ASSESSMENT OF INTRA OPERATIVE TIME FOR COMPUTER GUIDED POSTERIOR MANDIBLE ONLAY GRAFTING VERSUS FREE HAND ONLAY GRAFTING A RANDAMIZED CLINICAL SPLIT MOUTH TRIAL

Abstract Purpose: The aim of this study was to evaluate the efficacy of onlay vertical bone augmentation using patient specific guide in the reduction of intra-operative time and postoperative pain compared to the free hand technique in the vertically deficient posterior mandible ridge using autogenous cortico-cancellous bone. Methods: This study included 10 patients that had bilateral vertically deficient posterior mandibular alveolar ridges. For each patient, half of the ridge was augmented using 3D printed patient specific surgical guide for fixation of autogenous onlay bone graft, while the other half was augmented using free hand autogenous onlay bone graft technique using 3D printed cutting guide for the harvesting of the blocks for both groups. This was followed by a second-stage surgery for screws removal and delayed implant placement 6 months postoperatively. Results: Mean value of the intra-operative time for the study group (31.29±3.72 minutes) was less than that of the control group (40.94±3.04 minutes) which was statistically significant (p \u3c 0.0001). Conclusion: The use of patient specific surgical guide for the harvesting and fixation of onlay bone block in the vertically deficient posterior mandible is an efficient method for reducing the intra-operative time compared to the freehand technique

Comparative analysis of the efficacy of astigmatic correction after wavefront-guided and wavefront-optimized LASIK in low and moderate myopic eyes

AIM: To evaluate and compare the efficacy of the astigmatic correction achieved with laser in situ keratomileusis (LASIK) in eyes with myopic astigmatism using wavefront-guided (WFG) and wavefront-optimized (WFO) ablation profiles. METHODS: Prospective study included 221 eyes undergoing LASIK: 99 and 122 eyes with low and moderate myopic astigmatism (low and moderate myopia groups). Two subgroups were differentiated in each group according to the ablation profile: WFG subgroup, 109 eyes (45/64, low/moderate myopia groups) treated using the Advanced CustomVue platform (Abbott Medical Optics Inc.), and WFO subgroup, 112 eyes (54/58, low/moderate myopia groups) treated using the EX-500 platform (Alcon). Clinical outcomes were evaluated during a 6-month follow-up, including a vector analysis of astigmatic changes. RESULTS: Significantly better postoperative uncorrected visual acuity and efficacy index was found in the WFG subgroups of each group (P≤0.041). Postoperative spherical equivalent and cylinder were significantly higher in WFO subgroups (P≤0.003). In moderate myopia group, a higher percentage of eyes with a postoperative cylinder ≤0.25 D was found in the WFG subgroup (90.6% vs 65.5%, P=0.002). In low and moderate myopia groups, the difference vector was significantly higher in the WFO subgroup compared to WFG (P<0.001). In moderate myopia group, the magnitude (P=0.008) and angle of error (P<0.001) were also significantly higher in the WFO subgroup. Significantly less induction of high order aberrations were found with WFG treatments in both low and moderate myopia groups (P≤0.006). CONCLUSION: A more efficacious correction of myopic astigmatism providing a better visual outcome is achieved with WFG LASIK compared to WFO LASIK.Partially supported by a grant from Abbott Medical Optics

Minimally Invasive Approach in Surgical Management of Renal Neoplasms National Cancer Institute Experience

BACKGROUND: Minimally invasive nephrectomy is considered a technically challenging procedure requiring a long learning curve to reach acceptable warm ischemia time and perioperative complications. These minimally invasive techniques result in a shorter hospital stay and less post-operative pain. AIM: This study aims to demonstrate the National Cancer Institute experience regarding the benefits of laparoscopic and robot-assisted nephrectomy over open technique. METHODS: This is a retrospective descriptive cohort study including 62 patients with renal masses treated with nephrectomy whether partial, total or radical, 26 cases were treated by minimally invasive techniques (8 robotic and 18 laparoscopic), while 36 cases were treated by open technique. Inclusion criteria were patients between 20 and 70 years with renal neoplasm without renal vein thrombosis, with tumor stage T1 or T2 N0 M0. Exclusion criteria were patients with medical comorbidities that preclude surgical management or minimally invasive techniques and patients refusing surgery in general. RESULTS: Minimally invasive nephrectomy resulted in shorter hospital stay (mean hospital stay was 2.2 days for the minimally invasive group and 3.6 days for the open group) and less post-operative pain than open technique (p &lt; 0.001 and = 0.002, respectively), while open technique resulted in shorter operation time (p = 0.039, mean operation time 147.8 min compared to 184.8 in the minimally invasive group). CONCLUSION: Minimally invasive nephrectomy (laparoscopic and robotic) resulted in less post-operative pain and shorter hospital stay compared to open technique despite consuming longer operation time which may be decreased by improving the learning curve of operating surgeons

Humoral and cellular immune responses to modified hepatitis B plasmid DNA vaccine in mice

Purpose: To evaluate the immunogenicity and types of immune response of a quality-controlled modified recombinant hepatitis B surface antigen (HBsAg) plasmid encoding HBsAg in mice.Methods: The characterized plasmid DNA was used in the immunization of Balb/c mice. Three groups of mice were intramuscularly injected with three different concentrations (50, 25 and 10 μg/100 μL) of the modified plasmid. Humoral immune response was monitored by enzyme-linked immunosorbent assay (ELISA), while cellular immune response was investigated by analysis of spleen cytokine profile (TNFα, IFN γ and IL2) as well as CD69 expression level in CD4 and CD8 positive cells.Results: In general, the activated CD4 cells showing intracellular cytokines were higher than CD8 positive population of cells (p &lt; 0.05). These findings indicate that the vaccine induced both a humoral and cellular immunity. Cytokine profile also showed high levels of TNFα, IFN γ and IL2 and CD69 expression in the group of animals immunized at a dose of 10 μg when compared to control group (p &lt; 0.05).Conclusion: A 10 μg dose intramuscular injection of the modified DNA-based vaccine encoding HBsAg in mice induces both high humoral and cellular immune responses.Keywords: Hepatitis B virus, Plasmid DNA, Vaccine, Spleen cytokines, Humoral and cellular immune response

Corneal densitometry changes after femtosecond laser-assisted intracorneal ring segments implantation in keratoconus

Background: Intrastromal corneal ring segments are commonly implanted in the corneas of eyes with mild-to-moderate keratoconus; however, changes in corneal densitometry (CD) after implantation are a matter of debate in the current literature. We evaluated the changes in CD 1 and 3 months after femtosecond laser-assisted Keraring implantation. &nbsp; Methods: This retrospective, non-comparative, multicenter, case series study included patients with keratoconus who underwent femtosecond laser-assisted implantation of double segments with 90° and 160° arc lengths or two 160° arc length Keraring segments. Demographic and baseline clinical ophthalmic data were recorded. Corneal topography and tomography data acquired using a Pentacam HR Scheimpflug tomography system (Pentacam High Resolution; Oculus, Wetzlar, Germany) with a best-fit sphere were used as a reference surface. Using the Pentacam HR, CD measurements were acquired over a corneal area of 12 mm in total and at four concentric zones (0–2, 2–6, 6–10, and 10–12 mm) of three corneal stromal depths: 120 micrometers of the anterior corneal stromal layer, 60 micrometers of the posterior corneal stromal layer, and the central layer of stroma lying between these two layers. &nbsp; Results: We included 40 eyes of 40 patients, including 8 (20%) male and 32 (80%) female individuals, with a mean (standard deviation) age of 21.0 (6.4) years. We observed a significant improvement in the topographic values of steep keratometry (K), flat K, maximum K, and corneal astigmatism (all P &lt; 0.05), but not in the mean K, thinnest corneal pachymetry, corneal thickness at the apex, back elevation, or front elevation (all P &gt; 0.05). The mean total anterior, central, and posterior CD differed significantly among the time points, with a significant increase from the preoperative to the 1-month and 3-month postoperative visits (all P &lt; 0.05) and no difference between those of the 1-month and 3-month postoperative visits (all P &gt; 0.05). The mean CD for the anterior layer in the central, paracentral, and mid-peripheral zones, and the central layer in all four zones, differed significantly among time points, with a significant increase from the preoperative to the 1-month and 3-month postoperative visits (all P &lt; 0.05), which remained unchanged from the 1-month to the 3-month postoperative visit (all P &lt; 0.05), except for the central 2–6-mm zone, which decreased significantly from the 1-month to the 3-month postoperative visit (P &lt; 0.001). The CD of the central 10–12-mm zone did not differ significantly in each pairwise comparison (all P &gt; 0.05). In contrast, CD for the posterior layer in the paracentral zone decreased significantly from the preoperative to the 1-month and 3-month postoperative visits but increased, to a lesser extent, from the 1-month to the 3-month postoperative visit (all P &lt; 0.05). &nbsp; Conclusions: Femtosecond laser-assisted Keraring implantation significantly changes CD, with improvement in most topography parameters. Further longitudinal studies with larger sample sizes are required to verify these preliminary findings

Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility

Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm’s potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause

Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study

The Burden of Obstructive Lung Disease (BOLD) study was established to assess the prevalence of chronic airflow obstruction, a key characteristic of chronic obstructive pulmonary disease, and its risk factors in adults (≥40 years) from general populations across the world. The baseline study was conducted between 2003 and 2016, in 41 sites across Africa, Asia, Europe, North America, the Caribbean and Oceania, and collected high-quality pre- and post-bronchodilator spirometry from 28 828 participants. The follow-up study was conducted between 2019 and 2021, in 18 sites across Africa, Asia, Europe and the Caribbean. At baseline, there were in these sites 12 502 participants with high-quality spirometry. A total of 6452 were followed up, with 5936 completing the study core questionnaire. Of these, 4044 also provided high-quality pre- and post-bronchodilator spirometry. On both occasions, the core questionnaire covered information on respiratory symptoms, doctor diagnoses, health care use, medication use and ealth status, as well as potential risk factors. Information on occupation, environmental exposures and diet was also collected

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

A comparative study of lifetime reliability of planar MOSFET and FinFET due to BTI for the 16 nm CMOS technology node based on reaction-diffusion model

Intensive scaling of Integrated Circuits is a crucial factor for achieving high performance and astronomical packing density. However, this scaling is pushing planar MOSFET to its physical limitations. Nowadays, FinFET emerges as a promising alternative technology for planar MOSFET, due to their better efficiency. Nevertheless, this inevitably leads to a rising concern on the reliability of FinFET as the circuit lifetime reliability cannot be neglected due to this accelerated scaling of Integrated Circuits. This paper is considered as the first work that: 1) detects which CMOS technology, planar MOSFET or FinFET, is more robust against Bias Temperature Instability (BTI) aging degradation for the advanced nodes such as 16 nm; 2) precisely computes the effect of BTI on 16 nm FinFET using an adequate BTI Reaction Diffusion model that takes into consideration the effects of finite oxide thickness, and the influence of polysilicon; 3) investigates the efficiency in terms of power consumption and area for the predominant circuit level techniques that could be implemented to overcome the negative impact of BTI for FinFET technology. This research clearly indicates that FinFET technology is more robust against BTI aging degradation than planar MOSFET as the delay percentage for FinFET technology is lower than planar MOSFET technology by 26%. © 2019 Elsevier Lt