Stem cell- and growth factor-based regenerative therapies for avascular necrosis of the femoral head

Avascular necrosis (AVN) of the femoral head is a debilitating disease of multifactorial genesis, predominately affects young patients, and often leads to the development of secondary osteoarthritis. The evolving field of regenerative medicine offers promising treatment strategies using cells, biomaterial scaffolds, and bioactive factors, which might improve clinical outcome. Early stages of AVN with preserved structural integrity of the subchondral plate are accessible to retrograde surgical procedures, such as core decompression to reduce the intraosseous pressure and to induce bone remodeling. The additive application of concentrated bone marrow aspirates, ex vivo expanded mesenchymal stem cells, and osteogenic or angiogenic growth factors (or both) holds great potential to improve bone regeneration. In contrast, advanced stages of AVN with collapsed subchondral bone require an osteochondral reconstruction to preserve the physiological joint function. Analogously to strategies for osteochondral reconstruction in the knee, anterograde surgical techniques, such as osteochondral transplantation (mosaicplasty), matrix-based autologous chondrocyte implantation, or the use of acellular scaffolds alone, might preserve joint function and reduce the need for hip replacement. This review summarizes recent experimental accomplishments and initial clinical findings in the field of regenerative medicine which apply cells, growth factors, and matrices to address the clinical problem of AVN. © 2012 BioMed Central Ltd

Durability design of reinforced concrete structures: a comparison of the use of durability indexes in the deemed-to-satisfy approach and the full-probabilistic approach

Abstract: To show the application of the chloride conductivity index test in service life prediction (SLP) using both the deemed-to-satisfy and probabilistic approaches to performance-based durability design. It is desirable to adopt a performance-based approach with respect to durability design of reinforced concrete (RC) structures. This is based on the perception that the durability of RC is achieved when the limiting value from an established test method is met. In South Africa, the durability index (DI) approach has been developed, which permits performance-based specifications for durability of RC. This approach involves the application of a test method together with a SLP model. This integrated approach links material properties directly with the expected service life of RC structures and environmental conditions. Two DIs are relevant to degradation processes in RC: the chloride conductivity index which is related to chloride ingress, and the oxygen permeability index related to carbonation. The study presented here focuses on the application of the chloride conductivity index as the main input parameter of a SLP model concerned with chloride-induced reinforcement corrosion. The methodology and output of the SLP model as applied in the deemed-to-satisfy approach are compared with those of the probabilistic approach. Both approaches are exemplified using a concrete pier cast in situ in a marine environment. The performance-based durability specifications from the deemed-to-satisfy approach are found to be more conservative compared to those of the probabilistic approach

Fragmentation processes of ionized 5-fluorouracil in the gas phase and within clusters

We have measured mass spectra for positive ions produced from neutral 5-fluorouracil by electron impact at energies from 0 to 100 eV. Fragment ion appearance energies of this (radio-)chemotherapy agent have been determined for the first time and we have identified several new fragment ions of low abundance. The main fragmentations are similar to uracil, involving HNCO loss and subsequent HCN loss, CO loss, or FCCO loss. The features adjacent to these prominent peaks in the mass spectra are attributed to tautomerization preceding the fragmentation and/or the loss of one or two additional hydrogen atoms. A few fragmentions are distinct for 5-fluorouracil compared to uracil, most notably the production of the reactive moiety CF+. Finally, multiphoton ionization mass spectra are compared for 5-fluorouracil from a laser thermal desorption source and from a supersonic expansion source. The detection of a new fragment ion at 114 u in the supersonic expansion experiments provides the first evidence for a clustering effect on the radiation response of 5-fluorouracil. By analogy with previous experiments and calculations on protonated uracil, this is assigned to NH3 loss from protonated 5-fluorouracil

Modifying patterns of movement in people with low back pain -does it help? A systematic review

Background: Physiotherapy for people with low back pain frequently includes assessment and modification of lumbo-pelvic movement. Interventions commonly aim to restore normal movement and thereby reduce pain and improve activity limitation. The objective of this systematic review was to investigate: (i) the effect of movement-based interventions on movement patterns (muscle activation, lumbo-pelvic kinematics or postural patterns) of people with low back pain (LBP), and (ii) the relationship between changes in movement patterns and subsequent changes in pain and activity limitation. Methods. MEDLINE, Cochrane Central, EMBASE, AMI, CINAHL, Scopus, AMED, ISI Web of Science were searched from inception until January 2012. Randomised controlled trials or controlled clinical trials of people with LBP were eligible for inclusion. The intervention must have been designed to influence (i) muscle activity patterns, (ii) lumbo-pelvic kinematic patterns or (iii) postural patterns, and included measurement of such deficits before and after treatment, to allow determination of the success of the intervention on the lumbo-pelvic movement. Twelve trials (25% of retrieved studies) met the inclusion criteria. Two reviewers independently identified, assessed and extracted data. The PEDro scale was used to assess method quality. Intervention effects were described using standardised differences between group means and 95% confidence intervals. Results: The included trials showed inconsistent, mostly small to moderate intervention effects on targeted movement patterns. There was considerable heterogeneity in trial design, intervention type and outcome measures. A relationship between changes to movement patterns and improvements in pain or activity limitation was observed in one of six studies on muscle activation patterns, one of four studies that examined the flexion relaxation response pattern and in two of three studies that assessed lumbo-pelvic kinematics or postural characteristics. Conclusions: Movement-based interventions were infrequently effec tive for changing observable movement patterns. A relationship between changes in movement patterns and improvement in pain or activity limitation was also infrequently observed. No independent studies confirm any observed relationships. Challenges for future research include defining best methods for measuring (i) movement aberrations, (ii) improvements in movements, and (iii) the relationship between changes in how people move and associated changes in other health indicators such as activity limitation

A Seismic Performance Classification Framework to Provide Increased Seismic Resilience

Several performance measures are being used in modern seismic engineering applications, suggesting that seismic performance could be classified a number of ways. This paper reviews a range of performance measures currently being adopted and then proposes a new seismic performance classification framework based on expected annual losses (EAL). The motivation for an EAL-based performance framework stems from the observation that, in addition to limiting lives lost during earthquakes, changes are needed to improve the resilience of our societies, and it is proposed that increased resilience in developed countries could be achieved by limiting monetary losses. In order to set suitable preliminary values of EAL for performance classification, values of EAL reported in the literature are reviewed. Uncertainties in current EAL estimates are discussed and then an EAL-based seismic performance classification framework is proposed. The proposal is made that the EAL should be computed on a storey-by-storey basis in recognition that EAL for different storeys of a building could vary significantly and also recognizing that a single building may have multiple owners

Development of a piloted lean burner for an aero-engine combustor: influence of liquid fuel placement on pollutant emissions

Detailed investigations of different liquid fuel injectors for the main stage of a lean burnner were carried out. The main injector follows a jet in cross flow arrangement. Two other concepts with a prefilmer and trailing edge injection were additionally derived. It was found that the fuel split between main and pilot injector has a significant influence on flame structure. Low NOx emissions are observed with main burners with a low fuel penetration into the central recirculation zone