A review of computational methodologies to predict the fractional flow reserve in coronary arteries with stenosis.

Computational methodologies for predicting the fractional flow reserve (FFR) in coronary arteries with stenosis have gained significant attention due to their potential impact on healthcare outcomes. Coronary artery disease is a leading cause of mortality worldwide, prompting the need for accurate diagnostic and treatment approaches. The use of medical image-based anatomical vascular geometries in computational fluid dynamics (CFD) simulations to evaluate the hemodynamics has emerged as a promising tool in the medical field. This comprehensive review aims to explore the state-of-the-art computational methodologies focusing on the possible considerations. Key aspects include the rheology of blood, boundary conditions, fluid-structure interaction (FSI) between blood and the arterial wall, and multiscale modelling (MM) of stenosis. Through an in-depth analysis of the literature, the goal is to obtain an overview of the major achievements regarding non-invasive methods to compute FFR and to identify existing gaps and challenges that inform further advances in the field. This research has the major objective of improving the current diagnostic capabilities and enhancing patient care in the context of cardiovascular diseases.

Bone regeneration driven by a nano-hydroxyapatite/chitosan composite bioaerogel for periodontal regeneration.

The most recent progress in reconstructive therapy for the management of periodontitis and peri-implantitis bone defects has relied on the development of highly porous biodegradable bioaerogels for guided bone regeneration. The objective of this work was to evaluate in vitro the osteoinduction of periodontal-originating cells (human dental follicle mesenchymal cells, DFMSCs) promoted by a nano-hydroxyapatite/chitosan (nHAp/CS) bioaerogel, which was purified and sterilized by a sustainable technique (supercritical CO2). Moreover, the in vivo bone regeneration capacity of the nHAp/CS bioaerogel was preliminarily assessed as a proof-of-concept on a rat calvaria bone defect model. The quantification of DNA content of DFMSCs seeded upon nHAp/CS and CS scaffolds (control material) showed a significant increase from the 14th to the 21st day of culture. These results were corroborated through confocal laser scanning microscopy analysis (CLSM). Furthermore, the alkaline phosphatase (ALP) activity increased significantly on the 21st day, similarly for both materials. Moreover, the presence of nHAp promoted a significantly higher expression of osteogenic genes after 21 days when compared to CS scaffolds and control. CLSM images of 21 days of culture also showed an increased deposition of OPN over the nHAp/CS surface. The in vivo bone formation was assessed by microCT and histological analysis. The in vivo evaluation showed a significant increase in bone volume in the nHAp/CS test group when compared to CS and the empty control, as well as higher new bone formation and calcium deposition within the nHAp/CS structure. Overall, the present study showed that the nHAp/CS bioaerogel could offer a potential solution for periodontal and peri-implant bone regeneration treatments since the in vitro results demonstrated that it provided favorable conditions for DFMSC proliferation and osteogenic differentiation, while the in vivo outcomes confirmed that it promoted higher bone ingrowth.

Recommendations for the implementation of a national lung cancer screening program in Portugal-A consensus statement.

Lung cancer (LC) is a leading cause of cancer-related mortality worldwide. Lung Cancer Screening (LCS) programs that use low-dose computed tomography (LDCT) have been shown to reduce LC mortality by up to 25 % and are considered cost-effective. The European Health Union has encouraged its Member States to explore the feasibility of LCS implementation in their respective countries. The task force conducted a comprehensive literature review and engaged in extensive discussions to provide recommendations. These recommendations encompass the essential components required to initiate pilot LCS programs following the guidelines established by the World Health Organization. They were tailored to align with the specific context of the Portuguese healthcare system. The document addresses critical aspects, including the eligible population, methods for issuing invitations, radiological prerequisites, procedures for reporting results, referral processes, diagnostic strategies, program implementation, and ongoing monitoring. Furthermore, the task force emphasized that pairing LCS with evidence-based smoking cessation should be the standard of care for a high-quality screening program. This document also identifies areas for further research. These recommendations aim to guarantee that the implementation of a Portuguese LCS program ensures high-quality standards, consistency, and uniformity across centres.

Suprascapular nerve blocks with 5 mL × 10 mL in the treatment of primary adhesive capsulitis: pilot study of clinical trial.

PURPOSE: To assess whether 5 mL would not be less effective than 10 mL when performing a suprascapular nerve block, regarding shoulder function and quality of life in primary adhesive capsulitis. METHODS: This is a pilot study of a randomized, controlled, double-blind clinical trial conducted at a single center. Patients with AC characterized by constant pain and restricted movements in anterior elevation, 0°/90° external rotation, and internal rotation were selected. Two groups were randomly selected. In group I, a dose of 10 mL of bupivacaine was applied, while in group II, only 5 mL, in four weekly blocks. Sealed and sequentially numbered envelopes were used. The SF-36 and DASH questionnaires were applied in five moments. The t-Student test was used to compare the means, with a probability of rejecting null hypothesis of 5%. RESULTS: There were 17 participants with primary AC, seven in group I and 10 in group II. The average age was 54.30 and 50.43 years in the 5 mL and 10 mL groups, respectively. There were no differences when the means were compared by DASH: T0 (p = 0.074); T2 (p = 0.285); T4 (p = 0.333); T8 (p = 0.392), and T12 (p = 0.453). As for the SF-36, there were sparse differences in T2 in the domains of vitality (p = 0.006) and social aspects (p = 0.036) in favor of group I, and in the general health status domain in T8, in favor of group II (p = 0.033). CONCLUSION: The volume of 5 mL is not less effective than 10 mL when performing SSNB in the treatment of primary adhesive capsulitis.

Piezoelectric biomaterials with embedded ionic liquids for improved orthopedic interfaces through osseointegration and antibacterial dual characteristics.

Orthopedic implant failures, primarily attributed to aseptic loosening and implant site infections, pose significant challenges to patient recovery and lead to revision surgeries. Combining piezoelectric materials with ionic liquids as interfaces for orthopedic implants presents an innovative approach to addressing both issues simultaneously. In this study, films of poly(vinylidene fluoride-trifluoroethylene) (P(VDF-TrFE)) incorporated with 1-ethyl-3-methylimidazolium hydrogen sulfate ([Emim][HSO4]) ionic liquid were developed. These films exhibited strong antibacterial properties, effectively reducing biofilm formation, thereby addressing implant-related infections. Furthermore, stem cell-based differentiation assays exposed the potential of the composite materials to induce osteogenesis. Interestingly, our findings also revealed the upregulation of calcium channel expression as a result of electromechanical stimulation, pointing to a mechanistic basis for the observed biological effects. This work highlights the potential of piezoelectric materials with ionic liquids to improve the longevity and biocompatibility of orthopedic implants. Offering dual-functionality for infection prevention and bone integration, these advancements hold significant potential for advancing orthopedic implant technologies and improving patient outcomes.

Multifunctional piezoelectric surfaces enhanced with layer-by-layer coating for improved osseointegration and antibacterial performance.

Implant failure is primarily caused by poor osseointegration and bacterial colonization, which demands readmissions and revision surgeries to correct it. A novel approach involves engineering multifunctional interfaces using piezoelectric polyvinylidene fluoride (PVDF) materials, which mimic bone tissue's electroactive properties to promote bone integration and provide antibacterial functionality when mechanically stimulated. In this study, PVDF films were coated with antibacterial essential oil nanoparticles and antibiofilm enzymes using a layer-by-layer (LBL) approach to ensure antibacterial properties even without mechanical stimulation. The experimental results confirmed the LBL build-up and demonstrated notable antibiofilm properties against Pseudomonas aeruginosa and Staphylococcus aureus while enhancing pre-osteoblast cell proliferation under mechanical dynamic conditions in a bioreactor that replicated the real-life environment of implants within the body. The findings highlight the potential of PVDF-coated surfaces to prevent biofilm formation and boost cell proliferation through the piezoelectric effect, paving the way for advanced implantable devices with improved osseointegration and antibacterial performance.

Review: Update of nutritional requirements of goats for growth and pregnancy in hot environments.

Goats play an important role in the agricultural business, providing valuable income sources through producing high-quality animal protein. They are widespread livestock for rural households due to their inherent resiliency, adaptability to many environments, and suitability in sustainable production systems. While goats are reared in highly diverse environments, a great portion of their population is reared in hot environments. Heat stress is known to affect goats' productive and reproductive performance negatively. However, goats can remarkably thrive in harsh conditions due to physiological, metabolic, and molecular adaptive mechanisms. In the face of it, in the last decades, the nutrition of goats, particularly their nutritional requirements, has received special attention. Research groups worldwide have dedicated their efforts to updating feeding systems for goats. Our objective was to present the recent findings on the energy and nutrient requirements of growing and pregnant goats in hot environments. Energy and protein requirements for the maintenance and growth of goats are influenced by sex and genotype only when mature weight is not considered in the models. Sex and genotype affect the efficiency of energy use for growth but do not affect the efficiency of protein use. Major mineral requirements for maintenance and growth are not affected by sex, except for magnesium. However, the phosphorus, sodium, and potassium requirements of goats raised in hot environments differ from those in the feeding systems. This difference may be related to the adaptation mechanisms goats employ to cope with the hot environmental conditions. Regarding requirements for pregnancy, there was no effect of days of pregnancy on the energy or protein requirements. The efficiency of metabolizable energy utilization for pregnancy increased with the progress of pregnancy. Mineral accretion for pregnancy differs between single and twin pregnancies and, irrespective of pregnancy type, the mineral requirements increase as pregnancy progresses. The differences between the estimated dietary requirements of goats raised in hot environments and the most widely adopted feeding systems suggest that these goats may be using energy and nutrients to cope with heat stress and other stressors associated with hot environments. The recent findings on energy, protein, and mineral requirements of growing and pregnant goats can be an important resource of information for enhancing feeding systems worldwide.

Drawing improves memory in patients with hippocampal damage.

The hippocampus plays a critical role in the formation of declarative memories, and hippocampal damage leads to significant impairments in new memory formation. Drawing can serve as a form of multi-modal encoding that improves declarative memory performance relative to other multimodal encoding strategies such as writing. We examined whether, and to what extent, patients with hippocampal damage could benefit from the mnemonic strategy of drawing. Three patients with focal hippocampal damage, and one patient with both hippocampal and cortical lesions, in addition to 22 age-, sex-, and education-matched controls, were shown a list of words one at a time during encoding and instructed to either draw a picture or repeatedly write each word for 40 s. Following a brief filled delay, free recall and recognition memory for words from both encoding trial types were assessed. Controls showed enhanced recall and recognition memory for words drawn versus those that were written, an effect that was even more pronounced in patients with focal hippocampal damage. By contrast, the patient with both hippocampal and cortical lesions showed no drawing-mediated boost in either recall or recognition memory. These findings demonstrate that drawing is an effective encoding strategy, likely accruing from the engagement of extra-hippocampal processes including the integration of cortical-based motor, visual, and semantic processing, enabling more elaborative encoding.

Comet assay to evaluate chromosomal changes in chickens (Gallus gallus domesticus) contaminated by lead in a city in Bahia.

Chicken (Gallus gallus domesticus) is one of the primary sources of animal protein for the Brazilian population. Thus, the safety of this food is highly relevant. This study was based on the evidence of severe contamination of these animals by metals such as lead in Santo Amaro, Bahia. This exploratory study aimed to evaluate associations between lead levels in blood of chicken exposed to a contaminated area with the occurrence of chromosomal alterations, evidencing genotoxic effects. Serum lead analysis was performed by GF-AAS after dilution with a matrix modifier solution (Triton X-100 0.2% v/v and HNO3 0.1% v/v), while chromosomal damage was evaluated using the comet assay. The results showed genotoxic effects (positive comet assay) only for the specimen sample with higher serum lead concentrations (33.9 µg dL-1), suggesting the occurrence of toxic effects at this level of exposure. This work evaluated a relationship between the reduction of serum lead levels in chicken and increased distance from the primary polluting source - a lead processing plant (COBRAC). It also showed that lead is bioavailable in this territory, contaminating chicken and causing genotoxic effects in these animals, further expanding the concern with the local biota and the health of the residents of Santo Amaro.

Effects of previous infestation with Bemisia tabaci MEAM1 on the resistance to Chrysodeixis includens in Bt and non-Bt soybean plants.

Transgenic Bt soybean plants have been developed to control insect pests, such as Anticarsia gemmatalis and Chrysodeixis includens. This objective has been achieved successfully; however, recently, some authors claimed that Bt soybean plants have been more susceptible than non-Bt soybean to Bemisia tabaci MEAM1. In addition, it is unknown whether Bt soybean plants infested by B. tabaci become less resistant to target pests. Therefore, this study aimed to evaluate: (i) whether the previous infestation with B. tabaci can compromise Bt and non-Bt soybean resistance to C. includens; (ii) the effects of B. tabaci infestations on Bt and non-Bt soybean plant growth; and (iii) whether B. tabaci feeding reduces contents of chlorophyll and carotenoids of soybean plants. Bt and non-Bt soybean plants pre-infested with B. tabaci showed no changes in resistance to C. includens. Bt soybean plants infested with B. tabaci showed a lower plant height than uninfested plants. Differently, non-Bt soybean plants exhibited no reduction in plant growth due to B. tabaci feeding. Bt soybean plants suffered a reduction in dry matter only under double infestation (B. tabaci and C. includens), while non-Bt soybean plants experienced reduction in dry matter when infested with B. tabaci and C. includens or by C. includens only. B. tabaci feeding did not alter contents of chlorophyll and carotenoids, and perhaps the reduction in plant growth was related to salivary toxins. Concluding, both Bt and non-Bt soybean plants were susceptible to B. tabaci feeding, evidencing necessity of developing soybean cultivars resistant to B. tabaci.

Early detection of interstitial lung disease in rheumatic diseases: A joint statement from the Portuguese Pulmonology Society, the Portuguese Rheumatology Society, and the Portuguese Radiology and Nuclear Medicine Society.

INTRODUCTION: Interstitial lung disease (ILD) contributes significantly to morbidity and mortality in connective tissue disease (CTD). Early detection and accurate diagnosis are essential for informing treatment decisions and prognosis in this setting. Clear guidance on CTD-ILD screening, however, is lacking. OBJECTIVE: To establish recommendations for CTD-ILD screening based on the current evidence. METHOD: Following an extensive literature research and evaluation of articles selected for their recency and relevance to the characterization, screening, and management of CTD-ILD, an expert panel formed by six pulmonologists from the Portuguese Society of Pulmonology, six rheumatologists from the Portuguese Society of Rheumatology, and six radiologists from the Portuguese Society of Radiology and Nuclear Medicine participated in a multidisciplinary discussion to produce a joint statement on screening recommendations for ILD in CTD. RESULTS: The expert panel achieved consensus on when and how to screen for ILD in patients with systemic sclerosis, rheumatoid arthritis, mixed connective tissue disease, Sjögren syndrome, idiopathic inflammatory myopathies and systemic lupus erythematous. CONCLUSIONS: Despite the lack of data on screening for CTD-ILD, an expert panel of pulmonologists, rheumatologists and radiologists agreed on a series of screening recommendations to support decision-making and enable early diagnosis of ILD to ultimately improve outcomes and prognosis in patients with CTD.

Seagrass soils sequester up to half the metal emissions of one of the world's largest smelters.

One of the world's largest smelters has been operating in South Australia since 1889, affecting environment and human health. Here we quantified the magnitude of Pb, Zn and Cd emissions from the smelter sequestered in the soil of an adjacent 110 km2Posidonia australis seagrass meadows. Seagrass core records show that the smelter contaminated the entire area with decreasing sequestration with increasing distance from contamination points. The soil accumulated ~1300 t of Pb, ~3450 t of Zn, and ~ 90 t of Cd since 1889, and sequestered the equivalent of ~20 % of Pb, and ~50 % of Zn and Cd cumulative smelter emissions since 1999, showing that seagrass can be significant, long-term sinks of metal pollution in highly contaminated environments. Conservation efforts should prioritize these seagrass meadows to avoid the potential release of pollutants from their soils following habitat loss, which could turn seagrasses from a sink to a source of pollution.

Settleable atmospheric particulate matter affects the swimming performance and aerobic metabolic rate of Nile tilapia (Oreochromis niloticus).

Atmospheric particulate matter (APM) produced by the steel industry comprises a complex mixture of particles that includes a wide variety of metals and metallic nanoparticles. These particles settle out onto areas surrounding the industries. There is evidence that this 'settleable' APM (SePM) may cause air-to-water cross-contamination with significant effects on aquatic biota. Recent investigations have reported sublethal impacts on the gill structure and blood oxygen-carrying capacity of fishes, which raises the hypothesis that there will be consequences for gas exchange capacity and ability to support aerobic activities. Therefore, we investigated the effects of an environmentally relevant level of SePM contamination on swimming performance and associated aerobic metabolic rates in Nile tilapia, Oreochromis niloticus. Short-term exposure (96 h) to SePM reduced critical swimming speed, energetic efficiency of aerobic swimming, standard metabolic rate, maximum metabolic rate, and aerobic scope. The compromised swimming performance could have adverse ecological effects by limiting foraging ability, predator evasion, territorial protection, and migration. The impairments to aerobic capacity could also affect overall fish performance by influencing long-term energy balance and allocation to growth and reproduction. Thus, despite being sublethal, SePM contamination is considerably debilitating, and if its limiting effects are not compensated for in the longer term, this may reduce the survival and fitness of fish populations.

Using deep learning for pruning region detection and plant organ segmentation in dormant spur-pruned grapevines.

Even though mechanization has dramatically decreased labor requirements, vineyard management costs are still affected by selective operations such as winter pruning. Robotic solutions are becoming more common in agriculture, however, few studies have focused on grapevines. This work aims at fine-tuning and testing two different deep neural networks for: (i) detecting pruning regions (PRs), and (ii) performing organ segmentation of spur-pruned dormant grapevines. The Faster R-CNN network was fine-tuned using 1215 RGB images collected in different vineyards and annotated through bounding boxes. The network was tested on 232 RGB images, PRs were categorized by wood type (W), orientation (Or) and visibility (V), and performance metrics were calculated. PR detection was dramatically affected by visibility. Highest detection was associated with visible intermediate complex spurs in Merlot (0.97), while most represented coplanar simple spurs allowed a 74% detection rate. The Mask R-CNN network was trained for grapevine organs (GOs) segmentation by using 119 RGB images annotated by distinguishing 5 classes (cordon, arm, spur, cane and node). The network was tested on 60 RGB images of light pruned (LP), shoot-thinned (ST) and unthinned control (C) grapevines. Nodes were the best segmented GOs (0.88) and general recall was higher for ST (0.85) compared to C (0.80) confirming the role of canopy management in improving performances of hi-tech solutions based on artificial intelligence. The two fine-tuned and tested networks are part of a larger control framework that is under development for autonomous winter pruning of grapevines. Supplementary Information: The online version contains supplementary material available at 10.1007/s11119-023-10006-y.

Analysis of adrenaline autoinjectors acquisition in Portugal over 15 years.

Summary: Background. The adrenaline autoinjector (AAi) is universally recommended as the first-line treatment for anaphylactic reactions occurring outside the medical setting. The quantification of its acquisition may help estimate the prevalence of patients at risk of anaphylaxis with an indication for AAi. Objective. Evaluation of the global and regional frequency of AAi purchases in Mainland Portugal between 2003-2017 and calculate the inherent costs in 2017. Methods. AAi acquisition distribution analysis along this period. The population was divided in two age groups according to the adrenaline dosage. Results. A total of 10,993 AAi units of 0.15mg/0.3mL and 28,619 of 0.3mg/0.3mL were acquired in these 15 years, with an annual average of 733 and 1908 units, respectively. In cumulative values terms, Lisbon showed the highest number of AAI acquired and higher prevalence per region/100,000 inhabitants in both groups. In 2017, the annual cost for each age group was 64,202.71 € 187,447.70 € for patients and € 37,706.35 / 110,113.30 € for the National Health System. Conclusions. In the last 15 years, there was a progressive increase in AAi acquisition. We estimate a rate of anaphylaxis occurrence in Portugal according to AAi aquisition of 0.165%.

Eco-friendly fabricated multibioactive Ca(II)-antibiotic coordination framework coating on zinc towards improved bone tissue regeneration.

Zinc is a biodegradable candidate material for bone regeneration; however, concomitant implant-related infection and rejection require new solutions to raise the biomedical potential of zinc. Functionalization towards localized drug administration with bioactive frameworks can be a solution. It is herein reported for the first time an eco-friendly approach for coating zinc with multibioactive antibiotic coordination frameworks (ACF). ACF1, a new 1D framework with deprotonated nalidixic and salicylic acids, obtained by mechanochemistry, results from the coordination of Ca(II) centers to the organic acids anions. To maximize ACF1 loading and cells' adhesion, the surface area was increased by creating a porous 3D Zn layer. A coverage of ∼70% of the surface with ACF1, achieved by electrophoretic deposition in an aqueous solution, preserved the desired Zn degradation as |Z| in the order of 103 Ω.cm2 is attained for both bare and coated samples in physiological conditions. The bioactivities of the ACF1 powder are a strong antibacterial activity against Escherichia coli (MIC of 1.95 µg/mL) and weaker against Staphylococcus aureus (MIC of 250 µg/mL), while osteoblasts' cytocompatibility is achieved for concentration ranging between 10 and 100 µg/mL. In its coating form, the degradation of Zn coated with ACF1 results in nalidixic acid release, which may convey antibacterial activity to the implant. The osteoinduction observe over this new biomaterial relates to the precipitation of an apatite layer built from the Ca(II) of ACF1. The work described herein, where unexplored eco-friendly approaches were used, presents a new trend for the design of multibioactive coatings on bioresorbable metallic materials.

Determinants associated with uncontrolled asthma in Portugal: A national population-based study.

INTRODUCTION AND OBJECTIVES: Asthma is a chronic and heterogeneous disease that affects people of all ages and has a high estimated increase in prevalence worldwide. Asthma control represents a main goal in the disease management. International studies revealed low levels of disease control resulting in a significant burden for healthcare systems, not only in terms of quality of life, but also in terms of health costs. Modifiable and non-modifiable factors have been identified as relating to poor asthma control level. In this study we evaluated the distribution of asthma control levels in Portuguese adult population and examine the determinants associated with uncontrolled asthma. MATERIALS AND METHODS: Using a similar methodology to the one employed in the Asthma Insights and Reality in Europe (AIRE) survey, 327 active asthmatic patients were identified by random phone number and completed a questionnaire during 2011 to 2012. Asthma control was assessed by the evaluation of GINA based symptom control, by Asthma Control Test.äó (ACT) and by self-perception of control. To examine the relationship between uncontrolled asthma and its determinants, univariate logistic regression analysis, sequential multivariable regression and population attributable risk percentage were determinate. RESULTS: 35.2% active asthmatic patients had uncontrolled asthma, 64.8% partially controlled and none of the individuals had total control of asthma assessed by ACT test. Factors significantly associated with poor asthma control scores were: age (OR 1.02 per year of age; 95% CI: 1.01.Çô1.03), female sex (OR 1.87; 95% CI: 1.15.Çô3.04), educational level (OR 0.5; 95% CI: 0.28.Çô0.89 at high school level or over), occupation (OR 4.92; 95% CI: 2.12.Çô11.42 if looking for a first job or unemployed) (OR 2.51; 95% CI: 1.35.Çô4.65 if being retired), income (OR 0.23; 95% CI: 0.07.Çô0.72 if >619 euros), BMI (OR 1.09 per BMI unit; 95% CI: 1.03.Çô1.14), having rhinitis symptoms (OR 4.40; 95% CI: 2.56.Çô7.58) and using inhaled corticosteroids (OR 0.44; 95%CI: 0.24.Çô0.82 if used in the past or never used). Looking for a first job or being unemployed, BMI and having rhinitis symptoms remained significant after multivariate adjustments. CONCLUSIONS: Uncontrolled asthma was associated with several determinants. Their identification can contribute to improve asthma care both from clinical and from public health perspectives.

Peripheral nerve regeneration in rats using nerve graft in a vein conduit pre-filled with platelet-rich fibrin (PRF).

Treatment of peripheral nerve injury is not always satisfactory. To improve results, specific adjuvant methods have been used, such as platelet-rich fibrin (PRF) and vein conduits. The goal of this study was to assess whether use of PRF and vein conduits after nerve suture improves nerve regeneration as measured by a functional score and histomorphometry analysis. Ten isogenic spontaneously hypertensive rats were randomly assigned to 4 experimental procedures: 1) Sham group (n = 10); 2) Nerve graft (NG) group (n = 10); 3) Nerve graft covered with a vein conduit (NGVC) (n = 10); and 4) Nerve graft covered with a vein conduit pre-filled with PRF (NGVCP) (n = 10). Nerve repair results were evaluated on: sciatic functional index (SFI) at 0, 30, 60 and 90 days; morphometric and morphologic analysis of the distal nerve; and histological analysis of Fluoro-Gold® stained motor neurons in the anterior horn of the spinal cord. Compared to the Sham control group, the NGVC and NGVCP groups exhibited lower SFI on all measures. The NGVC group showed improvement in SFI at day 90, which was significant compared to the NG group. Fiber and axon diameters were comparable in the NGVC and NGVCP groups, which were both significantly lower than in the Sham and NG groups. Significant improvement was expected with PRF, but in fact the release of factors from this substance was not as effective as hoped.