Search results for: guided bone regeneration technique

Authors: Luke Sniewski, Pante Farvid, Phil Carter, Rita Csako

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Background and Aims: Self-Perceived Problematic Porn Use (SPPPU) refers to individuals who identify as or perceive themselves to be addicted to porn. These individuals feel they are unable to regulate their porn consumption and experience adverse consequences as a result of their use in everyday life. To the author’s best knowledge, this research represents the first study to intervene with pornography use with mindfulness meditation, and aims to investigate the experiences and challenges of men with SPPPU as they engage in a mindfulness meditation intervention. As meditation is commonly characterized by sitting and observing one’s internal experience with non-reaction and acceptance, the study’s principal hypothesis was that consistent practice of meditation would develop the participant’s capacity to respond to cravings, urges, and unwanted thoughts in less reactive, more productive ways. Method: This 12-mixed method research utilised Single Case Experimental Design (SCED) methodology, with a standard AB design. Each participant was randomly assigned to an initial baseline time period between 2 to 5 weeks before learning the meditation technique and practicing it for the remainder of the 12-week study. The pilot study included 3 participants, while the intervention study included 12. The meditation technique used for the study involved a 15-minute guided breathing exercise in the morning, along with a 15-minute guided concentration meditation in the evening. Results: At the time of submission, only pilot study results were available. Results from the pilot study indicate an improved capacity for self-awareness of the uncomfortable mental and emotional states that drove their participants’ pornography use. Statistically significant reductions were also observed in daily porn use, total weekly time spent viewing porn, as well as lowered Pornography Craving Questionnaire (PCQ) and Problematic Pornography Use Scale (PPUS) scores. Conclusion: Pilot study results suggest that meditation could serve as a complementary tool for health professionals to provide clients in conjunction with therapeutic interventions. Study limitations, directions for future research, and clinical implications to be discussed as well.

Keywords: meditation, behavioural change, pornography, mindfulness

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Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim

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The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.

Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis

Procedia PDF Downloads 367

Authors: Regina Rekuviene, Vykintas Samaitis, Liudas Mažeika, Audrius Jankauskas, Virginija Jankauskaitė, Laura Gegeckienė, Abdolali Sadaghiani, Shaghayegh Saeidiharzand

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Icing brings significant damage to aviation and renewable energy installations. Air-conditioning, refrigeration, wind turbine blades, airplane and helicopter blades often suffer from icing phenomena, which cause severe energy losses and impair aerodynamic performance. The icing process is a complex phenomenon with many different causes and types. Icing mechanisms, distributions, and patterns are still relevant to research topics. The adhesion strength between ice and surfaces differs in different icing environments. This makes the task of anti-icing very challenging. The techniques for various icing environments must satisfy different demands and requirements (e.g., efficient, lightweight, low power consumption, low maintenance and manufacturing costs, reliable operation). It is noticeable that most methods are oriented toward a particular sector and adapting them to or suggesting them for other areas is quite problematic. These methods often use various technologies and have different specifications, sometimes with no clear indication of their efficiency. There are two major groups of anti-icing methods: passive and active. Active techniques have high efficiency but, at the same time, quite high energy consumption and require intervention in the structure’s design. It’s noticeable that vast majority of these methods require specific knowledge and personnel skills. The main effect of passive methods (ice-phobic, superhydrophobic surfaces) is to delay ice formation and growth or reduce the adhesion strength between the ice and the surface. These methods are time-consuming and depend on forecasting. They can be applied on small surfaces only for specific targets, and most are non-biodegradable (except for anti-freezing proteins). There is some quite promising information on ultrasonic ice mitigation methods that employ UGW (Ultrasonic Guided Wave). These methods are have the characteristics of low energy consumption, low cost, lightweight, and easy replacement and maintenance. However, fundamental knowledge of ultrasonic de-icing methodology is still limited. The objective of this work was to identify the ice formation processes and its progress by employing ultrasonic guided wave technique. Throughout this research, the universal set-up for acoustic measurement of ice formation in a real condition (temperature range from +240 C to -230 C) was developed. Ultrasonic measurements were performed by using high frequency 5 MHz transducers in a pitch-catch configuration. The selection of wave modes suitable for detection of ice formation phenomenon on copper metal surface was performed. Interaction between the selected wave modes and ice formation processes was investigated. It was found that selected wave modes are sensitive to temperature changes. It was demonstrated that proposed ultrasonic technique could be successfully used for the detection of ice layer formation on a metal surface.

Keywords: ice formation processes, ultrasonic GW, detection of ice formation, ultrasonic testing

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Authors: Sibel Daglilar, Isil Kerti, Murat Karagoz, Fatih Dumludag, Oguzhan Gunduz, Faik Nuzhet Oktar

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Hydroxyapatite (HA) materials have common use in bone repairing due to its ability to accelerate the bone growth around the implant. In spite of being a biocompatible and bioactive material, HA has a limited usage as an implant material because of its weak mechanical properties. HA based composites are required to improve the strength and toughness properties of the implant materials without compromising of biocompatibility. The excellent mechanical properties and higher biocompatibilities are expected from each of biomedical composites. In this study, HA composites were synthesized by using bovine bone reinforced doped with different amount of (wt.%) Li2O. The pressed pellets were sintered at various sintering temperatures between 1000ºC and 1300°C, and mechanical, electrical properties of the obtained products were characterized. In addition to that, in vitro stimulated body fluid (SBF) tests for these samples were conducted. The most suitable composite composition for biomedical applications was discussed among the composites studied.

Keywords: biocomposites, sintering temperature, biocompatibility, electrical property, conductivity, mechanical property

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Authors: Elena I. Oprita, Oana Craciunescu, Rodica Tatia, Teodora Ciucan, Reka Barabas, Orsolya Raduly, Anca Oancea

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Healing of osteochondral defects requires repair of the damaged articular cartilage, the underlying subchondral bone and the interface between these tissues (the functional calcified layer). For this purpose, developing a single monophasic scaffold that can regenerate two specific lineages (cartilage and bone) becomes a challenge. The aim of this work was to develop variants of biodegradable cross-linked composite hydrogel based on natural polypeptides (gelatin), polysaccharides components (chondroitin-4-sulphate and hyaluronic acid), in a ratio of 2:0.08:0.02 (w/w/w) and mixed with Si-hydroxyapatite (Si-Hap), in two ratios of 1:1 and 2:1 (w/w). Si-Hap was synthesized and characterized as a better alternative to conventional Hap. Subsequently, both composite hydrogel variants were cross-linked with (N, N-(3-dimethylaminopropyl)-N-ethyl carbodiimide (EDC) and enriched with a small bioactive molecule (icariin). The small molecule icariin (Ica) (C33H40O15) is the main active constituent (flavonoid) of Herba epimedium used in traditional Chinese medicine to cure bone- and cartilage-related disorders. Ica enhances osteogenic and chondrogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), facilitates matrix calcification and increases the specific extracellular matrix (ECM) components synthesis by chondrocytes. Afterward, the composite hydrogels were characterized for their physicochemical properties in terms of the enzymatic biodegradation in the presence of type I collagenase and trypsin, the swelling capacity and the degree of crosslinking (TNBS assay). The cumulative release of Ica and real-time concentration were quantified at predetermined periods of time, according to the standard curve of standard Ica, after hydrogels incubation in saline buffer at physiological parameters. The obtained cross-linked composite hydrogels enriched with small-molecule Ica were also characterized for morphology by scanning electron microscopy (SEM). Their cytocompatibility was evaluated according to EN ISO 10993-5:2009 standard for medical device testing. Thus, analyses regarding cell viability (Live/Dead assay), cell proliferation (Neutral Red assay) and cell adhesion to composite hydrogels (SEM) were performed using NCTC clone L929 cell line. The final results showed that both cross-linked composite hydrogel variants enriched with Ica presented optimal physicochemical, structural and biological properties to be used as a natural scaffold able to repair osteochondral defects. The data did not reveal any toxicity of composite hydrogels in NCTC stabilized cell lines within the tested range of concentrations. Moreover, cells were capable of spreading and proliferating on both composite hydrogel surfaces. In conclusion, the designed biodegradable cross-linked composites enriched with Si and Ica are recommended for further testing as natural temporary scaffolds, which can allow cell migration and synthesis of new extracellular matrix within osteochondral defects.

Keywords: composites, gelatin, osteochondral defect, small molecule

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Authors: Faran Chaudhry, Anser Daud, Doris Braunstein, Oleg Safir, Allan Gross, Paul Kuzyk

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Background: Acetabular reconstruction in the context of massive acetabular bone loss is challenging. In rare scenarios where the extent of bone loss precludes shell placement (cup-cage), reconstruction at our center consisted of a cage combined with highly porous metal augments. This study evaluates survivorship, complications, and functional outcomes using this technique. Methods: A total of 131 cup-cage implants (129 patients) were included in our retrospective review of revisions of total hip arthroplasty from January 2003 to January 2022. Among these cases, 100/131 (76.3%) were women, the mean age at surgery time was 68.7 years (range, 29.0 to 92.0; SD, 12.4), and the mean follow-up was 7.7 years (range, 0.02 to 20.3; SD, 5.1). Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery and/or failure of the cup-cage reconstruction. Results: A total of 30 implants (23%) reached the study endpoint involving all-cause revision. Overall survivorship was 74.8% at 10 years and 69.8% at 15 years. Reasons for revision included infection 12/131 (9.1%), dislocation 10/131 (7.6%), aseptic loosening of cup and/or cage 5/131 (3.8%), and aseptic loosening of the femoral stem 2/131 (1.5%). The mean LLD improved from 12.2 ± 15.9 mm to 3.9 ± 11.8 (p<0.05). The horizontal and vertical hip centres on plain film radiographs were significantly improved (p<0.05). Functionally, there was a decrease in the number of patients requiring the use of gait aids, with fewer patients (34, 25.9%) using a cane, walker, or wheelchair post-operatively compared to pre-operatively (58, 44%). There was a significant increase in the number of independent ambulators from 24 to 47 (36%). Conclusion: The cup-cage construct is a reliable treatment option for the treatment of various acetabular defects. There are favourable survivorship, clinical and radiographic outcomes, with a satisfactory complication rate.

Keywords: revision total hip arthroplasty, acetabular defect, pelvic discontinuity, trabecular metal augment, cup-cage

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Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda

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— Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea.The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: diabetic foot, bone biopsy, osteitis, algeria

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Authors: Aniqa Jabeen

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The aim of this study was to evaluate the effectiveness of Tc-99m MIBI (Technetium 99-methoxy-iso-butyl-isonitrile) scintigraphy to differentiate malignancies from benign lesions, which were detected on planar bone scans. Materials and Methods: 59 patients with bone lesions were enrolled in the study. The scintigraphic findings were compared with the clinical, radiological and the histological findings. Each patient initially underwent a three-phase bone scan with Tc-99m MDP (Methylene Diphosphonate) and if evidence of lesion found, the patient then underwent a dynamic and static MIBI scintigraphy after three to four days. The MDP and MIBI scans were evaluated visually and quantitatively. For quantitative analysis count ratios of lesions and contralateral normal side (L/C) were taken by region of interests drawn on scans. The Student T test was applied to assess the significant difference between benign and malignant lesions p-value < 0.05 was considered significant. Result: The MDP scans showed the increase tracer uptake, but there was no significant difference between benign and malignant uptake of the radiotracer. However significant difference (p-value 0.015), in uptake was seen in malignant (L/C = 3.51 ± 1.02) and benign lesion (L/C = 2.50±0.42) on MIBI scan. Three of thirty benign lesions did not show significant MIBI uptake. Seven malignant appeared as false negatives. Specificity of the scan was 86.66%, and its Negative Predictive Value (NPV) was 81.25% whereas the sensitivity of scan was 79.31%. In excluding the axial metastasis from the lesions, the sensitivity of MIBI scan increased to 91.66% and the NPV also increased to 92.85%. Conclusion: MIBI scintigraphy provides its usefulness by distinguishing malignant from benign lesions. MIBI also correctly identifies metastatic lesions. The negative predictive value of the scan points towards its ability to accurately diagnose the normal (benign) cases. However, biopsy remains the gold standard and a definitive diagnostic modality in musculoskeletal tumors. MIBI scan provides useful information in preoperative assessment and in distinguishing between malignant and benign lesions.

Keywords: benign, malignancies, MDP bone scan, MIBI scintigraphy

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Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda

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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

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Authors: Abraha Hatsey, Nesibu Yahya, Abeje Eshete

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Ethiopian Orthodox Tewahido Church has a long tradition of conserving the Church vegetation and is an area treated as a refugee camp for many endangered indigenous tree species in Northern Ethiopia. Though around 36,000 churches exist in Ethiopia, only a few churches have been studied so far. Thus, this study assessed the land use land cover change of 3km buffer (1986-2018) and the woody species diversity and regeneration status of Tsimur St. Gebriel monastery in Tigray region, Northern Ethiopia. For vegetation study, systematic sampling was used with 100m spacing between plots and between transects. Plot size was 20m*20m for the main plot and 2 subplots (5m*5m each) for the regeneration study. Tree height, diameter at breast height(DBH) and crown area were measured in the main plot for all trees with DBH ≥ 5cm. In the subplots, all seedlings and saplings were counted with DBH < 5cm. The data was analyzed on excel and Pass biodiversity software for diversity and evenness analysis. The major land cover classes identified include bare land, farmland, forest, shrubland and wetland. The extents of forest and shrubland were declined considerably due to bare land and agricultural land expansions within the 3km buffer, indicating an increasing pressure on the church forest. Regarding the vegetation status, A total of 19 species belonging to 13 families were recorded in the monastery. The diversity (H’) and evenness recorded were 2.4 and 0.5, respectively. The tree density (DBH ≥ 5cm) was 336/ha and a crown cover of 65%. Olea europaea was the dominant (6.4m2/ha out of 10.5m2 total basal area) and a frequent species (100%) with good regeneration in the monastery. The rest of the species are less frequent and are mostly confined to water sources with good site conditions. Juniperus procera (overharvested) and the other indigenous species were with few trees left and with no/very poor regeneration status. The species having poor density, frequency and regeneration (Junperus procera, Nuxia congesta Fersen and Jasminium abyssinica) need prior conservation and enrichment planting. The indigenous species could also serve as a potential seed source for the reproduction and restoration of nearby degraded landscapes. The buffer study also demonstrated expansion of agriculture and bare land, which could be a threat to the forest of the isolated monastery. Hence, restoring the buffer zone is the only guarantee for the healthy existence of the church forest.

Keywords: church forests, regeneration, land use change, vegetation status

Procedia PDF Downloads 173

Authors: Adaour Mohamed Amine, Bachene Mohamed Sadek, Fortassi Mosaab, Siouda Wafaa

Abstract:

Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73% and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

Procedia PDF Downloads 74

Authors: Zoaib Mirza

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Half of the Muslim countries in the world have declared Islam the state religion in their constitutions. Yet, none of these countries have implemented authentic Islamic laws in line with the Quran (Holy Book), practices of Prophet Mohammad (P.B.U.H) called the Sunnah, and his four successors known as the Rightly Guided - Khalifa. Since their independence, these countries have adopted different government systems like Democracy, Dictatorship, Republic, Communism, and Monarchy. Instead of benefiting the people, these government systems have put these countries into political, social, and economic crises. These Islamic countries do not have equal representation and membership in worldwide political forums. Western countries lead these forums. Therefore, it is now imperative for the Muslim leaders of all these countries to collaborate, reset, and implement the original Islamic form of government, which led to the prosperity and success of people, including non-Muslims, 1400 years ago. They should unite as one nation under Khalifat, which means establishing the authority of Allah (SWT) and following the divine commandments related to the social, political, and economic systems. As they have declared Islam in their constitution, they should work together to apply the divine framework of the governance revealed by Allah (SWT) and implemented by Prophet Mohammad (P.B.U.H) and his four successors called Khalifas. This paper provides an overview of the downfall and the end of the Khalifat system by 1924, the ways in which the West caused political, social, and economic crises in the Muslim countries, and finally, a summary of the social, political, and economic systems implemented by the Prophet Mohammad (P.B.U.H) and his successors, Khalifas, called the Rightly Guided – Hazrat Abu Bakr (RA), Hazrat Omar (RA), Hazrat Usman (RA), and Hazrat Ali (RA).

Keywords: khalifat, khilafat-e-Rashida, the rightly guided, colonization, capitalism, neocolonization, government systems

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Authors: Auwal Abubakar, Shazril Imran Shaukat, Noor Khairiah A. Karim, Mohammed Zakir Kassim, Gokula Kumar Appalanaido, Hafiz Mohd Zin

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Background: Voluntary deep inspiration breath-hold radiotherapy (vDIBH-RT) is an effective cardiac dose reduction technique during left breast radiotherapy. This study aimed to assess the accuracy of the implementation of the vDIBH technique among left breast cancer patients without the use of a special device such as a surface-guided imaging system. Methods: The vDIBH-RT technique was implemented among thirteen (13) left breast cancer patients at the Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia. Breath-hold monitoring was performed based on breath-hold skin marks and laser light congruence observed on zoomed CCTV images from the control console during each delivery. The initial setup was verified using cone beam computed tomography (CBCT) during breath-hold. Each field was delivered using multiple beam segments to allow a delivery time of 20 seconds, which can be tolerated by patients in breath-hold. The data were analysed using an in-house developed MATLAB algorithm. PTV margin was computed based on van Herk's margin recipe. Results: The setup error analysed from CBCT shows that the population systematic error in lateral (x), longitudinal (y), and vertical (z) axes was 2.28 mm, 3.35 mm, and 3.10 mm, respectively. Based on the CBCT image guidance, the Planning target volume (PTV) margin that would be required for vDIBH-RT using CCTV/Laser monitoring technique is 7.77 mm, 10.85 mm, and 10.93 mm in x, y, and z axes, respectively. Conclusion: It is feasible to safely implement vDIBH-RT among left breast cancer patients without special equipment. The breath-hold monitoring technique is cost-effective, radiation-free, easy to implement, and allows real-time breath-hold monitoring.

Keywords: vDIBH, cone beam computed tomography, radiotherapy, left breast cancer

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Authors: Magdalena Korytowska, Gunnar Lengstrand, Cecilia Larsson Wexell

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Background: Breast cancer (BC) is the most common cancer among women worldwide, and cases are continuing to increase in Sweden. Bone is the most common metastatic site in breast cancer patients, where > 65-75% of women with advanced breast cancer develop bone metastases during their disease. To prevent the skeletal-related events of metastases (e.g., pathological fractures, bone loss, cancer-induced bone pain, and hypercalcemia bone), two different classes of antiresorptive medications (AR), bisphosphonate and denosumab are typically administered every 3 to 4 weeks. Since 2015, adjuvant bisphosphonate treatment has been used every six months for three to five years in postmenopausal women for the prevention of skeletal metastases and improved survival. Methods: A case-control study was conducted to test the hypotheses that patients treated with high-dose AR are at higher risk of developing MRONJ than breast cancer patients with adjuvant bisphosphonate treatment at a lower dose. Medical and odontological data was collected between 2015-2020. Assessment of oral health and dental care before and during oncological treatment took place at the specialist clinic for Orofacial medicine linked to the specific hospital. Results: In total, 220 patients were included, 101 patients in the high-dose group and 119 patients in the adjuvant BP-treatment group. MRONJ was diagnosed in 13 patients (14%) in the high-dose group. The mandible was affected in most of the cases (84.6%), with a mean duration of high-dose treatment of 19.7 months. In 46.2% of cases, no dental cause of MRONJ could be identified. Overall, estrogen receptor-positive (ER+) BC was the most representative type in 172 patients (78.2%). However, this was 83.9% in the high-dose cases group. The most used drug was denosumab. Twenty-five patients (26.9%) switched their medication from ZOL to denosumab during their oncological treatment. Patients with ER+ breast cancer were reported in 88 patients (87.8%) in the adjuvant group that was treated with ZOL. Conclusions: MRONJ was diagnosed only in the high-dose AR group. Dental assessment and care of patients in the adjuvant group should be considered, with a recommendation to potentially prolong ZOL treatment from 3 to 5 years, with concomitant use of hormonal therapy in patients diagnosed with ER+ breast cancer to prevent bone loss induced by oncological treatment. A new referral for dental assessment is very important in the case of bone metastases when treatment with high dose AR will be required since it is associated with a higher risk of MRONJ.

Keywords: antiresorptive therapy, breast cancer, dental care, MRONJ

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Authors: Albert Suryaprawira

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Patients requiring correction of severe Class III skeletal discrepancy historically has been among the most challenging treatments for orthodontists. Correction of an aesthetic and functional problem is crucially important. This is a case report of an adult male aged 18 years who complained of difficulty in chewing and speaking. Patient has a prominent profile with mandibular excess. The pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. The panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, the pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, the post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition between those radiographs was performed to analyse the outcome. It includes the superimposition of the cranial base, maxilla, and mandible. Superimposition is important to describe the amount of hard and soft tissue movement. It is also important to predict the possibility of relapse after the surgery. The patient needs to understand all the surgical plan, outcome and relapse prevention. The surgery included mandibular set back by bilateral sagittal split osteotomies. Although the discrepancy was severe using this combination of treatment and the use of radiographic superimposition, an aesthetically pleasing and stable result was achieved.

Keywords: cephalometric, mandibular set back, orthognathic, superimposition

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Authors: Maria Stepankova, Lucie Vistejnova, Pavel Klein, Tereza Blassova, Marketa Slajerova, Radek Sedlacek, Martin Bartos, Jaroslav Chlupac

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Background: Clinical outcome benefits of the segment rib fracture surgical therapy are well known and follow from better stabilization of the chest wall. Despite this, some authors still incline to conservative therapy and point out to possible rib fracture healing failure in connection with the bone vascular supply disturbance caused by metal plate implantation. This suggestion met neither experimental nor clinical verification and remains the object of discussion. In our pilot study we investigated the titanium plate fixation effect on the rib fracture healing in porcine model and its histological, biomechanical and radiological aspects. Materials and Method: Two porcine models (experimental group) underwent the operative chest wall stabilization with a titanium plate implantation after osteotomy. Two other porcine models (control group) were treated conservatively after osteotomy. Three weeks after surgery, all animals were sacrificed, treated ribs were explanted and the histological analysis, µCT imaging and biomechanical testing of the calluses tissue were performed. Results: In µCT imaging, experimental group showed a higher cortical bone volume compared to the control group. Histological analysis using the non-decalcified bone tissue blocks demonstrated more maturated callus with higher newly-formed osseous tissue ratio in experimental group in comparison to controls. In contrast, no significant differences in bone blood vessels supply in both groups were observed. This finding suggests that the bone blood supply in experimental group was not impaired. Biomechanical analysis using 3-point bending test demonstrated significantly higher bending stiffness and the maximum force in experimental group. Conclusion: Based on our observation, it could be concluded, that the titanium plate fixation of the rib fractures leads to faster bone callus maturation whereas does not cause the vascular supply impairment after 3 weeks and thus has a beneficial effect on the rib fracture healing.

Keywords: bone vascular supply, chest wall stabilization, fracture healing, histological analysis, titanium plate implantation

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Authors: Amirul Adlan, Motaz AlAqeel, Scott Evans, Vaiyapuri sumathi, Mark Davies, Rajesh Botchu

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Background & Objectives: Osteoid osteoma (OO) is a benign tumor of the bone commonly found in childhood and adolescence, causing bone pain, especially during the night. CT-guided radiofrequency ablation (RFA) is currently the mainstay treatment for OO. There is currently no literature reporting the outcomes of OO following RFA based on the histological presence of a nidus seen on a biopsy taken at the time of RFA. The primary aim of this study was to compare the clinical outcomes of OO between the group of patients with the presence of nidus on biopsy samples from RFA with those without nidus. Secondly, we aimed to examine other factors that may affect the outcomes of OO, reflecting our experience as a tertiary orthopedic oncology center. Methods: We retrospectively reviewed 88 consecutive patients diagnosed with osteoid osteoma treated with RFA between November 2005 and March 2015, consisting of 63 males (72%) and 25 females (28%). Sixty-six patients (75%) had nidus present in their biopsy samples. Patients’ mean age was 17.6 years (4-53). The median duration of follow-up was 12.5 months (6-20.8). Lesions were located in the appendicular skeleton in seventy-nine patients (90%), while nine patients (10%) had an OO in the axial skeleton. Outcomes assessed were based on patients’ pain alleviation (partial, complete, or no pain improvement) and the need for further interventions. Results: Pain improvement in the patient group with nidus in the histology sample was significantly better than in the group without nidus (OR 7.4, CI 1.35-41.4, p=0.021). The patient group with nidus on biopsy demonstrated less likelihood of having a repeat procedure compared to the group without nidus(OR 0.092, CI 0.016-0.542, p=0.008). Our study showed significantly better outcomes in pain improvement in appendicular lesions compared to the axially located lesions (p = 0.005). Patients with spinal lesions tend to have relatively poor pain relief than those with appendicular or pelvic lesions (p=0.007). Conclusions: Patients with nidus on histology had better pain alleviation compared to patients without nidus. The histological presence of nidus significantly reduces the chance of repeat interventions. The pain alleviation of osteoid osteoma following RFA is better in patients with appendicular lesions than spinal or axially located lesions.

Keywords: osteoid osteoma, benign tumour, radiofrequency ablation, oncology

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Authors: Rosemary Saidu, Taiyelolu Martins Ogunjirin

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The study examines the teaching environment and instructional materials on the performance of students in the English Language in selected secondary schools in Ogun State and its implication for counselling. Two research questions guided the study were developed. The study adopted a descriptive survey design. A multi-stage sampling technique was employed for the study. Samples of 100 students of Senior Secondary School Two (SSS11) were drawn. Purposive sampling technique was to select the five schools. Additionally, the instruments known as Teaching Environment and Instructional Materials on Students Performance in English Inventory (TEIMEI) and Student Achievement Scores (SAS) were used to elicit information. Thereafter, inferential statistics and the non-parametric chi-square statistics at 0.05 alpha levels and 3 degree of freedom were adopted as analytical tools. From the study, it was discovered among others that teaching environment and instructional materials significantly contributed to the performance of students in the English language. From the findings, it was recommended that among others functional language laboratory in the schools, counselors to regularly give guidance talk on the importance of the subject.

Keywords: performance, English language, teaching environment, instructional materials

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Authors: Kwi Young Kang

Abstract:

Objective: To determine the association between inflammatory and structural lesions on sacroiliac joint (SIJ) MRI and BMD and to identify risk factors for low BMD in patients with axial spondyloarthritis (axSpA). Methods: Seventy-six patients who fulfilled the ASAS axSpA criteria were enrolled. All underwent SIJ MRI and BMD measurement at the lumbar spine, femoral neck, and total hip. Inflammatory and structural lesions on SIJ MRI were scored. Laboratory tests and assessment of radiographic and disease activity were performed at the time of MRI. The association between SIJ MRI findings and BMD was evaluated. Results: Among the 76 patients, 14 (18%) had low BMD. Patients with low BMD showed significantly higher bone marrow edema (BME) and deep BME scores on MRI than those with normal BMD (p<0.047 and 0.007, respectively). Inflammatory lesions on SIJ MRI correlated with BMD at the femoral neck and total hip. Multivariate analysis identified the presence of deep BME on SIJ MRI, increased CRP, and sacroiliitis on X-ray as risk factors for low BMD (OR: 5.6, 14.6, and 2.5, respectively). Conclusion: The presence of deep BME on SIJ MRI, increased CRP levels, and severity of sacroiliitis on X-ray were independent risk factors for low BMD.

Keywords: axial spondyloarthritis, sacroiliac joint MRI, bone mineral density, sacroiliitis

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Authors: MyungGu Yeo, JongHan Ha, Gi-Hoon Yang, JaeYoon Lee, SeungHyun Ahn, Hyeongjin Lee, HoJun Jeon, YongBok Kim, Minseong Kim, GeunHyung Kim

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Tissue engineering is a rapidly growing interdisciplinary research area that may provide options for treating damaged tissues and organs. As a promising technique for regenerating various tissues, this technology requires biomedical scaffolds, which serve as an artificial extracellular matrix (ECM) to support neotissue growth. Electrospun micro/nanofibers have been used widely in tissue engineering because of their high surface-area-to-volume ratio and structural similarity to extracellular matrix. However, low mechanical sustainability, low 3D shape-ability, and low cell infiltration have been major limitations to their use. In this work, we propose new hybrid scaffolds interlayered with cell-laden electrospun micro/nano fibers and poly(caprolactone) microstructures. Also, we applied various concentrations of alginate and electric field strengths to determine optimal conditions for the cell-electrospinning process. The combination of cell-laden bioink (2 ⅹ 10^5 osteoblast-like MG63 cells/mL, 2 wt% alginate, 2 wt% poly(ethylene oxide), and 0.7 wt% lecithin) and a 0.16 kV/mm electric field showed the highest cell viability and fiber formation in this process. Using these conditions and PCL microstructures, we achieved mechanically stable hybrid scaffolds. In addition, the cells embedded in the fibrous structure were viable and proliferated. We suggest that the cell-embedded hybrid scaffolds fabricated using the cell-electrospinning process may be useful for various soft- and hard-tissue regeneration applications.

Keywords: bioink, cell-laden scaffold, micro/nanofibers, poly(caprolactone)

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Authors: Tracy Ho, Huann-Shyang Lin, Mina Lin

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This study investigated the different learning path of students with different learning attitude and learning styles in Arts Creation. Based on direct instruction, guided-discovery learning, and discovery learning theories, a tablet app including the following three learning areas were developed for students: (1) replication and remix practice area, (2) guided creation area, and (3) free creation area. Thirty. students with different learning attitude and learning styles were invited to use this app. Students’ learning behaviors were categorized and defined. The results will provide both educators and researchers with insights that can form a useful foundation for designing different content and strategy with the application of new technologies in school teaching. It also sheds light on how an educational App can be designed to enhance Arts Creation.

Keywords: App, arts creation, learning attitude, learning style, tablet

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Authors: Shan Zhou, Wenju Li, Kehui Chai

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Along with economic globalization, marketization and regional development, strengthen planning and construction of the New Town, which is always the main way to optimize the structure and function of metropolitan spatial configuration. But, the new town is often of high-intensity development, bringing a series of natural, ecological and environmental issues, so it is difficult to achieve sustainable development. In this paper, taking the administrative center of Jiangping in Dongxing as an example. It is analyzed from the following three aspects：Vertical design of road traffic，Space layout of mountain buildings，and the design of landscape. The purpose is to elaborate the hillside design methods guided by low-intensity damage, and explore the guiding significance of sustainable development of the hillside construction in the future.

Keywords: low-intensity damage, new town construction，hillside，sustainable development, natural, ecology

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Authors: Gizachew Belay Adugna, Yu-Tai Tao

Abstract:

Perovskite solar cells (PSCs) have been gaining impressive progress with excellent power conversion efficiency (PCE) of 25.5% in small-area devices. However, the conventional film coating approach is not applicable to large-area module fabrication. Meniscus-guided coating, including blade coating, slot-die coating, and bar coating, is solution processing and promising for large-area and cost-effective film coating to industrial-scale PSCs. Here, we develop simple and scalable solution shearing (SS) and bar coating (BC) methods to coat all layers on large-area (10x10 cm²) substrate in FTO/c-TiO₂/mp-TiO₂/ CH₃NH₃PbI₃/Spiro-OMeTAD/Ag device structure, except the Ag electrode. All solution-sheared PSC exhibited a champion power conversion efficiency of 15.89% in the conational DMF/DMSO solvent. Whereas a very high PCE of 20.30% compared to the controlled spin-coated device (SC, 17.60%) was achieved from the large area sheared perovskite film in a green ACN/MA solvent. Similarly, a remarkable PCE of 18.50% was achieved for a device fabricated from a large-area perovskite film in a simpler and more compatible Bar-coating system. This strategy demonstrates the huge potential for module fabrication and future PSC commercialization.

Keywords: Perovskite solar cells, larger area film coating, meniscus-guided film coating, solution-shearing, bar-coating, power conversion efficiency

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Authors: Hosam El-Sayed, Amira Abou El-Kheir, Salwa Mowafi, Marwa Abou Taleb

Abstract:

Two proteinic biopolymers; namely keratin and sericin, were extracted from their respective natural resources by simple appropriate methods. The said proteins were dissolved in the appropriate solvents followed by regeneration in a form of film polyvinyl alcohol. Proteinium thiocyanate (PTC) composite was prepared by reaction of a regenerated film with potassium thiocyanate in acid medium. In another experiment, the said acidified proteins were reacted with potassium thiocyante before dissolution and regeneration in a form of PTC composite. The possibility of using PTC composite for determination of the concentration of iron III ions in domestic as well as industrial water was examined. The concentration of iron III cations in water was determined spectrophotometrically by measuring the intensity of blood red colour of iron III thiocyanate obtained by interaction of PTC with iron III cation in the tested water sample.

Keywords: iron III cations, protein, sensor, thiocyanate, water

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Authors: F. Al-Sheikh, C. Moralejo, M. Pritzker, W. A. Anderson, A. Elkamel

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Ammonia in mining wastewater is a significant problem, and treatment can be especially difficult in cold climates where biological treatment is not feasible. An adsorption process is one of the alternative processes that can be used to reduce ammonia concentrations to acceptable limits, and therefore a LEWATIT resin strongly acidic H+ form ion exchange resin and a Bowie Chabazite Na form AZLB-Na zeolite were tested to assess their effectiveness. For these adsorption tests, two packed bed columns (a mini-column constructed from a 32-cm long x 1-cm diameter piece of glass tubing, and a 60-cm long x 2.5-cm diameter Ace Glass chromatography column) were used containing varying quantities of the adsorbents. A mining wastewater with ammonia concentrations of 22.7 mg/L was fed through the columns at controlled flowrates. In the experimental work, maximum capacities of the LEWATIT ion exchange resin were 0.438, 0.448, and 1.472 mg/g for 3, 6, and 9 g respectively in a mini column and 1.739 mg/g for 141.5 g in a larger Ace column while the capacities for the AZLB-Na zeolite were 0.424, and 0.784 mg/g for 3, and 6 g respectively in the mini column and 1.1636 mg/g for 38.5 g in the Ace column. In the theoretical work, Thomas, Adams-Bohart, and Yoon-Nelson models were constructed to describe a breakthrough curve of the adsorption process and find the constants of the above-mentioned models. In the regeneration tests, 5% hydrochloric acid, HCl (v/v) and 10% sodium hydroxide, NaOH (w/v) were used to regenerate the LEWATIT resin and AZLB-Na zeolite with 44 and 63.8% recovery, respectively. In conclusion, continuous flow adsorption using a LEWATIT ion exchange resin and an AZLB-Na zeolite is efficient when using a co-flow technique for removal of the ammonia from wastewater. Thomas, Adams-Bohart, and Yoon-Nelson models satisfactorily fit the data with R² closer to 1 in all cases.

Keywords: AZLB-Na zeolite, continuous adsorption, Lewatit resin, models, regeneration

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Authors: H. Yousefnia, S. Zolghadri

Abstract:

An early diagnosis of bone metastases is very important for providing a profound decision on a subsequent therapy. A prerequisite for the clinical application of new diagnostic radiopharmaceutical is the measurement of organ radiation exposure dose from biodistribution data in animals. In this study, the dosimetric studies of a novel agent for SPECT-imaging of bone methastases, 111In-(4-{[(bis(phosphonomethyl))carbamoyl]methyl}-7,10-bis(carboxymethyl)-1,4,7,10-tetraazacyclododec-1-yl) acetic acid (111In-BPAMD) complex, have been estimated in human organs based on mice data. The radiolabeled complex was prepared with high radiochemical purity at the optimal conditions. Biodistribution studies of the complex were investigated in male Syrian mice at selected times after injection (2, 4, 24 and 48 h). The human absorbed dose estimation of the complex was performed based on mice data by the radiation absorbed dose assessment resource (RADAR) method. 111In-BPAMD complex was prepared with high radiochemical purity >95% (ITLC) and specific activities of 2.85 TBq/mmol. Total body effective absorbed dose for 111In-BPAMD was 0.205 mSv/MBq. This value is comparable to the other 111In clinically used complexes. The results show that the dose to critical organs the complex is well within the acceptable considered range for diagnostic nuclear medicine procedures. Generally, 111In-BPAMD has interesting characteristics and can be considered as a viable agent for SPECT-imaging of the bone metastases in the near future.

Keywords: In-111, BPAMD, absorbed dose, RADAR

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Authors: Shynn Lim, Ching Tan

Abstract:

The paper presents the PASSION Programme designed by a government school in Singapore, guided by national goals as well as research-based pedagogies that aims to nurture students to become lifelong learners with the strength of character. The design and enactment of the integrated approach to develop in students good character, resilience and social-emotional well-being, future readiness, and active citizenship is guided by a set of principles that amalgamates Biesta’s domains of purposes of education and authentic learning. Data in terms of evidence of students’ learning and students’ feedback were collected, analysed, and suggests that the learning experience benefitted students by boosting their self-confidence, self-directed and collaborative learning skills, as well as empathy.

Keywords: lifelong learning, character and citizenship education, education and career guidance, 21CC, teaching and learning empathy

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Authors: Mohsin Talib Mohammed, Zahid A. Khan, Arshad N. Siddiquee

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The wide use of titanium (Ti) materials in medicine gives impetus to a search for development new techniques with elevated properties such as strength, corrosion resistance and Young's modulus close to that of bone tissue. This article presents the most recent state of the art on the use of equal channel angular pressing (ECAP) technique in evolving mechanical characteristics of the ultrafine-grained bio-grade Ti materials. Over past few decades, research activities in this area have grown enormously and have produced interesting results, including achieving the combination of conflicting properties that are desirable for biomedical applications by severe plastic deformation (SPD) processing. A comprehensive review of the most recent work in this area is systematically presented. The challenges in processing ultrafine-grained Ti materials are identified and discussed. An overview of the biomedical Ti alloys processed with ECAP technique is given in this review, along with a summary of their effect on the important mechanical properties that can be achieved by SPD processing. The paper also offers insights in the mechanisms underlying SPD.

Keywords: mechanical properties, ECAP, titanium, biomedical applications

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Authors: Nadhiya N. Subramony, Jenifer Vaughan, Lesley E. Scott

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In South Africa, the World Health Organisation estimated 454000 new cases of Mycobacterium tuberculosis (M.tb) infection (MTB) in 2015. Disseminated tuberculosis arises from the haematogenous spread and seeding of the bacilli in extrapulmonary sites. The gold standard for the detection of MTB in bone marrow is TB culture which has an average turnaround time of 6 weeks. Histological examinations of trephine biopsies to diagnose MTB also have a time delay owing mainly to the 5-7 day processing period prior to microscopic examination. Adding to the diagnostic delay is the non-specific nature of granulomatous inflammation which is the hallmark of MTB involvement of the bone marrow. A Ziehl-Neelson stain (which highlights acid-fast bacilli) is therefore mandatory to confirm the diagnosis but can take up to 3 days for processing and evaluation. Owing to this delay in diagnosis, many patients are lost to follow up or remain untreated whilst results are awaited, thus encouraging the spread of undiagnosed TB. The Xpert® MTB/RIF (Cepheid, Sunnyvale, CA) is the molecular test used in the South African national TB program as the initial diagnostic test for pulmonary TB. This study investigates the optimisation and performance of the Xpert® MTB/RIF on bone marrow aspirate specimens (BMA), a first since the introduction of the assay in the diagnosis of extrapulmonary TB. BMA received for immunophenotypic analysis as part of the investigation into disseminated MTB or in the evaluation of cytopenias in immunocompromised patients were used. Processing BMA on the Xpert® MTB/RIF was optimised to ensure bone marrow in EDTA and heparin did not inhibit the PCR reaction. Inactivated M.tb was spiked into the clinical bone marrow specimen and distilled water (as a control). A volume of 500mcl and an incubation time of 15 minutes with sample reagent were investigated as the processing protocol. A total of 135 BMA specimens had sufficient residual volume for Xpert® MTB/RIF testing however 22 specimens (16.3%) were not included in the final statistical analysis as an adequate trephine biopsy and/or TB culture was not available. Xpert® MTB/RIF testing was not affected by BMA material in the presence of heparin or EDTA, but the overall detection of MTB in BMA was low compared to histology and culture. Sensitivity of the Xpert® MTB/RIF compared to both histology and culture was 8.7% (95% confidence interval (CI): 1.07-28.04%) and sensitivity compared to histology only was 11.1% (95% CI: 1.38-34.7%). Specificity of the Xpert® MTB/RIF was 98.9% (95% CI: 93.9-99.7%). Although the Xpert® MTB/RIF generates a faster result than histology and TB culture and is less expensive than culture and drug susceptibility testing, the low sensitivity of the Xpert® MTB/RIF precludes its use for the diagnosis of MTB in bone marrow aspirate specimens and warrants alternative/additional testing to optimise the assay.

Keywords: bone marrow aspirate , extrapulmonary TB, low sensitivity, Xpert® MTB/RIF

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Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan

Abstract:

Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.

Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine

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