Nanotechnology in concrete – A review

Recent genomic studies have resulted in an emerging understanding of the role of chromatin regulators in the development of cancer. EZH2, a histone methyl transferase subunit of a Polycomb repressor complex, is recurrently mutated in several forms of cancer and is highly expressed in numerous others. Notably, both gain-of-function and loss-of-function mutations occur in cancers but are associated with distinct cancer types. Here we review the spectrum of EZH2-associated mutations, discuss the mechanisms underlying EZH2 function, and synthesize a unifying perspective that the promotion of cancer arises from disruption of the role of EZH2 as a master regulator of transcription. We further discuss EZH2 inhibitors that are now showing early signs of promise in clinical trials and also additional strategies to combat roles of EZH2 in cancer.

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Targeting EZH2 in cancer

For the past 30 years, improvements in the survival of patients with osteosarcoma have been mostly incremental. Despite evidence of genomic instability and a high frequency of chromothripsis and kataegis, osteosarcomas carry few recurrent targetable mutations, and trials of targeted agents have been generally disappointing. Bone has a highly specialized immune environment and many immune signalling pathways are important in bone homeostasis. The success of the innate immune stimulant mifamurtide in the adjuvant treatment of non-metastatic osteosarcoma suggests that newer immune-based treatments, such as immune checkpoint inhibitors, may substantially improve disease outcome.

Translational biology of osteosarcoma

Technical and commercial progress in the adoption of geopolymer cement

Clinicopathologic correlates of solitary fibrous tumors.

Biomechanical comparison of a 3D-printed sacrum prosthesis versus rod-screw systems for reconstruction after total sacrectomy: A finite element analysis.

With the development of surgical techniques and improvements in hemi-pelvic prosthesis systems, extra-articular resection can be performed as a limb-salvage procedure in selected patients whose hip joint is invaded by a sarcoma. The aim of this study was to describe the indications for and the technical details, post-operative complications, and oncologic and functional outcomes of this procedure. Eighteen patients with Enneking IIB or IB sarcoma who underwent extra-articular resection of the hip joint were enrolled. A modular pelvic endoprosthesis combined with a femoral endoprosthesis was used to reconstruct the bone and joint defect. Pathological diagnoses included osteosarcoma (7 patients), chondrosarcoma (7), undifferentiated high-grade pleomorphic sarcoma (3), and malignant peripheral nerve-sheath tumour (1). Wide, marginal and intralesional surgical margin was achieved in 13, four and one patients, respectively. There was one peri-operative death and the other 17 patients were followed up for 35.0 months (range, 10–75 months). Three patients had early-stage dislocations. One had a traumatic dislocation three years later. Two patients had wound complications. The average MSTS 93 score was 63.5% ± 10.8%. Four patients had local recurrence. The estimated three-year disease-free survival and overall survival for the 18 patients were both 50.0%. Although technically demanding, extra-articular resection of hip is a limb-salvage procedure that is worth considering for carefully selected patients.

Extra-articular resection is a limb-salvage option for sarcoma involving the hip joint.

Currently, modeling of social impacts in sustainable pavement management (SPM) is still in the infant stage, which generally causes significant social impacts and triggers several social hotspot issues. Therefore, this paper aims to evaluate the social impacts on pavement over its main life-cycle stages. To achieve this goal, the UNEP/SETAC guidelines were employed to develop the social life-cycle assessment (S-LCA) framework for pavement. Stakeholders, subcategories, and part of social indicators were identified from previous studies, and the other part of social indicators were particularly developed based on pavement characteristics. In particular, direct and indirect social indicators were both used, which evaluate social impacts directly and indirectly, respectively. Moreover, site-specific data were extensively collected and verified using cross-checking by multiple data collection approaches and sources, while generic data were adopted as reference values. Subsequently, the existing approaches of assigning scores were applied for direct and indirect social indicators, and the weights were determined using the analytic hierarchy process method. A final score was aggregated to evaluate the social impacts of pavement. In addition, a case study of traditional hot-mix asphalt (HMA) in China was applied and the social hotspots were identified for the local pavement sector. This study involved four pavement life-cycle stages of raw materials and production, construction, use, and maintenance, along with 4 stakeholders, 12 subcategories, and 16 social indicators. In particular, the use stage was addressed due to its significant social impacts during the long service life for pavement. Moreover, the subcategories and social indicators associated with worker category were most integrated, and the consumer was incorporated. In the case study of HMA pavement, the use stage contributed the greatest positive social impacts, while local community was identified as an important stakeholder, followed by worker. In addition, the subcategories of health and safety received the top three scores. However, gender discrimination was a significant social problem in the local pavement sector as indicated by the lowest score of equal opportunities subcategory. The proposed S-LCA framework is effective in evaluating the social impacts of pavement related to affected stakeholders during its main life-cycle stages. This study lays the foundation for the development of S-LCA framework for pavement, and the identified and proposed social indicators not only are used to evaluate the comprehensive social impacts of pavement, but also are suitable for other construction projects.

Modeling life-cycle social assessment in sustainable pavement management at project level

Objective
To introduce a new classification of Enneking type IV pelvic tumors involving the sacrum and a corresponding system of standardized surgical approaches and procedures for resection of such tumors, and to investigate the feasibility and therapeutic effect of the new system.

Methods
Data on 59 patients treated between February 2003 and February 2013 by standardized surgical approaches and procedures were retrospectively reviewed. The study subjects comprised 28 male and 31 female patients with a mean age at diagnosis of 36 years (range, 2–72 years). There are four subtypes in the new classification: (i) subtype IVa, neoplasms invading the ipsilateral sacral wing; (ii) subtype IVb, neoplasms invading the ipsilateral sacral foramina; (iii) subtype IVc, neoplasms invading the contralateral sacral foramina; and (iv) subtype IVd, neoplasms invading the whole of the sacrum. Standardized surgical approaches and procedures were devised for en-bloc resection for each subtype with adequate margins.

Results
Adequate margins were achieved in 43/59 patients (72.9%). The mean operation time was 5.0 h and the mean intraoperative blood loss 2157 mL. At the final follow-up, 27/53 patients (50.9%) who had been followed up were alive and in complete remission. The mean Musculoskeletal Tumor Society 93 score was 17.4 (58%) of a possible 30 points. The mean functional score for patients who had undergone a pelvic zone II resection was 15.2, compared with 19.0 for those with an intact pelvic zone II.

Conclusions
The proposed standardized protocols should help orthopaedic surgeons to achieve adequate margins, manage risk, achieve better oncologic and functional outcomes, and minimize perioperative complications when treating massive pelvic tumors involving the sacrum.

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Malignant Pelvic Tumors Involving the Sacrum: Surgical Approaches and Procedures Based on a New Classification

Purpose
To determine the frequency of major complications and identify related risk factors in surgery for hypervascular spinal tumors after preoperative selective arterial embolization.

Tao Ji

Papers

Biomechanical comparison of a 3D-printed sacrum prosthesis versus rod-screw systems for reconstruction after total sacrectomy: A finite element analysis.

Extra-articular resection is a limb-salvage option for sarcoma involving the hip joint.

Modeling life-cycle social assessment in sustainable pavement management at project level

Malignant Pelvic Tumors Involving the Sacrum: Surgical Approaches and Procedures Based on a New Classification

Risk factors for major complications in surgery for hypervascular spinal tumors: an analysis of 120 cases with adjuvant preoperative embolization