Periosteal Flaps Enhance Prefabricated Engineered Bone Reparative Potential

The clinical translation of bone tissue engineering for reconstructing large bone defects has not advanced without hurdles. The in vivo bioreactor (IVB) concept may therefore bridge between bone tissue engineering and reconstructive surgery by employing the patient body for prefabricating new prevascularized tissues. Ideally, IVB should minimize the need for exogenous growth factors/cells. Periosteal tissues are promising for IVB approaches to prefabricate tissue-engineered bone (TEB) flaps. However, the significance of preserving the periosteal vascular supply has not been adequately investigated. This study assessed muscle IVB with and without periosteal/pericranial grafts and flaps for prefabricating TEB flaps to reconstruct mandibular defects in sheep. The sheep (n = 14) were allocated into 4 groups: muscle IVB (M group; n(M) = 3), muscle + periosteal graft (MP group; n(MP) = 4), muscle + periosteal flap (MVP group; n(MVP) = 4), and control group (n(Control) = 3). In the first surgery, alloplastic bone blocks were implanted in the brachiocephalic muscle (M) with a periosteal graft (MP) or with a vascularized periosteal flap (MVP). After 9 wk, the prefabricated TEB flaps were transplanted to reconstruct a mandibular angle defect. In the control group, the defects were reconstructed by non-prevascularized bone blocks. Computed tomography (CT) scans were performed after 13 wk and after 23 wk at termination, followed by micro-CT (mu CT) and histological analyses. Both CT and mu CT analysis revealed enhanced new bone formation and decreased residual biomaterial volume in the MVP group compared with control and MP groups, while the M group showed less new bone formation and more residual biomaterial. The histological analysis showed that most of the newly formed bone emerged from defect edges, but larger areas of new bone islands were found in MP and MVP groups. The MVP group showed enhanced vascularization and higher biomaterial remodeling rates. The periosteal flaps boosted the reconstructive potential of the prefabricated TEB flaps. The regenerative potential of the periosteum was manifested after the transplantation into the mechanically stimulated bony defect microenvironment.Peer reviewe

Osteogenic Differentiation Potential of Human Bone Marrow and Amniotic Fluid-Derived Mesenchymal Stem Cells in Vitro & in Vivo

BACKGROUND: Cell therapies offer a promising potential in promoting bone regeneration. Stem cell therapy presents attractive care modality in treating degenerative conditions or tissue injuries. The rationale behind this is both the expansion potential of stem cells into a large cell population size and its differentiation abilities into a wide variety of tissue types, when given the proper stimuli. A progenitor stem cell is a promising source of cell therapy in regenerative medicine and bone tissue engineering. AIM: This study aimed to compare the osteogenic differentiation and regenerative potentials of human mesenchymal stem cells derived from human bone marrow (hBM-MSCs) or amniotic fluid (hAF-MSCs), both in vitro and in vivo studies. SUBJECTS AND METHODS: Human MSCs, used in this study, were successfully isolated from two human sources; the bone marrow (BM) and amniotic fluid (AF) collected at the gestational ages of second or third trimesters. RESULTS: The stem cells derived from amniotic fluid seemed to be the most promising type of progenitor cells for clinical applications. In a pre-clinical experiment, attempting to explore the therapeutic application of MSCs in bone regeneration, Rat lumbar spines defects were surgically created and treated with undifferentiated and osteogenically differentiated MSCs, derived from BM and second trimester AF. Cells were loaded on gel-foam scaffolds, inserted and fixed in the area of the surgical defect. X-Ray radiography follows up, and histopathological analysis was done three-four months post- operation. The transplantation of AF-MSCs or BM-MSCs into induced bony defects showed promising results. The AF-MSCs are offering a better healing effect increasing the likelihood of achieving successful spinal fusion. Some bone changes were observed in rats transplanted with osteoblasts differentiated cells but not in rats transplanted with undifferentiated MSCs. Longer observational periods are required to evaluate a true bone formation. The findings of this study suggested that the different sources; hBM-MSCs or hAF-MSCs exhibited remarkably different signature regarding the cell morphology, proliferation capacity and osteogenic differentiation potential CONCLUSIONS: AF-MSCs have a better performance in vivo bone healing than that of BM-MSCs. Hence, AF derived MSCs is highly recommended as an alternative source to BM-MSCs in bone regeneration and spine fusion surgeries. Moreover, the usage of gel-foam as a scaffold proved as an efficient cell carrier that showed bio-compatibility with cells, bio-degradability and osteoinductivity in vivo

Optimization of self-nanoemulsifying formulations for weakly basic lipophilic drugs: role of acidification and experimental design

ABSTRACT Formulators face great challenges in adopting systematic approaches for designing self-nanoemulsifying formulations (SNEFs) for different drug categories. In this study, we aimed to build-up an advanced SNEF development framework for weakly basic lipophilic drugs, such as cinnarizine (CN). First, the influence of formulation acidification on CN solubility was investigated. Second, formulation self-emulsification in media with different pH was assessed. Experimentally designed phase diagrams were also utilized for advanced optimization of CN-SNEF. Finally, the optimized formulation was examined using cross polarizing light microscopy for the presence of liquid crystals. CN solubility was significantly enhanced upon external and internal acidification. Among the various fatty acids, oleic acid-based formulations showed superior self-emulsification in all the tested media. Surprisingly, formulation turbidity and droplet size significantly decreased upon equilibration with CN. The design was validated using oleic acid/Imwitor308/Cremophor El (25/25/50), which showed excellent self-nanoemulsification, 43-nm droplet size (for CN-equilibrated formulations), and 88 mg/g CN solubility. In contrast to CN-free formulations, CN-loaded SNEF presented lamellar liquid crystals upon 50% aqueous dilution. These findings confirmed that CN-SNEF efficiency was greatly enhanced upon drug incorporation. The adopted strategy offers fast and accurate development of SNEFs and could be extrapolated for other weakly basic lipophilic drugs

Genome-wide association study for systemic lupus erythematosus in an egyptian population

Systemic lupus erythematosus (SLE) susceptibility has a strong genetic component. Genome-wide association studies (GWAS) across trans-ancestral populations show both common and distinct genetic variants of susceptibility across European and Asian ancestries, while many other ethnic populations remain underexplored. We conducted the first SLE GWAS on Egyptians–an admixed North African/Middle Eastern population–using 537 patients and 883 controls. To identify novel susceptibility loci and replicate previously known loci, we performed imputation-based association analysis with 6,382,276 SNPs while accounting for individual admixture. We validated the association analysis using adaptive permutation tests (n = 109). We identified a novel genome-wide significant locus near IRS1/miR-5702 (Pcorrected = 1.98 × 10−8) and eight novel suggestive loci (Pcorrected 0.8) with lead SNPs from four suggestive loci (ARMC9, DIAPH3, IFLDT1, and ENTPD3) were associated with differential gene expression (3.5 × 10−95 < p < 1.0 × 10−2) across diverse tissues. These loci are involved in cellular proliferation and invasion—pathways prominent in lupus and nephritis. Our study highlights the utility of GWAS in an admixed Egyptian population for delineating new genetic associations and for understanding SLE pathogenesis

Continuous education and training of shore staff in a national shipping company: why? and how?

There is no doubt about the importance of the existence of national shipping in any state, since it plays an important role during peace and hostilities; both economically and politically. This could be easily concluded from the various subsidies or protections that different states contribute to their shipping industry in order to maintain a reasonable size of merchant fleet. Shipping is a very capital intensive industry. In some countries such capital is not available with private investors. Therefore, governments realizing this and at the same time feeling the need for a national shipping, may set up a state owned shipping company. If these companies aim to fulfil the government’s objectives effectively, they must perform efficiently. To achieve this efficiency, personnel must be continuously updated in the latest shipping technologies and trained to use those which are applicable to that company. This paper is focused on the shore staff and tries to show that development and up-dating of shore staff is as important as having qualified and competent sea personnel, as effective planning, good cooperation and monitoring is necessary for efficient operation. In achieving this, the role of national shipping in the national economy and its political aspects are highlighted first. Then, changes in shipping management in recent times are elaborated while constraints and economical and social factors affecting shipping are enumerated. Later, the need for motivating of human resources, the key factor to efficiency, are discussed. This is followed up by showing how training and education could enhance personnel performance and competency. And finally one of the courses proposed is developed completely, as an example, using the topics in the Annex -1

Variations of the Circle of Willis in 100 Cadavers in Kerman Province

Abstract: Background & Aims: The relationship between variations of Willis circle and some cerebrovascular diseases has been shown in previous studies. A few studies have been conducted in Iran on these variations. Methods: This study was performed on 100 recently deceased Iranians due to car accidents who had been referred to Kerman Forensic Medicine Center for autopsy. The length and diameter of cerebral vessels were measured using glass plate method and variations of Willis circle were determined according to Lazorthes classification. Results: The sample included 81 males and 19 females aged 16-81 years. The two most prevalent forms of Willis circle were type 1 (50%) and type 4 (38%) according to Lazorthes classification. Asymmetry and hypoplasia were seen in 51% and 61% of cases respectively. Asymmetry was most often seen in the left posterior communication artery. There was no significant relationship between the presence of asymmetry in anterior cerebral arteries and the size of anterior communicating artery. Moreover, the size of the posterior communication artery had not been affected by the presence of asymmetry in the posterior cerebral arteries. Conclusion: However, the anatomical variations found in this study were similar to those in the literature, racial similarities among the studied populations do not allow to exclude the role of race on the variations of Willis circle. The difference between common variations in the cadaver and in vivo studies hypothesizes that radiological studies during life are more appropriate to show the role of race on the variations of the circle of Willis. Nonsignificant relationships between the size of communication arteries and anterior and posterior cerebral arteries support this hypothesis. Keywords: Aneurysm, Circle of Willis, Kerman, Variatio

Epidemiology and cost-analysis of emergency department patients treated following traffic accidents in Iran: A retrospective cross-sectional study

Introduction: Epidemiological analysis of traffic accidents can provide information for future plans to lower the cost and burden of road traffic accidents (RTAs). This study was aimed to determine the epidemiological characteristics of patients with RTAs. Methods: We conducted a retrospective cross-sectional study of RTA patients presenting in 2016 to the Emergency Department at Shahid Bahonar Medical Education Center in Kerman, Iran. A checklist including variables such as age, sex, month, in which the patient referred, final outcome, overall cost and the site of injury used to collect data. The diagnostic criteria were in accordance to ICD 10. Results: Of the total of 3277 patients who were studied, 2713 (82.78) were men and 564 (16.66) were women. Most of the accidents occurred at the age group of 16-30 years and the average cost of treatment in the hospital was 2152.45 USD. The most affected area was the lower limb. The majority of accidents occurred in spring and summer. The mortality rate was (2.74). Discussion: Injuries and deaths due to RTAs are a major public health problem, especially in young age groups. Therefore, more preventive programs targeting young adults should be considered to reduce the burden of RTAs. Conclusion: Epidemiology and cost analysis of results showed that men caused more accidents and costs burden for both health system and society. Considering they have a more share of activity, economy and workforce, it will cause more damage and adverse consequences for economy and social life of the society. © 2020 International Journal of Critical Illness and Injury Science | Published by Wolters Kluwer - Medknow 177

Milk thistle seeds and rosemary leaves as rabbit growth promoters

The trial aimed to study milk thistle seeds (MTS) and rosemary leaves (RL) as natural growth promoters for rabbits during 28-91 days of age. A total of 100 weaned rabbits were distributed into 5 groups (20 rabbits/group) fed the same basal diet. The 1st group (control) was unsupplemented, the 2nd and 3rd groups were supplemented with MTS at 5 and 10 g/kg, while the 4th and 5th groups were fed the basal diet supplemented with RL at 5 and 10 g/kg, respectively. MTS at 10g/kg significantly increased growth rate compared with the same dose of RL. In comparison to the control both MTS and RL5 were found to significantly increase growth rate, while MTS at both levels of supplementation resulted in a significant increase of feed intake. All the supplemented groups had a better feed conversion ratio than the control, with the best values obtained in the MTS10 and RL5 groups. Digestibility of crude protein, organic and dry matter of the MTS10 and RL5 groups exceeded those in the other groups. In relation to the control MTS and RL significantly increased red blood cell counts (RBCs), while RL also increased PCV, Hgb and MCHC. Lymphocyte counts were significantly increased at 5g/kg of both supplements compared to the control and the RL10 groups. There were significant decreases in the ALT and ALT/AST ratios in the supplemented groups compared to the control, while total anti-oxidant capacity (TAC) was higher in the supplemented groups. The total and LDL cholesterol levels were the lowest in the RL10 group. The MTS10 group had a higher dressing percentage compared with the RL10 and control groups. In turn, the MTS10 group showed moderate lymphoid follicle activation in the spleen and an increase in the absorption area of the ileum. High levels of RL resulted in low counts of spermatogenic cells