ring loss. The surgery is safe but more complex and time-consuming than the Baha® Attract implantation. The preliminary audiological results as well as the overall quality of life indicate that the Osia® is a better solution than the Baha® Attract. However, future studies should be carried out to make further observations in a larger group of patients, and with longer follow-up.
  Chemonucleolysis with condoliase, which degrades chondroitin sulfate, could be a new, minimally invasive therapeutic option for patients with lumbar disc herniation (LDH). The purpose of this study was to analyze prognostic factors for clinical outcomes in LDH patients subjected to chemonucleolysis with condoliase.
 
  Inclusion criteria for this procedure were 1) 18-70 years of age; 2) unilateral leg pain and positive straight leg raise (SLR) (<70°) or femoral nerve stretching test; 3) subligamentous extrusion verified on magnetic resonance imaging; 4) neurological symptoms consistent with a compressed nerve root on magnetic resonance imaging (MRI) images; and 5) minimum six months of follow-up. In total, 82 patients (55 men, 27 women; mean age, 47.2±15.5 years; mean follow-up, 9.1±3.0 months) who underwent chemonucleolysis with condoliase for painful LDH were included. An improvement of 50% or more in the Visual analogue scale (VAS) of leg pain was classified as effective.
 
  Seventy patients (85.4%) wereto the center of the intervertebral disc.
 Chemonucleolysis with condoliase is a safe and effective treatment for painful LDH; 85.4% of the patients showed improvement after the treatment without severe adverse events. To obtain the best outcome, condoliase should be injected into the center of the intervertebral disc.
  Spine fusion is a common procedure for the treatment of severe scoliosis, a frequent and challenging deformity associated with Neurofibromatosis type 1 (NF1). Moreover, deficiencies in NF1-Ras-MEK signaling affect bone formation and resorption that in turn impacts on spine fusion outcomes.
 
  In this study we describe a new model for AdCre virus induction of Nf1 deficiency in the spines of Nf1
  mice. The virus is delivered locally to the mouse spine in a fusion procedure induced using BMP-2. Systemic adjunctive treatment with the MEK inhibitor (MEKi) PD0325901 and the bisphosphonate zoledronic acid (ZA) were next trialed in this model.
 
  AdCre delivery resulted in abundant fibrous tissue (Nf1
  +393%, P<0.001) and decreased marrow space (Nf1
  -67%, P<0.001) compared to controls. While this did not significantly impact on the bone volume of the fusion mass (Nf1
  -14%, P=0.999 n.s.), the presence of fibrous tissue was anticipated to impact on the quality of spine fusion. Multinucleated TRAP+cells were observed in the fibrous tissues seen in Nf1
  spines. In Nf1
  spines, MEKi increased bone volume (+194%, P<0.001) whereas ZA increased bone density (+10%, P<0.002) versus BMP-2 alone.  https://www.selleckchem.com/products/turi.html  Both MEKi and ZA decreased TRAP+cells in the fibrous tissue (MEKi-62%, P<0.01; ZA-43%, P=0.054). No adverse effects were seen with either MEKi or ZA treatment including weight loss or signs of illness or distress that led to premature euthanasia.
 
  These data not only support the utility of an AdCre-virus induced knockout spine model, but also support further investigation of MEKi and ZA as adjunctive therapies for improving BMP-2 induced spine fusion in the context of NF1.
 These data not only support the utility of an AdCre-virus induced knockout spine model, but also support further investigation of MEKi and ZA as adjunctive therapies for improving BMP-2 induced spine fusion in the context of NF1.
  Prescription opioids have been extensively to manage postoperative pain in children. A growing body of evidence from the adult literature, suggests however, that healthcare providers may be prescribing far more opioids than required, with some studies demonstrating equivalent post-operative pain and clinical outcomes with their omission.
 
  The objectives of this prospective study were to assess the current heterogeneity of practice in post-operative opioids prescription following day case hypospadias surgery, to establish a streamlined discharge protocol, and to reduce the use of post-operative opioid prescription by 30% within a 4 month period through the use of systemic forcing functions and education.
 
  This prospective study was approved by the Quality Improvement (QI) sub-committee of the hospital's Research and Ethics Board (REB) and was compliant with the Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) guidelines. Recruited parents (n=84) were contacted for telephone interview folid prescriptions following hypospadias surgery is possible. We managed to achieve a relative reduction 56% which is comparable to other specialties, however, did it within a quality improvement framework to ensure fidelity and no adverse balancing measures. We also managed to reduce the number of doses prescribed in those receiving opioids post-intervention at week 9.
 
  Our study demonstrates opioids can be safely omitted in hypospadias cohorts without any adverse clinical outcomes or balancing measures. We recommend that opioids be used extremely judiciously in this population in order to minimize exposure in children.
 Our study demonstrates opioids can be safely omitted in hypospadias cohorts without any adverse clinical outcomes or balancing measures. We recommend that opioids be used extremely judiciously in this population in order to minimize exposure in children.The concept of wild food does not play a significant role in contemporary nutritional science and it is seldom regarded as a salient feature within standard dietary guidelines. The knowledge systems of wild edible taxa are indeed at risk of disappearing. However, recent scholarship in ethnobotany, field biology, and philosophy demonstrated the crucial role of wild foods for food biodiversity and food security. The knowledge of how to use and consume wild foods is not only a means to deliver high-end culinary offerings, but also a way to foster alternative models of consumption. Our aim in this paper is to provide a conceptual framework for wild foods, which can account for diversified wild food ontologies. In the first section of the paper, we survey the main conception of wild foods provided in the literature, what we call the Nature View. We argue that this view falls short of capturing characteristics that are core to a sound account of wilderness in a culinary sense. In the second part of the paper, we provide the foundation for an improved model of wild food, which can countenance multiple dimensions and degrees connoting wilderness in the culinary world.