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Mehran Kardar Statistical Physics Of Particles Pdf FreeThe following sampling was developed by students in the. Population Genetics. Chemotaxis. Packaging viral DNAMehran Kardar's homepage. Mehran Kardar: teaching. Teaching. Educational Activities. Mehran Kardar. Lecture Notes In the past several years, I have been involved with teaching. Books Statistical. Physics of Particles Statistical. Physics of Fields Projects. This is an ongoing project to develop a collection. The following sampling was developed by students in the. Mehran Kardar's homepage. Statistical Physics Of Particles Solutions Manual Quick Overview. Subject: Status: OK for US. Media: Mehran Kardar statistical physics of particles Solution manual.pdf 1183004. Statistical Physics Of Fields Mehran Kardar Pdf Free eBook Download Page 14. Advances in Imaging and Electron Physics. Statistical Physics Of Fields Mehran Kardar Pdf Free eBook Download Page 14. Mehran Kardar Statistical Physics Of Particles Pdf FileEquilibrium in statistical mechanics: systems exchanging energy are most likely to have individual energies that maximize the overall number of states. The Instructor Solutions manual is available in PDF format for the following textbooks. These manuals include full solutions to all problems and exercises with which chapters ended, but please DO NOT POST HERE, instead send an. Kardar, Statistical Physics of Particles A modern view on the subject which o ers many insights. This course is built on the. Clinical review: Acute respiratory distress syndrome - clinical ventilator management and adjunct therapy . Mechanisms of VILI include alveolar overdistension (volutrauma), repetitive alveolar opening and closure (atelectrauma), oxygen toxicity, and biotrauma, the pulmonary and systemic response to alveolar overdistension that may exacerbate lung inflammation and contribute to multiple organ dysfunction . Efforts to minimise VILI are focused on the use of low tidal volume ventilation to prevent volutrauma, the use of positive end- expiratory pressure (PEEP) to reduce alveolar collapse, and minimisation of exposure to potentially harmful oxygen concentrations. Specific therapies targeted at the immune response remain experimental to date. Acceptable parameters for the partial pressure of arterial oxygen (Pa. O2) and the partial pressure of arterial carbon dioxide are difficult to define. Although Pa. O2 of 5. Hg is considered the target range in many studies, more profound hypoxaemia may be well tolerated, as evidenced by the relatively rare occurrence of death due to refractory hypoxaemia in ARDS . However, caution should be exercised in view of the reported correlation between cognitive defects in survivors of ARDS and duration of arterial oxygen saturation < 9. In healthy human volunteers exposed to high concentrations of oxygen, tracheobronchitis develops after several hours . In a small series of patients with ARDS, ventilation with 1. Compared with other aspects of VILI, however, relatively little work has been done on oxygen toxicity in adults with ARDS, and the threshold for toxicity, particularly in the setting of an open lung strategy and low tidal volume ventilation, is unknown. Based on the limited available data, our practice is to aim for Fi. O2 . The optimal partial pressure of arterial carbon dioxide level for patients with ARDS is not clear, but mean levels of 6. Hg (8. 8. 7 k. Pa) and p. H 7. 2. 3 appear safe . Adjustment of the ventilator rate was used to target a normal p. H, with a mean respiratory rate of 3. Tidal volumes in patients with ARDS should therefore be in the order of 6 ml/kg predicted body weight with plateau pressures < 3. H2. O, accepting p. H as low as 7. 1. He acute respiratory distress syndrome (ARDS) is a devastating clinical syndrome of acute lung injury that affects both medical and surgical patients. More than 30 years ago, Ashbaugh and colleagues1 described a unique set of. CLINICAL REVIEW Acute respiratory distress syndrome Susannah K Leaver. High-Resolution Computed Tomography Findings of Acute Respiratory Distress Syndrome, Acute Interstitial Pneumonia. Expert Review of Respiratory Medicine 4:6. Many ventilation modes have been employed in ARDS. To add to the confusion, manufacturers often use different names for similar modes. One must choose between spontaneous breathing modes with partial ventilatory support, or controlled modes; either a pressure- controlled mode in which tidal volume is the dependent variable, or a volume- controlled mode in which peak pressure may vary. Spontaneous breathing with partial ventilatory support has been postulated to allow for better patient- ventilator synchrony, lower sedation requirements, and better preservation of diaphragmatic function with earlier liberation from mechanical ventilation. Data supporting this hypothesis, however, are currently very limited. A recent systematic review . One of these trials suggested improved oxygenation and increased number of ventilator- free days . The main disadvantage of spontaneous breathing is the potential for the patient to generate high transpulmonary pressures and tidal volumes; suppression of this often requires the use of high doses of sedation with or without muscle relaxants. Balancing the risks between increasing sedation in order to provide lung protection and allowing spontaneous ventilation in a more awake patient is often a difficult clinical problem with limited applicable evidence. Our practice is to aim for spontaneous breathing with partial ventilatory support, frequently using pressure support ventilation in patients with mild to moderate ARDS, while in moderate to severe ARDS patients we use sedation and muscle relaxants as necessary to achieve lung- protective ventilation. Proponents of pressure- controlled ventilation argue that this allows for better patient- ventilator synchrony, that the decelerating flow pattern allows better distribution of inspired gases, and that high transpulmonary pressures are more easily avoided . Conversely, volume- controlled ventilation allows safe tidal volumes to be delivered in a consistent pattern, thus avoiding alveolar overdistension . Pressure- regulated volume control ventilation aims to combine the advantages of both approaches, but may be problematic when patients are making variable or intermittent inspiratory efforts. There is no evidence of benefit for any one mode, the important point being to ensure both safe tidal volumes (6 ml/kg predicted body weight) and plateau pressures (. Using a transient increase in transpulmonary pressure, recruitment manoeuvres attempt to open previously atelectatic alveoli. This increase in the size of the ARDS baby lung . Several methods have been described, the most commonly used of which is a sustained inflation breath; for example, 4. H2. O for 4. 0 seconds . Another manoeuvre that appears to be gaining popularity is a step- wise increase in PEEP accompanied by low levels of pressure control ventilation . Common complications of any recruitment manoeuvre include transient hypotension and desaturation, while pneumothorax and other manifestations of barotrauma have been reported and transient alveolar overdistension during the manoeuvre may paradoxically worsen VILI . Recruitment manoeuvres are associated with an immediate improvement in oxygenation with variable sustainability, but have not been shown to improve clinically important outcomes . They may be most useful as a rescue therapy in refractory hypoxaemia or following deterioration in oxygenation attributable to worsening atelectasis. The sustainability of improvements in oxygenation with recruitment manoeuvres may depend on the use of PEEP as a means of maintaining recruitment. In selecting a PEEP level, one must consider both the target level (low, moderate, high) and the method for determining the actual numeric value of PEEP. In terms of target level, there is at least observational evidence to suggest that very low levels of PEEP (< 5 cm. H2. O) are associated with worse mortality . Acute Respiratory Distress Syndrome Clinical. Acute respiratory distress syndrome. Update on Pediatric Acute Respiratory Distress Syndrome Michael R. Prognosis and Predictors of Outcome in Pediatric Acute Respiratory Distress Syndrome Overall. This review discusses the changing definition of ARDS and. 30 On the basis of the results of screening of large numbers of patients by the NIH Acute Respiratory Distress Syndrome Network over the.Explore Respiratory Distress Syndrome. Other Names; Causes; Who Is at Risk; Signs & Symptoms; Diagnosis; Treatments; Prevention; Living With; Clinical Trials; Links; Related Topics. The acute respiratory distress syndrome. Respiratory Distress Syndrome, Adult*/history. Acute lung injury and the acute respiratory distress syndrome are. Translational Respiratory. Moore EE, Parsons PE: The role of chronic alcohol abuse in the development of acute respiratory distress syndrome. Pathophysiology of Acute Lung Injury and the. The debate regarding targets of moderate versus higher levels of PEEP is informed by three recent large RCTs that maintained low tidal volumes in all patients . While none of these trials individually showed a significant mortality benefit, when combined in an individual- patient meta- analysis the patients with moderate- severe ARDS (Pa. O2/Fi. O2 . In contrast, patients with mild ARDS (Pa. O2/Fi. O2 = 2. 01 to 3. PEEP; no benefit was seen in the overall population (see Figure 1) . ARDS, acute respiratory distress syndrome; CI, confidence interval; HR, hazard ratio; PEEP, positive end- expiratory pressure. Adapted with permission from . These methods most commonly consist of using a PEEP/Fi. O2 table in which PEEP is titrated to provide acceptable oxygenation . This decremental approach is most easily achieved by a sustained inflation breath or pressure control recruitment manoeuvre, followed by a decremental reduction in PEEP until a deterioration in compliance or oxygenation occurs, followed by a further recruitment manoeuvre and setting the PEEP 2 cm. H2. O above this point . This method of identifying a point of derecruitment correlates well with that found on serial computed tomography imaging . Similar results may be obtained regardless of the specific target used as a marker of lung opening . Transpulmonary pressure is then calculated and the PEEP set to achieve a positive end- expiratory transpulmonary pressure, with higher pressures used for higher Fi. O2 requirements. In a small singlecentre RCT this approach led to improvements in oxygenation and even a suggestion of improved mortality . Given the complexities involved in measuring and standardising oesophageal pressure measurements, and the preliminary nature of these findings, we believe that confirmation in the form of a larger multicentre RCT is required before this approach is used in the majority of ARDS patients. Other experimental methods of setting PEEP include titration to the minimum dead space fraction . In patients with moderate ARDS (Pa. O2/Fi. O2 = 1. 01 to 2. PEEP/Fi. O2 table . The main risk from this ratio increase is gas trapping, and therefore monitoring of the flow- time curve to ensure near- cessation of flow prior to inhalation is essential. Inverse ratio ventilation, with inspiratory: expiratory ratio > 1: 1, results in higher mean airway pressures and can improve oxygenation but appears less useful than increasing PEEP - and the associated intrinsic PEEP may worsen gas exchange, volutrauma, and haemodynamics. Alumni Mentor Program MizzouFacebook. Entfernen. Wir verwenden Cookies, um Inhalte zu personalisieren, Werbeanzeigen ma. Wenn du auf unsere Webseite klickst oder hier navigierst, stimmst du der Erfassung von Informationen durch Cookies auf und au. Weitere Informationen zu unseren Cookies und dazu, wie du die Kontrolle dar. Alumni Mentor Program. Alumni Mentor Program at New York Institute of Technology. Location United States. In the spirit of Bruins helping Bruins, the UCLA Alumni Mentor Program enables alumni to share their professional and personal experience and expertise with current UCLA students. The connections made within the UCLA Alumni. The Student-Alumni Mentoring Program brings together students and alumni in mutually rewarding relationships. The Inside Out Community Arts (IOCA) Alumni Mentor Program provides the opportunity for high school and college aged students to mentor middle school participants in the IOCA after-school program. These young leaders meet once. The Alumni-Student Mentoring Program builds on the success of a program run by Monash alumni for more than 10 years. If you are interested in mentoring a Monash student email us at [email protected]. How to Automatically Update an Active. X Control (Internet Explorer)Note. All a user must do is download an Active. X control from your site and subscribe to your Software Update Channel. When you release new versions of your Active. X control, subscribed users visiting a site that uses the new version can choose to receive the update automatically. The new version can be installed immediately, or precached for offline installation later. Requirements. This article applies to Active. X Controls, not applications or Java applets. For information about updating applications, see Publishing Application Updates on the Web. Support for Software Update Channels and Channel Definition Format (CDF) files began with Microsoft Internet Explorer. If you are using the Personal Web Server on your local computer, create a directory (\osd) under the \Webshare\Wwwroot directory and then create a subdirectory (\Generic. Sample) under the \osd directory. Windows administrators are going to be busy next week, as Microsoft plans to release twelve security patches for its products. The updates will include a fix for a. Your security settings will continue to block potentially harmful ActiveX controls and scripting from other. Find Windows Update using your Start Screen. Windows Update is included in the Control Panel. IE to Block Older ActiveX Controls, Starting with Java. Next week’s Microsoft Patch Tuesday security. The setting lists ActiveX controls. Copy the contents of the. Open Software Description sample into your share. Update the CHANNEL attribute of the CHANNEL element in Circ. Copy the updated version of Circ. Open Internet Explorer. This will install the first version of the Circle Active. X control (build 1). Subscribe to Circ. Add Active Channel logo, as shown in the following image. If you are subscribing a user to an automatic subscription, it is important to obtain the user's consent first. Users can click Customize to configure Windows Internet Explorer to either send an e- mail notification upon new software availability, or choose a custom schedule to tell Internet Explorer when to check for new software. You can define schedules in the CDF file with the SCHEDULE element under the CHANNEL element. Because the value of the USAGE element in the Circ. Distributing a New Version. Describes an update that introduces a security feature to block out-of-date ActiveX controls in Internet Explorer versions 8 through 11. What's this bulletin about? Microsoft Security Bulletin MS00-075 announces the availability of a patch that eliminates a vulnerability in Microsoft. At Microsoft our mission and values are to help people and businesses throughout the world realize their full potential.Now assume you have a new build, build 2 of your control, ready to roll out. You want all users who have build 1 to automatically update to build 2 as soon as they hit any page that uses the Circle control. Note. Precache does not mean autoinstall; Internet Explorer just caches the new build so the user can later install the control faster and even while offline). The new CDF file advertises build 2 of the Circle control. Note. You will also have to copy Circ. This is exactly the same as the real- life situation where the user sees only Circ. Circ. 3. When you update to version 2, you don't want version 1 to be available anymore, so you copy Circ. On the client computer, first make sure that the zone you are in is set for Custom. Under Active. X Controls And Plugins/Download Unsigned Active. X Controls, select Enable. Note that this is needed only for the demonstration file because the cabinet files are not signed; if they were signed, this would not be needed. Then select Favorites/Update All Subscriptions, or right- click the Circle channel (under Favorites/Software Updates) and select Update Now. Note that if the CDF file had defined an automatic schedule, this update would have happened automatically like any other subscription in Internet Explorer. The Circle channel icon will gleam (red gleam on the upper- left corner of the icon). If you set up the e- mail notification during subscription, you will receive e- mail notifying you of the updated software. When you click the Circle channel, Internet Explorer will navigate to the home page of the channel. This page has instructions on how to download/install the new version of Circle (in this case just a link to an HTML page with the object element for the new version of Circle). Alternately, if you return to view Circ. Circle Active. X control), the client will be automatically upgraded to version 2 because Internet Explorer knows that build 2 is available. In this simple example, note that the only way to see the version difference between the two Circle controls is to view the properties on the Circle control in the Downloaded Program Files directory. Related topics. Conceptual. Introduction to Active Channel Technology. Internet Component Download. Introduction to Software Update Channels. Microsoft prepares Word, Active. X fixes for Patch Tuesday. Windows administrators are going to be busy next week, as Microsoft Corp. The updates will include a fix for a widely reported vulnerability in Microsoft Word, as well as changes to the way Internet Explorer (IE) handles Active. X. That change, which comes in response to a recent patent lawsuit loss, might cause headaches for some administrators. Nine of the patches will address vulnerabilities in the Windows operating system, some of which Microsoft rates as critical. There will also be one . The vulnerability can be exploited to run unauthorized software on PCs, although users must first be first tricked into opening a maliciously encoded Word document. Microsoft also plans to finalize changes to the way IE processes dynamic content using Active. X. Microsoft is changing the way IE works in response to a 2. University of California and Eolas Technologies Inc. The changes will force developers to reprogram parts of their Web sites and intranets. Otherwise, IE will force users to click on a pop- up . With Tuesday's updates, though, there will be no way to avoid the Active. X changes. The biggest headache, however, will come from the sheer number of updates being released Tuesday, said Susan Bradley, chief technology officer at Tamiyasu, Smith, Horn and Braun, Accountancy Corp. Complicating matters is the fact that these patches will be released in the middle of Microsoft's Tech. Ed user conference. Installation on Windows systems Table of Contents Install Requirements PECL PHP Installer Tools on Windows Recommended Configuration on Windows systems Manual PHP Installation on Windows Troubleshooting PHP on Windows Installation on old Windows. PHP on Windows PHP now runs better than ever on Windows. Utilize the power of IIS 7.0 and the Windows Web App Gallery. Install PHP for Windows Here! Install PHP for Windows using the Microsoft Web Platform Installer. Ultimate List of Free Windows XP Software & Resources from Microsoft. Microsoft has over 1. FREE Windows XP, Windows Vista & Office Programs available for download — finding them all is extremely difficult . 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User Profile Deletion Utility (Delprof) deletes all data that is stored in a user profile including desktop settings, favorites, program- specific data that is contained in the Application Data folder, and the contents of the My Documents folder. User Profile Hive Cleanup helps with slow log off and unreconciled profile problems ensuring that user sessions are completely terminated when a user logs off when using Roaming Profiles or locked profiles as implemented through the Shared Computer Toolkit. Video Decoder Checkup Utility helps determine if an MPEG- 2 DVD video decoder is installed, and whether it’s compatible with Media Player 1. Media Center Edition. Windows Support Tools are intended for use by Microsoft support personnel and experienced users to assist in diagnosing and resolving computer problems. SECURITY, ANTI- SPYWARE & ANTI- VIRUS Baseline Security Analyzer includes a graphical and command line interface that can perform local or remote scans of Windows systems. 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Department of Energy’s National Renewable Energy Laboratory (NREL). It is the first philanthropy program of its kind within the financial services industry.“To address growing climate concerns, it is absolutely crucial to accelerate investments in innovative companies that provide clean technology solutions,” says Mary Wenzel, Wells Fargo head of Environmental Affairs. Startups will receive research and testing support at NREL’s world- class research facility in Golden, Colo., as well as coaching and mentorship from Wells Fargo’s vast network of financial and technical experts. Companies selected include: Energy Storage Systems (Portland) is developing an advanced flow battery that utilizes earth- abundant iron as its energy storage medium. This translates to unmatched affordability when the All- Iron Flow Battery (IFB) is used to address commercial energy storage needs. Liquid. Cool Solutions (Rochester, Minn.) is developing two forms of total immersion electronics cooling technology for large- scale data centers: Liquid Submerged Servers (LSS) and Liquid Submerged Computers (LSC). Initial testing of the LSS system has yielded 4. Smarter. Shade (Chicago) delivers on the promise of smart glass – significant energy savings, glare reduction and enhanced privacy impact – all in a seamless user- controlled shading interface that lasts 4- 5 times longer than blinds and shades. Smarter. Shade’s technology costs a fraction of the price of traditional smart glass and requires no electrical power. Watt. Stick Systems (San Francisco) is developing peel- and- stick electricity metering technology that can be safely and easily installed by nontechnical staff. By eliminating the need for sophisticated electrical installation, Watt. Stick Systems’ technology will drastically reduce total submetering costs for commercial buildings and open the door for significant long- term energy use reduction.“The IN2 program serves as a model for private and public sector collaboration working together for one common goal,” says Richard Adams, director of the Innovation and Entrepreneurship Center (IEC) at NREL. The goal is to create an ecosystem that fosters and accelerates the commercialization of promising commercial buildings technologies that can provide scalable solutions to reduce the energy impact of buildings. According to the Department of Energy, nearly 4. U. S. This program was developed to advance the commercialization of new sustainable technologies by validating them in the lab and then piloting them in select Wells Fargo locations. The PV Incubator program is designed to fund and inspire revolutionary advances in solar technology but tough goals and hard work are pre-requisites. Department of Energy’s (DOE) National Renewable Energy Laboratory (NREL) is seeking project proposals as part of DOE funding to accelerate commercialization of solar energy. The Photovoltaic (PV) Technology. Cleantech Group is partnering with Wells Fargo and National Renewable Energy Laboratory (NREL) for its Innovation Incubator Program. We are looking to select innovative early-stage private companies working on sustainable. Experts at the Energy Department's National Renewable Energy Laboratory (NREL) have confirmed that two companies in their PV Incubator Program have set new world records for their respective technologies. Department of Energy's (DOE) National Renewable Energy Laboratory (NREL) has announced partnerships with 13 U.S.
National Renewable Energy Laboratory. Leading Clean Energy Innovation. About NREL; Mission & Programs. NREL is a national laboratory of the U.S. Department of Energy, Office of Energy Efficiency and Renewable. NREL seeks proposals for Photovoltaic Technology Incubator Program. These proposals form part of the recently announced DoE funding to accelerate the commercialization of solar energy technologies. About Wells Fargo. Since 2. 01. 2, Wells Fargo has provided more than $3. This includes $3. Wells Fargo has reduced its greenhouse gas emissions by 2. The company also has made strategic environmental grants totaling $4. Wells Fargo environmental perspectives are available at the Wells Fargo Environmental Forum. Wells Fargo & Company (NYSE: WFC) is a nationwide, diversified, community- based financial services company with $1. Founded in 1. 85. San Francisco, Wells Fargo provides banking, insurance, investments, mortgage, and consumer and commercial finance through more than 8,7. ATMs, and the internet (wellsfargo. With approximately 2. Wells Fargo serves one in three households in the United States. Wells Fargo & Company was ranked No. Fortune’s 2. 01. 4 rankings of America’s largest corporations. Wells Fargo’s vision is to satisfy all our customers’ financial needs and help them succeed financially. Media. Pia Hahn. 2. Pia. hahn@wellsfargo. A Systematic Review of Animal Studies and Human Clinical Trials. The Ritchie Centre, Monash Institute of Medical Research (MIMR- PHI), Monash University, Clayton Branch, P. O. Box 6. 17. 8, South Yarra, VIC 3. Australia. 2Departments of Surgery and The Ritchie Centre, Monash Institute of Medical Research (MIMR- PHI), Monash University, Clayton Branch, 2. Wright Street, Clayton, VIC 3. Australia. 3Proteobioactives Research Laboratories, P. O. Box 3. 5, Brookvale, NSW 2. Australia. 4Mesoblast Ltd, Melbourne, VIC 3. Australia. 5Department of Surgery, Monash University, Clayton, VIC 3. Australia. 6Department of Neurosurgery, Alfred Hospital, Level 5, The Alfred Centre, Commercial Road, Prahran, Melbourne, VIC 3. Australia. 7The Ritchie Centre, Monash Institute of Medical Research (MIMR- PHI), Monash University, Clayton Branch, 2. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society FREE. Home > American Journal of Roentgenology > Volume 188, Issue 3 > Sonography of the Neonatal Spine: Part 1, Normal Anatomy, Imaging Pitfalls, and Variations That May Simulate Disorders. During the 1990s and 2000s a large number of papers have been published on lumbar motor control training, led by researchers from the University of Queensland. Practitioners across the world now recognise that local (commonly. A lumbar puncture (LP), also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid (CSF) for diagnostic testing. The main reason for a. Cell-Based Therapies Used to Treat Lumbar Degenerative Disc Disease: A Systematic Review of Animal Studies and Human Clinical Trials. Objective To review the methods and complications of exposing the anterior aspects of the thoracic and lumbosacral spine. Data Sources PubMed (journals database of the National Library of Medicine), text books, the. Wright Street, Clayton, VIC 3. Australia. Copyright . This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Low back pain and degenerative disc disease are a significant cause of pain and disability worldwide. The mechanism of action of transplanted cells, as well as the limitations of published studies, will be discussed. Introduction. Low back pain is the leading cause of disability in the developed world and has an enormous social impact on patients and their families, as well as a devastating economic impact on healthcare budgets . The annual cost of back pain in the United States is estimated to be as high as $5. Studies have shown that 7. Severe disc degeneration is associated with a twofold increase in chronic low back pain . There are many potential pain generators in the lumbar spine in addition to the disc. Moreover, differentiating the ageing disc from the symptomatically degenerate disc remains a major challenge . Thin hyaline cartilage endplates attach the disc to the adjacent vertebral bodies and disc nutrition passes through these end plates to the predominantly avascular IVD . The IVD functions to facilitate movement and flexibility of the vertebral column, whilst also having the ability to recover from deformation following axial loading. The native cell population of the disc represents approximately 1% of the disc tissue but is pivotal in maintaining disc metabolism . Cells of the NP and inner AF demonstrate chondrocytic morphology whilst cells in the outer AF are more fibroblastic- like . An imbalance between extracellular matrix degradation and synthesis results in progressive collapse and mechanical failure of the disc. An overall decrease in resident disc cell number and function and cellular responses to nutritional deficiencies leads to alterations in both the cartilaginous and proteoglycan matrix components of the disc . The loss of the pivotal water binding proteoglycan component leads to dehydration of the NP, impacting the discs ability to adequately distribute and recover from mechanical loading. As degeneration progresses neovascularisation, with concurrent neoinnervation, can occur within the degenerative AF and extend to within the NP . Endplate changes occur with thinning, calcification, and alterations in vascularity, as nutritionally deprived discs attempt to increase their nutrient supply. This creates a hostile environment that is a major challenge to maintain cell viability of both native cells or cells that are implanted in regenerative therapies. For citation purposes: Johnson TG, Von SJ, Hope WW. Clinical anatomy of the abdominal wall: hernia surgery. OA Anatomy 2014 Jan 25;2(1):3. Why is MRI not used as the routine initial test for patients with LBP? Related questions concern which patients should get MRI without radiography and the importance of the spinal stenosis and disk protrusion identified on the. 90% of patients will have improvement of symptoms within 3 months with nonoperative care. Moreover, changes within the adjacent vertebral bodies and endplates occur, including sclerosis and subchondral bone microfracture . Initial treatments include conservative therapies such as analgesics, physical therapies, and psychological pain management strategies. When these nonoperative treatments fail, surgical interventions, such as lumbar fusion or total disc arthroplasty, are commonly performed. These treatments are often successful; however they do not address the underlying cause and, despite these interventions, some patients remain with chronic pain and disability. Substantial progress has occurred in the fields of regenerative medicine, tissue engineering, and stem cell therapies, with the aim of treating and reversing disc degeneration, as well as augmenting and enhancing current treatments. Clinical trials have commenced utilising cell- based biological therapies to treat many common diseases, including those affecting the musculoskeletal system and, in particular, degenerative discopathies. Culture expanded disc chondrocytes and mesenchymal stem cells, isolated from bone marrow or other sources, are the two cell types most commonly used by researchers to biologically repair the degenerate disc. Other types of stem or progenitor cells, used in either an autologous or allogeneic fashion, have also been investigated in studies. Several small clinical trials have recently been published with another larger randomised phase- 2 trial currently underway . Significant positive and negative findings of trials published to date will be highlighted, and the relative benefits and limitations of various cell types and treatment strategies will be discussed. Animal models of disc degeneration and the applicability of these models to the human condition will also be addressed. Knowledge of what has been achieved to date, as well as the limitations of these achievements, is important to guide future trials as this exciting field of regenerative medicine translates toward the clinic. Methods. We performed a literature search using the MEDLINE online electronic database between 1. Google Scholar, and the Cochrane Database. The following keywords were queried in combination with intervertebral disc: stem cell, mesenchymal stem cell, progenitor cell, nucleus pulposus cell, disc chondrocyte, disc regeneration, and tissue engineering. The search was limited to articles published in English. Studies utilising either stem cells, progenitor cells, or intervertebral disc chondrocytes to regenerate the intervertebral disc were included in the analysis. The indexes of suitable articles were reviewed for further relevant published studies. Publications comprised of in vitro work only were excluded. Studies were then grouped into one of the following four categories for analysis: (1) studies utilising chondrocyte transplantation, obtained from intervertebral disc tissue or other cartilage sources, (2) studies utilising stem and progenitor cell transplantation, including mesenchymal stem cells (MSCs) and other cell types obtained from noncartilaginous tissues, (3) studies comparing chondrocyte and stem cell transplantation, and (4) human clinical trials utilising any form of cell- based therapy to repair degenerative discs, including chondrocytes and stem cell therapies. The flow diagram for our search is outlined in Figure 1. Figure 1: Flow diagram demonstrating the systematic analysis process. Studies Utilising Intervertebral Disc or Chondrocyte (or Chondrocyte- Like) Cell Transplantation. There were 1. 4 studies identified assessing the ability of disc derived and nondisc derived chondrocytes to regenerate IVDs, as shown in Table 1. Table 1: Studies assessing the ability of disc derived and non- disc derived chondrocytes to regenerate lumbar intervertebral discs. Animal Models Utilised. It should be noted that the amount of nuclear material removed in the nucleotomy procedure differed between studies and is listed in Table 1. Cell Types Utilised. NP cells into target discs. The remaining studies utilised AF cells, NP tissue, or whole disc. Allogeneic administration was performed in 1. NP cells were injected into the rabbit disc . Outcomes. In 1. 2/1. T2 signal on MRI. Gruber et al. No other cell related morbidity or negative outcomes were reported in any other study utilising chondrocyte transplantation. Studies Utilising Stem Cell and Progenitor Cell Transplantation. There were 2. 5 studies assessing the ability of different types of stem cells or progenitor cells to regenerate the IVD identified, as shown in Table 2. Table 2: Studies assessing the ability of different types of stem cells or progenitor cells to regenerate lumbar intervertebral discs. Animal Models Utilised. The remaining 2. 2/2. Cell Type Utilised. Bone marrow derived MSCs were the most commonly used stem cell treatment, used in 2. MSCs, 7/2. 5 used allogeneic administration, and 4/2. MSC xeno- transplantation to treat degenerate animal discs. MSCs, either autologous or xenogeneic human MSCs, whilst other cell types investigated included human embryonic stem cells (ESCs), autologous synovial derived MSCs, human olfactory neurosphere derived stem cells, and allogeneic mesenchymal precursor cells (MPCs). Puramatrix, or PFG- TGF- beta. Outcomes. The outcomes of these studies are summarized in Table 2. MRI T2 signal, following cell administration. GAG or collagen II content or measuring expression of genes known to be important for matrix restoration, such as Col. Sox- 9. 1. 2/2. 5 studies assessed the viability of cells following transplantation with varying survival times reported, ranging from 1. Several other studies, however, reported leakage or nonviability of cells following injection. Studies Comparing MSC and Chondrocyte Transplantation. Three studies directly compared the ability of MSCs and chondrocytes to regenerate IVDs . When used alone, however, both the MSCs and NPCs were equally ineffective in repairing the damaged rat disc. Table 3: Studies comparing the efficacy of MSCs and chondrocytes to regenerate lumbar intervertebral discs. These allogeneic MSCs were found not to be viable at 3 months and there was no evidence of proteoglycan production in their model. Clinical Trials Utilising Cell Based Disc Therapies. Four published clinical studies utilising cell- based therapies to treat human lumbar disc degeneration were identified . Three of these studies reported favourable results. The Euro. 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