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Background: Dental tissue engineering is an alternative procedure for restoring damaged dental tissues. Adipose-derived stem cells are a new source of cells for regenerative endodontics in combination with scaffold materials. The descriptive data about this regenerative process is still insufficient. Objective: To evaluate the regenerative potential of Adipose-derived stem cells using a self-assembling polypeptide scaffold for the dentin-pulp complex in an emptied root canal space. Material and Methods: 40 root segments of human single-rooted teeth were transplanted into the albino rats’ dorsal subcutaneous tissue. Root segments were divided into two groups: group I contained only a self-assembling polypeptide scaffold, and group II contained fluorescent-labeled Adipose-derived stem cells embedded in a self-assembling polypeptide scaffold. The newly formed tissues were assessed on the 60th and 90th days post-transplantation using routine histological examination, Masson trichrome staining, and scanning electron microscopy. Results: Group I showed granulation tissue without any signs of predentin formation or odontoblast-like cells. Group II revealed the presence of predentin tissue along the dentin margin, with arranged odontoblast-like cells. An organized connective tissue with abundant vasculature and calcific masses was observed in the pulp space. Conclusion: Adipose-derived stem cells can be considered as alternative stem cells for regenerating the dentin-pulp complex. Dentin pulp complex regeneration utilizing a self-assembling polypeptide scaffold alone would not yield successful results.

Aim: The aim of this study was to compare the dynamic cyclic fatigue resistance of M3-ProGold files and Pepsi Gold Files.Materials and methods: Eighty files of size 25/.06 of M3 Pro Gold files and Pepsi Gold files (each n = 40) were evaluated for dynamic cyclic fatigue resistance inside two artificial stainless steel canals with 2 different radii [(60 curvature, 3 mm radius) and (60 curvature, 5 mm radius)] at body temperature while submerged in distilled water at 37 ° ± 1 °C. The NCF (number of cycles to failure) was calculated. The data of NCF were analyzed using ANOVA and Tukey post hoc tests (P ≤ 0 .05). Results: The Pepsi Gold files had a significantly higher number of cycles to failure than the M3 Pro Gold files in both canal radii at body temperature. Conclusion: Pepsi Gold files have greater resistance to cyclic fatigue than M3 Pro Gold files.

ABSTRACTBackground and aim Diabetic nephropathy (DN) is a major microvascular diabetic complication representing the key leading reason for end-stage renal disease (ESRD). The current work aimed to evaluate the value of urinary and serum NGAL (neutrophil gelatinase-associating lipocalin), as an early biomarker of DN in subjects with type-2 diabetes mellitus (T2DM).Methods The study included 300 adult subjects with T2DM subdivided into 3 groups: Group A: 100 subjects with normoalbuminuria. Group B: 100 subjects with moderately increased albuminuria. Group C: 100 subjects with severely increased albuminuria.Results Serum NGAL and urinary NGAL were significantly elevated in T2DMsubjects with albuminuria than in normoalbuminuric T2DMsubjects (p

Abstract Heart valve disease is a major cause of mortality and morbidity worldwide with no effective medical therapy and no ideal valve substitute emulating the extremely sophisticated functions of a living heart valve. These functions influence survival and quality of life. This has stimulated extensive attempts at tissue engineering “living” heart valves. These attempts utilised combinations of allogeneic/ autologous cells and biological scaffolds with practical, regulatory, and ethical issues. In situ regeneration depends on scaffolds that attract, house and instruct cells and promote connective tissue formation. We describe a surgical, tissue-engineered, anatomically precise, novel off-the-shelf, acellular, synthetic scaffold inducing a rapid process of morphogenesis involving relevant cell types, extracellular matrix, regulatory elements including nerves and humoral components. This process relies on specific material characteristics, design and “morphodynamism”.

ABSTRACTSmall molecule therapy is a critical component of targeted anticancer treatment, with tyrosine kinase inhibitors (TKIs) being the first compounds to treat the clonal Chronic Myelogenous Leukaemia (CML) translocation t (9;22) (q34; q11) effectively since 2001. TKIs, such as imatinib, have improved the 10-year survival rate of CML patients to 80%. They bind the BCR::ABL1 kinase and inhibit downstream signaling pathways. However, therapy failure may be seen in 20-25% of CML patients due to intolerance or inadequacy related to BCR::ABL1 dependent or independent mechanisms. This review aimed to summarize current treatment options involving TKIs, resistance mechanisms and the prospective approaches to overcome TKI resistance. We highlight BCR::ABL1-dependent mechanisms of TKI resistance by reviewing clinically-documented BCR::ABL1 mutations and their consequences for TKI binding. In addition, we summarize BCR::ABL1 independent pathways, including the relevance of drug efflux, dysregulation of microRNA, and the involvement of alternative signaling pathways. We also discuss future approaches, such as gene-editing techniques in the context of CML, as potential therapeutic strategies.

Abstract The consistent increase of Coronavirus disease 2019 (COVID-19) cases parallel with the rate of deaths and the controversial response regarding the vaccines caused an increase in the burden of psychological diseases. This study aimed to evaluate the psychological condition of healthcare workers (HCWs) in a pediatric cancer hospital and to identify the knowledge, attitude, and perception (KAP) of HCWs toward COVID-19 vaccination. A cross-sectional observational study was conducted between April to May 2021. A validated, confidential survey was employed to measure the mental health of HCWs and the KAP toward COVID-19 vaccines. The total responses were 395, of which 11.4% physicians, 18.5% pharmacists, and 70.1% were nurses. Sixty-six percent of HCWs had different degrees of anxiety and depression. Nurses significantly accounted for the highest anxiety levels (P = 0.003), while the cumulative anxiety score was significantly higher in HCWs who had a positive history of COVID-19 infection (P = 0.026). Although 67.6% of HCWs believe that “vaccines are essential for us,”, the vaccination rate was 21.3%. The Factors associated with not receiving the vaccine were younger ages (P = 0.014), nurses (P = 3.6987 × 10–7), negative history of COVID-19 infection (P = 0.043) and believing that infections can happen after taking the vaccine (P = 1.5833 × 10–7). Healthcare organizations must take serious intervention to decrease the mental load on HCWs and facilitate the vaccination process.

Objectives: To investigate the incidence, types and pathophysiology of criss-cross pattern of the proximal pulmonary arteries in common arterial trunk and its influence on management and outcomes. Methods: Retrospective review of all patients with common arterial trunk who underwent Aswan Truncus Operation with regard to the origin and course of the proximal pulmonary artery branches as defined by 3D segmented models pre, immediately and 1 and 2 years after operation. Results: Between January 2019 and September 2022, 39 patients (19 males, aged 1–12 months) underwent the Aswan Truncus Operation. 18 patients (46%) had criss-cross arrangement of the proximal pulmonary artery. The mortality, ICU and hospital stay were not affected by the presence or absence of the criss-cross pattern. However, following operation in the criss-cross group, there was evidence of different degrees of kinking and twisting of the right pulmonary artery. This resulted in severe narrowing which required stenting or reoperation at different stages (1 during ICU stay and another after 1 year). Separate origin of the left pulmonary artery (Criss-cross Type 2) from a long stenotic ductus arteriosus required resection of the stenotic segment followed by anastomosis to the right pulmonary artery recreating a 60° angle of bifurcation. Conclusion: Criss-cross pattern of proximal pulmonary arteries is common in patients with common arterial trunk. Pre-operative diagnosis and tailored approaches of repair are required to prevent late complications.

Background: Nikaidoh translocation operation is increasingly being used for patients with TGA, VSD and LVOTO. The early results of this operation are excellent and possibly better than the Rastelli repair. However, the long-term results remain inadequately defined. Methods and results: Detailed follow up data of a patient, 12 years after Nikaidoh operation, using computerized image analysis are reported. The patient complained of chest pain on exertion. Imaging showed severe dilatation of the non-coronary sinus of the aortic root, compressing the RVOT and pulmonary artery branches resulting in RV dilatation. The dilated aortic sinus showed marked pulsatility with expansion during systole and diastole. As the child was symptomatic, with a risk of aneurysm rupture, excision was performed. This complication is thought to be due to interruption of the innervation of the root as well as cutting vasa vasorum. Conclusion: Nikaidoh operation is a viable solution for the repair of TGA, VSD, PS. Dilatation of the neo-aortic root should be carefully followed and causes of the dilatation investigated.

Objectives: In an attempt to enhance applicability and outcomes of corrections of common arterial trunk, we have recently described a novel method of correction based on the concept of morphodynamism, and preserving the structure of the right ventricle. The intermediate influence of this operation on right ventricular (RV) structure and function have not been described. Methods and results: Thirty eight Patients (age: 1–12 months) underwent the novel repair. There were 2 early and 4 late deaths. All patients underwent early CT scans, 12 had repeat CT and 8 had MRI after 1 year or more from the operation. Detailed computerized analysis of the RV size, shape, pattern of contraction and function was performed. The shape and size were preserved, at the second investigation, with no evidence of dilatation of the neo-RV outflow, which appeared to contribute to overall function of the RV. The directional pattern of contraction showed enhanced longitudinal and radial contributions with minimal twisting. The movement of the RV free wall and septum were almost equal, with normal shape of the septum. The instantaneous pattern of contraction followed a consistent peristalsis sequence with significant contraction of both the body and the neo-outflow. The pulmonary regurgitant fraction, at follow up, varied from 22% to 42% (30 ± 6%) with preserved RV to pulmonary artery ventriculo-arterial coupling. Conclusion: The size, shape and pattern of contraction of the RV following the novel common arterial trunk repair appears to be well preserved in the intermediate term.

Abstract Objectives: Post-treatment apical periodontitis is an inflammatory disorder of peri-radicular tissues caused by either persistent or secondary intra-radicular infection . The present study compared the prognosis of cases treated with the “selective root retreatment” concept to the traditional retreatment approach. Material and Methods: Forty patients complaining of failed root canal treatment having a periapical lesion in one root were selected. The cases were randomly divided into two groups; group (S): selective root canal retreatment in which only the affected root was retreated and group (T): traditional root canal retreatment in which all canals were retreated. The peri-radicular condition was evaluated radiographically using the Periapical Index (PAI) for one year. The chi-square test statistical tests analyzed the outcome data. Results: At the baseline examination, There was no significant difference between the two groups regarding the patients’ baseline mean periapical indices . After one year, we found that the mean periapical index declined without a significant difference between the two groups. Conclusions: The present study points to selective root retreatment as a successful “minimally invasive alternative” in cases of an independently diseased root. The remaining treated roots can be retained without intervention provided that they are confirmed: “healthy”. Clinical Relevance: Selective root retreatment is a promising conservative option in the treatment of failed endodontic cases with periapical pathosis related to an individual root.

Purpose. To compare implantable collamer lenses (ICLs) and acrylic implantable phakic contact lenses (IPCLs) in the treatment of myopia in adults, as regards refractive outcome and adverse effects. Methods. Prospective, randomized comparative study with phakic intraocular lenses (IOLs) was carried out for treatment of myopia. Patients were randomized into two groups: one for ICL and the other for IPCL. Preoperative assessments included a full examination, pentacam, endothelial cell count, and biometry. We compared the adverse effects and refractive outcomes between both groups. The study was registered in clinical trials and the registration number is NCT04624035. Results. Sixty eyes of sixty patients (28 in the ICL group and 32 in the IPCL group) with a follow-up period of 12 months. The mean preoperative spherical equivalent was −12.7 ± 3.4 D and −13.6 ± 4.4 D in the ICL and IPCL groups, respectively (P=0.37). The mean postoperative spherical equivalent value was ±0.4 ± 0.2 D and ±0.6 ± 0.1 D in the ICL and IPCL groups, respectively. Uncorrected visual acuity (UCVA) has improved from 1.3 ± 0.06 to 0.15 ± 0.02 Log MAR in the ICL group (P

The success of tissue-engineered heart valves rely on a balance between polymer degradation, appropriate cell repopulation, and extracellular matrix (ECM) deposition, in order for the valves to continue their vital function. However, the process of remodeling is highly dynamic and species dependent. The carbon fibers have been well used in the construction industry for their high tensile strength and flexibility and, therefore, might be relevant to support tissue-engineered hearts valve during this transition in the mechanically demanding environment of the circulation. The aim of this study was to assess the suitability of the carbon fibers to be incorporated into tissue-engineered heart valves, with respect to optimizing their cellular interaction and mechanical flexibility during valve opening and closure. The morphology and surface oxidation of the carbon fibers were characterized by scanning electron microscopy (SEM). Their ability to interact with human adipose-derived stem cells (hADSCs) was assessed with respect to cell attachment and phenotypic changes. hADSCs attached and maintained their expression of stem cell markers with negligible differentiation to other lineages. Incorporation of the carbon fibers into a stand-alone tissue-engineered aortic root, comprised of jet-sprayed polycaprolactone aligned carbon fibers, had no negative effects on the opening and closure characteristics of the valve when simulated in a pulsatile bioreactor. In conclusion, the carbon fibers were found to be conducive to hADSC attachment and maintaining their phenotype. The carbon fibers were sufficiently flexible for full motion of valvular opening and closure. This study provides a proof-of-concept for the incorporation of the carbon fibers into tissue-engineered heart valves to continue their vital function during scaffold degradation.

ABSTRACT Objective There is controversy regarding cognitive function in patients with congenital adrenal hyperplasia (CAH). This study is aimed at the assessment of cognitive functions in children with CAH, and their relation to hydrocortisone (HC) therapy and testosterone levels. Subjects and methods Thirty children with CAH due to 21 hydroxylase deficiency were compared with twenty age- and sex-matched healthy controls. HC daily and cumulative doses were calculated, the socioeconomic standard was assessed, and free testosterone was measured. Cognitive function assessment was performed using the Wechsler Intelligence Scale – Revised for Children and Adults (WISC), the Benton Visual Retention Test, and the Wisconsin Card Sorting Test (WCST). Results The mean age (SD) of patients was 10.22 (3.17) years [11 males (36.7%), 19 females (63.3%)]. Mean (SD) HC dose was 15.78 (4.36) mg/m 2 /day. Mean (SD) cumulative HC dose 44,689. 9 (26,892.02) mg. Patients had significantly lower scores in all domains of the WISC test, performed significantly worse in some components of the Benton Visual Retention Test, as well as in the Wisconsin Card Sorting Test. There was no significant difference in cognitive performance when patients were subdivided according to daily HC dose (< 10, 10 – 15, > 15 mg/m 2 /day). A positive correlation existed between cumulative HC dose and worse results of the Benton test. No correlation existed between free testosterone and any of the three tests. Conclusion Patients with CAH are at risk of some cognitive impairment. Hydrocortisone therapy may be implicated. This study highlights the need to assess cognitive functions in CAH.

Purpose. To evaluate the different IOP readings by Goldmann applanation tonometer (GAT), ICare rebound tonometer, and Tono-Pen in keratoconus patients after MyoRing implantation. To assess the influence of central corneal thickness (CCT) and thinnest corneal location (TCL) on IOP measurements by different tonometers. Setting. Prospective observational study was conducted in two private centers in Egypt from February 2015 to November 2016. Methods. Seventeen eyes of 10 patients suffering from keratoconus and who underwent MyoRing implantation were recruited. All subjects underwent GAT, ICare, and Tono-Pen IOP measurements in random order. Central corneal thickness and thinnest corneal location were assessed by Pentacam. Difference in mean in IOP readings was assessed by T-test. Correlation between each pair of devices was evaluated by Pearson correlation coefficient. The Bland–Altman analysis was used to assess intertonometer agreement. Results. Seventeen eyes (10 patients) were evaluated. The mean IOP reading was 13.9 ± 3.68, 12.41 ± 2.87, and 14.29 ± 1.31 mmHg in GAT, ICare, and Tono-Pen group, respectively. There was a significant difference between IOP readings by GAT/ICare and Tono-Pen/ICare (p value: 0.032 and 0.002, respectively) with no significant difference between GAT/Tono-Pen (p value: 0.554). Mean difference in IOP measurements between GAT/ICare was 1.49 ± 2.61 mmHg, Tono-Pen/ICare was 1.89 ± 2.15 mmHg, and GAT/Tono-Pen was −0.39 ± 2.59 mmHg. There was no significant correlation between the difference in IOP readings among any pair of devices and CCC or TCL. The Bland–Altman analysis showed a reasonable agreement between any pair of tonometers.

Time and precision of the results are the most important factors in any code used for nuclear calculations. Despite of the high accuracy of Monte Carlo codes, MCNP and Serpent, in many cases their relatively long computational time leads to difficulties in using any of them as the main calculation code. Usually, Monte Carlo codes are used only to benchmark the results. The deterministic codes, which are usually used in nuclear reactor’s calculations, have limited precision, due to the approximations in the methods used to solve the multi-group transport equation. Self- Shielding treatment, an algorithm that produces an average cross-section defined over the complete energy domain of the neutrons in a nuclear reactor, is responsible for the biggest error in any deterministic codes. There are mainly two resonance self-shielding models commonly applied: models based on equivalence and dilution and models based on subgroup approach. The fundamental problem with any self-shielding method is that it treats any isotope as there are no other isotopes with resonance present in the reactor. The most practical way to solve this problem is to use multi-energy groups (50-200) that are chosen in a way that allows us to use all major resonances without self-shielding. In this paper, we perform cell calculations, for a fresh seed fuel pin which is used in thorium/uranium reactors, by solving 172 energy group transport equation using the deterministic DRAGON code, for the two types of self-shielding models (equivalence and dilution models and subgroup models) Using WIMS-D5 and DRAGON data libraries. The results are then tested by comparing it with the stochastic MCNP5 code. We also tested the sensitivity of the results to a specific change in self-shielding method implemented, for example the effect of applying Livolant-Jeanpierre Normalization scheme and Rimman Integration improvement on the equivalence and dilution method, and the effect of using Ribbon extended approach on sub-group method. The results of Kinf, in case of fresh seed fuel pin which is used in thorium/uranium PWR, show that a high accuracy is obtained by using some specific self-shielding modules. It is also shown that for the implemented self-shielding models DRAGON library is more reliable than WIMS-D5 library, and that applying Livolant-Jeanpierre Normalization scheme is essential with the equivalence and dilution self-shielding method.

Background Data: Post-laminectomy deformities after surgery for the spinal tumors in children are common and affect the functional outcome. Laminoplasty may decrease the incidence of postoperative progressive spinal deformity requiring subsequent fusion. Study Design: Retrospective clinical case study. Purpose: To assess the outcome of laminoplasty in children with spinal tumors with special stress on the incidence of postoperative spinal instability. Patients and Methods: This study included fourteen children who underwent laminoplasty during resection of spinal tumors between January 2013 and September 2014. The Cobb angle was used to detect the development of spinal deformity in the sagittal plane. The modified McCormick scale was used for evaluation of the functional outcome of the patients. Results: Gross total excision of the intraspinal tumor was achieved in 57.1% of the patients. No patients developed spinal sagittal deformity in a mean followup period of 18 months that required fusion. Improved functional outcome was noticed in 71.4% of the patients. Conclusion: Laminoplasty for the resection of the spinal tumors in children was very valuable in decreasing the incidence of progressive sagittal spinal deformity resulting in better fuctional outcome. (2015ESJ085)

Background Data: Laminectomy for cervical spondylotic myelopathy with no signs of instability is a standard surgical option but it may be associated with postlaminectomy kyphosis. Study Design: Retrospective clinical case study. Purpose: To evaluate the clinical outcome in a series of patients who underwent laminectomy for cervical myelopathy with special stress on the incidence of postoperative spinal instability. Patients and Methods: This study included twenty two patients who underwent laminectomy at a single or more levels, without fusion, for cervical spondylotic myelopathy. The clinical assessment included history taking, neurological examination and postoperative clinical outcome. The radiological assessment included magnetic resonance imaging, computed tomography, and plain anteroposterior, lateral, and lateral flexion-extension X-rays of the cervical spine. The postoperative clinical outcome was assessed in comparison with the preoperative condition as: improved, stable or worsened. Results: Improvement of gait disturbance occurred in 69% of the concerned patients. Sensory deficits and radicular pain improved in the upper limbs (UL) and lower limbs (LL) in 73% and 50%, respectively. Motor deficits improved in the UL and LL in 69% and 55% of the patients, respectively. Postoperative clinical deterioration occurred in two patients (9.1%) and one patient (4.5%) developed postoperative kyphosis. Conclusion: Laminectomy usually results in improvement of the neurological deficits and radicular pain in patients with cervical spondylotic myelopathy with low incidence of postoperative clinical deterioration and instability. (2015ESJ081)

Periventricular leukomalacia (PVL), a brain injury affecting premature infants is commonly associated with cerebral palsy. PVL results from hypoxia-ischemia (HI) with or without infection and is characterized by white matter necrotic lesions, hypomyelination, microglial activation, astrogliosis, and neuronal death. It is important to study a PVL mouse model that mimics human PVL in symptomatology, anatomic and molecular basis. In our neonate mice model, bilateral carotid arteries were temporary ligated at P5 followed by hypoxic exposure (FiO2 of 8% for 20 min.). At P5 in mice, the white matter is more vulnerable to HI injury than the grey matter. In our PVL model, mice suffer from significant hind limb paresis, incoordination and feeding difficulties. Histologically they present with ventriculomegally, white matter loss, microglial activation and neuronal apoptosis. HI injury increases proinflammtory cytokines, activates NF-kB, activates microglia and causes nitrative stress. All these inflammatory mediators lead to oligodendroglial injury and white matter loss. Neurobehavioral analysis in the PVL mice model at P60 showed that the HI group had a significant decrease in hind limb strength, worsening rotarod testing and worsening performance in the open field test. This new PVL model has great advantages far beyond just mimicking human PVL in clinical features and histopathology. Long term survival, the development of cerebral palsy and the ability of using this model in transgenic animals will increase our understanding of the mechanistic pathways underlying PVL and defining specific targets for the development of suitable therapeutics.

Diabetic nephropathy (DN) is a major microvascular diabetic complication representing the key leading reason for end-stage renal disease (ESRD). The current work aimed to evaluate the value of urinary and serum NGAL (neutrophil gelatinase-associating lipocalin), as an early biomarker of DN in subjects with type-2 diabetes mellitus (T2DM). The study included 300 adult subjects with T2DM subdivided into 3 groups: Group A: 100 subjects with normoalbuminuria. Group B: 100 subjects with moderately increased albuminuria. Group C: 100 subjects with severely increased albuminuria. Serum NGAL and urinary NGAL were significantly elevated in T2DMsubjects with albuminuria than in normoalbuminuric T2DMsubjects (p < 0.001). Serum NGAL and urinary NGAL were positively associated with albumin/creatinine Ratio, (p < 0.001). ROC curve analysis was done to discriminate among moderately/severely increased albuminuria from normoalbuminuria showed a cutoff point ≤ 10.76 for serum NGAL with AUC 0.785 (p value < 0.001) and a cutoff point ≤ 15.811 with AUC 0.687 for urinary NGAL(p < 0.001). NGAL can be utilized as a biomarker for the early diagnosis of DN. Both urinary NGAL and serum NGAL may predict albuminuria and can be utilized as a noninvasive tool for diagnosing, grading, and progressions of DN. [ABSTRACT FROM AUTHOR]