Use of demineralized bone matrix in spinal fusion

Spinal fusion remains the gold-standard treatment for several pathological spine conditions. Although, autologous Iliac Crest Bone Grafting is considered the goldstandard graft choice to promote spinal fusion; however, it is associated with significant donor site morbidity and a limited graft quantity. Therefore, several bone graft alternatives have been developed, to augment arthrodesis. The purpose of this review is to present the results of clinical studies concerning the use of demineralized bone matrix(DBM), alone or as a composite graft, in the spinal fusion. A critical review of the English-language literature was conducted on Pubmed, using key word "demineralized bone matrix", "DBM", "spinal fusion", and "scoliosis". Results had been restricted to clinical studies. The majority of clinical trials demonstrate satisfactory fusion rates when DBM is employed as a graft extender or a graft enhancer.Limited number of prospective randomized controlled trials(4 studies), have been performed comparing DBM to autologous iliac crest bone graft in spine fusion. The majority of the clinical trials demonstrate comparable efficacy of DBM when it used as a graft extender in combination with autograft, but there is no clinical evidence to support its use as a standalone graft material. Additionally, high level of evidence studies are required, in order to optimize and clarify the indications of its use and the appropriate patient population that will benefit from DBM in spine arthrodesis.

Risk assessment instruments for screening bone mineral density in a Mediterranean population

AIM To evaluate the power of six osteoporosis-screening instruments in women in a Mediterranean country.METHODS Data concerning several osteoporosis risk factors were prospectively collected from 1000 postmenopausal women aged 42-87 years who underwent dual-energy X-ray absorptiometry(DEXA) screening. Six osteoporosis risk factor screening tools were applied to this sample to evaluate their performance and choose the most appropriate tool for the study population.RESULTS The most important screening tool for osteoporosis status was the Simple Calculated Osteoporosis Risk Estimation, which had an area under the curve(AUC)of 0.678, a sensitivity of 72%, and a specificity of 72%, with a cut-off point of 20.75. The most important screening tool for osteoporosis risk was the Osteoporosis Self-assessment Tool, which had an AUC of 0.643, a sensitivity of 77%, and a specificity of 46%,with a cut-off point of-2.9.CONCLUSION Some commonly used clinical risk instruments demonstrate high sensitivity for distinguishing individuals with DEXA-ascertained osteoporosis or reduced bone mineral density.

Rapid and robust control of single quantum dots

The combination of single particle detection and ultrafast laser pulses is an instrumental method to track dynamics at the femtosecond time scale in single molecules,quantum dots and plasmonic nanoparticles.Optimal control of the extremely short-lived coherences of these individual systems has so far remained elusive,yet its successful implementation would enable arbitrary external manipulation of otherwise inaccessible nanoscale dynamics.In ensemble measurements,such control is often achieved by resorting to a closed-loop optimization strategy,where the spectral phase of a broadband laser field is iteratively optimized.This scheme needs long measurement times and strong signals to converge to the optimal solution.This requirement is in conflict with the nature of single emitters whose signals are weak and unstable.Here we demonstrate an effective closed-loop optimization strategy capable of addressing single quantum dots at room temperature,using as feedback observable the two-photon photoluminescence induced by a phase-controlled broadband femtosecond laser.Crucial to the optimization loop is the use of a deterministic and robust-against-noise search algorithm converging to the theoretically predicted solution in a reduced amount of steps,even when operating at the few-photon level.Full optimization of the single dot luminescence is obtained within~100 trials,with a typical integration time of 100 ms per trial.These times are faster than the typical photobleaching times in single molecules at room temperature.Our results show the suitability of the novel approach to perform closed-loop optimizations on single molecules,thus extending the available experimental toolbox to the active control of nanoscale coherences.