Improved Bone Regeneration Using Biodegradable Polybutylene Succinate Artificial Scaffold in a Rabbit Model

The treatment of extensive bone loss represents a great challenge for orthopaedic and reconstructive surgery. Most of the time, those treatments consist of multiple-stage surgeries over a prolonged period, pose significant infectious risks and carry the possibility of rejection. In this study, we investigated if the use of a polybutylene succinate (PBS) micro-fibrillar scaffold may improve bone regeneration in these procedures. In an in vivo rabbit model, the healing of two calvarial bone defects was studied. One defect was left to heal spontaneously while the other was treated with a PBS scaffold. Computed tomography (CT) scans, histological and immunohistochemical analyses were performed at 4, 12 and 24 weeks. CT examination showed a significantly larger area of mineralised tissue in the treated defect. Histological examination confirmed a greater presence of active osteoblasts and mineralised tissue in the scaffold-treated defect, with no evidence of inflammatory infiltrates around it. Immunohistochemical analysis was positive for CD56 at the transition point between healthy bone and the fracture zone. This study demonstrates that the use of a PBS microfibrillar scaffold in critical bone defects on a rabbit model is a potentially effective technique to improve bone regeneration

Using and Reporting the Delphi Method for Selecting Healthcare Quality Indicators: A Systematic Review

OBJECTIVE: Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1) to describe reporting of the Delphi method to develop quality indicators, 2) to discuss specific methodological skills for quality indicators selection 3) to give guidance about this practice. METHODOLOGY AND MAIN FINDING: Three electronic data bases were searched over a 30 years period (1978-2009). All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results) were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used). Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80) of studies reported response rates for all rounds, 60% (48/80) that feedback was given between rounds, 77% (62/80) the method used to achieve consensus and 57% (48/80) listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63%) with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31). In 40/70 (57%) studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40) of cases. Among 75 studies describing criteria to select quality indicators, 28 (37%) used validity and 17(23%) feasibility. CONCLUSION: The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys

The frequency-dependent Wright-Fisher model: diffusive and non-diffusive approximations

We study a class of processes that are akin to the Wright-Fisher model, with transition probabilities weighted in terms of the frequency-dependent fitness of the population types. By considering an approximate weak formulation of the discrete problem, we are able to derive a corresponding continuous weak formulation for the probability density. Therefore, we obtain a family of partial differential equations (PDE) for the evolution of the probability density, and which will be an approximation of the discrete process in the joint large population, small time-steps and weak selection limit. If the fitness functions are sufficiently regular, we can recast the weak formulation in a more standard formulation, without any boundary conditions, but supplemented by a number of conservation laws. The equations in this family can be purely diffusive, purely hyperbolic or of convection-diffusion type, with frequency dependent convection. The particular outcome will depend on the assumed scalings. The diffusive equations are of the degenerate type; using a duality approach, we also obtain a frequency dependent version of the Kimura equation without any further assumptions. We also show that the convective approximation is related to the replicator dynamics and provide some estimate of how accurate is the convective approximation, with respect to the convective-diffusion approximation. In particular, we show that the mode, but not the expected value, of the probability distribution is modelled by the replicator dynamics. Some numerical simulations that illustrate the results are also presented

Cyber Insurance

This volume covers a wide spectrum of issues relating to economic and political development enabled by information and communication technology (ICT)

Toxicological Effects of Weapons of Mass Destruction and Noxious Agents in Modern Warfare and Terorrism

Oružja za masovno uništavanje najbolji su primjer uporabe civilizacijskih tehnoloških dostignuća u štetne svrhe i protiv ljudske civilizacije. Unatoč nastojanjima oko kontrole i smanjenja njihove količine, rizik zbog samoga postojanja pa čak i širenja zahtijeva da se o njihovoj uporabi i dalje vodi računa i da se povećaju obrambene mjere – nuklearno-biološko-kemijske obrane (NBKO). Osim suvremenog vojnika koji je u vojnim i mirovnim operacijama diljem svijeta izložen raznim noksama kemijskog, biološkog i radiološkog podrijetla, nezaštićeno i uglavnom slabo educirano civilno stanovništvo može biti izloženo terorističkim napadima. Oružja za masovno uništavanje i nokse kemijskog, biološkog i radiološkog podrijetla uzrokuju razne toksikološke posljedice, a bez obzira na njihovo podrijetlo, imaju zajednički nazivnik djelovanja – poremećaj fi ziološkog stanja u organizmu. Poremećaji proizašli nakon izlaganja tim noksama nerijetko se teško determiniraju, dijagnosticiraju i liječe. U ovome su radu s biomedicinskog aspekta obrađene važnije nokse kemijskog, biološkog i radiološkog podrijetla na temelju odabranih primjera iz terorizma i suvremenog ratovanja: polonij-210, osiromašeni uran, salmonela, bedrenica (antraks), genetički modifi cirane bakterije, polimerno predivo “paučina” i bojni otrovi sarin i iperit.Weapons of mass destruction (WMD) best portray the twisted use of technological achievements against the human species. Despite arm control efforts, WMD threat continues to exist and even proliferate. This in turn calls for improvement in defensive measures against this threat. The modern soldier is exposed to a number of chemical, biological, and radiological agents in military and peace operations, while civilians are mainly exposed to terrorist attacks. Regardless of origin or mode of action, WMDs and other noxious agents aim for the same – to make an organism dysfunctional. Because their effects are often delayed, these agents are hard to spot on time and treat. This review presents a biomedical aspect of agents used in warfare and terrorism, including polonium-210, depleted uranium, salmonella, anthrax, genetically modifi ed bacteria, cobweb-like polymer fi bre, sarin, and mustard gas

Creative Thinking and Modelling for the Decision Support in Water Management

This paper reviews the state of art in knowledge and preferences elicitation techniques. The purpose of the study was to evaluate various cognitive mapping techniques in order to conclude with the identification of the optimal technique for the NetSyMod methodology. Network Analysis Creative System Modelling (NetSyMod) methodology has been designed for the improvement of decision support systems (DSS) with respect to the environmental problems. In the paper the difference is made between experts and stakeholders knowledge and preference elicitation methods. The suggested technique is very similar to the Nominal Group Techniques (NGT) with the external representation of the analysed problem by means of the Hodgson Hexagons. The evolving methodology is undergoing tests within several EU-funded projects such as: ITAES, IISIM, NostrumDSS