulted in lower new bone formation compared to allograft; however, no statistically significant differences were observed regarding residual particle and SCT. Overall, regeneration procedures adding autogenous bone, plasma derivate or growth factors achieved in general greater new bone formation and tissue gain. Conclusions: There is limited evidence favoring the effect of a certain type of barrier membrane in GBR. Data needs to be evaluated carefully; however, resorbable membranes are correlated with greater new bone formation values, especially when combined with allograft materials and/or the addition of autogenous bone, platelet reach plasma (PRP) or growth factors in the regeneration area. More studies assessing the histological outcomes of different GBR protocols and procedures testing different biomaterials are needed to maximize the clinical and histological outcomes in bone regeneration science.

Keywords: barrier membrane, graft material, guided bone regeneration, implant surgery, histology

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Authors: N. G. I. Aroshana, S. Edirisooriya

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Construction of highway is the most emerging development tendency in Sri Lanka. With these development activities, there are a lot of environmental and social issues started. Landscape fragmentation is one of the main issues that highly effect to the environment by the construction of expressways. Sri Lankan expressway system getting effort to treat fragmented landscape by using highway crossing structures. This paper designates, a highway post construction landscape study on the effectiveness of the landscape connectivity structures to restore connectivity. Geographic Information Systems (GIS), least cost path tool has been used in the selected two plots; 25km alone the expressway to identify animal crossing paths. Animal accident data use as measure for determining the most contributed plot for landscape connectivity. Number of patches, Mean patch size, Class area use as a parameter to determine the most effective land use class to reestablish the landscape connectivity. The findings of the research express scrub, grass and marsh were the most positively affected land use typologies for increase the landscape connectivity. It represents the growth increased by 8% within the 12 years of time. From the least cost analysis within the plot one, 28.5% of total animal crossing structures are within the high resistance land use classes. Southern expressway used reinforced compressed earth technologies for construction. It has been controlled the growth of the climax community. According to all findings, it could assume that involvement of the landscape crossing structures contributes to re-establish connectivity, but it is not enough to restore the majority of disturbance performed by the expressway. Connectivity measures used within the study can use as a tool for re-evaluate future involvement of highway crossing structures. Proper placement of the highway crossing structures leads to increase the rate of connectivity. The study recommends that monitoring the all stages (preconstruction, construction and post construction) of the project and preliminary design, and the involvement of the research applied connectivity assessment strategies helps to overcome the complication regarding the re-establishment of landscape connectivity using the highway crossing structures that facilitate the growth of flora and fauna.

Keywords: landscape fragmentation, least cost path, land use analysis, landscape connectivity structures

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Authors: Mona Almanasef, Dalia Almaghaslah, Geetha Kandasamy, Rajalakshimi Vasudevan, Sadia Batool

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Background: Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers to the provision of these services in Saudi Arabia. Materials and Methods: This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in the Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers to practicing public health roles. Results: The total number of respondents was 193. The proportion of respondents who reported that they were “very involved” or “involved” in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counseling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunization. Most of the barriers in the current research were rated as having low relevance to the provision of public health services. Conclusion: Findings in the current research suggest that community pharmacists in the Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

Keywords: community pharmacist, public health, Asir region, Saudi Arabia

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Authors: Zhichao Song, Swanand Vaidya

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Nowadays, most portable (e.g., smartphones) and wearable (e.g., smartwatches and earphones) consumer hardware are designed to be dustproof following IP5 or IP6 ratings to ensure the product is able to handle potentially dusty outdoor environments. On the other hand, the design guideline is relatively vague for indoor devices (e.g., smart displays and speakers). While it is generally believed that the indoor environment is much less dusty, in certain circumstances, dust ingression is still able to cause functional failures, such as microphone frequency response shift and camera black spot, or cosmetic dissatisfaction, mainly the dust build up in visible pockets and gaps which is hard to clean. In this paper, we developed a simulation methodology to analyze dust settlement and ingression into known ports of a device. A closed system is initialized with dust particles whose sizes follow Weibull distribution based on data collected in a user study, and dust particle movement was approximated as a settlement in stationary fluid, which is governed by Stokes’ law. Following this method, we simulated dust ingression into MEMS microphone through the acoustic port and protective mesh. Various design and environmental parameters are evaluated including mesh pore size, acoustic port depth-to-diameter ratio, mass density of dust material and inclined angle of microphone port. Although the dependencies of dust resistance on these parameters are all monotonic, smaller mesh pore size, larger acoustic depth-to-opening ratio and more inclined microphone placement (towards horizontal direction) are preferred for dust resistance; these preferences may represent certain trade-offs in audio performance and compromise in industrial design. The simulation results suggest the quantitative ranges of these parameters, with more pronounced effects in the improvement of dust resistance. Based on the simulation results, we proposed several design guidelines that intend to achieve an overall balanced design from audio performance, dust resistance, and flexibility in industrial design.

Keywords: dust settlement, numerical simulation, microphone design, Weibull distribution, Stoke's equation

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Authors: Rashida Rahmat Zohra, Afsheen Aman, Shah Ali Ul Qader

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Commercially important biopolymer, dextran, is enzymatically degraded into lower molecular weight fractions of vast industrial potential. Various organisms are associated with dextranase production, among which fungal, yeast and bacterial origins are used for commercial production. Dextranases are used to remove contaminating dextran in sugar processing industry and also used in oral care products for efficient removal of dental plaque. Among the hydrolytic products of dextran, isomaltooligosaccharides have prebiotic effect in humans and reduces the cariogenic effect of sucrose in oral cavity. Dextran derivatives produced by hydrolysis of high molecular polymer are also conjugated with other chemical and metallic compounds for usage in pharmaceutical, fine chemical industry, cosmetics, and food industry. Owing to the vast application of dextran and dextranases, current study focused on purification and analysis of kinetic parameters of dextranase from a newly isolated strain of Bacillus licheniformis KIBGE-IB25. Dextranase was purified up to 35.75 folds with specific activity of 1405 U/mg and molecular weight of 158 kDa. Analysis of kinetic parameters revealed that dextranase performs optimum cleavage of low molecular weight dextran (5000 Da, 0.5%) at 35ºC in 15 min at pH 4.5 with a Km and Vmax of 0.3738 mg/ml and 182.0 µmol/min, respectively. Thermal stability profiling of dextranase showed that it retained 80% activity up to 6 hours at 30-35ºC and remains 90% active at pH 4.5. In short, the dextranase reported here performs rapid cleavage of substrate at mild operational conditions which makes it an ideal candidate for dextran removal in sugar processing industry and for commercial production of low molecular weight oligosaccharides.

Keywords: Bacillus licheniformis, dextranase, gel permeation chromatograpy, enzyme purification, enzyme kinetics

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Authors: Belyayev P. E., Makeyeva I. R., Mastyuk D. A., Pigasov E. E.

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Previously, the phrase ”hydrogen safety” was often used in terms of NPP safety. Due to the rise of interest to “green” and, particularly, hydrogen power engineering, the problem of hydrogen safety at industrial facilities has become ever more urgent. In Russia, the industrial production of hydrogen is meant to be performed by placing a chemical engineering plant near NPP, which supplies the plant with the necessary energy. In this approach, the production of hydrogen involves a wide range of combustible gases, such as methane, carbon monoxide, and hydrogen itself. Considering probable incidents, sudden combustible gas outburst into open space with further ignition is less dangerous by itself than ignition of the combustible mixture in the presence of many pipelines, reactor vessels, and any kind of fitting frames. Even ignition of 2100 cubic meters of the hydrogen-air mixture in open space gives velocity and pressure that are much lesser than velocity and pressure in Chapman-Jouguet condition and do not exceed 80 m/s and 6 kPa accordingly. However, the space blockage, the significant change of channel diameter on the way of flame propagation, and the presence of gas suspension lead to significant deflagration acceleration and to its transition into detonation or quasi-detonation. At the same time, process parameters acquired from the experiments at specific experimental facilities are not general, and their application to different facilities can only have a conventional and qualitative character. Yet, conducting deflagration and detonation experimental investigation for each specific industrial facility project in order to determine safe infrastructure unit placement does not seem feasible due to its high cost and hazard, while the conduction of numerical experiments is significantly cheaper and safer. Hence, the development of a numerical method that allows the description of reacting flows in domains with complex geometry seems promising. The base for this method is the modification of Kuropatenko method for calculating shock waves recently developed by authors, which allows using it in Eulerian coordinates. The current work contains the results of the development process. In addition, the comparison of numerical simulation results and experimental series with flame propagation in shock tubes with orifice plates is presented.

Keywords: CFD, reacting flow, DDT, gas explosion

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Authors: Maryam Bahreini, Mostafa Talebi Garekani, Fatemeh Rasooli, Atefeh Abdollahi

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Introduction: Procedural sedation and analgesia have been desirable to handle painful procedures. The trend to find the agent with more efficacy and less complications is still controversial; thus, many sedative regimens have been studied. This study tried to assess the effectiveness and adverse effects of thiopental sodium-fentanyl with the known medication, ketamine-propofol for procedural sedation in the emergency department. Methods: Consenting patients were enrolled in this randomized double-blind trial to receive either 1:1 ketamine-propofol (KP) or thiopental-fentanyl (TF) 1:1 mg: Mg proportion on a weight-based dosing basis to reach the sedation level of American Society of Anesthesiologist class III/IV. The respiratory and hemodynamic complications, nausea and vomiting, recovery agitation, patient recall and satisfaction, provider satisfaction and recovery time were compared. The study was registered in Iranian randomized Control Trial Registry (Code: IRCT2015111325025N1). Results: 96 adult patients were included and randomized, 47 in the KP group and 49 in the TF group. 2.1% in the KP group and 8.1 % in the TF group experienced transient hypoxia leading to performing 4.2 % versus 8.1 % airway maneuvers for 2 groups, respectively; however, no statistically significant difference was observed between 2 combinations, and there was no report of endotracheal placement or further admission. Patient and physician satisfaction were significantly higher in the KP group. There was no difference in respiratory, gastrointestinal, cardiovascular and psychiatric adverse events, recovery time and patient recall of the procedure between groups. The efficacy and complications were not related to the type of procedure or patients’ smoking or addiction trends. Conclusion: Ketamine-propofol and thiopental-fentanyl combinations were effectively comparable although KP resulted in higher patient and provider satisfaction. It is estimated that thiopental fentanyl combination can be as potent and efficacious as ketofol with relatively similar incidence of adverse events in procedural sedation.

Keywords: adverse effects, conscious sedation, fentanyl, propofol, ketamine, safety, thiopental

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Authors: N. Jait, M. Maamar, H. Khibri, H. Harmouche, N. Mouatssim, W. Ammouri, Z. Tazimezaelek, M. Adnaoui

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Introduction: Uveitis presents with inflammation of the uvea, intraocular, of heterogeneous etiology and presentation. The objective of our study is to describe the clinical and therapeutic characteristics of infectious uveitis in HIV+ and HIV- patients. Patients and Methods: This is a retrospective study conducted at the internal medicine department of CHU Ibn Sina in Rabat over a period of 12 years (2010–2021), collecting 42 cases of infectious uveitis. Results: 42 patients were identified. 34% (14 cases) had acquired immunosuppression (9 cases: 22% had HIV infection and 12% were on chemotherapy), and 66% were immunocompetent. The M/F sex ratio was 1.1. The average age was 39 years old. Uveitis revealed HIV in a single case; 8/9 patients have already been followed, their average viral load is 3.4 log and an average CD4 count is 356/mm³. The revealing functional signs were: ocular redness (27%), decreased visual acuity (63%), visual blurring (40%), ocular pain (18%), scotoma (13%), and headaches (4%). The uveitis was site: anterior (30%), intermediate (6%), posterior (32%), and pan-uveitis (32%); unilateral in 80% of patients and bilateral in 20%. The etiologies of uveitis in HIV+ were: 3 cases of CMV, 2 cases of toxoplasmosis, 1 case of tuberculosis, 1 case of HSV, 1 case of VZV, and 1 case of syphilis. Etiologies of immunocompetent patients: tuberculosis (41%), toxoplasmosis (18%), syphilis (15%), CMV infection (4 cases: 10%), HSV infection (4 cases: 10%) , lepromatous uveitis (1 case: 2%), VZV infection (1 case: 2%), a locoregional infectious cause such as dental abscess (1 case: 2%), and one case of borreliosis (3% ). 50% of tuberculous uveitis was of the pan-uveitis type, 75% of the uveitis by toxoplasmosis was of the posterior type. Uveitis was associated with other pathologies in 2 seropositive cases (cerebral vasculitis, multifocal tuberculosis). A specific treatment was prescribed in all patients. The initial evolution was favorable in 67%, including 12% HIV+. 11% presented relapses of the same seat during uveitis of the toxoplasmic, tuberculous and herpetic type. 47% presented complications, of which 4 patients were HIV+: 3 retinal detachments; 7 Retinal hemorrhages. 6 unilateral blindness (including 2 HIV+ patients). Conclusion: In our series, the etiologies of infectious uveitis differ between HIV+ and HIV- patients. In HIV+ patients most often had toxoplasmosis and CMV, while HIV - patients mainly presented with tuberculosis and toxoplasmosis. The association between HIV and uveitis is undetermined, but HIV infection was an independent risk factor for uveitis.

Keywords: uveitis, HIV, immunosuppression, infection

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Authors: Muñiz-Lino Marcos Agustín, Vazquez Borbolla Jessica, Licéaga-Escalera Carlos

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The ectomesenchymal tissues involved in tooth development and their remnants are the origin of different odontogenic lesions, including tumors and cysts of the jaws, with a wide range of clinical behaviors. Dentigerous cyst (DC) represents approximately 20% of all cases of odontogenic cysts, and it has been demonstrated that it can develop benign and malignant odontogenic tumors. DC is characterized by bone destruction of the area surrounding the crown of a tooth which has not erupted and it contain is liquid. The treatment of odontogenic tumors and cysts usually are partial or total removal of the jaw, causing important secondary co-morbidities. However, molecules implicated in DC pathogenesis as well in its development to odontogenic tumors remains unknown. A cellular model may be useful to study these molecules, but that model has not been established yet. Here, we reported the establishment of a cell culture derived from a dentigerous cyst. This cell line was named DeCy-1. In spite of its ectomesenchymal morphology, DeCy-1 cells express epithelial markers such as cytokeratins 5, 6, and 8. Furthermore, these cells express the ODAM protein, which is present in odontogenesis and in dental follicle, indicating that DeCy-1 cells derived from odontogenic epithelium. Analysis by electron microscopy of this cell line showed that it has a high vesicular activity, suggesting that DeCy-1 could secrete molecules that may be involved in DC pathogenesis. Thus, secreted proteins were analyzed by PAGE-SDS, where we observed approximately 11 bands. In addition, the capacity of these secretions to degrade proteins was analyzed by gelatin substrate zymography. A degradation band of about 62 kDa was found in these assays. Western blot assays suggested that the matrix metalloproteinase 2 (MMP-2) is responsible of this protease activity. Thus, our results indicate that the establishment of a cell line derived from DC is a useful in vitro model to study the biology of this odontogenic lesion and its participation in the development of odontogenic tumors.

Keywords: dentigerous cyst, MMP20, cancer, cell culture

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Authors: Arkinzhan Mametov, Alexey Abilov

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Strong earthquakes are dangerous natural phenomena that lead to the destruction of entire cities and the death of a large number of people. The recent strong earthquakes in Turkey and in a number of other states have shown that as a result of them, there are significant human casualties and huge destruction. The city of Almaty is located in the foothill basin of the Trans-Ili Alatau of the Tien Shan Mountain system, in a zone with 9–10-point seismicity. Almaty (formerly Verniy) was founded in 1856 and, since that period, has experienced two catastrophic earthquakes - in 1887 and 1911, which led almost to the complete destruction of the city. Since that time, according to seismologists, the city has been annually exposed to small seismic impacts of 2-3 points. This forced the subsequent search for ways to protect buildings and the public through the use of earthquake-resistant structures and materials, limiting the number of stores of buildings and increasing gaps between them, which was carried out quite consistently and since 1957. However, at present, it is necessary to state a number of violations, primarily of the urban development plan – the placement of high-density multi-stores commercial housing in the urban environment, bypassing the existing regulations and standards in the city. Their appearance contributes to a greater concentration of residents transport in a limited area, which can lead to harmful consequences during powerful earthquakes. The experience of eliminating the consequences of catastrophic earthquakes shows that an important factor in reducing human losses is timely technical and medical assistance to victims of earthquakes, the elimination of blockages, provision of temporary housing and evacuation of the population, especially in winter. In cities located in areas with high seismicity, it is necessary to ensure strict compliance with the requirements of urban development regulations, taking into account the entire complex of planning and organizational measures to minimize the destruction of buildings and human casualties.

Keywords: high seismic zones, urban planning regulations, special standards for planing, minimizing the human casualties

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Authors: F. DelGaudio, H. Gill

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Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.

Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation

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Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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