Enamel matrix derivative and bone grafts for periodontal regeneration of intrabony defects. A systematic review and meta-analysis

OBJECTIVE The aim of the present systematic review and meta-analysis was to assess the clinical efficacy of regenerative periodontal surgery of intrabony defects using a combination of enamel matrix derivative (EMD) and bone graft compared with that of EMD alone. MATERIALS AND METHODS The Cochrane Oral Health Group specialist trials, MEDLINE, and EMBASE databases were searched for entries up to February 2014. The primary outcome was gain of clinical attachment (CAL). Weighted means and forest plots were calculated for CAL gain, probing depth (PD), and gingival recession (REC). RESULTS Twelve studies reporting on 434 patients and 548 intrabony defects were selected for the analysis. Mean CAL gain amounted to 3.76 ± 1.07 mm (median 3.63 95 % CI 3.51-3.75) following treatment with a combination of EMD and bone graft and to 3.32 ± 1.04 mm (median 3.40; 95 % CI 3.28-3.52) following treatment with EMD alone. Mean PD reduction measured 4.22 ± 1.20 mm (median 4.10; 95 % CI 3.96-4.24) at sites treated with EMD and bone graft and yielded 4.12 ± 1.07 mm (median 4.00; 95 % CI 3.88-4.12) at sites treated with EMD alone. Mean REC increase amounted to 0.76 ± 0.42 mm (median 0.63; 95 % CI 0.58-0.68) at sites treated with EMD and bone graft and to 0.91 ± 0.26 mm (median 0.90; 95 % CI 0.87-0.93) at sites treated with EMD alone. CONCLUSIONS Within their limits, the present results indicate that the combination of EMD and bone grafts may result in additional clinical improvements in terms of CAL gain and PD reduction compared with those obtained with EMD alone. The potential influence of the chosen graft material or of the surgical procedure (i.e., flap design) on the clinical outcomes is unclear. CLINICAL RELEVANCE The present findings support the use of EMD and bone grafts for the treatment of intrabony periodontal defects.

Circulating matrix metalloproteinase 9 levels in relation to sampling methods, femoral and carotid atherosclerosis.

OBJECTIVES To examine whether circulating levels of matrix metalloproteinase 9 (MMP-9) were associated with ultrasound-assessed intima-media thickness (IMT) and echolucent plaques in the carotid and femoral arteries. To examine preanalytical sources of variability in MMP-9 concentrations related to sampling procedures. SUBJECTS AND DESIGN Plasma and serum MMP-9 levels were compared with ultrasound assessed measures of femoral and carotid atherosclerosis, in a cross-sectional study of 61-year-old men (n = 473). Preanalytical sources of variability in MMP-9 levels were examined in 10 healthy subjects. Main outcome measures were circulating levels of MMP-9 in serum and plasma, IMT of the carotid and femoral arteries, and plaque status based on size and echolucency. SETTING Research unit at university hospital. RESULTS Plasma concentrations of total and active MMP-9 were associated with femoral artery IMT independently of traditional cardiovascular risk factors, and were higher in subjects with moderate to large femoral plaques. Plasma MMP-9 concentration was higher in men with echolucent femoral plaques (P = 0.006) compared with subjects without femoral plaques. No similar associations were found for carotid plaques. MMP-9 concentrations were higher in serum than in plasma, and higher when sampling was performed with Vacutainer than with syringe. MMP-9 levels in serum were more strongly associated with peripheral neutrophil count compared with MMP-9 levels in plasma. CONCLUSIONS Plasma MMP-9 levels were associated with atherosclerosis in the femoral artery, and total MMP-9 concentration was higher in men with echolucent femoral plaques. The choice of sample material and sampling method affect the measurements of circulating MMP-9 levels.

1D.03: Inactive Matrix Gla Protein is Assocated with Renal Resistive Index in a Population-Based Study

OBJECTIVE Renal resistive index (RRI) varies directly with renal vascular stiffness and pulse pressure. RRI correlates positively with arteriolosclerosis in damaged kidneys and predicts progressive renal dysfunction. Matrix Gla-protein (MGP) is a vascular calcification inhibitor that needs vitamin K to be activated. Inactive MGP, known as desphospho-uncarboxylated MGP (dp-ucMGP), can be measured in plasma and has been associated with various cardiovascular (CV) markers, CV outcomes and mortality. In this study we hypothesize that increased RRI is associated with high levels of dp-ucMGP. DESIGN AND METHOD We recruited participants via a multi-center family-based cross-sectional study in Switzerland exploring the role of genes and kidney hemodynamics in blood pressure regulation. Dp-ucMGP was quantified in plasma samples by sandwich ELISA. Renal doppler sonography was performed using a standardized protocol to measure RRIs on 3 segmental arteries in each kidney. The mean of the 6 measures was reported. Multiple regression analysis was performed to estimate associations between RRI and dp-ucMGP adjusting for sex, age, pulse pressure, mean pressure, renal function and other CV risk factors. RESULTS We included 1035 participants in our analyses. Mean values were 0.64 ± 0.06 for RRI and 0.44 ± 0.21 (nmol/L) for dp-ucMGP. RRI was positively associated with dp-ucMGP both before and after adjustment for sex, age, body mass index, pulse pressure, mean pressure, heart rate, renal function, low and high density lipoprotein, smoking status, diabetes, blood pressure and cholesterol lowering drugs, and history of CV disease (P < 0.001). CONCLUSIONS RRI is independently and positively associated with high levels of dp-ucMGP after adjustment for pulse pressure and common CV risk factors. Further studies are needed to determine if vitamin K supplementation can have a positive effect on renal vascular stiffness and kidney function.

Using the contribution matrix to evaluate complex study limitations in a network meta-analysis: a case study of bipolar maintenance pharmacotherapy review.

BACKGROUND Limitations in the primary studies constitute one important factor to be considered in the grading of recommendations assessment, development, and evaluation (GRADE) system of rating quality of evidence. However, in the network meta-analysis (NMA), such evaluation poses a special challenge because each network estimate receives different amounts of contributions from various studies via direct as well as indirect routes and because some biases have directions whose repercussion in the network can be complicated. FINDINGS In this report we use the NMA of maintenance pharmacotherapy of bipolar disorder (17 interventions, 33 studies) and demonstrate how to quantitatively evaluate the impact of study limitations using netweight, a STATA command for NMA. For each network estimate, the percentage of contributions from direct comparisons at high, moderate or low risk of bias were quantified, respectively. This method has proven flexible enough to accommodate complex biases with direction, such as the one due to the enrichment design seen in some trials of bipolar maintenance pharmacotherapy. CONCLUSIONS Using netweight, therefore, we can evaluate in a transparent and quantitative manner how study limitations of individual studies in the NMA impact on the quality of evidence of each network estimate, even when such limitations have clear directions.

The Effects Of Reinforcement Inclusions On Wear Tolerance, Playing Quality And Physical Properties In A Silt Loam And Sand Rootzone Matrix

Reinforcement inclusions have been advocated to alleviate wear, compaction, and unstable surfaces in sports fields, but little research on the effects of these materials has been conducted in the USA. Experiments were established on a native silt loam and a sand rootzone matrix, seeded with a Kentucky bluegrass (Poa pratensis L.) blend, at the Joseph Troll Turf Research Center, University of Massachusetts, Amherst, USA to determine the effects of reinforcement inclusions on wear, surface hardness, traction, ball roll, ball bounce resilience, water infiltration rate, soil bulk density, air porosity, total porosity, and root weights. Three types of reinforcement inclusions (Sportgrass, Netlon, Turfgrids) were tested along with a non-reinforced control in a three year study. The treatments were set out in a randomized complete block design with four replications in both soils. No inclusion provided less wear or greater infiltration or air-filled porosity relative to the control. Reinforcement inclusions showed significant differences, however, in surface hardness, traction, and ball roll relative to the control, although this varied with the time of year. Infiltration rates, airfilled porosity, total pore space, bulk density, hardness, traction, ball roll, and ball rebound were greater on the sand rootzone than on the silt loam. Significant correlations were present between soil bulk density, surface hardness, traction, and ball roll. Based on our study, the use of reinforcement inclusions to provide better wear tolerance for sand or native soil athletic fields is not warranted. Certain playing surface characteristics, however, may be slightly improved with the use of reinforcement inclusions. The use of sands for sports surfaces is justified based upon the improvement in playing quality characteristics and soil physical properties important to a good playing surface.

Matrix metalloproteinase-1 as a prognosticator in malignant glioma

The overall purpose of this study was to assess the relationship between the promoter region polymorphism (-2607 1G/2G) of matrix metalloproteinase-1 (MMP-1) polymorphism and outcome in brain tumor patients diagnosed with a primary brain tumor between 1994 and 2000 at The University of Texas M. D. Anderson Cancer Center. The MMP-1 polymorphism was genotyped for all brain tumor patients who participated in the Family Brain Tumor Study and for whom blood samples were available. Relevant covariates were abstracted from medical records for all cases from the original protocol, including information on demographics, tumor histology, therapy and outcome was obtained. The hypothesis was that brain tumor patients with the 2G allele have a poorer prognosis and shorter survival than brain tumor patients with the 1G allele. ^ Experimental Design: Genetic variants for the MMP-1 enzyme were determined by a polymerase chain reaction-restriction fragment length polymorphism assay. Comparison was made between the overall survival for cases with the 2G polymorphism and overall survival for cases with the 1G polymorphism using multivariable Cox Proportional-Hazard analysis, controlling for age, sex, Karnofsky Performance Scale (KPS), extent of surgery, tumor histology and treatment received. Kaplan-Meier and Cox Proportional-Hazard analyses were utilized to assess if the MMP-1 polymorphisms were related to overall survival. Results: Overall survival was not statistically significantly different between the 2G allele brain tumor patients and the 1G allele patients and there was no statistically significant difference between tumor types. ^ Conclusions: No association was found between MMP-1 polymorphisms and survival in patients with malignant gliomas. ^

Analysis and design of multirate synchronous sampling schemes for sparse multiband signals

We consider the problem of developing efficient sampling schemes for multiband sparse signals. Previous results on multicoset sampling implementations that lead to universal sampling patterns (which guarantee perfect reconstruction), are based on a set of appropriate interleaved analog to digital converters, all of them operating at the same sampling frequency. In this paper we propose an alternative multirate synchronous implementation of multicoset codes, that is, all the analog to digital converters in the sampling scheme operate at different sampling frequencies, without need of introducing any delay. The interleaving is achieved through the usage of different rates, whose sum is significantly lower than the Nyquist rate of the multiband signal. To obtain universal patterns the sampling matrix is formulated and analyzed. Appropriate choices of the parameters, that is the block length and the sampling rates, are also proposed.

Design of universal multicoset sampling patterns for compressed sensing of multiband sparse signals

Many problems in digital communications involve wideband radio signals. As the most recent example, the impressive advances in Cognitive Radio systems make even more necessary the development of sampling schemes for wideband radio signals with spectral holes. This is equivalent to considering a sparse multiband signal in the framework of Compressive Sampling theory. Starting from previous results on multicoset sampling and recent advances in compressive sampling, we analyze the matrix involved in the corresponding reconstruction equation and define a new method for the design of universal multicoset codes, that is, codes guaranteeing perfect reconstruction of the sparse multiband signal.

Variable impedance LED matrix control system for lamps in PV applications

The interest in LED lighting has been growing recently due to the high efficacy, lifelime and ruggedness that this technology offers. However the key element to guarantee those parameters with these new electronic devices is to keep under control the working temperature of the semiconductor crystal. This paper propases a LED lamp design that fulfils the requ irements of a PV lighting systems, whose main quality criteria is reliability. It uses directly as a power supply a non·stabilized constant voltage source, as batteries. An electronic control architecture is used to regulate the current applied to the LEO matri)( according to their temperature and the voltage output value of the batteries with two pulse modulation signals (PWM) signals. The first one connects and disconnects the LEOs to the power supply and the second one connects and disconnects several emitters to the electric circuit changing its overall impedance. A prototype of the LEO lamp has been implemented and tested at different temperaturas and battery voltages.

Polyolefin fibre-reinforced concrete : from material behaviour to numerical and design considerations

La presente Tesis proporciona una gran cantidad de información con respecto al uso de un nuevo y avanzado material polimérico (con base de poliolefina) especialmente adecuada para ser usada en forma de fibras como adición en el hormigón. Se han empleado fibras de aproximadamente 1 mm de diámetro, longitudes entre 48 y 60 mm y una superficie corrugada. Las prometedoras propiedades de este material (baja densidad, bajo coste, buen comportamiento resistente y gran estabilidad química) justifican el interés en desarrollar el esfuerzo de investigación requerido para demostrar las ventajas de su uso en aplicaciones prácticas. La mayor parte de la investigación se ha realizado usando hormigón autocompactante como matriz, ya que este material es óptimo para el relleno de los encofrados del hormigón, aunque también se ha empleado hormigón normal vibrado con el fin de comparar algunas propiedades. Además, el importante desarrollo del hormigón reforzado con fibras en los últimos años, tanto en investigación como en aplicaciones prácticas, también es muestra del gran interés que los resultados y consideraciones de diseño que esta Tesis pueden tener. El material compuesto resultante, Hormigón Reforzado con Fibras de Poliolefina (HRFP o PFRC por sus siglas inglesas) ha sido exhaustivamente ensayado y estudiado en muchos aspectos. Los resultados permiten establecer cómo conseguidos los objetivos buscados: -Se han cuantificado las propiedades mecánicas del PFRC con el fin de demostrar su buen comportamiento en la fase fisurada de elementos estructurales sometidos a tensiones de tracción. -Contrastar los resultados obtenidos con las bases propuestas en la normativa existente y evaluar las posibilidades para el uso del PFRC con fin estructural para sustituir el armado tradicional con barras de acero corrugado para determinadas aplicaciones. -Se han desarrollado herramientas de cálculo con el fin de evaluar la capacidad del PFRC para sustituir al hormigón armado con las barras habituales de acero. -En base a la gran cantidad de ensayos experimentales y a alguna aplicación real en la construcción, se han podido establecer recomendaciones y consejos de diseño para que elementos de este material puedan ser proyectados y construidos con total fiabilidad. Se presentan, además, resultados prometedores en una nueva línea de trabajo en el campo del hormigón reforzado con fibras combinando dos tipologías de fibras. Se combinaron fibras de poliolefina con fibras de acero como refuerzo del mismo hormigón autocompactante detectándose sinergias que podrían ser la base del uso futuro de esta tecnología de hormigón. This thesis provides a significant amount of information on the use of a new advanced polymer (polyolefin-based) especially suitable in the form of fibres to be added to concrete. At the time of writing, there is a noteworthy lack of research and knowledge about use as a randomly distributed element to reinforce concrete. Fibres with an approximate 1 mm diameter, length of 48-60 mm, an embossed surface and improved mechanical properties are employed. The promising properties of the polyolefin material (low density, inexpensive, and with good strength behaviour and high chemical stability) justify the research effort involved and demonstrate the advantages for practical purposes. While most of the research has used self-compacting concrete, given that this type of matrix material is optimum in filling the concrete formwork, for comparison purposes standard vibration compacted mixes have also been used. In addition, the interest in fibre-reinforced concrete technology, in both research and application, support the significant interest in the results and considerations provided by the thesis. The resulting composite material, polyolefin fibre reinforced concrete (PFRC) has been extensively tested and studied. The results have allowed the following objectives to be met: -Assessment of the mechanical properties of PFRC in order to demonstrate the good performance in the post-cracking strength for structural elements subjected to tensile stresses. -- Assessment of the results in contrast with the existing structural codes, regulations and test methods. The evaluation of the potential of PFRC to meet the requirements and replace traditional steel-bar reinforcement applications. -Development of numerical tools designed to evaluate the capability of PFRC to substitute, either partially or totally, standard steel reinforcing bars either alone or in conjunction with steel fibres. -Provision, based on the large amount of experimental work and real applications, of a series of guidelines and recommendations for the practical and reliable design and use of PFRC. Furthermore, the thesis also reports promising results about an innovative line in the field of fibre-reinforced concrete: the design of a fibre cocktail to reinforce the concrete by using two types of fibres simultaneously. Polyolefin fibres were combined with steel fibres in self-compacting concrete, identifying synergies that could serve as the base in the future use of fibre-reinforced concrete technology.

Design, synthesis, and characterization of a photoactivatable flavocytochrome molecular maquette

We report the construction of a synthetic flavo-heme protein that incorporates two major physiological activities of flavoproteins: light activation of flavin analogous to DNA photolyase and rapid intramolecular electron transfer between the flavin and heme cofactors as in several oxidoreductases. The functional tetra-α-helix protein comprises two 62-aa helix-loop-helix subunits. Each subunit contains a single cysteine to which flavin (7-acetyl-10-methylisoalloxazine) is covalently attached and two histidines appropriately positioned for bis-his coordination of heme cofactors. Both flavins and hemes are situated within the hydrophobic core of the protein. Intramolecular electron transfer from flavosemiquinone generated by photoreduction from a sacrificial electron donor in solution was examined between protoporphyrin IX and 1-methyl-2-oxomesoheme XIII. Laser pulse-activated electron transfer from flavin to meso heme occurs on a 100-ns time scale, with a favorable free energy of approximately −100 meV. Electron transfer from flavin to the lower potential protoporphyrin IX, with an unfavorable free energy, can be induced after a lag phase under continuous light illumination. Thus, the supporting peptide matrix provides an excellent framework for the positioning of closely juxtaposed redox groups capable of facilitating intramolecular electron transfer and begins to clarify in a simplified and malleable system the natural engineering of flavoproteins.

Batimastat, a potent matrix mealloproteinase inhibitor, exhibits an unexpected mode of binding.

Matrix metalloproteinase enzymes have been implicated in degenerative processes like tumor cell invasion, metastasis, and arthritis. Specific metalloproteinase inhibitors have been used to block tumor cell proliferation. We have examined the interaction of batimastat (BB-94) with a metalloproteinase [atrolysin C (Ht-d), EC 3.4.24.42] active site at 2.0-angstroms resolution (R = 16.8%). The title structure exhibits an unexpected binding geometry, with the thiophene ring deeply inserted into the primary specificity site. This unprecedented binding geometry dramatizes the significance of the cavernous primary specificity site, pointing the way for the design of a new generation of potential antitumor drugs.

Design of artificial myocardial microtissues

Cultivation technologies promoting organization of mammalian cells in three dimensions are essential for gene-function analyses as well as drug testing and represent the first step toward the design of tissue replacements and bioartificial organs. Embedded in a three-dimensional environment, cells are expected to develop tissue-like higher order intercellular structures (cell-cell contacts, extracellular matrix) that orchestrate cellular functions including proliferation, differentiation, apoptosis, and angiogenesis with unmatched quality. We have refined the hanging drop cultivation technology to pioneer beating heart microtissues derived from pure primary rat and mouse cardiomyocyte cultures as well as mixed populations reflecting the cell type composition of rodent hearts. Phenotypic characterization combined with detailed analysis of muscle-specific cell traits, extracellular matrix components, as well as endogenous vascular endothelial growth factor (VEGF) expression profiles of heart microtissues revealed (1) a linear cell number-microtissue size correlation, (2) intermicrotissue superstructures, (3) retention of key cardiomyocyte-specific cell qualities, (4) a sophisticated extracellular matrix, and (5) a high degree of self-organization exemplified by the tendency of muscle structures to assemble at the periphery of these myocardial spheroids. Furthermore (6), myocardial spheroids support endogenous VEGF expression in a size-dependent manner that will likely promote vascularization of heart microtissues produced from defined cell mixtures as well as support connection to the host vascular system after implantation. As cardiomyocytes are known to be refractory to current transfection technologies we have designed lentivirus-based transduction strategies to lead the way for genetic engineering of myocardial microtissues in a clinical setting.

Peptide quantification by matrix-assisted laser desorption ionisation time-of-flight mass spectrometry: Investigations of the cyclotide kalata B1 in biological fluids

A rapid method has been developed for the quantification of the prototypic cyclotide kalata B I in water and plasma utilizing matrix-assisted laser desorption ionisation time-of-flight (MALDI-TOF) mass spectrometry. The unusual structure of the cyclotides means that they do not ionise as readily as linear peptides and as a result of their low ionisation efficiency, traditional LC/MS analyses were not able to reach the levels of detection required for the quantification of cyclotides in plasma for pharmacokinetic studies. MALDI-TOF-MS analysis showed linearity (R-2 > 0.99) in the concentration range 0.05-10 mu g/mL with a limit of detection of 0.05 mu g/mL (9 fmol) in plasma. This paper highlights the applicability of MALDI-TOF mass spectrometry for the rapid and sensitive quantification of peptides in biological samples without the need for extensive extraction procedures. (c) 2005 Elsevier B.V. All rights reserved.

A probabilistic switch model of information flow in social networks: Application for virtual circuits to organizational design

Network building and exchange of information by people within networks is crucial to the innovation process. Contrary to older models, in social networks the flow of information is noncontinuous and nonlinear. There are critical barriers to information flow that operate in a problematic manner. New models and new analytic tools are needed for these systems. This paper introduces the concept of virtual circuits and draws on recent concepts of network modelling and design to introduce a probabilistic switch theory that can be described using matrices. It can be used to model multistep information flow between people within organisational networks, to provide formal definitions of efficient and balanced networks and to describe distortion of information as it passes along human communication channels. The concept of multi-dimensional information space arises naturally from the use of matrices. The theory and the use of serial diagonal matrices have applications to organisational design and to the modelling of other systems. It is hypothesised that opinion leaders or creative individuals are more likely to emerge at information-rich nodes in networks. A mathematical definition of such nodes is developed and it does not invariably correspond with centrality as defined by early work on networks.