Mechanical strength of bone allografts subjected to chemical sterilization and other terminal processing methods

Infectious disease transmission through the use of human donor allografts can be a catastrophic complication in an otherwise straightforward surgical procedure. The use of bone allograft in reconstructive orthopedic surgeries is increasing, yet severe complications, including death, can result if the transplanted tissues transmit a communicable disease to the tissue recipient. The BioCleanse((R)) tissue sterilization process is a fully automated, low-temperature chemical sterilization process that renders allograft tissue sterile. The purpose of this study was to evaluate the effect of a chemical tissue sterilization process on the mechanical strength of cortical bone allografts prior to implantation. Cylindrical cortical bone specimens were harvested from seven human cadaver donors and treated either by: chemical sterilization alone; chemical sterilization and terminal sterilization by gamma irradiation; chemical sterilization, lyophilization, terminal sterilization by STERRAD and rehydration; or untreated. The specimens were tested to failure in axial compression, diametral compression, shear, or bending. There were no significant differences in ultimate stress, strain, or fracture energy between the chemically sterilized and control groups in any of the testing modes.     

A review of osteoinductive testing methods and sterilization processes for demineralized bone

Allogeneic demineralized bone has been used extensively as a clinical graft material because it has osteoinductive and osteoconductive properties. Concerns over processing and terminal sterilization procedures that may reduce performance have led clinicians to call for assurances of product potency. There is extensive experience on effects of demineralized bone in animal and cell culture models with the possibility for future evidence-based standards for release of products. Evaluation of the current state of knowledge leads to the fact that we cannot conclude that performance of different lots of demineralized bone allografts in in vivo or in vitro test systems can be used as a measure of clinical performance. It may be possible to adopt an osteoinductivity standard for release-to-market, but it should be followed by clinical monitoring and further research.Presented in part at the 27th Annual Meeting of the American Association of Tissue Banks, San Diego, CA, August 24, 2003.     

Surgical methods of contraception and sterilization

Many techniques for surgically sterilizing dogs and cats have been described; each technique offers advantages and disadvantages to both the patient and surgeon. Techniques that have been described include traditional midline ovariohysterectomy, lateral flank ovariohysterectomy, castration, early age gonadectomy, ovariectomy, laparoscopic ovariohysterectomy and ovariectomy, and vasectomy. Regardless of the technique selected, strict adherence to sound surgical technique and asepsis is mandatory for good surgical outcome with minimal complications. This review will discuss surgical principles, complications, outcomes, as well as relevant current literature associated with each of these techniques of surgical sterilization.     

Non-surgical methods of contraception and sterilization

The Humane Society of the United States estimates that each year between 8 and 10 million dogs and cats enter shelters and 4-5 million of these animals are euthanized due to lack of homes. Many veterinarians within the United States recommend surgical sterilization for population control in dogs and cats. However, there are non-surgical methods to control reproduction. Pharmacologic methods of contraception and sterilization can be safe, reliable and reversible. Hormonal treatments using progestins, androgens, or gonadotropin releasing hormone (GnRH) analogs act to either directly block reproductive hormone receptor-mediated events, or indirectly block conception via negative feedback mechanisms. Immunocontraception, via vaccination against GnRH, the luteinizing hormone receptor or zona pellucida proteins, is also possible. Intratesticular or intraepididymal injections provide a method for non-surgical sterilization of the male dog and cat. Additional methods have been employed for mechanical disruption of fertility including intravaginal and intrauterine devices and ultrasound testicular ablation. Alternative approaches to surgical sterilization will be reviewed.     

Biological methods of air purification (review of the literature)

Biological methods of air purification are reviewed, which can be applied to deep air purification of complex multicomponent mixtures from harmful, toxic and odorous substances at room temperature and atmospheric pressure. Microbiological and technological aspects of the problem are discussed. Operation characteristics of biofilters, bioscrubbers and trickle bed bioreactors are compared. Prospects of air biopurification are considered.     

Terminal sterilization of medical devices using vaporized hydrogen peroxide: a review of current methods and emerging opportunities

Medical devices are an important and growing aspect of healthcare provision and are increasing in complexity to meet established and emerging patient needs. Terminal sterilization plays a vital role in the provision of safe medical devices. While terminal sterilization technologies for medical devices include multiple radiation options, ethylene oxide remains the predominant nonthermal gaseous option, sterilizing c. 50% of all manufactured devices. Vaporized hydrogen peroxide (abbreviated VH2O2 by the International Organization for Standardization) is currently deployed for clinical sterilization applications, where its performance characteristics appear aligned to requirements, constituting a viable alternative low-temperature process for terminal processing of medical devices. However, VH2O2 has operational limitations that create technical challenges for industrial-scale adoption. This timely review provides a succinct overview of VH2O2 in gaseous sterilization and addresses its applicability for terminal sterilization of medical devices. It also describes underappreciated factors such as the occurrence of nonlinear microbial inactivation kinetic plots that may dictate a need to develop a new standard approach to validate VH2O2 for terminal sterilization of medical devices.     

The effect of sterilization on mechanical properties of soft tissue allografts

One major concern regarding soft tissue allograft use in surgical procedures is the risk of disease transmission. Current techniques of tissue sterilization, such as irradiation have been shown to adversely affect the mechanical properties of soft tissues. Grafts processed using Biocleanse processing (a proprietary technique developed by Regeneration Technologies to sterilize human tissues) will have better biomechanical characteristics than tissues that have been irradiated. Fifteen pairs of cadaveric Achilles tendon allografts were obtained and separated into three groups of 10 each. Three treatment groups were: Biocleanse, Irradiated, and Control (untreated). Each specimen was tested to determine the biomechanical properties of the tissue. Specimens were cyclically preloaded and then loaded to failure in tension. During testing, load, displacement, and optical strain data were captured. Following testing, the cross sectional area of the tendons was determined. Tendons in the control group were found to have a higher extrinsic stiffness (slope of the load–deformation curve, p = .005), have a higher ultimate stress (force/cross sectional area, p = .006) and higher ultimate failure load (p = .003) than irradiated grafts. Biocleanse grafts were also found to be stiffer than irradiated grafts (p = .014) yet were not found to be statistically different from either irradiated or non-irradiated grafts in terms of load to failure. Biocleanse processing seems to be a viable alternative to irradiation for Achilles tendon allografts sterilization in terms of their biomechanical properties.     

Therapeutic abortion with concurrent sterilization: comparison of methods

Among patients seeking abortion are a group who request concurrent sterilization. This study compared three combinations of abortion and sterilization techniques. Suction termination with laparoscopic tubal ligation appears to be the combination of choice, for the mean hospital stay of patients undergoing this procedure was two days and the operative morbidity was 3.1%. For suction termination with tubal ligation at laparotomy, and hysterotomy with tubal ligation the mean hospital stays were 6 and 5.7 days respectively and the operative morbidity was four to five times greater.     

Resource scheduling methods in cloud and fog computing environments: a systematic literature review

In recent years, cloud computing can be considered an emerging technology that can share resources with users. Because cloud computing is on-demand, efficient use of resources such as memory, processors, bandwidth, etc., is a big challenge. Despite the advantages of cloud computing, sometimes it is not a proper choice due to its delay in responding appropriately to existing requests, which led to the need for another technology called fog computing. Fog computing reduces traffic and time lags by expanding cloud services to the network and closer to users. It can schedule resources with higher efficiency and utilize them to impact the user's experience dramatically. This paper aims to survey some studies that have been done in the field of scheduling in fog/cloud computing environments. The focus of this survey is on published studies between 2015 and 2021 in journals or conferences. We selected 71 studies in a systematic literature review (SLR) from four major scientific databases based on their relation to our paper. We classified these studies into five categories based on their traced parameters and their focus area. This classification comprises 1—performance 2—energy efficiency, 3—resource utilization, 4—performance and energy efficiency, and 5—performance and resource utilization simultaneously. 42.3% of the studies focused on performance, 9.9% on energy efficiency, 7.0% on resource utilization, 21.1% on both performance and energy efficiency, and 19.7% on both performance and resource utilization. Finally, we present challenges and open issues in the resource scheduling methods in fog/cloud computing environments.

     

木霉病的研究现状

木霉在自然界广泛分布,绝大多数对人类无害,但有些种类能够感染人类造成木霉病,其引起的人类感染表现形式多样,容易误诊。本文对Medline和中文文献数据库中的相关文献进行了系统查阅和分析,综合归纳了木霉病的致病种、地域分布、危险因子、临床表现形式、药物敏感性及其诊疗方案等,该综述对全面了解木霉病的特征及其临床医师的诊断具有重要的意义。     

Temozolomide-related infections: review of the literature

Temozolomide (TMZ) is an alkylating, antineoplastic agent which is being used to treat cases of refractory anaplastic astrocytoma, newly-diagnosed glioblastoma multiforme and metastatic melanoma. TMZ causes lymphopenia and T-cell dysfunction in most of the patients. Related to this toxicity several opportunistic infections have been reported in the literature, but were not well characterized. To further investigate this topic, relevant English language studies were identified through Medline. There were 36 previously reported cases of infection related to TMZ. The median age of the cases was 55 years (range 33-73). The most frequently experienced infections were mucocutaneous candidiasis (n=11; 28.2%), herpes zoster (n=5; 12.8%), herpes simplex virus (n=4; 10.2%), cytomegalovirus (CMV) (n=5; 12.8%), pneumocystis carinii pneumonia (PCP) (n=3; 7.6%), hepatitis B virus (HBV) (n=2; 5.1%) and others (n=9; 23%). Mortality rates were 28.5% (n=4/14) in patients with reported outcome. In this survey, about one third of the TMZ-related severe infections resulted in death. Patients treated with TMZ are at increased risk for opportunistic viral and bacterial infection. Therefore, close monitoring of patients receiving TMZ for opportunistic infections should be carried out.     

Preservation methods for kidney and liver

With the successful testing of the immunosuppressive effects of cyclosporine in transplant patients in 1978, the field of organ transplants began an exponential growth. With that, the field of organ preservation became increasingly important as the need to increase preservation time and improve graft function became paramount. However, for every patient that receives a transplanted organ, there are 4 more on the waiting list. In addition, a patient dies from the lack of a transplant almost every 1½ hour. To alleviate this donor crisis, there is a need to expand the donor pool to marginal donor organs. The main reason these organs are underutilized is because the current method of static preservation, simple cold storage, is ineffective. This article will provide a general review of the methods of preservation including simple cold storage, hypothermic machine perfusion, normothermic machine perfusion, and oxygen persufflation. In addition, the article will provide a review of how these dynamic preservation methods have improved the recovery and preservation of marginal donor organs including donation after cardiac death and fatty livers.     

Preservation methods for kidney and liver

With the successful testing of the immunosuppressive effects of cyclosporine in transplant patients in 1978, the field of organ transplants began an exponential growth. With that, the field of organ preservation became increasingly important as the need to increase preservation time and improve graft function became paramount. However, for every patient that receives a transplanted organ, there are four more on the waiting list. In addition, a patient dies from the lack of a transplant almost every 1½ hour. To alleviate this donor crisis, there is a need to expand the donor pool to marginal donor organs. The main reason these organs are underutilized is because the current method of static preservation, simple cold storage, is ineffective. This article will provide a general review of the methods of preservation including simple cold storage, hypothermic machine perfusion, normothermic machine perfusion, and oxygen persufflation. In addition, the article will provide a review of how these dynamic preservation methods have improved the recovery and preservation of marginal donor organs including Donation after Cardiac Death and Fatty livers.     

Preservation methods for the storage of anaerobic sludges

Different preservation methods were evaluated for the storage of anaerobic sludges: room temperature, refrigeration at 4 °C, freezing at –20 °C and freeze-drying. Specific methanogenic activity for glucose and acetate were used as indicators of the subsequent recovery of the anaerobic sludge. Storage at room temperature and refrigeration resulted in a better conservation of the methanogenic activity than freezing and freeze-drying.