Individualized cyclic mechanical loading improves callus properties during the remodelling phase of fracture healing in mice as assessed from time-lapsed in vivo imaging

Fracture healing is regulated by mechanical loading. Understanding the underlying mechanisms during the different healing phases is required for targeted mechanical intervention therapies. Here, the influence of individualized cyclic mechanical loading on the remodelling phase of fracture healing was assessed in a non-critical-sized mouse femur defect model. After bridging of the defect, a loading group (n = 10) received individualized cyclic mechanical loading (8–16 N, 10 Hz, 5 min, 3 × /week) based on computed strain distribution in the mineralized callus using animal-specific real-time micro-finite element analysis with 2D/3D visualizations and strain histograms. Controls (n = 10) received 0 N treatment at the same post-operative time-points. By registration of consecutive scans, structural and dynamic callus morphometric parameters were followed in three callus sub-volumes and the adjacent cortex showing that the remodelling phase of fracture healing is highly responsive to cyclic mechanical loading with changes in dynamic parameters leading to significantly larger formation of mineralized callus and higher degree of mineralization. Loading-mediated maintenance of callus remodelling was associated with distinct effects on Wnt-signalling-associated molecular targets Sclerostin and RANKL in callus sub-regions and the adjacent cortex (n = 1/group). Given these distinct local protein expression patterns induced by cyclic mechanical loading during callus remodelling, the femur defect loading model with individualized load application seems suitable to further understand the local spatio-temporal mechano-molecular regulation of the different fracture healing phases.

Endodontic Treatment of Periapical Lesions Using Bioceramic Sealers

This article presents clinical cases of successful endodontic treatment of the main types of combined apical and marginal pathology. Based on the results obtained, the optimal method that ensures a successful treatment result for this pathology in one visit, often without subsequent surgical manipulations, is an adequate endodontic mechanical intervention with subsequent obturation of the root canals with a bioceramic sealer, which is confirmed by the literature data.

Endodontic treatment of perioapical lesions using bioceramic sealers

A number of researchers note the fact that today, in more than 5.7% of the teeth in patients over 40-45 years old with apical periodontal lesions, during a comprehensive examination, lesions of the marginal periodontium are also diagnosed.Materials and methods. The success of endodontic treatment of such teeth with the use of traditionally used polymer sealers is extremely low. Pathology develops due to a mixed apical-periodontal microflora. The use of bioceramic sealers has been reported to significantly improve the prognosis for endodontic intervention. Bioceramics inherently is the most biocompatible material and consists of aluminum oxide, zirconium dioxide, bioactive glass, glass ceramics, composite components and coatings, hydroxyapatite and resorbable calcium phosphates.Results. This article presents clinical cases of successful endodontic treatment of the main types of combined apical and marginal pathology. 9-11 months after treatment, the diagnosed signs of perio-dontal and periapical pathology are not determined.Conclusions. Based on the results obtained, the optimal method that ensures a successful treat-ment result for this pathology in one visit, often without subsequent surgical manipulations, is an ade-quate endodontic mechanical intervention with subsequent obturation of the root canals with a bioc-eramic sealer, which is confirmed by the literature data.

E-Line Powered Mechanical Tool Technologies Provide Efficient, Reduced Risk Solutions in Complex Intervention Operations

Latest developments in drilling and wellbore completion technologies lead to even more complex intervention conditions. Conventional techniques using slickline or coiled tubing are ill-suited for many of these conditions due to operational complexity, effectiveness, or efficiency. Powered mechanical intervention with e-line alleviates some of these limitations and opens lower risk intervention applications. This paper details two applications: a fishing operation that could not be performed with slickline or coiled tubing and a completion disk rupturing operation where the operator saved 1.5 days. Powered mechanical intervention is a combination of complementary technologies that enable "intelligently controlled intervention operations." Downhole tractors enable access into complex well trajectories. Surface-controlled, powered anchors coupled with a linear actuator can generate very high axial forces with precise and real-time downhole measurements of forces and displacement. Operating parameters can be monitored in real time to prevent damage to damaged completion components. Uncontrolled tool movement due to high differential pressures is prevented. Such precise control of downhole forces and movements enables complex intervention operations previously done with coiled tubing or a full workover. The first application example details a fishing operation. A retrievable plug along with its setting tool was stuck in the production tubing after prematurely setting. Multiple fishing attempts with heavy-duty slickline jars were unsuccessful. Coiled tubing was not deployed as its lack of force precision could have generated excessive downhole force and sheared the fish. An e-line-conveyed linear actuator tool was used to latch onto the fish with the help of an overshot and was released from the retrievable plugs by application of optimal, highly controlled, linear force to minimize damage. The second case involved rupturing a ceramic disk installed in completion. High differential pressure across the disk restricted the use of slickline which could have been damaged due to the high expected differential pressure. The alternative with coiled tubing milling requires a larger personnel and equipment footprint in addition to the associated HSE exposure and lack of efficiency. An innovative technique using the e-line linear actuator and a pointed chisel was devised and deployed. Real-time feedback from the tool sensors gave confirmation of the rupturing of various components of the ceramic disk, and the anchors eliminated any tool movement during pressure equalization. The operation was completed in 12 hours, resulting in time savings of almost 36 hours. An e-line intervention is a low risk, effective, and efficient solution while having an accurate depth and positioning, coupled with controlled downhole operations. With precise control of operating parameters, operations which were previously possible with coiled tubing or workover can be done on e-line more efficiently.

Effects of mechanical interventions in the management of knee osteoarthritis: protocol for an OA Trial Bank systematic review and individual participant data meta-analysis

IntroductionKnee osteoarthritis (OA) is a prevalent and disabling musculoskeletal condition. Biomechanical factors may play a key role in the aetiology of knee OA, therefore, a broad class of interventions involves the application or wear of devices designed to mechanically support knees with OA. These include gait aids, bracing, taping, orthotics and footwear. The literature regarding efficacy of mechanical interventions has been conflicting or inconclusive, and this may be because certain subgroups with knee OA respond better to mechanical interventions. Our primary aim is to identify subgroups with knee OA who respond favourably to mechanical interventions.Methods and analysisWe will conduct a systematic review to identify randomised clinical trials of any mechanical intervention for the treatment of knee OA. We will invite lead authors of eligible studies to share individual participant data (IPD). We will perform an IPD meta-analysis for each type of mechanical intervention to evaluate efficacy, with our main outcome being pain. Where IPD are not available, this will be achieved using aggregate data. We will then evaluate five potential treatment effect modifiers using a two-stage approach. If data permit, we will also evaluate whether biomechanics mediate the effects of mechanical interventions on pain in knee OA.Ethics and disseminationNo new data will be collected in this study. We will adhere to institutional, national and international regulations regarding the secure and confidential sharing of IPD, addressing ethics as indicated. We will disseminate findings via international conferences, open-source publication in peer-reviewed journals and summaries posted on websites serving the public and clinicians.PROSPERO registration numberCRD42020155466.

Possibility of Using Microwave Radiation for Rehabilitation of Historical Masonry Constructions

In the last years, there has been a growing demand for renovations and redevelopment of older buildings that do not meet today's building standards. A very common problem is the insufficient, damaged or completely missing waterproofing of buildings, which leads to water (or moisture) penetration into the structure of the building, but there are several possibilities to disseminate moisture into structures. Many rehabilitation methods require mechanical intervention into the structure of the building, but we mustn’t forget the structures where these procedures cannot be used, specifically objects with a rich historical value, that are protected by the National Heritage Institute.This article is focused on suitability, functionality and possibilities of using a non-destructive method of drying historic masonry with microwave radiation. First the method of microwave drying is described in general, then its use in construction practice is explained. Following is a description of the experimental work carried out at the Faculty of Civil Engineering. Outcome of this work is comparison of effects of microwave drying on samples of masonry containing three different types of building materials. One of these samples is made of brick construction, which has reached the age of 350 years. At the end, the results of the experiment and the consequent suggested recommendations are summarized.

Individualized cyclic mechanical loading improves callus properties during the remodelling phase of fracture healing in mice as assessed from time-lapsed in vivo imaging

Fracture healing is regulated by mechanical loading. Understanding the underlying mechanisms during the different healing phases is required for targeted mechanical intervention therapies. Here, the influence of individualized cyclic mechanical loading on the remodelling phase of fracture healing was assessed in a mouse femur defect model. After bridging of the defect, a loading group (n=10) received individualized cyclic mechanical loading (8-16 N, 10 Hz, 5 min, 3x/week) based on computed strain distribution in the callus using animal-specific real-time micro-finite element analysis. Controls (n=10) received 0 N treatment at the same post-operative time-points. By registration of consecutive scans, structural and dynamic callus morphometric parameters were followed in three callus sub-volumes and the adjacent cortex showing that the remodelling phase of fracture healing is highly responsive to cyclic mechanical loading with changes in dynamic parameters leading to significantly larger callus formation and mineralization. Loading-mediated maintenance of callus remodelling was associated with distinct effects on Wnt-signalling-associated molecular targets Sclerostin and Rankl in callus sub-regions and the adjacent cortex. Given these distinct local protein expression patterns induced by cyclic mechanical loading, the femur defect loading model with individualized load application seems suitable to understand the local spatio-temporal mechano-molecular regulation of the different fracture healing phases.