Cross-sectional area of the paraspinal muscles and its association with muscle strength among fighter pilots : A 5-year follow-up

Background: A small cross sectional area (CSA) of the paraspinal muscles may be related to low back pain among military aviators but previous studies have mainly concentrated on spinal disc degeneration. Therefore, the primary aim of the study was to investigate the changes in muscle CSA and composition of the psoas and paraspinal muscles during a 5-year follow up among Finnish Air Force (FINAF) fighter pilots. Methods: Study population consisted of 26 volunteered FINAF male fighter pilots (age: 20.6 (±0.6) at the baseline). The magnetic resonance imaging (MRI) examinations were collected at baseline and after 5 years of follow-up. CSA and composition of the paraspinal and psoas muscles were obtained at the levels of 3-4 and 4-5 lumbar spine. Maximal isometric strength tests were only performed on one occasion at baseline. Results: The follow-up comparisons indicated that the mean CSA of the paraspinal muscles increased (p <0.01) by 8% at L3-4 level and 7% at L4-5 level during the 5-year period. There was no change in muscle composition during the follow-up period. The paraspinal and psoas muscles' CSA was positively related to overall maximal isometric strength at the baseline. However, there was no association between LBP and muscle composition or CSA. Conclusions: The paraspinal muscles' CSA increased among FINAF fighter pilots during the first 5 years of service. This might be explained by physically demanding work and regular physical activity. However, no associations between muscle composition or CSA and low back pain (LBP) experienced were observed after the five-year follow-up. © 2019 The Author(s).Peer reviewe

S53P4 bioactive glass scaffolds induce BMP expression and integrative bone formation in a critical-sized diaphysis defect treated with a single-staged induced membrane technique

Surgical management of critical-sized diaphyseal defects involves multiple challenges, and up to 10% result in delayed or non-union. The two-staged induced membrane technique is successfully used to treat these defects, but it is limited by the need of several procedures and bone graft. Repeated procedures increase costs and morbidity, while grafts are subject to donor-site complications and scarce availability. To transform this two-staged technique into one graft-independent procedure, we developed amorphous porous scaffolds sintered from the clinically used bioactive glass S53P4. This work constitutes the first evaluation of such scaffolds in vivo in a critical-sized diaphyseal defect in the weight-bearing rabbit femur. We provide important knowledge and prospects for future development of sintered S53P4 scaffolds as a bone substitute. Critical-sized diaphysis defects are complicated by inherent sub-optimal healing conditions. The two staged induced membrane technique has been used to treat these challenging defects since the 1980 & rsquo;s. It involves temporary implantation of a membrane-inducing spacer and subsequent bone graft defect filling. A single-staged, graft-independent technique would reduce both socio-economic costs and patient morbidity. Our aim was to enable such single-staged approach through development of a strong bioactive glass scaffold that could replace both the spacer and the graft filling. We constructed amorphous porous scaffolds of the clinically used bioactive glass S53P4 and evaluated them in vivo using a critical sized defect model in the weight-bearing femur diaphysis of New Zealand White rabbits. S53P4 scaffolds and standard polymethylmethacrylate spacers were implanted for 2, 4, and 8 weeks. Induced membranes were confirmed histologically, and their osteostimulative activity was evaluated through RT-qPCR of bone morphogenic protein 2, 4, and 7 (BMPs). Bone formation and osseointegration were examined using histology, scanning electron microscopy, energy-dispersive X-ray analysis, and micro-computed tomography imaging. Scaffold integration, defect union and osteosynthesis were assessed manually and with X-ray projections. We demonstrated that S53P4 scaffolds induce osteostimulative membranes and produce osseointegrative new bone formation throughout the scaffolds. We also demonstrated successful stable scaffold integration with early defect union at 8 weeks postoperative in critical-sized segmental diaphyseal defects with implanted sintered amorphous S53P4 scaffolds. This study presents important considerations for future research and the potential of the S53P4 bioactive glass as a bone substitute in large diaphyseal defects. Statement of significance Surgical management of critical-sized diaphyseal defects involves multiple challenges, and up to 10% result in delayed or non-union. The two-staged induced membrane technique is successfully used to treat these defects, but it is limited by the need of several procedures and bone graft. Repeated procedures increase costs and morbidity, while grafts are subject to donor-site complications and scarce availability. To transform this two-staged technique into one graft-independent procedure, we developed amorphous porous scaffolds sintered from the clinically used bioactive glass S53P4. This work constitutes the first evaluation of such scaffolds in vivo in a critical-sized diaphyseal defect in the weight-bearing rabbit femur. We provide important knowledge and prospects for future development of sintered S53P4 scaffolds as a bone substitute. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of Acta Materialia Inc. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )Peer reviewe

S53P4 bioactive glass scaffolds induce BMP expression and integrative bone formation in a critical-sized diaphysis defect treated with a single-stage d induce d membrane technique

Surgical management of critical-sized diaphyseal defects involves multiple challenges, and up to 10% result in delayed or non-union. The two-staged induced membrane technique is successfully used to treat these defects, but it is limited by the need of several procedures and bone graft. Repeated procedures increase costs and morbidity, while grafts are subject to donor-site complications and scarce availability. To transform this two-staged technique into one graft-independent procedure, we developed amorphous porous scaffolds sintered from the clinically used bioactive glass S53P4. This work constitutes the first evaluation of such scaffolds in vivo in a critical-sized diaphyseal defect in the weight-bearing rabbit femur. We provide important knowledge and prospects for future development of sintered S53P4 scaffolds as a bone substitute. Critical-sized diaphysis defects are complicated by inherent sub-optimal healing conditions. The two staged induced membrane technique has been used to treat these challenging defects since the 1980 & rsquo;s. It involves temporary implantation of a membrane-inducing spacer and subsequent bone graft defect filling. A single-staged, graft-independent technique would reduce both socio-economic costs and patient morbidity. Our aim was to enable such single-staged approach through development of a strong bioactive glass scaffold that could replace both the spacer and the graft filling. We constructed amorphous porous scaffolds of the clinically used bioactive glass S53P4 and evaluated them in vivo using a critical sized defect model in the weight-bearing femur diaphysis of New Zealand White rabbits. S53P4 scaffolds and standard polymethylmethacrylate spacers were implanted for 2, 4, and 8 weeks. Induced membranes were confirmed histologically, and their osteostimulative activity was evaluated through RT-qPCR of bone morphogenic protein 2, 4, and 7 (BMPs). Bone formation and osseointegration were examined using histology, scanning electron microscopy, energy-dispersive X-ray analysis, and micro-computed tomography imaging. Scaffold integration, defect union and osteosynthesis were assessed manually and with X-ray projections. We demonstrated that S53P4 scaffolds induce osteostimulative membranes and produce osseointegrative new bone formation throughout the scaffolds. We also demonstrated successful stable scaffold integration with early defect union at 8 weeks postoperative in critical-sized segmental diaphyseal defects with implanted sintered amorphous S53P4 scaffolds. This study presents important considerations for future research and the potential of the S53P4 bioactive glass as a bone substitute in large diaphyseal defects. Statement of significance Surgical management of critical-sized diaphyseal defects involves multiple challenges, and up to 10% result in delayed or non-union. The two-staged induced membrane technique is successfully used to treat these defects, but it is limited by the need of several procedures and bone graft. Repeated procedures increase costs and morbidity, while grafts are subject to donor-site complications and scarce availability. To transform this two-staged technique into one graft-independent procedure, we developed amorphous porous scaffolds sintered from the clinically used bioactive glass S53P4. This work constitutes the first evaluation of such scaffolds in vivo in a critical-sized diaphyseal defect in the weight-bearing rabbit femur. We provide important knowledge and prospects for future development of sintered S53P4 scaffolds as a bone substitute. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of Acta Materialia Inc. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )Peer reviewe

The International Cancer Expert Corps: A Unique Approach for Sustainable Cancer Care in Low and Lower-Middle Income Countries

The growing burden of non-communicable diseases including cancer in low- and lower-middle income countries (LMICs) and in geographic-access limited settings within resource-rich countries requires effective and sustainable solutions. The International Cancer Expert Corps (ICEC) is pioneering a novel global mentorship–partnership model to address workforce capability and capacity within cancer disparities regions built on the requirement for local investment in personnel and infrastructure. Radiation oncology will be a key component given its efficacy for cure even for the advanced stages of disease often encountered and for palliation. The goal for an ICEC Center within these health disparities settings is to develop and retain a high-quality sustainable workforce who can provide the best possible cancer care, conduct research, and become a regional center of excellence. The ICEC Center can also serve as a focal point for economic, social, and healthcare system improvement. ICEC is establishing teams of Experts with expertise to mentor in the broad range of subjects required to establish and sustain cancer care programs. The Hubs are cancer centers or other groups and professional societies in resource-rich settings that will comprise the global infrastructure coordinated by ICEC Central. A transformational tenet of ICEC is that altruistic, human-service activity should be an integral part of a healthcare career. To achieve a critical mass of mentors ICEC is working with three groups: academia, private practice, and senior mentors/retirees. While in-kind support will be important, ICEC seeks support for the career time dedicated to this activity through grants, government support, industry, and philanthropy. Providing care for people with cancer in LMICs has been a recalcitrant problem. The alarming increase in the global burden of cancer in LMICs underscores the urgency and makes this an opportune time fornovel and sustainable solutions to transform cancer care globally

Guiding Dynamic Symbolic Execution Toward Unverified Program Executions

Most techniques to detect program errors, such as testing, code reviews, and static program analysis, do not fully verify all possible executions of a program. They leave executions unverified when they do not check certain properties, fail to verify properties, or check properties under certain unsound assumptions such as the absence of arithmetic overflow. In this paper, we present a technique to complement partial verification results by automatic test case generation. In contrast to existing work, our technique supports the common case that the verification results are based on unsound assumptions. We annotate programs to reflect which executions have been verified, and under which assumptions. These annotations are then used to guide dynamic symbolic execution toward unverified program executions. Our main technical contribution is a code instrumentation that causes dynamic symbolic execution to abort tests that lead to verified executions, to prune parts of the search space, and to prioritize tests that cover more properties that are not fully verified. We have implemented our technique for the .NET static analyzer Clousot and the dynamic symbolic execution tool Pex. It produces smaller test suites (by up to 19.2%), covers more unverified executions (by up to 7.1%), and reduces testing time (by up to 52.4%) compared to combining Clousot and Pex without our technique

Elongation mechanism of the ion shaping of embedded gold nanoparticles under swift heavy ion irradiation

The elongation process under swift heavy ion irradiation (74 MeV Kr ions) of gold NPs, with a diameter in the range 10-30 nm, and embedded in a silica matrix has been investigated by combining experiment and simulation techniques: three-dimensional thermal spike (3DTS), molecular dynamics (MD) and a phenomenological simulation code specially developed for this study. 3DTS simulations evidence the formation of a track in the host matrix and the melting of the NP after the passage of the impinging ion. MD simulations demonstrate that melted NPs have enough time to expand after each ion impact. Our phenomenological simulation relies on the expansion of the melted NP, which flows in the track in silica with modified (lower) density, followed by its recrystallization upon cooling. Finally, the elongation of the spherical NP into a cylindrical one, with a length proportional to its initial size and a width close to the diameter of the track, is the result of the superposition of the independent effects of each expansion/recrystallization process occurring for each ion impact. In agreement with experiment, the simulation shows the gradual elongation of spherical NPs in the ion-beam direction until their widths saturate in the steady state and reach a value close to the track diameter. Moreover, the simulations indicate that the expansion of the gold NP is incomplete at each ion impact.Peer reviewe

Creating nanoporous graphene with swift heavy ions

This article has an erratum: DOI 10.1016/j.carbon.2017.03.065We examine swift heavy ion-induced defect production in suspended single layer graphene using Raman spectroscopy and a two temperature molecular dynamics model that couples the ionic and electronic subsystems. We show that an increase in the electronic stopping power of the ion results in an increase in the size of the pore-type defects, with a defect formation threshold at 1.22–1.48 keV/layer. We also report calculations of the specific electronic heat capacity of graphene with different chemical potentials and discuss the electronic thermal conductivity of graphene at high electronic temperatures, suggesting a value in the range of 1 Wm−1 K−1. These results indicate that swift heavy ions can create nanopores in graphene, and that their size can be tuned between 1 and 4 nm diameter by choosing a suitable stopping power.Peer reviewe

On Deciding Local Theory Extensions via E-matching

Satisfiability Modulo Theories (SMT) solvers incorporate decision procedures for theories of data types that commonly occur in software. This makes them important tools for automating verification problems. A limitation frequently encountered is that verification problems are often not fully expressible in the theories supported natively by the solvers. Many solvers allow the specification of application-specific theories as quantified axioms, but their handling is incomplete outside of narrow special cases. In this work, we show how SMT solvers can be used to obtain complete decision procedures for local theory extensions, an important class of theories that are decidable using finite instantiation of axioms. We present an algorithm that uses E-matching to generate instances incrementally during the search, significantly reducing the number of generated instances compared to eager instantiation strategies. We have used two SMT solvers to implement this algorithm and conducted an extensive experimental evaluation on benchmarks derived from verification conditions for heap-manipulating programs. We believe that our results are of interest to both the users of SMT solvers as well as their developers

Shell Corrections of Superheavy Nuclei in Self-Consistent Calculations

Shell corrections to the nuclear binding energy as a measure of shell effects in superheavy nuclei are studied within the self-consistent Skyrme-Hartree-Fock and Relativistic Mean-Field theories. Due to the presence of low-lying proton continuum resulting in a free particle gas, special attention is paid to the treatment of single-particle level density. To cure the pathological behavior of shell correction around the particle threshold, the method based on the Green's function approach has been adopted. It is demonstrated that for the vast majority of Skyrme interactions commonly employed in nuclear structure calculations, the strongest shell stabilization appears for Z=124, and 126, and for N=184. On the other hand, in the relativistic approaches the strongest spherical shell effect appears systematically for Z=120 and N=172. This difference has probably its roots in the spin-orbit potential. We have also shown that, in contrast to shell corrections which are fairly independent on the force, macroscopic energies extracted from self-consistent calculations strongly depend on the actual force parametrisation used. That is, the A and Z dependence of mass surface when extrapolating to unknown superheavy nuclei is prone to significant theoretical uncertainties.Comment: 14 pages REVTeX, 8 eps figures, submitted to Phys. Rev.