Open Defects Research Articles

Construction and predictive value of risk models of maternal serum alpha-fetoprotein variants and fetal open neural tube defects.

The correlation of maternal serum alpha-fetoprotein (AFP) variants (AFP-L2, AFP-L3), free beta-human chorionic gonadotropin (free β-hCG), and open neural tube defects (ONTDs) during the second trimester, and the screening efficiency of different risk models remain indistinct. We conducted a retrospective case-control study, and studied 57 pregnant women with ONTD fetuses and 569 pregnant women with normal fetuses. The receiver operating characteristic curve method indicated the best cutoff value and area under the curve (AUC). The predictive value of ONTD risk models by free β-hCG, AFP, AFP-L2, and AFP-L3 was investigated via integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA). Compared to the control group, AFP, AFP-L2, and AFP-L3 levels were significantly higher, while free β-hCG level was significantly lower in the study group. The triple-index model of free β-hCG + AFP-L2 + AFP-L3 and the dual-index model of AFP-L2 + AFP-L3 showed the best predictive values, respectively (AUC = 0.905; AUC = 0.885). The order of the single-index model AUCs was AFP-L3 > AFP-L2 > AFP > free β-hCG. The negative predictive value, false positive rate, and negative likelihood ratio of AFP-L2, AFP-L3 alone, or combined with free β- hCG were better than those of AFP alone; however, the positive likelihood ratio was the opposite. The replacement of AFP by AFP-L2 or AFP-L3 combined with free β-hCG increased the IDI and NRI for predicting ONTD. The top five DCAs were AFP-L2 + free β-hCG, free β-hCG, AFP-L3, AFP + free β-hCG, and AFP. Indicators of maternal serum free β-hCG, AFP-L2, and AFP-L3 in the second trimester exhibited high sensitivity and specificity screening for ONTD fetuses. Risk models constructed using AFP-L2 + AFP-L3 and AFP-L2 + AFP-L3 + free β-hCG demonstrated better screening efficiency.

OP054: Chromosomal microarray analysis for open neural tube defect: The prevalence of significant results and implications on in utero repair

Open neural tube defects (ONTD) are the second-most-common major congenital anomaly, and have been associated with environmental insults or genetic factors. Prenatal screening and diagnosis are widely available, and in utero repair has demonstrated superior outcomes for eligible patients. The Management of Myelomeningocele Study (MOMS) required a normal karyotype as one of the eligibility criteria for in utero repair. However, current guidelines recommend genetic testing by chromosomal microarray analysis (CMA) when a major congenital anomaly is detected prenatally.

Manipulating magnetic and magnetoresistive properties by oxygen vacancy complexes in GCMO thin films

The effect of in situ annealing is investigated in Gd0.1Ca0.9MnO3 (GCMO) thin films in oxygen and vacuum atmospheres. We show that the reduction of oxygen content in GCMO lattice by vacuum annealing induced more oxygen complex vacancies in both subsurface and interface regions and larger grain domains when compared with the pristine one. Consequently, the double exchange interaction is suppressed and the metallic-ferromagnetic state below Curie temperature turned into spin-glass insulating state. In contrast, the magnetic and resistivity measurements show that the oxygen treatment increases ferromagnetic phase volume, resulting in greater magnetization (M S) and improved magnetoresistivity properties below Curie temperature by improving the double exchange interaction. The threshold field to observe the training effect is decreased in oxygen treated film. In addition, the positron annihilation spectroscopy analysis exhibits fewer open volume defects in the subsurface region for oxygen treated film when compared with the pristine sample. These results unambiguously demonstrate that the oxygen treated film with significant spin memory and greater magnetoresistance can be a potential candidate for the future memristor applications.

Ankle joint salvage and reconstruction by limited ORIF combined with an Ilizarov external fixator for complex open tibial pilon fractures (AO 43-C3.3) with segmental bone defects

BackgroundOpen pilon fractures combined with sizeable segmental bone defects are rare, difficult to treat, and often result in the loss of ankle joint function. The purpose of this study was to determine clinical outcomes in patients with open pilon fractures and sizeable segmental bone defects treated by limited ORIF combined with an Ilizarov external fixator.MethodsWe conducted a retrospective analysis of open pilon fractures with sizeable segmental bone defects treated by limited ORIF combined with the Ilizarov external fixator strategy between July 2014 and August 2019. All patients were included for assessments of fracture healing and infection rates. Ankle functional outcomes were assessed in all patients according to the Paley criteria and American Orthopedic Foot and Ankle Society Score (AOFAS) at least 24 months post-injury.ResultsAll patients were followed up for a mean of 41.09 months. The mean bone defect size was 5.64 ± 1.21 cm. The average EFI and BTI were 1.56 ± 0.28 months/cm and 11.12 ± 0.74 days/cm, respectively. According to the Paley evaluation system, the success rate of ankle joint reconstruction was 64% (7/11). The mean score based on the AOFAS functional assessment was 77.73 ± 8.87. Five patients showed posttraumatic arthritis, one of whom required ankle arthrodesis. Three patients developed pin site infections, and one patient developed a deep infection after bone grafting.ConclusionThe strategy of limited ORIF combined with an Ilizarov external fixator can restore ankle function in most patients with complex open tibial pilon fractures. Ankle stiffness, pin tract infection, and traumatic arthritis were the most common complications associated with this therapy.

Amniotic fluid-derived stem cell potential for therapeutic and surgical use: A review of the literature.

Spina bifida is a debilitating neutral tube defect affecting many infants. The impact and severity of spina bifida depends on whether the patient exhibits a closed defect, spina bifida occulta, or an open defect, spina bifida aperta. Patients with spina bifida have physical and mental disabilities which merit further research into less invasive, more successful treatments. In addition to serving as protection for the growing fetus and facilitating nutrient exchange, amniotic fluid (AF) is a rich source of a mixed population of stem cells. As such, in vitro culture of AF-derived stem cells has shown promise among therapeutic and surgical applications. We present a critical evaluation of the current preclinical efforts, amniotic fluid-derived stem cell (AFSC) culture process, and the subsequent therapeutic application, with a focus on improvements for spina bifida outcomes in the pediatric patient population. An evidence - based literature review to investigate the current literature surrounding AFSC culture and use, with an emphasis on the benefits for spina bifida treatment. 47 literature sources from PubMed and three studies from ClinicalTrials.gov. This review synthesizes the current literature, which shows promising data on AFSC pluripotency, as well as successful in utero coverage from AFSC - supported environments in a multitude of animal models.

Safety and feasibility of delivery room cuddles in infants with surgical defects: A quality improvement project

Background: Delivery Room Cuddles (DRC) is a growing practice with recognized benefits for parent-infant bonding, breastfeeding rates, and infant stress responses. Methods: We introduced DRC at St. Mary’s NICU, Manchester, in October 2020. As part of a formal QI process, we have been continuously collecting data on all babies admitted to our NICU from the delivery suite to review rates of DRC and monitor for any beneficial effects / adverse events. From October 2020 to May 2021, we admitted 41 babies with known surgical defects; 56% of whom had a DRC, including intubated babies with congenital diaphragmatic hernias, and babies with open surgical defects. Results: There have been no adverse incidents directly related to DRC and more babies who had a DRC received breast milk than those who did not Conclusion: Our study demonstrates that DRC can be implemented safely in surgical babies.

TO STUDY THE COMPARISON BETWEEN LONG TERM RESULTS OF DIFFERENT METHOD OF MANAGING POST-TRAUMATIC LONG BONE DEFECTS

BACKGROUND: The severe long bone defects usually follow high-energy trauma and are often associated with a signicant soft-tissue injury. The goal of management of these open long bone defects is to provide stable xation with maintenance of limb length and soft-tissue coverage. Thus, we aimed to compare the different methods in the treatment of patients with post-traumatic long bone defects, based on the long-term functional and selfevaluation results. METHODS: We retrospectively reviewed data on patients with post-traumatic long bone defects of the lower extremities from August 2018 to December 2020. The patients are divided into three groups according to the surgical method used to treat the defects (group 1, free vascularized bular transfer; group 2, distraction osteogenesis; group 3, the induced membrane technique). Data including the complication rates, entire treatment period, long-term visual analog scale scores, and Sickness Impact Prole (SIP) scores during follow-up were recorded. RESULTS: A total of 300 patients were included, with 105, 125, and 70 patients in groups 1, 2, and 3, respectively. The major complication rates were 22.6%, 25.8%, and 26.6% for the groups (P > 0.05), respectively. The mean treatment durations for bony defects, from surgery to non-protected weightbearing, were 65.1, 46.5, and 56.6 weeks for each group, respectively. At 2 years postoperatively, the average SIP scores for each group were 10.5, 11.7, and 11.5, respectively (P > 0.05). CONCLUSION: Patients who sustained long bone defects can be advised that either one of these three methods which typically results in long-term outcomes equivalent to others. Level of evidence: retrospective study.

Development and characterization of cannabidiol-loaded alginate copper hydrogel for repairing open bone defects in vitro

The clinical treatment of open bone defects caused by accidental bone trauma, bone tumors, bone diseases and bone infections is challenging. In this study, we designed and fabricated a multifunctional alginate-based hydrogel that contains cannabidiol (CBD), SA@Cu/CBD hydrogel, for repairing open bone defects. The results of physicochemical characterization showed that the SA@Cu/CBD hydrogel was successfully prepared and showed a suitable swelling ratio, high thermal stability, and stable mechanical properties. In vitro evaluation of antibacterial activity indicated that more than 90% of S. aureus and E. coli were inhibited compared to the control group. The ALP activity assay showed that the ALP expression level of MC3T3-E1cells in SA@Cu/CBD hydrogel was approximately 2-fold higher than that in the control group on day 7 and 14. Additionally, compared to the control group, the level of mineralized deposits in SA@Cu/CBD hydrogel was also improved by about 2 times on day 14. The PCR results indicated the mRNA expression levels of osteogenic markers (ALP, Col1α1, OCN, and RUNX2 genes) and angiogenic markers (EGFL6 and VEGF genes) in SA@Cu/CBD hydrogel were significantly upregulated compared to that in the control group, and the mRNA expression levels of critical inflammatory cytokines (TNF-α and IL-1β) in the SA@Cu/CBD hydrogel were significantly down-regulated compared to that in SA@Cu hydrogel. Taken together, these results demonstrated that the SA@Cu/CBD hydrogel showed significantly anti-bacterial, anti-inflammation, angiogenic and osteogenic activities in vitro studies. Thus, SA@Cu/CBD hydrogels may be a promising candidate in repairing open bone defects.

Perforator-based keystone flap in the reconstruction of extensive tissue defects after lumbosacral spondylodesis

Prolonged surgical site infections after spinal fusion surgery may lead to exposure of the implant due to the formation of extensive tissue defects and endanger the clinical outcome. This study aims to enlighten the role of the keystone perforator flap method in the reconstruction of lumbar soft tissue defects. The retrospective study included 11consecutive patients with a wound dehiscence of over 6 × 6 cm defect area persisting for 2weeks after spinal fusion. The keystone perforator flap was applied for the reconstruction of tissue defects, whereas the arterial blood supply of the flaps was based on the intramuscular and intermuscular perforating branches of the dorsal branches of the lumbar arteries. The median age of our cohort was 58years. The median body mass index (BMI) and Charlson comorbidity index (CCI) were 29.9 and 3.4, respectively. In eight cases alumbosacral was carried out whereas in the remaining series alumbar fusion was performed. In the course of the subsequent wound revision, on average 4applications of negative pressure wound therapy (NPWT) were performed. The average defect size was 7.5 cm in width and 16.5 cm in length. The microbiological analysis of the tissue samples obtained intraoperatively after repeated NPWT revealed positive evidence of pathogenic bacteria in all cases. The average duration of inpatient treatment after flap surgery was 15days, which was significantly shorter than the NPWT management of the open defect wounds (15.5 ± 2.5 vs. 37 ± 16.5, p < 0.05). The keystone perforator flap offers astable coverage for soft tissue defects and supports infection control after spinal fusion.

Efficacy and safety of external tissue expansion technique in the treatment of soft tissue defects: a systematic review and meta-analysis of outcomes and complication rates.

Currently, various external tissue expansion devices are becoming widely used. Considering the scarcity of relevant application standards, this systematic review was performed to explore the effectiveness and safety of external tissue expansion techniques for the reconstruction of soft tissue defects. A systematic review and meta-analysis on the efficacy and safety of external tissue expansion technique was conducted. A comprehensive search was performed in the following electronic databases: PubMed/Medline, Embase, Cochrane Library (Wiley Online Library), and Web of Science. Studies reporting patients with soft tissue defects under the treatment of external tissue expansion technique were included. A total of 66 studies with 22 different types of external tissue expansion devices met the inclusion criteria. We performed a descriptive analysis of different kinds of devices. A single-arm meta-analysis was performed to evaluate the efficacy and safety of the external tissue expansion technique for different aetiologies. The pooled mean wound healing time among patients with defects after fasciotomy was 10.548days [95% confidence interval (CI) = 5.796-15.299]. The pooled median wound healing times of patients with defects after excisional surgery, trauma, chronic ulcers and abdominal defects were 11.218days (95% CI = 6.183-16.253), 11.561days (95% CI = 7.062-16.060), 15.956days (95% CI = 11.916-19.996) and 12.853 days (95% CI=9.444-16.227), respectively. The pooled wound healing rates of patients with defects after fasciotomy, excisional surgery, trauma, chronic ulcers and abdominal defects were 93.8% (95% CI=87.1-98.2%), 97.2% (95%CI=92.2-99.7%), 97.0% (95%CI=91.2-99.8%), 99.5% (95%CI=97.6-100%), and 96.8% (95%CI=79.2-100%), respectively. We performed a subgroup analysis in patients with diabetic ulcers and open abdominal wounds. The pooled median wound healing time of patients with diabetic ulcers was 11.730days (95% CI = 10.334-13.125). The pooled median wound healing time of patients with open abdomen defects was 48.810days (95% CI = 35.557-62.063) and the pooled successful healing rate was 68.8% (95% CI = 45.9-88.1%). A total of 1686 patients were included, 265 (15.7%) of whom experienced complications. The most common complication was dehiscence (n = 53, 3.14%). Our systematic review is the first to demonstrate the efficacy and safety of external tissue expansion in the management of soft tissue defects. However, we must interpret the meta-analysis results with caution considering the limitations of this review. Large-scale randomized controlled trials and long-term follow-up studies are still needed to confirm the effectiveness and evaluate the quality of healing.

In vivo investigation of open-pored magnesium scaffolds LAE442 with different coatings in an open wedge defect.

The magnesium alloy LAE442 showed promising results as a bone substitute in numerous studies in non-weight bearing bone defects. This study aimed to investigate the in vivo behavior of wedge-shaped open-pored LAE442 scaffolds modified with two different coatings (magnesium fluoride (MgF2, group 1)) or magnesium fluoride/calcium phosphate (MgF2/CaP, group 2)) in a partial weight-bearing rabbit tibia defect model. The implantation of the scaffolds was performed as an open wedge corrective osteotomy in the tibia of 40 rabbits and followed for observation periods of 6, 12, 24, and 36 weeks. Radiological and microcomputed tomographic examinations were performed in vivo. X-ray microscopic, histological, histomorphometric, and SEM/EDS analyses were performed at the end of each time period. µCT measurements and X-ray microscopy showed a slight decrease in volume and density of the scaffolds of both coatings. Histologically, endosteal and periosteal callus formation with good bridging and stabilization of the osteotomy gap and ingrowth of bone into the scaffold was seen. The MgF2 coating favored better bridging of the osteotomy gap and more bone-scaffold contacts, especially at later examination time points. Overall, the scaffolds of both coatings met the requirement to withstand the loads after an open wedge corrective osteotomy of the proximal rabbit tibia. However, in addition to the inhomogeneous degradation behavior of individual scaffolds, an accumulation of gas appeared, so the scaffold material should be revised again regarding size dimension and composition.

Restoration of the microvasculature and hemodynamics in the oral mucosa wound defects area with and without a piezoelectric polymer membrane

Introduction. Restoration of blood supply to tissues is crucial for the regeneration of wound defects. The purpose of this research was to study the effect of piezoelectric polymers on the restoration of microcirculation and hemodynamics in the area of oral mucosa wound defects. Materials and methods. The study was carried out on 60 Wistar rats divided into four groups (15 rats each): control (intact) and 3 experimental groups. In group 1, the animals had an open wound defect. In groups 3 and 2, the rats had a wound defect covered with a membrane with and without copper modification, respectively. The specimens for subsequent light and electron microscopy were collected on days 3, 7, and 12. We studied qualitative and quantitative indicators of microcirculation and hemodynamics restoration. Results. Day 3: in all experimental groups, the arteriolo-venular relationship and the pericapillary diffusion index significantly decreased, while the Kernogan index increased. We also observed a significant increase in VEGF expression. Day 7: in experimental group 3, the values of the Kernogan index and the arteriolo-venular relationship were restored, and the pericapillary diffusion index remained significantly higher than in the control group. In the groups 1 and 2, none of the indicators reached the control values. VEGF expression decreased in all groups. On day 12 in group 1, the arteriolo-venular relationship, the Kernogan index and the index of pericapillary diffusion differed from the control group, in contrast to groups 2 and 3, where all the studied parameters were restored. Expression of VEGF in group 1 was significantly less than the control values, and in groups 2 and 3 it was significantly higher. Conclusion. We revealed that closing of oral mucosa wound defects by a piezoelectric polymer membrane led to the restoration of hemodynamic parameters and promoted active vascular formation. Keywords: wound defect, oral cavity, inflammation, regeneration, microcirculation, neoangiogenesis

Soft tissue reconstruction using fasciocutaneous flaps in compound fracture tibia: A case series

Objective: To study the role fasciocutaneous flap as a method of soft-tissue reconstruction in open tibial fractures soft-tissue defect and to compare their outcome when used as early coverage with that of delayed coverage. Materials and Methods: A total of 30 patients with open tibial fractures (type IIIB) were subjected to fasciocutaneous flap for the soft-tissue defect. Patients were divided into two groups based on the timing of soft-tissue reconstruction comprising of 15 patients in each group. Group I the early group (0-7 days) and group II delayed group (8-30 days). Results: Road traffic accidents accounted for the majority of fractures with 77.7% and 60% in group I and group II. The right leg was involved in 20 patients (66.7%) and left leg in 10 patients (33.33%). Middle one-third of the leg being the predominant site of wound defect 66.7% and 60% in group I and group II respectively. 66.7% of superficial infection was found with the delayed closure (group II) and 46% with early closure (group II). 26.7% of deep bony infection was found to be with the delayed closure and 20% with early closure. 80% of flap survived completely in group I while 73.3% flap survived in group II. In group I the time to union was between 13 weeks and 25 weeks accounting for 73.3% of the cases and in group II the time to union was between 26 weeks and 52 weeks, which accounted for 80% of the cases. The average hospital stay was 13.4 days in group I with 80% ranging in between 10 days and 20 days and in group II the average stay was 22.8 days with 53.3% ranging from 21 days to 30 days. Conclusion: The goals of soft tissue coverage in open fractures are to achieve a safe and early durable coverage, avoid nosocomial infection and optimize the healing and facilitate the future reconstruction.

Quality Improvement in Flexible Printed Circuit Board (FPCB) Using DMAIC Methodology: An Investigation in Semiconductor Industry

Continuous Process Improvement is methodology to solve the defect problem by increasing the effectiveness and efficiency of the business performances. DMAIC (Define-Measure-Analysis-Improve-Control) is a data improvement cycle designed for business process to find flaw or inefficiencies particularly resulting in defect or reject. This study was conducted at Company A and used DMAIC method to reduce the open defect for the circuit on the Flexible Printed Circuit Board (FPCB) from 0.6% to 0.3%. Part 13236 which has the highest open defect problem was chosen as the project improvement main focus. Imaging area was the main focus in this project because of its process forming the circuit. DMAIC methodology are initiated by problem identification through the past record of the open defect. The result observed for period of four months. After improvement, Part 13236 that have the highest defect decrease from 0.68% to 0.28% while the overall open defect decreases from 0.6% to 0.3%. The decline on product defect rate helps the company to improve the effectiveness and efficiency of business performances. It also results in cost saving which improves company’s profit margin in the long term.

The Influence of Mesenteric Defects Closure on the Use of Computed Tomography for Abdominal Pain 5 Years After Laparoscopic Gastric Bypass\u2014a Post Hoc Analysis of a Randomized Clinical Trial

BackgroundAbdominal pain after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common and unwanted complication that typically leads to further exploration through radiology. Concerns have been raised regarding the consequences of this radiation exposure and its correlation with the lifetime risk of cancer. The aim of this study was to evaluate the differences in computed tomography (CT) use between LRYGB patients with open and closed mesenteric defects and to assess the radiological findings and radiation doses.MethodsThis subgroup analysis included 300 patients randomized to either closure (n = 150) or nonclosure (n = 150) of mesenteric defects during LRYGB. The total number of CT scans performed due to abdominal pain in the first 5 postoperative years was recorded together with the radiological findings and radiation doses.ResultsA total of 132 patients (44%) underwent 281 abdominal CT scans, including 133 scans for 67 patients with open mesenteric defects (45%) and 148 scans for 65 patients with closed mesenteric defects (43%). Radiological findings consistent with small bowel obstruction or internal hernia were found in 31 (23%) of the scans for patients with open defects and in 18 (12%) of the scans for patients with closed defects (p = 0.014). The other pathological and radiological findings were infrequent and not significantly different between groups. At the 5-year follow-up, the total radiation dose was 82,400 mGy cm in the nonclosure group and 85,800 mGy cm in the closure group.ConclusionClosure of mesenteric defects did not influence the use of CT to assess abdominal pain.Graphical abstract

The AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Neonatal and Infant Spine.

The AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Neonatal and Infant Spine.

Fault Modeling and Efficient Testing of Memristor-Based Memory

Memristor-based memory technology is one of the emerging memory technologies, which is a potential candidate to replace traditional memories. Efficient test solutions are required to enable the quality and reliability of such products. In previous works, fault models are caused by open, short and bridge defects and parametric variations during the fabrication. However, these fault models cannot describe the bridge defects that cause the state of the faulty cell to an undefined state. In this paper, we analyze the different effects of bridge defects and aggregate their faulty behavior into new fault models, undefined coupling fault and dynamic undefined coupling fault. In addition, an enhanced March algorithm is designed to detect all the modeled faults. In one resistor crossbar with <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$N$ </tex-math></inline-formula> memristors, the enhanced March algorithm requires <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$8N$ </tex-math></inline-formula> write and <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$7N$ </tex-math></inline-formula> read operations with negligible hardware overhead. To reduce the test time, a March RC algorithm is proposed based on read operations with new reference currents, which requires <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$4N+2$ </tex-math></inline-formula> write and <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$6N$ </tex-math></inline-formula> read operations. Analytical results show that the proposed test algorithms can detect all the modeled faults outperforming all the previous methods. Subsequently, a Design-for-Testability scheme is proposed to implement March RC algorithm with a little area overhead.

Investigation of the Expression of Inflammatory Markers in Oral Biofilm Samples in Patients with Systemic Scleroderma and the Association with Clinical Periodontal Parameters-A Preliminary Study.

Background: Systemic scleroderma (SSc) has multiple orofacial effects. The aim of this study was to analyze the expression of inflammatory mediators in biofilm samples. It was hypothesized that different expression levels and clinical associations might be drawn. Methods: A total of 39 biofilm samples from group 1 = SSc and group 2 = healthy control were examined for the expression levels of interleukin (IL)-2,-6, and -10; matrix metalloprotease (MMP)-9; and surface antigens CD90 and CD34 by quantitative real-time PCR and clinical parameters. Relative quantitative (RQ) gene expression was determined using the ∆∆CT method. Results: The mean bleeding on probing values (p = 0.006), clinical attachment loss (CAL) (p = 0.009), gingival recession (p = 0.020), limited mouth opening (p = 0.001) and cervical tooth defects (p = 0.011) were significantly higher in group 1. RQ expressions of IL-2 and CD34 were significantly lower, IL-6, MMP-9, and CD90 were significantly higher. There was a significant positive correlation of IL-6/MMP-9 and negative correlation of mouth opening/CAL and IL-6/CAL. Conclusion: Different expression levels of IL-2, IL-6, MMP-9, CD34 and CD90 were detected in biofilm samples from patients with SSc compared to control. An immunological correlation to the clinical parameters of mouth opening and CAL was shown; thus, we conclude that SSc might have an impact on periodontal tissues.

Evaluation of the safety and effectiveness of a sealant hemostatic patch for preventing cerebrospinal fluid leaks in cranial surgery

ABSTRACT Background Cerebrospinal fluid (CSF) leak remains a significant source of morbidity after neurosurgical procedures. The objective is to evaluate the effectiveness and safety of a polyethylene glycol-coated collagen patch (PCC) in different neurosurgical procedures. Methods A retrospective, single-center cohort study in patients who underwent a cranial neurosurgical procedure. After collecting multiple data variables, patients were divided into two groups depending on the use of PCC as sealant on dural closure following procedures. Results Data from 230 patients were collected (PCC, 128; control group, 102). Incidence of CSF leakage was significantly lower in the PCC group (p < .001). Complications that were significantly lower in PCC than the control group included surgical infection (p = .022), and hydrocephalus (p = .017), as well as reduced rates of reintervention (p < .001) and shorter hospital stays (p = .028). Factors associated with a higher incidence of CSF leakage included posterior fossa procedures, reinterventions, and the need for CSF drainage placement. PCC reduced the risk of suffering CSF leakage by more than 75% (p = .002) once adjusted for age, surgical approach, type of cranial opening, reintervention, CSF drainage, dural substitute, and dural defect coverage. Conclusions Our findings confirm PCC as an effective means of preventing CSF leakage following cranial neurosurgery with fewer associated complications.

Positron annihilation lifetime spectroscopy: When is it feasible to decompose the spectrum?

Positron annihilation lifetime spectroscopy (PALS) has the potential to determine open volume defect identities and concentrations only if the spectrum can be accurately decomposed into its constituent parts. The intrinsic difficulty of decomposing PALS spectra into their constituent lifetimes and intensities is demonstrated, and it is shown that the global minimum of the objective function does not represent the true solution for a range of typical experimental scenarios. We show that the function currently employed in standard fitting methods cannot be improved upon with alternate weighting schemes. Resolution function width minimally impacts fit decomposition quality but errors are reduced with higher counts. A regression model is developed based on the experimental count, intensity of the defect component, and difference between the defect and bulk lifetime which predicts the anticipated intrinsic error of the objective function global minimum in estimating the fraction of positrons which annihilate in the bulk. This can be employed to determine whether a given PALS spectrum can be successfully decomposed into defect types and lifetimes.