Clinical application of ceramics in anterior cervical discectomy and fusion: A review and update

Study Design: Narrative review. Objectives: Anterior cervical discectomy and fusion (ACDF) is a reliable procedure, commonly used for cervical degenerative disc disease. For interbody fusions, autograft was the gold standard for decades; however, limited availability and donor site morbidities have led to a constant search for new materials. Clinically, it has been shown that calcium phosphate ceramics, including hydroxyapatite (HA) and tricalcium phosphate (TCP), are effective as osteoconductive materials and bone grafts. In this review, we present the current findings regarding the use of ceramics in ACDF. Methods: A review of the relevant literature examining the clinical use of ceramics in anterior cervical discectomy and fusion procedures was conducted using PubMed, OVID and Cochrane. Result: HA, coralline HA, sandwiched HA, TCP, and biphasic calcium phosphate ceramics were used in combination with osteoinductive materials such as bone marrow aspirate and various cages composed of poly-ether-ether-ketone (PEEK), fiber carbon, and titanium. Stand-alone ceramic spacers have been associated with fracture and cracks. Metallic cages such as titanium endure the risk of subsidence and migration. PEEK cages in combination with ceramics were shown to be a suitable substitute for autograft. Conclusion: None of the discussed options has demonstrated clear superiority over others, although direct comparisons are often difficult due to discrepancies in data collection and study methodologies. Future randomized clinical trials are warranted before definitive conclusions can be drawn. © The Author(s) 2017

The evaluation of base deficit as the predictive agent of mortality in geriatric trauma

زمینه و هدف: کمبود باز (Base deficit) به عنوان یک عامل مرتبط با کاهش پرفیوژن نسجی مخفی شناخته شده است، لیکن نقطه بحرانی مؤثر در ایجاد این حالت و مرگ و میر به دنبال تروما تعیین نشده است. در این مطالعه ارزش پیشگویی کننده کمبود باز در مرگ و میر و نقطه برش آن در افراد سالمند مورد بررسی قرار گرفت. روش بررسی: در یک مطالعه تحلیلی - آینده نگر 300 بیمار سالمند (سن بالاتر یا مساوی 65 سال) مبتلا به تروما در مرکز پزشکی الزهراء (س) دانشگاه علوم پزشکی اصفهان مورد بررسی قرار گرفتند. از هر بیمار گازهای خونی آنالیز شده و مقدار کمبود باز محاسبه گردید و عوامل مؤثر در تغییرات کمبود باز مورد ارزیابی قرار گرفت. وضعیت بیماران تا زمان ترخیص و یا مرگ پیگیری شد و عوامل مؤثر در مرگ بیماران نیز مورد بررسی قرار گرفت. جهت تجزیه و تحلیل داده ها از محاسبه رگرسیون استفاده شد. یافته ها: نتایج این مطالعه نشان داد که در افراد سالمند مبتلا به تروما و علائم حیاتی پایدار، کمبود باز تنها عامل پیشگویی کننده مرگ می باشد (01/0

Effect of human chorionic gonadotropin on sexual maturation, sex steroids and thyroid hormone levels in Caspian lamprey (Caspiomyzon wagneri Kessler, 1870)

The objective of this study was to determine the effect of human chorionic gonadotropin (hCG) on sexual maturation, plasma sex steroids [17β-estradiol, (E2) and 17α-hydroxy progesterone (17α_OHP)] and thyroid hormones (triiodothyronine, T3 and thyroxin, T4) levels in upstream - migrating Caspian lamprey. During the experiment, 36 fish (24 females and 12 males) in spring 2013 and 36 fish (24 females and 12 males) in fall 2013 were collected from the Shirud River estuary in Mazandaran Province, the Southern Caspian Sea during their upstream migration to the freshwater. All fish were injected with hCG at the doses of 1000, 1500 and 2000 IU.kg BW-1. The injection was a two - step process (50% of hormone in each step) by 12 h interval. After the first injection, fish were retained in the cages in the river beds and 24 hours after the second injection, fish were checked for egg and sperm release after mild abdomen pressure. Blood samples were taken for determining sex steroid levels. Results showed that hCG hormone injections caused increase in migration of germinal vesicle in the oocyte of female and sperm release in males. Significant differences were found in the serum E2 and 17α-OHP levels in hCG - injected fish compared to the control. However, no significant differences were found in serum T3 and T4 levels in the hCG -injected fish. According to the results, the appropriate hCG dosage to induce the reproduction acceleration in Caspian lamprey is 1500-2000 IU.kg BW-1

Prognostic factors for esophageal squamous cell Carcinoma-A Population-Based study in Golestan province, Iran, a high incidence area

Golestan Province in northern Iran is an area with a high incidence of esophageal squamous cell carcinoma (ESCC). We aimed to investigate prognostic factors for ESCC and survival of cases in Golestan, on which little data were available. We followed-up 426 ESCC cases participating in a population-based case-control study. Data were analyzed using the Kaplan-Meier method and the Cox proportional hazard models. Median survival was 7 months. Age at diagnosis was inversely associated with survival, but the association was disappeared with adjustment for treatment. Residing in urban areas (hazard ratio, HR = 0.70; 95 CI 0.54-0.90) and being of non-Turkmen ethnic groups (HR = 0.76; 95 CI 0.61-0.96) were associated with better prognosis. In contrast to other types of tobacco use, nass (a smokeless tobacco product) chewing was associated with a slightly poorer prognosis even in models adjusted for other factors including stage of disease and treatment (HR = 1.38; 95 CI 0.99-1.92). Opium use was associated with poorer prognosis in crude analyses but not in adjusted models. Almost all of potentially curative treatments were associated with longer survival. Prognosis of ESCC in Golestan is very poor. Easier access to treatment facilities may improve the prognosis of ESCC in Golestan. The observed association between nass chewing and poorer prognosis needs further investigations; this association may suggest a possible role for ingestion of nass constituents in prognosis of ESCC. © 2011 Aghcheli et al

Drug-related mutational patterns in hepatitis B virus (HBV) reverse transcriptase proteins from Iranian treatment-Naïve chronic HBV patients

Background: Immunomodulators and Nucleotide analogues have been used globally for the dealing of chronic hepatitis B virus (HBV) infection. However, the development of drug resistance is a major limitation to their long-term effectiveness. Objectives: The aim of this study was to characterize the hepatitis B virus reverse transcriptase (RT) protein variations among Iranian chronic HBV carriers who did not receive any antiviral treatments. Materials and Methods: Hepatitis B virus partial RT genes from 325 chronic in active carrier patients were amplified and directly sequenced. Nucleotide/amino acid substitutions were identified compared to the sequences obtained from the database. Results: All strains belonging to genotype D.365 amino-acid substitutions were found. Mutations related to lamivudine, adefovir, telbivudine, and entecavir occurred in (YMDD) 4% (n = 13), (SVQ) 17.23% (n = 56), (M204I/V + L180M) 2.45% (n = 8) and (M204I) 2.76% (n = 9) of patients, respectively. Conclusions: RT mutants do occur naturally and could be found in HBV carriers who have never received antiviral therapy. However, mutations related to drug resistance in Iranian treatment-naïve chronic HBV patients were found to be higher than other studies published formerly. Chronic HBV patients should be monitored closely prior the commencement of therapy to achieve the best regimen option. © 2013, KOWSAR Corp

Association of tooth loss and oral hygiene with risk of gastric adenocarcinoma

Poor oral health and tooth loss have been proposed as possible risk factors for some chronic diseases, including gastric cancer. However, a small number of studies have tested these associations. We conducted a case-control study in Golestan Province, Iran, that enrolled 309 cases diagnosed with gastric adenocarcinoma (118 noncardia, 161 cardia, and 30 mixed-locations) and 613 sex, age, and neighborhood matched controls. Data on oral health were obtained through physical examination and questionnaire including tooth loss, the number of decayed, missing, and filled teeth, and frequency of tooth brushing. ORs and 95% confidence intervals (95% CI) were obtained using conditional logistic regression models adjusted for potential confounders. Standard one degree-of-freedom linear trend test and a multiple degree-of-freedom global test of the effect of adding oral hygiene variables to the model were also calculated. Our results showed apparent associations between tooth loss and decayed, missing, filled teeth (DMFT) score with risk of gastric cancer, overall and at each anatomic subsite. However, these associations were not monotonic and were strongly confounded by age. The results also showed that subjects who brushed their teeth less than daily were at significantly higher risk for gastric cardia adenocarcinoma ORs (95% CI) of 5.6 (1.6-19.3). We found evidence for an association between oral health and gastric cancer, but the nonmonotonic association, the relatively strong effect of confounder adjustment, and inconsistent results across studies must temper the strength of any conclusions. © 2013 AACR

Measurement of the photon and thermal neutron doses of contralateral breast surface in breast cancer radiotherapy

Introduction and purpose:During the radiation therapy of tumoral breast, the contralateral breast (CB) will receive scattered doses. In the present study, the photon and thermal neutron dose values received by CB surface during breast cancer radiation therapy were measured.Materials and methods:The right breast region of RANDO phantom was considered as CB, and the measurements of photon and thermal neutron dose values were carried out on this region surface. The phantom was irradiated with 18 MV photon beams, and the dose values were measured with thermoluminescent dosimeter (TLD-600 and TLD-700) chips for 11 � 13, 11 � 17 and 11 � 21 cm2 field sizes in the presence of physical and dynamic wedges.Results:The total dose values (photon + thermal neutron) received by the CB surface in the presence of physical wedge were 12·06, 15·75 and 33·40 of the prescribed dose, respectively, for 11 � 13, 11 � 17 and 11 � 21 cm2 field sizes. The corresponding dose values for dynamic wedge were 9·18, 12·92 and 29·26 of the prescribed dose, respectively. Moreover, the results showed that treatment field size and wedge type affect the received photon and thermal neutron doses at CB surface.Conclusion:According to our results, the total dose values received at CB surface during breast cancer radiotherapy with high-energy photon beams are remarkable. In addition, the dose values received at CB surface when using a physical wedge were greater than when using a dynamic wedge, especially for medial tangential fields. © Cambridge University Press 2019

TRY plant trait database - enhanced coverage and open access

Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Predictors of oropharyngeal cancer survival in Europe

Objectives: HPV16-positive oropharyngeal cancer (OPC) patients experience better outcomes compared to HPV16-negative patients. Currently, strategies for treatment de-escalation are based on HPV status, smoking history and disease stage. However, the appropriate cut-point for smoking and the role of other non-clinical factors in OPC survival remains uncertain. Materials and Methods: We examined factors associated with OPC outcome in 321 patients recruited in a large European multi-center study. Seropositivity for HPV16 E6 was used as a marker of HPV16 positive cancer. Hazard ratios (HR) and confidence intervals (CI) were estimated using Cox proportional models adjusted for potential confounders. Results: Overall 5-year survival following OPC diagnosis was 50%. HPV16-positive OPC cases were at significantly lower risk of death (aHR = 0.51, 95% CI: 0.32–0.80). A significant effect on OPC survival was apparent for female sex (aHR 0.50: 95% CI: 0.29–0.85) and being underweight at diagnosis (aHR: 2.41, 95% CI: 1.38–4.21). A 10 pack year smoking history was not associated with overall survival. Higher stage at diagnosis appeared as the only factor significantly associated with OPC recurrence (aHR: 4.88, 95% CI: 2.12–11.21). Conclusion: This study confirms that HPV16 status is an independent prognostic factor for OPC survival while female sex lowers risk of death and being underweight at diagnosis increases the risk of death. Smoking was not an independent predictor of OPC survival.</p

Assessment of the Linkages and Leakages in a Cloud-Based Computing Collaboration among Construction Stakeholders

The uniqueness of the construction industry can be understood in the large volumes of information in terms of paper works, processes, and communication disseminated daily. The voluminous information requires close coordination which cloud based systems offer. The aim of this research is to assess the linkages and leakages in a cloud-based computing collaboration among construction stakeholders. A purposive sampling technique was used in selecting the participants of the study. A questionnaire based instrument was distributed to eighty (80) construction stakeholder in Lagos State, Nigeria. The data collected was analyzed using SPSS v.21. Statistical tools such as frequencies, stacked bars, mean scores, factor analysis, and analysis of variance (ANOVA) were used in the study. The result of the study revealed that construction stakeholders rarely utilize cloud-based technologies for their construction processes. Construction professionals that access cloud based technologies, do so with their smart mobile phones, laptops, and tablet. The study classified the leakages that exist in the use of cloud-based technologies as securitybased factors, cloud-based infrastructure factors, and cloud-based benefits deficiency based factors. In conclusion, the study revealed that the linkages in the use of cloudbased technologies include knowledge sharing, remote access of back-office activities and engendering collaboration among construction stakeholders. It was recommended that construction stakeholders should leverage on the benefits cloud-based technologies has to offer in today’s competitive economy. Construction stakeholdersshould be adequately informed on the available cloud-based computing technologies and the additions it can bring into the construction process. Cloud computing technology vendors should improve on the security and privacy features of the platform for adequate protection of building data