Global decarbonization potential of CO2 mineralization in concrete materials.

CO2 mineralization products are often heralded as having outstanding potentials to reduce CO2-eq. emissions. However, these claims are generally undermined by incomplete consideration of the life cycle climate change impacts, material properties, supply and demand constraints, and economic viability of CO2 mineralization products. We investigate these factors in detail for ten concrete-related CO2 mineralization products to quantify their individual and global CO2-eq. emissions reduction potentials. Our results show that in 2020, 3.9 Gt of carbonatable solid materials were generated globally, with the dominant material being end-of-life cement paste in concrete and mortar (1.4 Gt y-1). All ten of the CO2 mineralization technologies investigated here reduce life cycle CO2-eq. emissions when used to substitute comparable conventional products. In 2020, the global CO2-eq. emissions reduction potential of economically competitive CO2 mineralization technologies was 0.39 Gt CO2-eq., i.e., 15% of that from cement production. This level of CO2-eq. emissions reduction is limited by the supply of end-of-life cement paste. The results also show that it is 2 to 5 times cheaper to reduce CO2-eq. emissions by producing cement from carbonated end-of-life cement paste than carbon capture and storage (CCS), demonstrating its superior decarbonization potential. On the other hand, it is currently much more expensive to reduce CO2-eq. emissions using some CO2 mineralization technologies, like carbonated normal weight aggregate production, than CCS. Technologies and policies that increase recovery of end-of-life cement paste from aged infrastructure are key to unlocking the potential of CO2 mineralization in reducing the CO2-eq. footprint of concrete materials.

Carbon-cement supercapacitors as a scalable bulk energy storage solution.

The large-scale implementation of renewable energy systems necessitates the development of energy storage solutions to effectively manage imbalances between energy supply and demand. Herein, we investigate such a scalable material solution for energy storage in supercapacitors constructed from readily available material precursors that can be locally sourced from virtually anywhere on the planet, namely cement, water, and carbon black. We characterize our carbon-cement electrodes by combining correlative EDS-Raman spectroscopy with capacitance measurements derived from cyclic voltammetry and galvanostatic charge-discharge experiments using integer and fractional derivatives to correct for rate and current intensity effects. Texture analysis reveals that the hydration reactions of cement in the presence of carbon generate a fractal-like electron-conducting carbon network that permeates the load-bearing cement-based matrix. The energy storage capacity of this space-filling carbon black network of the high specific surface area accessible to charge storage is shown to be an intensive quantity, whereas the high-rate capability of the carbon-cement electrodes exhibits self-similarity due to the hydration porosity available for charge transport. This intensive and self-similar nature of energy storage and rate capability represents an opportunity for mass scaling from electrode to structural scales. The availability, versatility, and scalability of these carbon-cement supercapacitors opens a horizon for the design of multifunctional structures that leverage high energy storage capacity, high-rate charge/discharge capabilities, and structural strength for sustainable residential and industrial applications ranging from energy autarkic shelters and self-charging roads for electric vehicles, to intermittent energy storage for wind turbines and tidal power stations.

Carbon-negative cement manufacturing from seawater-derived magnesium feedstocks.

This study describes and demonstrates key steps in a carbon-negative process for manufacturing cement from widely abundant seawater-derived magnesium (Mg) feedstocks. In contrast to conventional Portland cement, which starts with carbon-containing limestone as the source material, the proposed process uses membrane-free electrolyzers to facilitate the conversion of carbon-free magnesium ions (Mg2+) in seawater into magnesium hydroxide [Mg(OH)2] precursors for the production of Mg-based cement. After a low-temperature carbonation curing step converts Mg(OH)2 into magnesium carbonates through reaction with carbon dioxide (CO2), the resulting Mg-based binders can exhibit compressive strength comparable to that achieved by Portland cement after curing for only 2 days. Although the proposed "cement-from-seawater" process requires similar energy use per ton of cement as existing processes and is not currently suitable for use in conventional reinforced concrete, its potential to achieve a carbon-negative footprint makes it highly attractive to help decarbonize one of the most carbon-intensive industries.

Osteosarcoma cell death induced by innovative scaffolds doped with chemotherapeutics.

Osteosarcoma (OS) cancer treatments include systemic chemotherapy and surgical resection. In the last years, novel treatment approaches have been proposed, which employ a drug-delivery system to prevent offside effects and improves treatment efficacy. Locally delivering anticancer compounds improves on high local concentrations with more efficient tumour-killing effect, reduced drugs resistance and confined systemic effects. Here, the synthesis of injectable strontium-doped calcium phosphate (SrCPC) scaffold was proposed as drug delivery system to combine bone tissue regeneration and anticancer treatment by controlled release of methotrexate (MTX) and doxorubicin (DOX), coded as SrCPC-MTX and SrCPC-DOX, respectively. The drug-loaded cements were tested in an in vitro model of human OS cell line SAOS-2, engineered OS cell line (SAOS-2-eGFP) and U2-OS. The ability of doped scaffolds to induce OS cell death and apoptosis was assessed analysing cell proliferation and Caspase-3/7 activities, respectively. To determine if OS cells grown on doped-scaffolds change their migratory ability and invasiveness, a wound-healing assay was performed. In addition, the osteogenic potential of SrCPC material was evaluated using human adipose derived-mesenchymal stem cells. Osteogenic markers such as (i) the mineral matrix deposition was analysed by alizarin red staining; (ii) the osteocalcin (OCN) protein expression was investigated by enzyme-linked immunosorbent assay test, and (iii) the osteogenic process was studied by real-time polymerase chain reaction array. The delivery system induced cell-killing cytotoxic effects and apoptosis in OS cell lines up to Day 7. SrCPC demonstrates a good cytocompatibility and it induced upregulation of osteogenic genes involved in the skeletal development pathway, together with OCN protein expression and mineral matrix deposition. The proposed approach, based on the local, sustained release of anticancer drugs from nanostructured biomimetic drug-loaded cements is promising for future therapies aiming to combine bone regeneration and anticancer local therapy.

Applications of clinker microscopy for approaching a special case study in cement production.

Within this article the importance of the optical light microscopy for the investigation of cement clinker is illustrated by three examples: (a) Ono's method plays an important role in the case of the production of oil well clinker where the reactivity of alite and additionally the melting phase influences strongly the properties of the later cement; (b) the use of secondary fuels can lead to unexpected phenomena in the clinker matrix accompanied by strange changes in colour; (c) for the interpretation of CSA clinkers, the combination of light and scanning electron microscopy can give important information about the formation of clinker phases depending on the burning conditions which can hardly be detected by other methods. However, in case of CSA clinker, there is still little knowledge about the relationship between production and hydraulic properties of the clinker and therefore no systematic documentation is available.

Application of various microscopy techniques to study early-age and longer-term behaviour of super sulphated cement microstructure.

Super sulphated cement (SSC) is a very promising substitute for traditional construction materials (i.e. Portland cement), due to its enhanced durability and particularly low environmental impact. This paper explores the microstructure and certain properties of SSC, focusing on the particular complexities of its microstructure and the difficulties of microanalysis of its hydrates. To do so, SSC paste samples were first cast to identify hydration products using X-ray diffraction, then observed at early age using confocal laser scanning microscopy (CLSM) and at early and late age using scanning electron microscopy. In addition, concrete cores impregnated with fluorescein in order to highlight porosity, cracking and aggregates debonding were observed under UV light using optical microscopy (OM), showing a complete absence of cracking and aggregate debonding. Both microscopy techniques (CLSM and UV light OM) have been applied to this type of binder for the first time. The results show that SSC microstructure is characterised by a sophisticated intergrowth of various phases, including ettringite and amorphous calcium-(alumina)-silicate hydrate gels. Finally, Monte-Carlo simulation of electron-matter has been provided for a better understanding of EDS analysis.

Cements and concretes materials characterisation using machine-learning-based reconstruction and 3D quantitative mineralogy via X-ray microscopy.

3D imaging via X-ray microscopy (XRM), a form of tomography, is revolutionising materials characterisation. Nondestructive imaging to classify grains, particles, interfaces and pores at various scales is imperative for our understanding of the composition, structure, and failure of building materials. Various workflows now exist to maximise data collection and to push the boundaries of what has been achieved before, either from singular instruments, software or combinations through multimodal correlative microscopy. An evolving area on interest is the XRM data acquisition and data processing workflow; of particular importance is the improvement of the data acquisition process of samples that are challenging to image, usually because of their size, density (atomic number) and/or the resolution they need to be imaged at. Modern advances include deep/machine learning and AI resolutions for this problem, which address artefact detection during data reconstruction, provide advanced denoising, improved quantification of features, upscaling of data/images, and increased throughput, with the goal to enhance segmentation and visualisation during postprocessing leading to better characterisation of samples. Here, we apply three AI and machine-learning-based reconstruction approaches to cements and concretes to assist with image improvement, faster throughput of samples, upscaling of data, and quantitative phase identification in 3D. We show that by applying advanced machine learning reconstruction approaches, it is possible to (i) vastly improve the scan quality and increase throughput of 'thick' cores of cements/concretes through enhanced contrast and denoising using DeepRecon Pro, (ii) upscale data to larger fields of view using DeepScout and (iii) use quantitative automated mineralogy to spatially characterise and quantify the mineralogical/phase components in 3D using Mineralogic 3D. These approaches significantly improve the quality of collected XRM data, resolve features not previously accessible, and streamline scanning and reconstruction processes for greater throughput.

New equation for estimation of dental age by tooth cementum thickness in adolescents and adults: forensic aspects.

OBJECTIVE: Our research was aimed to establish the equation and to determine its precision for dental age estimation in adolescents, adults and the elderly based on the thickness of deposited dental cement. DESIGN: The study sample consisted of 206 donor teeth of both sexes (10 to 82 years of age). The roots were transversely cut (6 cuts) on an ISOMET 1000 cutter at apical, middle, and cervical parts (slice thickness 0.3 to 0.5 µm). Measurements of cement thickness on incisions were made with a light microscope and an Olympus EP50 camera with previous microscope calibration for each measurement episode. Measurements were carried out clockwise at 4 measuring points on each incision. Statistical analyses were conducted using statistical software packages STATISTICA version 12.0 StatSoft, Inc. 2013, and MedCalc® version 22.0. RESULTS: Mean cement thickness (MCT) significantly declined from apical to cervical cuts (P < 0.001, ANOVA) and was thicker in teeth with a destroyed tooth crown (P < 0.001, ANOVA) and in molars compared to incisors (P < 0.001, ANOVA). MCT was greater in men and in teeth with more than one root but without reaching statistical significance. MCT showed a significant increase from the second decade of chronological age with a peek at sixth decade and declined to the ninth decade (P < 0.001, ANOVA). Piecewise linear regression defined a breakpoint age of 53 years, so two different equations were calculated (≤ 53 years and > 53 years). CONCLUSIONS: The resulting equation is recommended for estimating dental age in forensic analyses.

Mining threats in high-level biodiversity conservation policies.

Amid a global infrastructure boom, there is increasing recognition of the ecological impacts of the extraction and consumption of construction minerals, mainly processed as concrete, including significant and expanding threats to global biodiversity. We investigated how high-level national and international biodiversity conservation policies address mining threats, with a special focus on construction minerals. We conducted a review and quantified the degree to which threats from mining these minerals are addressed in biodiversity goals and targets under the 2011-2020 and post-2020 biodiversity strategies, national biodiversity strategies and action plans, and the assessments of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services. Mining appeared rarely in national targets but more frequently in national strategies. Yet, in most countries, it was superficially addressed. Coverage of aggregates mining was greater than coverage of limestone mining. We outline 8 key components, tailored for a wide range of actors, to effectively mainstream biodiversity conservation into the extractive, infrastructure, and construction sectors. Actions include improving reporting and monitoring systems, enhancing the evidence base around mining impacts on biodiversity, and modifying the behavior of financial agents and businesses. Implementing these measures could pave the way for a more sustainable approach to construction mineral use and safeguard biodiversity.

Amenazas de la minería a las políticas de alto nivel para la conservación de la biodiversidad Resumen Enmedio del auge global del desarrollo de infraestructura, hay un mayor reconocimiento de los impactos ecológicos de la extracción y consumo de materiales para construcción, procesados predominantemente como concreto. Estos materiales representan amenazas significativas y en expansión para la biodiversidad global. Investigamos cómo son abordadas las amenazas de la minería por las políticas nacionales e internacionales de alto nivel para la conservación de la biodiversidad, con enfoque especial en los minerales para construcción. Realizamos una revisión exhaustiva y cuantificamos el grado en el cual son abordadas las amenazas de la extracción de estos minerales en los objetivos y metas para la biodiversidad bajo estrategias 2011­2020 y post 2020, las estrategias y planes de acción nacionales para la biodiversidad, y las evaluaciones de la Plataforma Intergubernamental Científico­normativa sobre Diversidad Biológica y Servicios de los Ecosistemas. La minería raramente apareció en los objetivos nacionales, pero fue más frecuente en las estrategias nacionales. Sin embargo, fue abordada superficialmente en la mayoría de los países. La cobertura de minería de agregados fue mayor que la cobertura de la minería de caliza. Describimos ocho componentes clave, adaptados para una amplia gama de actores, para incorporar eficazmente la conservación de la biodiversidad en los sectores extractivo, desarrollo de infraestructura y construcción. Las acciones incluyen la mejora de los sistemas de informes y monitoreo, el reforzamiento de la base de evidencias en torno a los impactos de la minería sobre la biodiversidad y la modificación del comportamiento de los agentes financieros y comerciales. La implementación de estas medidas podría allanar el camino para un enfoque más sostenible en el uso de minerales para la construcción y la salvaguarda de la biodiversidad.

Bio-inspired synthesis of silver nanoparticles usingSalsola imbricataand its application as antibacterial additive in glass ionomer cement.

Nanotechnology has gained immense popularity and observed rapid development due to the remarkable physio-chemical properties of nanoparticles (NPs) and related nanomaterials. The green production of NPs has many benefits over traditional techniques because the current procedures are expensive, time-consuming, and involve harmful substances that limit their applicability. This study aimed to use a novel green source, theSalsola imbricata(SI) plant, which is commonly found in Central Asia and known for its medicinal properties as a reducing and stabilizing agent for the synthesis of AgNPs. The current study also utilized efficient statistical design, the Plackett-Burman Design (PBD) of Experiment method to synthesize the NPs. The characterization of NPs was carried out using UV-Vis spectroscopy, Fourier transform infrared spectroscopy, and scanning electron microscopy (SEM). The PBD results showed that only two out of four factorsi.e.AgNO3concentration and incubation time, were significant for the synthesis of SI-AgNPs. While remaining factors, incubation temperature and plant extract: AgNO3ratio were non-significant. The SEM analysis result showed that SI-AgNPs had a size of 20-50 nm. The SI-AgNPs demonstrated strong antibacterial activity against oral pathogens such asS. mutans and Lactobacillus acidophilus, with the highest efficacy observed at a concentration of 2 mg ml-1. The addition of SI-AgNPs in glass ionomer cement significantly increased the antibacterial activity of GIC againstS. mutans. Based on the results of the current study, the plant based AgNPs can be further evaluated in detail as alternate antimicrobial agent either alone or in combination with other antimicrobial agents for different dental applications.

Zero-Emission Cement Plants with Advanced Amine-Based CO2 Capture.

Decarbonization of the cement sector is essentially required to achieve carbon neutrality to combat climate change. Amine-based CO2 capture is a leading and practical technology to deeply remove CO2 from the cement industry, owing to its high retrofittability to existing cement plants and extensive engineering experience in industrial flue gas decarbonization. While research efforts have been made to achieve low-carbon cement with 90% CO2 removal, a net-zero-emission cement plant that will be required for a carbon neutrality society has not yet been investigated. The present study proposed an advanced amine-based CO2 capture system integrated with a cement plant to achieve net-zero CO2 emission by pushing the CO2 capture efficiency to 99.7%. Monoethanomaine (MEA) and piperazine/2-amino-2-methyl-1-propanol (PZ-AMP) amine systems, which are considered to be the first- and second-generation capture agents, respectively, were detailed investigated to deeply decarbonize the cement plant. Compared to MEA, the advanced PZ-AMP system exhibited excellent energy performance with a regeneration duty of ∼2.6 GJ/tonne CO2 at 99.7% capture, 39% lower than the MEA process. This enabled a low CO2 avoided cost of $72.0/tonne CO2, which was 18% lower than that of the MEA-based zero-emission process and even 16.2% lower than the standard 90% MEA process. Sensitivity analysis revealed that the zero-emission capture cost of the PZ-AMP system would be further reduced to below $56/tonne CO2 at a $4/GJ steam production cost, indicating its economic competitiveness among various CO2 capture technologies to achieve a zero-emission cement plant.

Enhanced Nesquehonite Formation and Stability in the Presence of Dissolved Silica.

One possible carbon dioxide sequestration strategy is via the carbonation of dissolved Mg2+ obtained through olivine ((Mg,Fe)2SiO4) dissolution. However, silica is also produced during the breakdown of olivine. This component may have a detrimental effect on the yield of Mg-carbonate as Mg2+ incorporation into complex Mg silicate phases would limit CO2 uptake by this system. Yet this potential competition is currently not considered. Here, we use crystal growth experiments at temperatures applicable for potential coastal applications to test the effect of silica on the formation of the hydrated Mg-carbonate phase nesquehonite (MgCO3·3H2O). Solution chemistry analysis coupled with phase identification demonstrates that the presence of silica in the solution can actually assist the formation of nesquehonite and increase its yield by as much as 60 times. Our findings suggest that the presence of silica changes interfacial stabilities, lowering the energetic barrier for nesquehonite nucleation. In addition, in situ attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) transformation experiments demonstrated that nesquehonite precipitating in a solution containing a high concentration of dissolved silica exhibits enhanced stability against its transformation into hydromagnesite. These findings will help to better constrain what we expect for applications of olivine during carbon remediation strategies as well as assist yields for industrial applications that use Mg-based cement as building materials to facilitate a CO2-neutral or negative footprint.

Applying machine learning random forest (RF) method in predicting the cement products with a co-processing of input materials: Optimizing the hyperparameters.

Co-processing recycled waste during cement production, i.e., using alternative materials such as secondary raw materials or secondary raw fuels, is widely practiced in developed countries. Alternative raw materials or fuels contain high concentrations of heavy metals and other hazardous chemicals, which might lead to the potential for dangerous heavy metals and hazardous chemicals to be transferred to clinker or cement products, resulting in exposure and emissions to people or the environment. Managing input materials and predicting which inputs affect the final concentration is essential to prevent potential hazards. We used the data of six heavy metals by input raw materials and input fuels of cement manufacturers in 2016-2017. The concentrations of Pb and Cu in cement were about 10-200 times and 4 to 200 times higher than other heavy metals (Cr, As, Cd, Hg), respectively. We profiled the influence of heavy metal concentration of each input material using the principal component analysis (PCA), which analyzed the leading causes of each heavy metal. The Random Forest (RF) ensemble model predicted cement heavy metal concentrations according to input materials. In the case of Cu, Cd, and Cr, the training performance showed R square values of 0.71, 0.71, and 0.92, respectively, as a result of predicting the cement heavy metal concentration according to the heavy metal concentration of each cement input material using the RF model, which is a machine learning model. The results of this study show that the RF model can be used to predict the amount and concentration of alternative raw materials and alternative fuels by controlling the concentration of heavy metals in cement through the concentration of heavy metals in the input materials.

Sulfoaluminate cement-modified loess as bioretention cell filler for nutrient removal from stormwater runoff.

In order to reduce the consumption of sand and gravel resources, the use of loess can reduce transportation costs and realize the in-situ construction of spongy in areas with rich loess resources. But the collapsibility and low permeability of loess make it unable to be directly used as the filler of bioretention cells. In this study, sulfoaluminate cement (SAC) mixed with a small amount of basalt fiber was considered to be used for loess modification, and the physicochemical properties and nutrient removal effect of SAC-modified loess as filler in bioretention cells were comprehensively evaluated. The results showed that when the SAC dosage was 15% and the basalt fiber addition was 0% (S15B0) and 0.6% (S15B6) and the curing time was 14 days, the stability and appropriate permeability can be exhibited, which can preliminarily satisfy the requirements of bioretention cell. SAC made the maximum adsorption capacity of S15B0 and S15B6 for ammonia nitrogen (NH4+-N) and phosphate higher than that of sand by 10.96%-31.51% and 45.92%-76.72%, respectively. The hydration products in SAC modified loess can fill the internal pores of loess particles and provide structural support, and ultimately reduce the accumulated pores, mesoporous pore size (20%) and surface homogeneity. Both S15B0 and S15B6 showed good removal effects of NH4+-N and COD. The TP removal efficiency was stable at 95.43%∼99.95%. Both the antecedent drying days and the submerged zone have an effect on the nitrogen removal in the bioretention cells, where a longer antecedent drying days is detrimental to the nitrogen removal, and the installation of a submerged zone improves the nitrogen removal. The basalt fiber can enhance the transformation process from nitrate-nitrogen to nitrite-nitrogen in the bioretention cell. Therefore, the modification of SAC can provide a certain idea for the in-situ use of loess as the filler of the bioretention cell.

Oil spill in an amazon blackwater environment: Biochemical and physiological responses of local fish species.

The accidental spill of petroleum asphalt cement (PAC) in São Raimundo (SR Harbor, located on the Rio Negro (Manaus, Amazonas, Brazil) was monitored through the analysis of polyciclic aromatic hydrocarbons (PAHs) in water and a set of biomarkers in fishes (exposure biomarkes: PAHs-type metabolites concentrations in bile; the activities of ethoxyresorufin-O-deethylase (EROD), glutathione-S-transferase (GST), catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) in liver. Effect biomarkers: lipid peroxidation concentration (LPO) in liver, acetylcholinesterase activity in brain, and genotoxic DNA damage in erythrocytes). Two fish species, Acarichthys heckelii and Satanoperca jurupari, were collected 10, 45, and 90 days after the PAC spill in São Raimundo. At the same time, fish were collected from the Tupé Sustainable Development Reserve (Tupé) which served as a reference area. The sampling periods were related to the rising waters of the natural flood pulse of the Rio Negro. Higher concentrations of PAHs in water were observed at 10 and 45 days and returned to the values of TP 90 days after the PAC spill, a period in which harbor waters rose about 0.2 m. Unlike the PAHs in water, biomarker responses in both fish species significantly increased following the PAC spill in SR. Hepatic ethoxyresorufin-O-deethylase (EROD), PAH-like metabolites in bile, and erythrocyte DNA damage increases, together with inhibition of acetylcholinesterase (AChE) activity in the brain were the most evident responses for both fish species. The calculated pyrolytic index showed mixed sources of PAHs (petrogenic and pyrolytic). The applied PCA-FA indicated important relationships between dissolved organic carbon (DOC) and PAHs concentrations in water, where DOC and PAHs concentrations contributed to biomarkers responses for both fish species in all collection periods.

Magnesium malate-modified calcium phosphate bone cement promotes the repair of vertebral bone defects in minipigs via regulating CGRP.

Active artificial bone substitutes are crucial in bone repair and reconstruction. Calcium phosphate bone cement (CPC) is known for its biocompatibility, degradability, and ability to fill various shaped bone defects. However, its low osteoinductive capacity limits bone regeneration applications. Effectively integrating osteoinductive magnesium ions with CPC remains a challenge. Herein, we developed magnesium malate-modified CPC (MCPC). Incorporating 5% magnesium malate significantly enhances the compressive strength of CPC to (6.18 ± 0.49) MPa, reduces setting time and improves disintegration resistance. In vitro, MCPC steadily releases magnesium ions, promoting the proliferation of MC3T3-E1 cells without causing significant apoptosis, proving its biocompatibility. Molecularly, magnesium malate prompts macrophages to release prostaglandin E2 (PGE2) and synergistically stimulates dorsal root ganglion (DRG) neurons to synthesize and release calcitonin gene-related peptide (CGRP). The CGRP released by DRG neurons enhances the expression of the key osteogenic transcription factor Runt-related transcription factor-2 (RUNX2) in MC3T3-E1 cells, promoting osteogenesis. In vivo experiments using minipig vertebral bone defect model showed MCPC significantly increases the bone volume fraction, bone density, new bone formation, and proportion of mature bone in the defect area compared to CPC. Additionally, MCPC group exhibited significantly higher levels of osteogenesis and angiogenesis markers compared to CPC group, with no inflammation or necrosis observed in the hearts, livers, or kidneys, indicating its good biocompatibility. In conclusion, MCPC participates in the repair of bone defects in the complex post-fracture microenvironment through interactions among macrophages, DRG neurons, and osteoblasts. This demonstrates its significant potential for clinical application in bone defect repair.

A systematic review and meta-analysis of antibiotic-loaded bone cement for prevention of deep surgical site infections following primary total joint replacement.

BACKGROUND: The use of antibiotic-loaded bone cement (ALBC) as a mean for preventing deep surgical site infections (SSI) after total joint replacement is controversial. Therefore, we have conducted a meta-analysis to evaluate the prophylactic effect of ALBC for SSI prevention in patients undergoing arthroplasty. This study was conducted to revise treatment guidelines for MRSA infections in Japan. METHODS: PubMed (Medline), Scopus, Embase, Web of Science and Cochrane library were searched for relevant articles comparing preventive effect of ALBC for patients undergoing primary total joint arthroplasty by August 2022. Primary outcome was the incidence of deep SSI. Subgroup analyses by type of surgery (total hip (THA) or knee (TKA) arthroplasty) and by causative pathogen (methicillin-resistant Staphylococcus aureus (MRSA)) were performed. RESULTS: Of the 3379 studies identified for screening, six studies involving 5745 patients were included. The use of ALBC significantly reduced the incidence of deep SSI in overall patients (risk ratio [RR] 0.60, 95% confidential interval [CI] 0.39-0.92), but the evidence level was very low. There was no significant preventive effect for ALBC compared with non-ALBC in both THA and TKA (THA, RR 0.52, 95% CI 0.23-1.16; TKA, RR 0.64, 95% CI 0.38-1.06), and for preventing MRSA-SSI (RR 0.27, 95% CI 0.03-2.41). CONCLUSIONS: Although the overall preventive effect of ALBC was significant, the evidence level was very low. Thus, the routine use of ALBC as a mean to prevent SSI in arthroplasty may not be suggested.

Clinical significance of cement leakage in kyphoplasty and vertebroplasty: a systematic review.

BACKGROUND: Osteoporotic vertebral compression fractures affect a large number of elderly people and cause significant issues with pain and mobility. Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) are employed to treat those who remain symptomatic, with comparable clinical outcomes. Although PVP is faster and less expensive, concerns around cement-leakage complications make PKP perceptively safer. METHODS: By means of systematic review, we sought to ascertain whether PVP did carry a higher risk of cement-leakage and associated symptomatic complications (neural compromise, pulmonary embolism and need for emergency decompression surgery). RESULTS: Our search of 138 articles returned six studies after shortlisting and manual review: three randomised-controlled trials, and three retrospective comparative studies which met our criteria and directly compared cement-leakage rates and complications between the two treatments. 532 PVPs and 493 PKPs recorded 213 (39.3%) and 143 (28.9%) leaks, respectively (p < 0.0005). Of these, no leaks resulted in any of the aforementioned leak-related complications. No meta-analysis was performed due to heterogeneity of the data. CONCLUSIONS: We therefore concluded that whilst PVP does result in more cement leaks, this does not appear to be clinically significant. Further studies would add weight to this conclusion, and cost-effectiveness should be assessed to restore confidence in PVP. LEVEL OF EVIDENCE: Level III Evidence.

Biological performance of a bioabsorbable magnesium-magnesium phosphate cement interbody fusion cage in a porcine lumbar interbody fusion model: a feasibility study.

PURPOSE: The aim of the study was to evaluate the feasibility of a bioabsorbable cage consisting of magnesium and magnesium phosphate cement (MPC) in a porcine lumbar interbody fusion model. METHODS: Twelve male Ba-Ma mini pigs underwent lumbar discectomy and fusion with an Mg-MPC cage or a PEEK cage at the L3/L4 and L4/L5 level. Computed tomography (CT) scans were made to evaluate the distractive property by comparing average disc space height (DSH) before and at 6, 12, and 24 weeks after the operation. After the lumbar spines were harvested at 6 or 24 weeks after the operation, micro-CT examination was conducted to analyze the fusion rate, and stiffness of motion segments was investigated through mechanical tests. A histological study was performed to evaluate the tissue type, inflammation, and osteolysis in the intervertebral space. RESULTS: CT scans showed no significant difference between the two groups in average DSH at each time point. Micro-CT scans revealed an equal fusion rate in both groups (0% at 6 weeks, 83.3% at 24 weeks). Both groups showed time-dependent increases in stability, the Mg-MPC cages achieved an inferior stiffness at 6 weeks and a comparable stiffness at 24 weeks. Histologic evaluation showed the presence of newly formed bone in both groups. However, empty spaces were observed at the interface or around the Mg-MPC cages. CONCLUSION: Compared with the PEEK cages, the Mg-MPC cages achieved comparable distraction, fusion rate, and spinal stability at 24 weeks after the operation. However, due to inferior stiffness at the early stage and fast degradation, further modification of material composition and design are necessary.

Cement-augmented locked plate fixation proximal humerus fractures in elderly patient: a systematic review and meta-analysis.

BACKGROUND: This systemic review and meta-analysis aimed to evaluate the clinical outcomes of proximal humeral fracture in elderly patient fixation using locked plate with or without cement augmentation. METHODS: The databases of PubMed, Embase, and Cochrane Library were searched in August 2023 for literature comparing the clinical outcomes of patients with PHFs treated with locked plate alone and locked plate augmented with cement. Data describing study design; level of evidence; inclusion criteria; demographic information; final follow-up; revision rate; implant failure rate; avascular necrosis rate; total complication rate; constant score; and disability of arm, shoulder, and hand (DASH) score were collected. RESULTS: Eight studies (one randomized-controlled trial and seven observational studies), involving 664 patients, were identified. Compared with locked plates alone, using cement-augmented locked plates reduced the implant failure rate (odds ratio (OR) = 0.19; 95% confidence interval (CI) 0.10-0.39; P < 0.0001) and total complication rate (OR = 0.45; 95% CI 0.29-0.69; P = 0.0002) and improved DASH scores (mean difference (MD) = 2.99; 95% CI 1.00-4.98; P = 0.003). However, there was no significant difference in clinical outcomes, including revision rate, avascular necrosis rate, and constant score. CONCLUSION: In this review and meta-analysis, fixation of the PHFs in elderly patients using locked plates with or without cement augmentation has no significant difference in revision rate, but the implant failure and total complication rates may be lesser on using the cement-augmented locked plate for fixation than on using a locked plate alone. Good results are expected for most patients treated with this technique. TRIAL REGISTRATION: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)21 guidelines were followed to conduct this systematic review and meta-analysis and was registered as a protocol in PROSPERO (CRD42022318798).