Search

Purpose: To investigate the medium-term survival of Dalbo-Rotex retention elements, identify potential risk factors for complication or loss, and consider economic factors. Materials and Methods: Patients treated with Dalbo-Rotex retention elements in a university setting were retrospectively identified and examined. Clinical data comprised assessments of the dental, periodontal, endodontic, and prosthetic situation, including radiographic analysis. Patient satisfaction was quantified with visual analog scale questionnaires. Five-year Kaplan-Meier plots for relative survival and success rates were calculated. Results: The 45 included patients had a total of 76 Dalbo-Rotex retention elements. Of these, 12 Dalbo-Rotex elements failed and complications occurred in 42.1% of elements, equating to a survival rate of 84.2% and a success rate of 47.4% after a mean observation period of 49.2 ± 52.4 months (range: 6 to 219 months). The 5-year cumulative survival and success rates were 62.4% (95% CI: 44.0% to 88.4%) and 35.6% (95% CI: 23.8% to 53.2%), respectively. Patients' self-assessment of prosthesis retention was rated at 82 (IQR 40 to 92.2) with low pain perception at 4.5 (IQR 0 to 30). Probing pocket depth levels were significantly reduced in patients adhering to a regular recall interval compared with those with longer intervals. Conclusions: Chairside Dalbo-Rotex retention elements are a straightforward chairside method for prosthesis retention that achieve good survival over medium-term follow-ups with high patient satisfaction. This technique is therefore a viable alternative to cast post copings and can be particularly valuable for patients with limited financial resources. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate clasp-retained removable partial dentures (C-RPDs) with a metal framework for survival, maintenance requirements, and biologic implications. Method and materials: C-RPDs were retrospectively analyzed based on patient records. Treatment failure was defined as fracture of a framework component (metal base or connector) or loss of an abutment tooth. Other outcome variables included factors that might conceivably impact C-RPD survival (maxilla vs mandible, Kennedy classes, opposing dentitions, treatment by students vs certified dental practitioners), mobility and caries of abutment teeth (in relation to clasp designs), and maintenance requirements (relining, clasp or resin fractures). Differences were evaluated by appropriate statistical tests at the P≤.05 level. Results: A total of 612 patients (339 men, 273 women) 60.0±11.5years old at delivery were included, covering 842 C-RPDs and a mean observation period of 42.1±33.2months. Kaplan-Meier C-RPD survival was 76.2% after 5years and 49.5% after 10years. Biologic complications (ie, loss of abutment teeth) accounted for the vast majority (95.6%) of C-RPD failures, and Kaplan-Meier C-RPD survival was significantly better in the mandible (P=.015). Some clasp designs contributed significantly to caries and removal of abutment teeth (both P<.05). No other significant differences were noted. Conclusion: Tooth loss both emerges as the main cause of C-RPD failure and might be amenable to careful selection of clasp designs. Overall, better C-RPD survival should be expected in the mandible. A noncon-tributory role of Kennedy classes and opposing dentitions is tentatively suggested based on numerically heterogenous subgroups. [ABSTRACT FROM AUTHOR]

Purpose: To assess the clinical performance of CAD/CAM laminate veneers placed by a single operator and systematically evaluated for up to 10 years. Materials and Methods: A total of 197 laminate veneers fabricated using either feldspathic ceramics (VMII) or lithium disilicate ceramics (EmaxCAD) were followed up to 10 years in 32 patients. Technical, esthetic, and biologic findings of each restoration were evaluated using modified United States Public Health Service criteria. The survival and complication rates were assessed using Kaplan-Meier survival analysis and compared using log-rank test. Statistical significance was set at P < .05. Results: The estimated Kaplan-Meier survival rate was 91.9% after the mean observation period. According to the ceramic system used, the estimated Kaplan-Meier survival rate amounted to 92.7% for EmaxCAD and 89.1% for VMII. Survival rates were significantly affected by the location of veneer according to log-rank test (P < .05). A range of survival rates between 83.3% and 98.6% were observed based on the location of veneer. Conclusions: CAD/CAM laminate veneers milled from feldspathic or lithium disilicate ceramics have comparable long-term survival rates. Oral positioning affects the survival of veneers. Veneers of incisors have higher survival rates than the veneers of maxillary canines and premolars. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical survival and impact on oral health--related quality of life (OHRQoL) of immediate loading of implant-supported full-arch CAD/CAM--milled PMMA interim restorations. Materials and Methods: This was a practice-based prospective cohort study performed in a Portuguese dental clinic. Eleven patients received a total of 17 CAD/CAM fully implant-supported, screw-retained, full-arch restorations with milled PMMA and were followed up for 1 year. The primary outcome was prosthesis survival, determined with a modification of the California Dental Association score and a Kaplan-Meier survival function analysis. The secondary outcome was the patient quality of life, as defined by application of the OHIP-14-PT questionnaire and standardized effect size variation between two visits. Significance was set at 5%. Results: Survival probability at 12 months was 76%, complete fracture of the prosthesis occurred in 17.6% of the cases, and small fractures without lab involvement occurred in 5.9% of cases. There was a significant improvement in OHRQoL between visit 1 and visit 4. The mean difference and effect size for total OHIP-14-PT score were -32.91 ± 3.68 and 3.66 (95% CI -1.83 to -5.80) respectively (P < .001* Wilcoxon matched paired rank test). Conclusions: Fullarch implant-supported CAD/CAM--milled PMMA interim prosthesis seem to be a viable approach with good survival rate and great impact on patient OHRQoL. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the published literature on tooth--tissue supported removable partial dentures (RPDs) and determine the attachment system that provides the best clinical outcome. Materials and Methods: A comprehensive search of studies published up to November 2021 was performed in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The study protocol was approved and was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42021268449). The PICO question was, "What is the best attachment system used in Kennedy class I and II removable partial dentures?" Results: The search identified 871 articles, of which 21 met the inclusion criteria. The evaluation period in the studies ranged from 3 to 282 months. A total of 1,357 patients were included, of which 526 used prostheses with attachments. The mini SG attachment (extracoronal) was the most commonly used attachment, and the survival rate ranged from 37% to 98.1% in 10 studies, with no significant differences between the systems. Among the 10 studies selected for quantitative analysis, the meta-analysis revealed an overall failure rate of 16.6% (95% CI: 10.4% to 25.4%) and heterogeneity of I² = 65.725 (q value: 26.258, P = .002). Conclusions: Clinical studies comparing different attachment systems for rehabilitation are lacking. Our findings suggest that attachment-retained RPDs have good retention and better esthetics than conventional RPDs, and the extracoronal attachment system is the most viable choice for treatment at the free end. [ABSTRACT FROM AUTHOR]

Purpose: To assess the complications, satisfaction, and quality of life of patients rehabilitated with delayed and immediate loading of single crowns. Materials and Methods: An electronic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase databases up to February 2023. Only prospective studies and randomized and nonrandomized clinical trials comparing immediate and delayed loading were included. For the quantitative analysis, dichotomous and consistent variables were evaluated with a 95% confidence interval. Results: A total of 20 studies were evaluated. No statistically significant difference was observed between protocols: satisfaction (I²: 0%; P = .42), quality of life (I²: 0 %; P = .05), biologic complications (I²: 9%; P = .17), mechanical complications (I²: 58%; P = .84), and survival rate (I²: 0%; P = .38). The subgroup analysis showed significant differences only for marginal bone loss (MBL) when immediate implants were placed in the mandible (I²: 15%; P = .01) and posterior zone (I²: 0%; P = .001). Conclusions: Complications and patient-centered outcomes for immediate single-implant crowns were comparable to delayed loading. Scientific evidence showed no significant difference between loading protocols for survival rates. Note that several factors could interfere with the complication events, implant failures, and MBL. The subgroup analysis showed that only immediate implants placed in the posterior mandible had a higher and statistically significant mean MBL. [ABSTRACT FROM AUTHOR]

BACKGROUND: Rates of pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) for breast cancer have improved, especially among human epidermal growth factor 2-positive (HER2+) and triple-negative subtypes. The frequency and significance of biomarker profile change in residual disease are unclear. This study aimed to determine the rate of biomarker profile changes after NAC and the impact on clinical outcomes in a contemporary cohort. METHODS: Upon institutional review board approval, the study identified 634 consecutive patients treated with NAC between 2010 and 2022 at two academic institutions. The study cohort was focused on patients with residual disease who underwent biomarker profile retesting. Biomarker profile change for each subtype was compared across groups using Fisher-Irwin tests. Cox Proportional Hazards Model and Kaplan-Meier plots were performed to evaluate the association of changed versus unchanged biomarker profile with event-free survival. RESULTS: Biomarker retesting was performed for 259 (61.4 %) of 422 patients with residual disease. Biomarker profile change occurred in 18.1 % overall and was significantly higher among those with pre-NAC HER2+ disease (32.7 %, 17/52) than among those with HER2-disease (14.5 %, 30/207) (p = 0.004). Conversion of pre-NAC biomarker profiles of HR+HER2- and HR+HER2+ to triple-negative breast cancer (TNBC) post-NAC may be associated with worse event-free survival, hazard ratios of 2.23 (95 % confidence interval [CI], 0.90-5.53; p = 0.08), trending toward significance, and 36.7 (95 % CI, 2.2-610.8; p = 0.01), respectively. CONCLUSIONS: The results from one of the largest contemporary cohorts demonstrated that biomarker profile change in patients with residual disease after NAC was common. Furthermore, specific biomarker profile change in residual disease may have prognostic value. These findings strengthen the rationale for routine re-testing of biomarkers in residual disease after NAC.

BACKGROUND: Surgical and adjuvant management of mucinous cystic neoplasms (MCNs) lacks formal guidelines and data is limited to institutional studies. Factors associated with receipt of adjuvant therapy and any associated impact on survival remain to be clarified. In the absence of other data, guidelines that recommend adjuvant chemotherapy for invasive pancreatic adenocarcinoma have been extrapolated to MCN. PATIENTS AND METHODS: The National Cancer Database (2004-2019) was utilized to identify all patients that underwent pancreatic resection for invasive MCNs. Patients that received neoadjuvant therapy or did not undergo lymphadenectomy were excluded. Patient, tumor, and treatment factors associated with survival were assessed. RESULTS: For 161 patients with invasive MCN, median overall survival (OS) was 133 months and 45% of patients received adjuvant therapy. Multivariable analysis demonstrated that poorly differentiated tumors [odds ratio (OR) 4.19, 95% confidence interval (CI) 1.47-11.98; p = 0.008] and positive lymph node status (OR 2.67, 95% CI 1.02-6.98; p = 0.042) were independent predictors of receiving adjuvant therapy. Lymph node positivity [hazard ratio (HR) 2.90, 95% CI 1.47-5.73; p = 0.002], positive margins (HR 5.28, 95% CI 2.28-12.27; p

BACKGROUND: Invasive lobular carcinoma (ILC) of the breast grows in a diffuse pattern, resulting in a high risk of positive margins at surgical resection. Oncoplastic approaches have been shown to reduce this risk, but concerns persist around the safety of immediate oncoplastic surgery for those with ILC. This study evaluated the short- and long-term oncologic outcomes of immediate oncoplastic surgery for patients with ILC. METHODS: This study retrospectively analyzed an institutional database of stages I to III ILC patients who underwent breast-conserving surgery (BCS) with or without immediate oncoplastic surgery (oncoplastic closure or oncoplastic reduction mammoplasty [ORM]). The study compared positive margin rates, rates of successful BCS, and recurrence-free survival (RFS) by type of surgery. RESULTS: For 494 patients the findings showed that the use of immediate ORM was associated with significantly lower odds of positive margins (odds ratio [OR], 0.34; 95 % confidence interval [CI], 0.17-0.66; p = 0.002). Both lumpectomy with oncoplastic closure and ORM were significantly associated with higher rates of successful BCS than standard lumpectomy (94.2 %, 87.8 %, and 73.9 %, respectively; p < 0.001). No difference in RFS was observed between those undergoing immediate oncoplastic surgery and those undergoing standard lumpectomy alone. CONCLUSIONS: The patients with stages I to III ILC who underwent immediate oncoplastic surgery had significant benefits including lower odds of positive margins and higher rates of successful BCS, with both types of immediate oncoplastic surgery showing similar RFS compared with lumpectomy alone. This supports the oncologic safety of immediate oncoplastic surgery for diffusely growing tumors such as ILC, providing it an ideal option for patients desiring BCS.

BACKGROUND: Invasive lobular carcinoma (ILC) is the second most common subtype of breast cancer. Although mammography is known to have low sensitivity for ILC, there are no data to guide the optimal surveillance after treatment. We explored surveillance strategies after breast-conserving surgery (BCS) for ILC and determined the proportion of imaging-detected recurrences versus interval cancers. METHODS: From an institutional database of 813 women, we retrospectively identified patients who underwent BCS for stage I-III ILC and subsequently had a recurrence. We categorized patients by surveillance strategy and determined the modality of recurrence detection. Interval cancer rates for local recurrences were compared across surveillance strategies using the Chi-square test. We evaluated overall survival with the log-rank test and a Cox proportional hazards model. RESULTS: We included 58 patients with ILC who had a recurrence after BCS. Of these, 22 (37.9%) had local recurrence, 27 (46.6%) had distant recurrence, and 9 (15.5%) had both local and distant recurrence. Most patients underwent routine mammographic surveillance (65.2%), with 19.6% having supplemental breast magnetic resonance imaging (MRI) and 15.2% having no surveillance. The interval cancer rate was significantly higher in the mammographic surveillance group compared with the MRI surveillance group (61.9% vs. 16.7%; p

BACKGROUND: For patients with clinically node-positive (cN+) breast cancer undergoing neoadjuvant chemotherapy (NAC), retrieving previously clipped, biopsy-proven positive lymph nodes during sentinel lymph node biopsy [i.e., targeted axillary dissection (TAD)] may reduce false negative rates. However, the overall utilization and impact of clipping positive nodes remains uncertain. PATIENTS AND METHODS: We retrospectively analyzed cN+ ISPY-2 patients (2011-2022) undergoing axillary surgery after NAC. We evaluated trends in node clipping and associations with type of axillary surgery [sentinel lymph node (SLN) only, SLN and axillary lymph node dissection (ALND), or ALND only] and event-free survival (EFS) in patients that were cN+ on a NAC trial. RESULTS: Among 801 cN+ patients, 161 (20.1%) had pre-NAC clip placement in the positive node. The proportion of patients that were cN+ undergoing clip placement increased from 2.4 to 36.2% between 2011 and 2021. Multivariable logistic regression showed nodal clipping was independently associated with higher odds of SLN-only surgery [odds ratio (OR) 4.3, 95% confidence interval (CI) 2.8-6.8, p < 0.001]. This was also true among patients with residual pathologically node-positive (pN+) disease. Completion ALND rate did not differ based on clip retrieval success. No significant differences in EFS were observed in those with or without clip placement, both with or without successful clip retrieval [hazard ratio (HR) 0.85, 95% CI 0.4-1.7, p = 0.7; HR 1.8, 95% CI 0.5-6.0, p = 0.3, respectively]. CONCLUSION: Clip placement in the positive lymph node before NAC is increasingly common. The significant association between clip placement and omission of axillary dissection, even among patients with pN+ disease, suggests a paradigm shift toward TAD as a definitive surgical management strategy in patients with pN+ disease after NAC.

Existing risk prediction models for hospitalized heart failure patients are limited. We identified patients hospitalized with a diagnosis of heart failure between 7 May 2013 and 26 April 2022 from a large academic, quaternary care medical centre (training cohort). Demographics, medical comorbidities, vitals, and labs were collected and were used to construct random forest machine learning models to predict in-hospital mortality. Models were compared with logistic regression, and to commonly used heart failure risk scores. The models were subsequently validated in patients hospitalized with a diagnosis of heart failure from a second academic, community medical centre (validation cohort). The entire cohort comprised 21 802 patients, of which 14 539 were in the training cohort and 7263 were in the validation cohort. The median age (25th-75th percentile) was 70 (58-82) for the entire cohort, 43.2% were female, and 6.7% experienced inpatient mortality. In the overall cohort, 7621 (35.0%) patients had heart failure with reduced ejection fraction (EF ≤ 40%), 1271 (5.8%) had heart failure with mildly reduced EF (EF 41-49%), and 12 910 (59.2%) had heart failure with preserved EF (EF ≥ 50%). Random forest models in the validation cohort demonstrated a c-statistic (95% confidence interval) of 0.96 (0.95-0.97), sensitivity (SN) of 87.3%, and specificity (SP) of 90.6% for the prediction of in-hospital mortality. Models for those with HFrEF demonstrated a c-statistic of 0.96 (0.94-0.98), SN 88.2%, and SP 91.0%, and those for patients with HFpEF showed a c-statistic of 0.95 (0.93-0.97), SN 87.4%, and SP 89.5% for predicting in-hospital mortality. The random forest model significantly outperformed logistic regression (c-statistic 0.87, SN 75.9%, and SP 86.9%), and current existing risk scores including the Acute Decompensated Heart Failure National Registry risk score (c-statistic of 0.70, SN 69%, and SP 62%), and the Get With the Guidelines-Heart Failure risk score (c-statistic 0.69, SN 67%, and SP 63%); P

BACKGROUND: After treatment of pregnancy-associated breast cancer (PABC), some women desire future pregnancy. While safety of pregnancy after breast cancer has been demonstrated, the same cannot be said about women with PABC. OBJECTIVE: The aim of this study was to describe the incidence and outcomes of patients with PABC with subsequent pregnancies compared with those without another pregnancy. METHODS: A retrospective chart review identified patients diagnosed with breast cancer during pregnancy or within 5 years postpartum between 2011 and 2023. Patients were then screened for further pregnancy. Clinicopathologic variables, oncologic outcomes, and pregnancy outcomes were recorded. The Chi-square test and t-test were used to compare patients with subsequent pregnancy with those without. Kaplan-Meier method and log-rank test were used to estimate 5-year disease-free survival (DFS). RESULTS: Overall, 75 patients with PABC were identified, 58 of whom had PABC and no further pregnancies (NSP-PABC) and 17 with subsequent pregnancy (SP-PABC). Compared with patients with NSP-PABC, patients with SP-PABC were significantly younger (p = 0.015) and less likely to have prior pregnancies (p

BackgroundMany adolescent and young adult (AYA) patients with breast cancer (BC) receive adjuvant therapy as initial treatment, with long-term bone marrow suppression as a potential complication, but no studies have evaluated the impact of race/ethnicity on the development of bone marrow suppression in AYA BC survivors.Patients and methodsFemale patients ages 15-39 years diagnosed with BC (2006-2018) and surviving ≥ 2 years were identified from the California Cancer Registry and linked to statewide hospitalization data. We estimated the cumulative incidence of developing late effects of bone marrow suppression, such as leukopenia, anemia, thrombocytopenia, bleeding, and infection/sepsis, during hospital discharge diagnoses present ≥ 2 years after diagnosis. We examined the impact of sociodemographic and clinical factors on late effects using multivariate Cox proportional hazards regression.ResultsOf 11,293 patients, 42.8% were non-Hispanic (nH) White, 28.8% Hispanic, 19.5% nH Asian/Pacific Islander, and 7.5% nH Black. In multivariable analyses, nH Blacks had the highest risk (versus nH Whites) of anemia [hazard ratio (HR) 1.72, 95% confidence interval (CI) 1.47-2.02], leukopenia (HR 1.56, CI 1.14-2.13), thrombocytopenia (HR 1.46, CI 1.08-1.99), major infection/sepsis (HR 1.64, CI 1.4-1.92), and bleeding (HR 1.89, CI 1.39-2.58). Hispanics had a higher risk of developing anemia (HR 1.17, CI 1.04-1.32), bleeding (HR 1.4, CI 1.12-1.76), and major infections/sepsis (HR 1.36, CI 1.21-1.52). Asian/Pacific Islanders had only a higher risk of developing bleeding (HR 1.33, CI 1.03-1.72). Patients from a low neighborhood socioeconomic status had a 20% higher risk of infection/sepsis (HR 1.21, CI 1.1-1.34), but there were no associations for the other late effects.ConclusionsWe identified that AYAs of nH Black, Hispanic, and Asian/Pacific Islander race/ethnicity are at an increased risk of several late effects after adjuvant therapy compared with nH White patients. From these data, providers can implement early/frequent screening of hematologic late effects in these high-risk survivors.

Fluctuations in energy gap and coupling constants between chromophores can play an important role in absorption and energy transfer across a collection of two-level systems. In photosynthesis, light-induced quantum coherence can affect the efficiency of energy transfer to the designated "trap" state. Theoretically, the interplay between fluctuations and coherence has been studied often, employing either a Markovian or a perturbative approximation. In this study, we depart from these approaches to incorporate memory effects by using Kubo's quantum stochastic Liouville equation. We introduce the effects of decay of the created excitation (to the ground state) on the desired propagation and trapping that provides a direction of flow of the excitation. In the presence of light-induced pumping, we establish a relation between the efficiency, the mean survival time, and the correlation decay time of the bath-induced fluctuations. A decrease in the steady-state coherence during the transition from the non-Markovian regime to the Markovian limit results in a decrease in efficiency. As in the well-known Haken–Strobl model, the ratio of the square of fluctuation strength to the rate plays a critical role in determining the mechanism of energy transfer and in shaping the characteristics of the efficiency profile. We recover a connection between the transfer flux and the imaginary part of coherences in both equilibrium and excited bath states, in both correlated and uncorrelated bath models. We uncover a non-monotonic dependence of efficiency on site energy heterogeneity for both correlated and uncorrelated bath models. [ABSTRACT FROM AUTHOR]

Purpose: To compare the peri-implant bone loss of mandibular complete-arch implant-supported fixed prostheses (FPSs) supported by three and four implants and to correlate with the size of the horizontal and vertical distal cantilever at prosthesis placement (T1) and after 1 year (T2). Materials and Methods: A total of 72 external hexagon (EH) type implants were placed in 20 participants. Of these, 24 supported an FPS with three implants (G3I) and 48 with four implants (G4I). The mandibular implants were named 1, 2, 3, and 4 according to their location in the arch, in a clockwise direction. Digital periapical radiographs were taken at times T1 and T2 for analysis and measurement of peri-implant bone loss. The horizontal and vertical distal cantilevers were measured with a digital caliper and correlated with peri-implant bone loss. Results: The survival rate of implants in G3I was 91.66%, and in G4I it was 97.91%. The mean bone loss in G3I was 0.88 ± 0.89 mm, and in G4I it was 0.58 ± 0.78 mm (P = .225). There was no correlation between distal horizontal cantilevers and bone loss in the studied groups, with G3I being -0.25 (P = .197) and G4I -0.22 (P = .129). Larger vertical cantilevers of implants 1 (P = .018), 3 (P =.015), and 4 (P = .045) correlated with greater bone loss in G4I. Conclusions: The number of implants in an FPS did not influence peri-implant bone loss after 1 year of follow-up. Larger vertical cantilevers influenced greater bone loss in complete-arch implant-supported fixed prostheses supported by four implants. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate how the crown-to-implant (C/I) ratio affects the loss of crestal bone at single-crown implants and bridges in patients with periodontal disease. Materials and Methods: A total of 39 patients treated for periodontitis were rehabilitated with 108 implant-supported single crowns and bridges. Each patient was examined over a 5- to 20-year period on a 3- to 6-month recall schedule. At each session, we recorded periodontal clinical parameters. In addition, intraoral radiographs were taken after superstructure insertion (baseline) and then at 1, 3, 5, 10, 15, and 20 years. The study population was divided by anatomical C/I ratio (Group 1: C/I = 1, Group 2: C/I > 1). Results: Implants had a 96.2% 5-year survival rate and 92.6% 20-year survival rate. The overall prevalence was 10.1% for mucositis and 1.1% for peri-implantitis. The survival rate (P = .68), incidence of mucositis (P = .325), and incidence of peri-implantitis (P = .077) did not significantly differ in the group comparison. The mean annual peri-implant bone loss was 0.09 ± 0.41 mm and was not significantly different between the groups. Mean bone loss was not significantly different until the 10th year of observation, during which Group 2 presented significantly less bone loss. The correlation of annual bone loss and clinical C/I ratio showed a small but significant negative effect throughout the entire study period (R = -0.217; P < .01). Conclusions: Increased crestal bone loss was not observed with implants with higher C/I ratios, both anatomical and clinical, and they even showed signs of less crestal bone loss. [ABSTRACT FROM AUTHOR]

Objective: The evidence base for the use of space maintainers is relatively sparce despite being used for decades after the premature loss of primary molars. This study aims to increase the dental evidence base via investigating retrospectively the success rates of prefabricated fixed and removable space maintainers inserted from 2019 to 2021 and followed up until February 2023 at a specialized university clinic and to identify reasons for any reported minor and major failure. The authors hypothesized that there is no significant difference in failure rates between fixed and removable space maintainers inserted after the premature loss of a single primary molar per quadrant. Method and materials: Patients' digital records were searched yielding 645 space maintainers. After the application of inclusion criteria, 157 (67%) fixed prefabricated space maintainers in 112 children and 77 (33%) removable space maintainers in 61 children were analyzed for an average of 18.4 ± 9.5 months. Results: Kaplan-Meier survival analysis with Mantel-Cox statistics showed an overall cumulative survival time of 31.6 months (SE = 1.15, 95% CI = 29.4 to 33.9). Major failure occurred significantly more in removable maintainers (n = 40/67, 59.7%), mostly due to loss of the appliance, compared to fixed space maintainers (n = 27/67, 40.3%; P < .001). The present study indicates that space maintainers were mainly placed in young children with high caries experience, where treatment was mostly possible using advanced behavior management. Conclusions: Fixed space maintainers had a significantly lower failure rate than their removable counterpart. However, both require continual repairs, preservation, or even replacement till the eruption of the permanent tooth. [ABSTRACT FROM AUTHOR]

BackgroundStandard treatment for patients with newly diagnosed glioblastoma includes surgery, radiotherapy (RT), and temozolomide (TMZ) chemotherapy (TMZ/RT→TMZ). The proteasome has long been considered a promising therapeutic target because of its role as a central biological hub in tumor cells. Marizomib is a novel pan-proteasome inhibitor that crosses the blood-brain barrier.MethodsEuropean Organisation for Research and Treatment of Cancer 1709/Canadian Cancer Trials Group CE.8 was a multicenter, randomized, controlled, open-label phase 3 superiority trial. Key eligibility criteria included newly diagnosed glioblastoma, age > 18 years and Karnofsky performance status > 70. Patients were randomized in a 1:1 ratio. The primary objective was to compare overall survival (OS) in patients receiving marizomib in addition to TMZ/RT→TMZ with patients receiving the only standard treatment in the whole population and in the subgroup of patients with MGMT promoter-unmethylated tumors.ResultsThe trial was opened at 82 institutions in Europe, Canada, and the U.S. A total of 749 patients (99.9% of the planned 750) were randomized. OS was not different between the standard and the marizomib arm (median 17 vs. 16.5 months; HR = 1.04; P = .64). PFS was not statistically different either (median 6.0 vs. 6.3 months; HR = 0.97; P = .67). In patients with MGMT promoter-unmethylated tumors, OS was also not different between standard therapy and marizomib (median 14.5 vs. 15.1 months, HR = 1.13; P = .27). More CTCAE grade 3/4 treatment-emergent adverse events were observed in the marizomib arm than in the standard arm.ConclusionsAdding marizomib to standard temozolomide-based radiochemotherapy resulted in more toxicity, but did not improve OS or PFS in patients with newly diagnosed glioblastoma.

BACKGROUND: Ileal neuroendocrine tumors (i-NETs) are characterized by their multifocality and bulky mesenteric mass. Having shown that minimally invasive surgery (MIS) utilizing a hand-access port device has favorable short-term outcomes and achieves the goals of surgery for i-NETs, we sought to analyze long-term survival outcomes of MIS. METHODS: One hundred and sixty-eight patients who underwent resection of primary i-NETs at a single institution between January 2007 and February 2023 were retrospectively studied. Patients were categorized into the MIS or open surgery cohorts on an intention-to-treat basis. Open surgery was selected mainly based on the need for hepatectomy or bulky mesenteric mass resection. Overall survival was analyzed using log-rank tests with propensity score matching (PSM) and Cox proportional hazards regression. PSM was performed to reduce standardized mean differences of the variables to

BACKGROUND: In 2023 alone, its estimated that over 64,000 patients will be diagnosed with PDAC and more than 50,000 patients will die of the disease. Current guidelines recommend neoadjuvant therapy for patients with borderline resectable and locally advanced PDAC, and data is emerging on its role in resectable disease. Neoadjuvant chemotherapy may increase the number of patients able to receive complete chemotherapy regimens, increase the rate of microscopically tumor-free resection (R0) margin, and aide in identifying unfavorable tumor biology. To date, this is the largest study to examine surgical outcomes after long-duration neoadjuvant chemotherapy for PDAC. METHODS: Retrospective analysis of single-institution data. RESULTS: The routine use of long-duration therapy in our study (median cycles: FOLFIRINOX = 10; gemcitabine-based = 7) is unique. The majority (85%) of patients received FOLFIRINOX without radiation therapy; the R0 resection rate was 76%. Median OS was 41 months and did not differ significantly among patients with resectable, borderline-resectable, or locally advanced disease. CONCLUSIONS: This study demonstrates that in patients who undergo surgical resection after receipt of long-duration neoadjuvant FOLFIRINOX therapy alone, survival outcomes are similar regardless of pretreatment resectability status and that favorable surgical outcomes can be attained.

Purpose: To retrospectively determine the cumulative survival rate (CSR) and marginal bone level change (ΔMBL) around novel hybrid design tissue-level (TL) dental implants that support multiple-screw-retained restorations. Materials and Methods: Implant CSRs were analyzed at the implant and patient level using Kaplan-Meier estimates. ΔMBL was measured by comparing the periapical loading and follow-up visit radiographs using an improved standardized digital methodology based on image gray levels. ΔMBL outcomes were subject to linear mixed regression to identify potential risk factors. Results: A total of 301 TL implants in 69 patients with an average age of 62.6 ± 11.7 years (range: 36 to 87 years) at the time of implant placement were considered for the analysis. All 301 implants were successfully restored and loaded. The 54-month CSRs at the implant and patient levels were 98.9% (95% CI: 96.7 to 99.6) and 95.3% (95% CI: 86.1 to 98.5), respectively. ΔMBL after a mean follow-up of 22 ± 10.7 months after loading was 0.00 ± 0.57 mm. None of the implant sites showed marginal bone loss exceeding 1.5 mm. Multivariate regression analysis revealed a significant association between ΔMBL and the loading protocol (P = .027) but not between ΔMBL and age or transgingival height. Conclusions: The high CSRs and stable peri-implant marginal bone levels support the use of recent TL implants, which have a hybrid design inherited from the bone-level implant-abutment connection, as a suitable treatment option for restoring partially or fully edentulous patients with a good mid-term prognosis. These results should be complemented by further prospective studies in a real-world multicenter private practice setup that represents the daily realities of implant treatment. [ABSTRACT FROM AUTHOR]

Purpose: This German S3 clinical practice guideline offers evidence-based recommendations for the use of composite materials in direct restorations of permanent teeth. Outcomes considered were the survival rates and restoration quality and process quality of the manufacturing process. Part 1 of this two-part presentation deals with the indication classes. Materials and Methods: A systematic literature search was conducted by two methodologists using MEDLINE and the Cochrane Library via the OVID platform, including studies up to December 2021. Six PICO questions were developed to guide the search. Recommendations were formulated by a panel of dental professionals from 20 national societies and organizations based on the collected evidence. Results: Composite materials are a viable option for the direct restoration of cavity Classes I-V and may also be used for restorations with cusp replacement, and tooth shape corrections. In the posterior region, direct composite restorations should be preferred over indirect composite inlays. For Class V restorations, composite materials can be used if adequate contamination control and adhesive technique are ensured. Conclusion: The guideline is the first to provide comprehensive evidence on the use of direct composite materials. However, further long-term clinical studies with comparators such as (modified) glass-ionomer cements are necessary. Regular updates will detail the future scope and limitations of direct composite restorations. [ABSTRACT FROM AUTHOR]

Purpose: Numerous studies report on the outcome performance of posterior composite restorations. However, there are fewer studies providing data for anterior restorations. The aim of this study was to evaluate the clinical outcome performance of anterior permanent restorations by analyzing a large dataset from a German national health insurance company. Materials and Methods: Routine claims data from a major German national health insurance company were assessed. Fee codes were used for tracing restoration careers on a day-count basis. The treatment was defined as a placed restoration (Class III and IV) on a mesial or distal tooth surface, irrespective of the extension. The restorations were placed between January 1, 2010 and December 31, 2013. Statistical analyses were conducted using Kaplan-Meier survival analysis to determine cumulative 4-year survival rates. The primary outcome was re-intervention on the same surface. Secondary outcomes were crowning and extraction which were analyzed separately. Results: A total of 2,417,791 restorations involving mesial surfaces and a number of 2,409,031 restorations involving distal surfaces were observed. At 4 years, the cumulative survival rates concerning the primary outcome "re-intervention" were 79.9% for mesial and 80.9% for distal restorations. The respective annual failure rates (AFR) were 5.5% and 5.2%. Fouryear survival rates for the secondary outcome "crown" were 93.8% for mesial and 94.1% for distal anterior restorations. The respective AFRs were 1.6% and 1.5%. For the secondary outcome "extraction," the respective rates were 94.6% for mesial and 93.9% for distal restorations. The respective AFRs were 1.4% and 1.6%. Conclusion: The performance of permanent anterior restorations which were placed in general dental practices in Germany can be rated as acceptable. [ABSTRACT FROM AUTHOR]

Purpose: The study evaluated the clinical performance of partial indirect resin composite (PIRC) restorations with "proximal box elevation" (PBE) placed in molars. Materials and Methods: Sixty-three patients received 80 posterior PIRC (SR Nexco, Ivoclar Vivadent) restorations. Large posterior defects with cuspal loss and deep cervical margins were included in the study. PBE was performed priorto preparation and impression making. Two independent observers evaluated the restorations using the FDI criteria (scores 1-5) foresthetic, functional, and biological properties. Patients were recalled at 6 months and 1, 2, and 3 years. Overall success rates were calculated (Kaplan-Meier analysis) and compared (log-rank tests) according to baseline variables. The impact of the baseline variables on the failure of the restorations was analyzed (multiple proportional Cox regression). Results: Seventy-nine (98.7%), 69 (88.4%), 66 (92.9%), 44 (86.2%) and 45 (91.8%) PIRCs completed their follow up at baseline, 6 months, and 1, 2 and 3 years, respectively. In total, 10 failures were observed: 5 with partial loss, 4 with material chipping, and one with secondary caries, yielding an overall success rate of 87.5% and a survival rate of 93.8%, with a mean observation timeof 26.5 ± 13.6 months. Conclusions: PIRCs with PBE demonstrated a high survival rate and satisfactory esthetic properties. Failure was less likelyfor PIRC restorations with partial cuspal coverage (onlay) compared to full cuspal coverage (overlay). [ABSTRACT FROM AUTHOR]

The article discusses a study which compared the fit and fracture load of temporary fixed partial prostheses fabricated by means of a conventional direct technique, milling or 3D printing. Topics covered include the strength of the fixed dental prostheses, the values of the fracture test, and the maximum mastication forces in the molar region.

Purpose: To review experimental peri-implantitis studies using rat models and summarize different peri-implantitis induction techniques and evaluate their effectiveness. Materials and Methods: Electronic searches were conducted by two independent examiners to address the following issues. Meta-analyses explored the marginal bone loss (MBL) of four types of peri-implantitis induction methods in rats. The detailed induction tactics--such as the implant design, implant size, surgical process, time cost, induction methods, and endpoint measurements--were summarized. Results: Of the 18 included studies, 38.9% of the studies placed implants at the maxillary first molar, and 44.4% placed them at the alveolar ridge region anterior to the maxillary first molar. As for the induction method, the numbers of published studies on ligature methods, bacterial inoculation, and bacterial lipopolysaccharide inoculation were equally high among all selected studies. The total implant survival rate at the end was 160 out of 213 implants (75.11%). Eight studies with high pooled heterogeneity (I2 = 98, P < .01) in the meta-analysis reported an overall MBL (µ-CT) of 0.47 mm (95% CI = 0.14 to 0.81). A subgroup analysis estimated an MBL of 0.31 mm (95% CI = 0.12 to 0.50) for bacterial inoculation and 0.66 mm (95% CI = 0.07 to 1.26) for the ligature method. Histopathologic analysis revealed that peri-implantitis in rats was similar to peri-implantitis lesions in humans. Conclusions: Implant placement at the maxillary first molar with bacterial inoculation and the silk ligature method to build peri-implantitis rat models is reliable to use for research on peri-implantitis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Female sex is a significant risk factor for pulmonary arterial hypertension (PAH), yet males with PAH have worse survival - a phenomenon referred to as the sex paradox in PAH. METHODS: All adult PAH patients in the Pulmonary Hypertension Association Registry (PHAR) with congruent sex and gender were included. Baseline differences in demographics, hemodynamics, functional parameters, and quality of life were assessed by sex. Kaplan-Meier survival analysis was used to evaluate survival by sex. Mediation analysis was conducted with Cox proportional hazards regression by comparing the unadjusted hazard ratios for sex before and after adjustment for covariates. The plausibility of collider-stratification bias was assessed by modeling how large an unmeasured factor would have to be to generate the observed sex-based mortality differences. Subgroup analysis was performed on idiopathic and incident patients. RESULTS: Among the 1,891 patients included, 75% were female. Compared to men, women had less favorable hemodynamics, lower 6-minute walk distance, more PAH therapies, and worse functional class; however, sex-based differences were less pronounced when accounting for body surface area or expected variability by gender. On multivariate analysis, women had a 48% lower risk of death compared to men (Hazard Ratio 0.52, 95% Confidence interval 0.36 - 0.74, p

BACKGROUND: Multidisciplinary heart team (HT) evaluation is recommended for patients with severe primary mitral regurgitation to optimize treatment decisions. However, its impact on patient outcomes remains unknown. We evaluated the impact of implementing mitral HT on patient survival. METHODS AND RESULTS: We conducted a retrospective cohort study of patients with new diagnoses of severe primary mitral regurgitation in a large healthcare network echocardiogram database between 2016 and 2020. We compared the incidence of multidisciplinary evaluation by structural cardiology and cardiac surgery services and 2-year survival before and after mitral HT implementation. The 1:1 propensity-score matching between pre- and post-mitral HT used Society of Thoracic Surgeons Predicted Risk of Mortality for mitral repair, age, sex, race, heart failure symptoms, inpatient setting, history of MI, and dementia as covariates. Logistic regression identified variables associated with the likelihood of undergoing multidisciplinary evaluation. Among 70 510 echocardiograms performed, 391 patients had severe primary mitral regurgitation (median age, 77 years; 46% women). Multidisciplinary evaluation increased from 29% to 89% (P

Chronic graft-versus-host-disease (cGVHD) is divided into two subtypes: classic (absence of acute GVHD features) and overlap cGVHD (ocGVHD), in which both chronic and acute GVHD clinical features are present simultaneously. While worse outcomes with ocGVHD have been reported, there are few recent analyses. We performed a secondary analysis of data from the ABA2 trial (N = 185), in which detailed GVHD data were collected prospectively and systematically adjudicated. Analyses included cumulative incidence of classic versus ocGVHD, their specific organ manifestations, global disease severity scores, non-relapse mortality (NRM), disease-free survival (DFS) and overall survival (OS) in these two cGVHD subtypes. Of 92 patients who developed cGVHD, 35 were classified as ocGVHD. The 1-year cumulative incidence, organ involvement, and global severity of classic and ocGVHD were similar between ABA2 patients receiving CNI/MTX+placebo and CNI/MTX+abatacept; thus, cohorts were combined for ocGVHD evaluation. This analysis identified ocGVHD as having significantly higher severity at presentation and at maximum global severity compared to classic cGVHD. OS and DFS were significantly lower for ocGVHD versus classic cGVHD. OcGVHD is associated with increased cGVHD severity scores, and is associated with decreased OS and DFS compared to classic cGVHD, underscoring the high risks with this cGVHD subtype.

Few studies have reported the outcomes of short implants with a follow-up time > 10 years. This retrospective study aimed to evaluate the long-term outcomes of short locking-taper implants supporting single crowns in the posterior region. Patients who received these supporting implants (≤ 8 mm) in the posterior region from 2008 to 2010 were included. The clinical and radiographic outcomes and patient satisfaction were recorded. A total of 18 patients with 34 implants were included. The cumulative survival rate was 91.4% and 83.3% at implant and patient levels, respectively. Tooth brushing habit and history of periodontitis were significantly associated with implant failure (P < .05). The median marginal bone loss (MBL) was 0.24 mm (IQR: 0.01 to 0.98 mm). Biologic and technical complications occurred in 14.7% and 17.8% of implants, respectively. The mean modified Sulcus Bleeding Index was 0.52 ± 0.63, and the mean peri-implant probing depth was 2.38 ± 0.79 mm. All patients were at least quite satisfied, with the majority of patients (88.9%) being fully satisfied with the treatment. Within the limitations of this study, the short locking-taper implants supporting single crowns in the posterior region achieved promising outcomes in the long-term follow-up. [ABSTRACT FROM AUTHOR]

Dental implants are currently the preferred choice to restore function and esthetics. Nonetheless, explantation is sometimes inevitable in cases with advanced bone loss, implant fracture, or improper implant position. This study aimed to propose an algorithm for reimplantation at sites of previous failure. There is limited evidence on the replacement of failed implants, most of which are case reports or clinical trials with a small number of patients. To the best of the authors' knowledge, this is the first study proposing a clinical-decision algorithm to help clinicians manage implant failures with new implants. There are a variety of reasons contributing to implant failure: The etiologic factor of failure and the morphology of the residual defect have paramount importance on implant removal techniques and subsequent treatment modalities. There is no consensus on a distinct protocol to replace failed implants. However, the clinicians and patients should know that placing a new implant in an area with a history of failure, regardless of early or late implant failure, may have a lower survival rate. [ABSTRACT FROM AUTHOR]

Purpose: Alveolar ridge split (ARS) is ridge augmentation to mitigate ridge width loss that typically follows tooth extraction. This study aimed to determine the efficacy of ARS on alveolar ridge horizontal dimensional changes and the survival rates of implants placed into the same sites. Materials and Methods: An electronic and manual search was conducted for English articles published up to January 1, 2021. The PICO (problem, intervention, comparison, outcome) model for quantitative studies was established to address the following two focused questions: (1) What are the effects of the ARS technique on increasing alveolar width and implant survival?; and (2) what are the factors that influence the efficacy of the ARS technique? The outcome measures in this systematic review and meta-analysis were mean alveolar ridge gain—horizontal (buccolingual) in millimeters from baseline (initial presentation) to final assessment (minimum of 12 weeks after ARS), implant survival rate, and patient-reported complication rate. The risk of bias was evaluated using the ROBINS-I assessment tool for non-randomized interventional studies. Weighted means were calculated, and pooled effects and 95% confidence intervals (95% CI) were depicted on forest plots. Publication bias was assessed by funnel plot and Rosenthal Statistics. A sensitivity analysis was undertaken to assess the primary outcome. Results: Overall, 35 studies met the inclusion criteria and were included in the systematic review. The mean alveolar ridge gain for ARS was 3.06 mm (95% CI: 3.01 to 3.12 mm). A mean gain of 2.99 mm (95% CI: 2.93 to 3.04 mm) was found after sensitivity analysis, excluding one article with a high risk of bias. There were no significant differences in ridge width in the group with bone graft (mean difference [95% CI] of 2.97 mm [2.91 to 3.03 mm]) and in the group without bone graft (mean difference [95% CI] of 3.06 mm [2.92 to 3.20 mm]). The ARS technique demonstrated a 98.17% implant survival rate in 4,446 implants, 4,103 of which were placed at the time of ARS with a 97.72% implant survival rate, and 343 placed in a delayed approach with a 99.14% implant survival rate. The risk of bias was low in 14.2%, low to moderate in 68.5%, moderate in 11.4%, and severe/moderate in 5.7% of the included studies. Conclusions: ARS shows a high implant survival rate in narrow alveolar ridges, adequate horizontal alveolar ridge dimensional gain regardless of adding grafting material, and minimal patient-reported complications. [ABSTRACT FROM AUTHOR]

Multiple myeloma (MM) is twice as common in Black individuals compared with in White individuals, and diabetes mellitus (DM) disproportionately affects Black patients. Although numerous studies have shown a correlation between DM and MM, this has not been studied in the context of race and in vivo mechanisms. We conducted a retrospective clinical study of 5383 patients with MM of which 15% had DM (White, 12% and Black, 25%). Multivariable Cox models showed reduced overall survival (OS) for patients with DM (hazard ratio, 1.27; 95% confidence interval, 1.11-1.47; P < .001). This appeared to be driven by a marked difference in OS between White patients with and without DM but not in Black patients. In contrast, obesity was associated with better OS in Black patients but not in White patients. To complement this analysis, we assessed MM growth in a genetically engineered immunocompromised nonobese diabetic (Rag1-/-/muscle creatinine kinase promoter expression of a human IGF1R [M] with a lysine [K] to arginine [R] point mutation) mouse model to evaluate the mechanisms linking DM and MM. MM.1S xenografts grew in more Rag1-/-/MKR mice and grew more rapidly in the Rag1-/-/MKR mice compared with in controls. Western blot analysis found that MM1.S xenografts from Rag1-/-/MKR mice had higher phosphorylated S6 ribosomal protein (Ser235/236) levels, indicating greater activation of the mammalian target of rapamycin pathway. Our study is, to our knowledge, the first to evaluate racial differences in DM prevalence and survival in MM, as well as the effect of DM on tumor growth in mouse models. Our results suggest that DM may contribute to the higher incidence of MM in Black patients; and to improve survival in MM, DM management cannot be ignored.

Advanced melanoma is considered the most aggressive and deadly form of skin cancer whose incidence has been rising over the past three decades. In the absence of treatment, the median overall survival for advanced-stage metastatic disease is less than 6 months. Although most melanomas detected at an early stage can be cured with surgery, a subset of these eventually metastasize. Therefore, a critical need exists to identify unique molecular features that would be predictive of long-term outcome and response to specific therapies. Recent promising therapeutic regimens have included the use of immune checkpoint inhibitors, such as anti-PD1 antibodies. However, the ability to identify responders and non-responders to this therapy remains elusive. To address this challenge at the molecular level, previously our laboratory identified the emergence of a stem cell phenotype associated with advanced melanoma and other aggressive forms of cancer. Underlying this phenotype is the aberrant re-expression of the embryonic morphogen Nodal. Particularly noteworthy, we have observed Nodal to remain in advanced tumors of non-responders to standard-of-care therapies (i.e., BRAFi). This pilot study is the first proof-of-principle attempt to predict treatment response survival outcome in a small cohort of melanoma patients receiving anti-PD1 immune checkpoint inhibitor therapy - based on their Nodal expression profile. Using advanced multiplex immunohistochemistry-based digital pathology, the major finding of this preliminary study indicates that higher Nodal expression is often associated with poorer overall survival after anti-PD1 therapy, reaching nearly statistical relevance.

Breast cancer is the most common type of cancer that affect women and yet there is no substantive cure. On early diagnosis of breast lesions with this size using mammogram would help the affected tumor patients have a good survival rate. Detecting cancer cells is a challenging task and hence we propose a single valued neutrosophic approach for segmenting breast tumor lesions in mammogram images. In this neutrosophic approach, the intensity values are represented as truth, indeterminacy and falsity membership in where the indeterminacy are noise, and the breast regions are the true and falsity values. The computations of these memberships are then pre-processed using α-mean­ and ­β-enhancement to minimize the indeterminacy. Finally, gamma clustering techniques are used to localize and segment the tumor from the background breast tissue region. Experiments are conducted on publicly available datasets and the proposed method is evaluated and achieves a better segmentation performance. [ABSTRACT FROM AUTHOR]

Background: Osteosarcoma (OS), recognized as the predominant malignant tumor originating from bones, necessitates an in-depth comprehension of its intrinsic mechanisms to pinpoint novel therapeutic targets and enhance treatment methodologies. The role of fat mass and obesity-associated (FTO) in OS, particularly its correlation with malignant traits, and the fundamental mechanism, remains to be elucidated. Materials and Methods: 1. The FTO expression and survival rate in tumors were analyzed. 2. FTO in OS cell lines was quantified utilizing western blot and PCR. 3. FTO was upregulated and downregulated separately in MG63. 4. The impact of FTO on the proliferation and migration of OS cells was evaluated using CCK-8, colony formation, wound healing, and Transwell assays. 5. The expression of miR-150-5p in OS cells-derived exosomes was identified. 6. The binding of miR-150-5p to FTO was predicted by TargetScan and confirmed by luciferase reporter assay. 7. The impact of exosome miR-150-5p on the proliferation and migration of OS cells was investigated. Results: The expression of FTO was higher in OS tissues compared to normal tissues correlating with a worse survival rate. Furthermore, the downregulation of FTO significantly impeded the growth and metastasis of OS cells. Additionally, miR-150-5p, which was downregulated in both OS cells and their derived exosomes, was found to bind to the 3′-UTR of FTO through dual luciferase experiments. Exosomal miR-150-5p was found to decrease the expression of FTO and inhibit cell viability. Conclusions: We identified elevated levels of FTO in OS, which may be attributed to insufficient miR-150-5p levels in both the cells and exosomes. It suggests that the dysregulation of miR-150-5p and its interaction with FTO could potentially promote the development of OS. [ABSTRACT FROM AUTHOR]

This study proposes a heterogeneous mediation analysis for survival data that accommodates multiple mediators and sparsity of the predictors. We introduce a joint modeling approach that links the mediation regression and proportional hazards models through Bayesian additive regression trees with shared typologies. The shared tree component is motivated by the fact that confounders and effect modifiers on the causal pathways linked by different mediators often overlap. A sparsity‐inducing prior is incorporated to capture the most relevant confounders and effect modifiers on different causal pathways. The individual‐specific interventional direct and indirect effects are derived on the scale of the logarithm of hazards and survival function. A Bayesian approach with an efficient Markov chain Monte Carlo algorithm is developed to estimate the conditional interventional effects through the Monte Carlo implementation of the mediation formula. Simulation studies are conducted to verify the empirical performance of the proposed method. An application to the ACTG175 study further demonstrates the method's utility in causal discovery and heterogeneity quantification. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the productive performance and survival rate of dourado (Salminus brasiliensis) in biofloc technology (BFT) and in a traditional system with 20% water renewal per day. The design was completely randomized with two treatments and four replications. The experimental units were composed of aquariums with a useful volume of 50 L and constant aeration, with 20 fish (4.12 g; 6.25 cm) allocated in each. In treatment with the traditional system, 10 L of water was siphoned from the aquariums every day during the 28 days of the experimental period. Water quality, productive performance, survival, and body score analysis for injuries were evaluated. Better water quality was observed in the BFT production system. No significant differences were observed at the end of the experiment for average weight, length (standard and total), daily weight gain, and specific growth rate. The results of feed conversion ratio, final biomass, and biomass gain were better (P < 0.05) for fish in BFT (1.44; 155.33 g; and 72.88 g/day) compared to the traditional system with partial water renewal (1.84; 128.1 g; and 45.5 g/day). Survival and body score analysis for injuries were better (P < 0.05) in fish maintained in BFT. In conclusion, the BFT production system provides a decrease in aggressiveness, better production performance, and survival rates and thus is more suitable for S. brasiliensis production in the initial phase compared to the traditional system with partial water renewal. [ABSTRACT FROM AUTHOR]

Aiming at the problem that inserting a needle into the abdomen of spindle-shaped fish can easily damage the internal organs during vaccine injection, this paper takes grass carp as the experimental object and designs a fry adsorption injection device. Through theoretical analysis, the key factors affecting the adsorption force are determined. The internal cavity of the adsorption block is simulated and optimized under the given boundary conditions. The single-factor test shows that the H-shaped suction head has the best adsorption effect. Further orthogonal experiments found that the height of the adsorption port, the adsorption port's length, and the diameter of the adsorption port are important factors that affect the test results, and they are arranged in descending order of their importance. The optimal parameter combination is the adsorption port height of 3 mm, adsorption port length of 15 mm, and adsorption pore diameter of 3 mm. Under these parameters, the success rate of needle insertion is 98%, and the survival rate of fry is 100%, which can meet the production requirements. In summary, the adsorption and injection device is simple in design, easy to operate, and can significantly reduce the damage to the fish body. It provides an effective solution and design reference for fish vaccination. [ABSTRACT FROM AUTHOR]

The striped murrel (Channa striatus) is an economically valuable species in aquaculture due to its high price, medicinal properties, rapid growth, widespread consumer appeal, and ability to thrive in high-density intensive farming owing to its air-breathing capabilities. Despite these advantages, challenges in larval rearing hinder the production of high-quality fingerlings with increased survival rate. This review examines current larval rearing protocols for striped murrel, identifies bottlenecks, and explores digestive development during early stages to enhance understanding of its ontogeny. While advancements have been made, there are gaps in knowledge regarding the roles of specific genes and hormones during early development, and the impact of environmental factors on larval survival and metabolism. To address these gaps, this review draws an extensive knowledge acquired from studies on other fish species, examining digestive and metabolic genes, hormones, and environmental factors, with the goal of advancing larviculture practices for striped murrel. In addition, this review provides insights into the methodologies for studying the digestive system during early developmental stages of striped murrel larvae. [ABSTRACT FROM AUTHOR]

In this study, we investigated the effects of different Ca2+ and Mg2+ concentrations in the water column on the growth and molting of Macrobrachium rosenbergii. We used three concentrations of both Ca2+ and Mg2+ and tested these in culture experiments over a period of four complete molting cycles. Analyses revealed that increasing concentrations of Ca2+ in the water led to a gradual reduction in the expression levels of MIH and a gradual increase in the expression levels of EcR and chitinase, thus accelerating molting frequency and shortening the molting cycle. However, high concentrations of Ca2+ significantly reduced the survival rate of M. rosenbergii. Increasing concentrations of Mg2+ in the water column led to a significant increase in heart beat count (P < 0.05); in addition, malate dehydrogenase activity during postmolt A and intermolt C tended to increase, and energy metabolism was accelerated. Furthermore, increased Ca2+ concentrations in the water column promoted an increase in the Ca2+ content of muscles and shells. In contrast, as the Mg2+ concentration in the water column increased, the Mg2+ content in the muscles and shells showed different patterns of change. Too low or too high Ca2+ and Mg2+ concentrations in the external environment had differing degrees of negative effects on the gill tissue such as edema and necrosis. In summary, low levels of Ca2+ and Mg2+ in the external environment reduced ion levels in the muscle and shell; inhibited growth, molting, and survival; and exerted negative effects on the gill tissue. Furthermore, high concentrations of Ca2+ and Mg2+ may accelerate molting rate and energy metabolism, but can cause more serious damage to gill tissue and reduce the survival rate. [ABSTRACT FROM AUTHOR]

Objectives: Rural patients have poor cancer outcomes and clinical trial (CT) enrollment compared to urban patients due to attitudinal, awareness, and healthcare access differential. Knowledge of cancer survival disparities and CT enrollment is important for designing interventions and innovative approaches to address the stated barriers. The study explores the potential disparities in cancer survival rates and clinical trial enrollments in rural and urban breast and lung cancer patients. Our hypotheses are that for both cancer types, urban cancer patients will have longer 5-year survival rates and higher enrollment rates in clinical trials than those in rural counties. Methods: We compared breast and lung cancer patients' survival rates and enrollment ratios in clinical trials between rural (RUCC 4-9) and urban counties in Georgia at a Comprehensive Cancer Center (CCC). To assess these differences, we carried out a series of independent samples t-tests and Chi-Square tests. Results: The outcomes indicate comparable 5-year survival rates across rural and urban counties for breast and lung cancer patients, failing to substantiate our hypothesis. While clinical trial enrollment rates demonstrated a significant difference between breast and lung cancer patients at CCC, no significant variation was observed based on rural or urban classification. Conclusion: These findings underscore the need for further research into the representation of rural patients with diverse cancer types at CCC and other cancer centers. Further, the findings have considerable implications for the initiation of positive social change to improve CT participation and reduce cancer survival disparities. [ABSTRACT FROM AUTHOR]

This study sought to comprehensively evaluate the diagnosis, therapeutic interventions, and outcomes of individuals afflicted with malignant parotid tumors at a tertiary care otolaryngology department in Heilbronn, Germany, spanning the years 2010–2018. The primary objective was to juxtapose this dataset with findings from analogous single and multicenter investigations. We conducted a meticulous analysis of electronic medical records pertaining to 45 patients subjected to primary parotid cancer treatment. The male‐to‐female ratio was 3:2, with an average age of 61 years. Predominant histological types included mucoepidermoid and squamous cell carcinomas, with ultrasound emerging as the predominant diagnostic modality (97.8% sensitivity). Intraoperative frozen sections exhibited a high level of sensitivity. Notably, lymph node metastasis was prevalent in T3 tumors, frequently located intraparotid and at Neck level II. Solely one patient exhibited distant metastases (pulmonary). All patients underwent parotidectomy, and 29% necessitated a secondary procedure due to positive resection margins. Postoperative complications encompassed facial nerve palsy, seromas, and salivary fistulas. Adjuvant radiotherapy (38%) was recommended for high‐grade tumors, T3/T4 stage, N+, perineural invasion (PNI), and positive or uncertain surgical margins. Neck dissection was executed in 67% of instances, with 20% revealing occult lymph node metastases. Recurrence manifested in 22% of patients, primarily as locoregional recurrence (80%) and distant metastases (20%). The 3‐year recurrence‐free survival (RFS), cancer‐specific survival (CSS), and overall survival (OS) rates stood at 72.1%, 91.9%, and 87.5%, respectively. Noteworthy factors influencing RFS included preoperative facial palsy, T stage, resection margins, and PNI. In summary, the management of parotid cancer involving surgical interventions, neck dissection, and radiotherapy in high‐risk patients yielded commendable outcomes with minimal complications, showcasing survival rates exceeding 70%. Timely diagnosis at an early stage is imperative for achieving tumor‐free margins and enhancing survival rates. More assertive therapeutic strategies are advocated for cases presenting with preoperative facial nerve palsy and PNI. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusions To evaluate the influence of horizontal and vertical dental preparation techniques on tooth‐supported fixed restorations, with specific focus on survival and success rates, periodontal‐related variables, and patient‐reported outcome (PROs) measures.A comprehensive literature search of relevant randomized and controlled clinical trials (RCTs/CCTs), prospective/retrospective cohort studies, and case series with a minimum follow‐up period of 3 years was performed across electronic databases (Medline, Embase, and Cochrane) up to January 2024. Primary outcomes included success and survival rates, and secondary outcomes included periodontal variables, both mechanical and biological complications, and PROs. Two reviewers independently conducted study selection, data extraction, and quality assessment. Of the 837 articles initially identified, 19 were included in the final analysis. A meta‐analysis was conducted to compare the preparation techniques using survival and success rates as the main outcomes. Additionally, periodontal variables were analyzed.The included studies varied in design, follow‐up duration, restoration type, and materials used. Survival rates showed no significant differences between vertical and horizontal techniques (risk ratio (RR) 0.96–1.04, p = 0.95). Additionally, success rates (RR 0.93–1.14, p = 0.53) and periodontal variables also showed varied results with no clear preference for either technique.Both the horizontal and vertical preparation techniques exhibited comparable survival and success rates for dental restorations. Given that there was no significant difference in outcomes between the two, the choice of technique may depend on the clinician's preference and specific clinical scenarios. [ABSTRACT FROM AUTHOR]

To explore the altered malignant behavior, prognosis and survival of glioblastoma in contact with Subventricular Zone (SVZ) and independent predictors on patients' overall survival. The records of 131 patients with supratentorial primary glioblastoma who underwent surgery at our hospital between 2012 and 2018 were reviewed retrospectively. The authors reviewed preoperative MRI images and divided patients into two groups: Glioblastoma not in contact with SVZ (G-SVZ) and glioblastoma in contact with SVZ (G + SVZ). They computed and compared the overall survival (OS) of these two groups using the Kaplan–Meier method. The correlation between G + SVZ and OS was investigated using the Cox Proportional Hazard Ratio Model. The median progression-free survival (PFS) of the patient was 10 months (Interquartile Range), and the median OS was 13 months. At six months and one year, the OS was 81 percent and 51.1 percent, respectively. Patients with G + SVZ and G-SVZ had a median OS of 12 months and 15 months, respectively (p = 0.0093). According to Cox Multivariate model, repeat surgery (p = 0.001), among other independent predictors, including age ≥60, Karnofsky Performance Score (KPS) < 70, and extent of resection (Subtotal/biopsy vs total resection), had the strongest associated decreased OS. G + SVZ independently correlated significantly with reduced patient survival (p = 0.014). Repeat surgery had the strongest association with decreased OS among the independent predictors of survival in patients with G + SVZ lesions. Prospective studies about molecular mechanisms are needed to explain why G + SVZ lesions are thought to be aggressive and associated with a poor prognosis. [ABSTRACT FROM AUTHOR]

Background Inflammation and insufficient physical inactivity contribute to individual-level risk of disease recurrence and death in stage III colon cancer. The extent to which increased inflammatory risk can be offset by sufficient physical activity remains unknown. Methods This cohort study was nested within the Cancer and Leukemia Group B (now part of the Alliance for Clinical Trials in Oncology) and Southwest Oncology Group randomized trial. Inflammatory burden was quantified by high-sensitivity C-reactive protein, interleukin-6, and soluble tumor necrosis factor-α receptor 2 after recovery from tumor resection. Physical activity was measured during and after postoperative chemotherapy. The primary endpoint was disease-free survival. Results The 3-year disease-free survival rate was 88.4% among patients with low inflammation and sufficient physical activity (referent group for all comparisons), 84.9% with low inflammation and insufficient physical activity (absolute risk difference = −3.5 percentage points, 95% confidence interval [CI] = −11.3 to 4.3; P  = .38), 78.0% with intermediate inflammation and insufficient physical activity (absolute risk difference = −10.4 percentage points, 95% CI = −17.4 to −3.3; P  = .007), and 79.7% with high inflammation and insufficient physical activity (absolute risk difference = −8.7 percentage points, 95% CI = −15.7 to −1.6; P  = .022). In contrast, the 3-year disease-free survival rate was 87.3% among patients with intermediate inflammation and sufficient physical activity (absolute risk difference = −1.1 percentage points, 95% CI = −7.5 to 5.3; P  = .74) and 84.4% with high inflammation and sufficient physical activity (absolute risk difference = −4.0 percentage points, 95% CI = −12.3 to 4.3; P  = .34). Conclusion In this observational study of stage III colon cancer patients, physical activity was associated with improved disease-free survival despite high inflammation. Patients with intermediate or high inflammation who were physically active had disease-free survival rates that were not statistically significantly different from those with low inflammation. [ABSTRACT FROM AUTHOR]

The post-fledging period, defined as the period after a young bird leaves its nest, is a crucial stage for birds and is often when they face the highest risk of mortality. Current management for breeding birds has been primarily informed by the nesting and adult stages while the post-fledging period is often understudied, despite birds spending an equal or greater amount of time in the post-fledging period than they do in the nest. In 2020 and 2021 we documented habitat used, including water depth and vegetation height, cover, and type, and survival of 50 fledglings of Least Bittern (Ixobrychus exilis), a cryptic marsh bird of conservation concern in the midwestern United States. We compared habitat used by fledglings to habitat at randomly selected points within a daily dispersal distance determined by the fledgling's age. Fledglings used points with denser and taller marsh vegetation than random points and they relied on persistent emergent vegetation, which likely provides greater predator protection, thermal refuge, and foraging opportunities. Fledgling habitat use was age-dependent and related to flight ability, with younger, pre-flight fledglings using denser habitats and older juveniles with flight ability using more open habitat. Additionally, 86% of Least Bittern fledglings survived until 30 d post-hatch (when they often left the marsh they hatched in), a higher survival rate than in the limited previous studies of fledglings. Mortality resulted from predation and exposure, and the greatest mortality risk was in the 3 d following fledging and in 2020. Our results suggest that managing for a diversity of marsh habitats, including both densely vegetated habitats commonly used by nesting Least Bitterns and more open marsh habitats, is important for fledglings. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Compared to the 'single biopsy + single vitrification' approach, do 'double biopsy + double vitrification' or 'single biopsy + double vitrification' arrangements compromise subsequent clinical outcomes following euploidy blastocyst transfer? SUMMARY ANSWER Both 'double biopsy + double vitrification' and 'single biopsy + double vitrification' led to reduced live birth/ongoing pregnancy rates and clinical pregnancy rates. WHAT IS KNOWN ALREADY? It is not uncommon to receive inconclusive results following blastocyst biopsy and preimplantation genetic testing for aneuploidy (PGT-A). Often these blastocysts are warmed for re-test after a second biopsy, experiencing 'double biopsy + double vitrification'. Furthermore, to achieve better workflow, IVF laboratories may choose to routinely vitrify all blastocysts and schedule biopsy at a preferred timing, involving 'single biopsy + double vitrification'. However, in the current literature, there is a lack of systematic evaluation of both arrangements regarding their potential clinical risks in reference to the most common 'single biopsy + single vitrification' approach. STUDY DESIGN, SIZE, DURATION A systematic review and meta-analysis were performed, with the protocol registered in PROSPERO (CRD42023469143). A search in PUBMED, EMBASE, and the Cochrane Library for relevant studies was carried out on 30 August 2023, using the keywords 'biopsy' and 'vitrification' and associated variations respectively. Only studies involving frozen transfers of PGT-A tested euploid blastocysts were included, with those involving PGT-M or PGT-SR excluded. PARTICIPANTS/MATERIALS, SETTING, METHODS Study groups included blastocysts having undergone 'double biopsy + double vitrification' or 'single biopsy + double vitrification', with a 'single biopsy + single vitrification' group used as control. The primary outcome was clinical pregnancy, while secondary outcomes included live birth/ongoing pregnancy, miscarriage, and post-warming survival rates. Random effects meta-analysis was performed with risk ratios (RR) and 95% CIs were used to present outcome comparisons. MAIN RESULTS AND THE ROLE OF CHANCE A total of 607 records were identified through the initial search and nine studies (six full articles and three abstracts) were eventually included. Compared to 'single biopsy + single vitrification', 'double biopsy + double vitrification' was associated with reduced clinical pregnancy rates (six studies, n = 18 754; RR = 0.80, 95% CI = 0.71–0.89; I 2 = 0%) and live birth/ongoing pregnancy rates (seven studies, n = 20 964; RR = 0.72, 95% CI = 0.63–0.82; I 2 = 0%). However, no significant changes were seen in miscarriage rates (seven studies, n = 22 332; RR = 1.40, 95% CI = 0.92–2.11; I 2 = 53%) and post-warming survival rates (three studies, n = 13 562; RR = 1.00, 95% CI = 0.99–1.01; I 2 = 0%) following 'double biopsy + double vitrification'. Furthermore, 'single biopsy + double vitrification' was also linked with decreased clinical pregnancy rates (six studies, n = 13 284; RR = 0.84, 95% CI = 0.76–0.92; I 2 = 39%) and live birth/ongoing pregnancy rates (seven studies, n = 16 800; RR = 0.79, 95% CI = 0.69–0.91; I 2 = 70%), and increased miscarriage rates (five studies, n = 15 781; RR = 1.48, 95% CI = 1.31–1.67; I 2 = 0%), but post-warming survival rates were not affected (three studies, n = 12 452; RR = 0.99, 95% CI = 0.97–1.01; I 2 = 71%) by 'single biopsy + double vitrification'. LIMITATIONS, REASONS FOR CAUTION All studies included in this meta-analysis were retrospective with varying levels of heterogeneity for different outcomes. Not all studies had accounted for potential confounding factors. Only one study reported neonatal outcomes. WIDER IMPLICATIONS OF THE FINDINGS Our data indicated adverse impacts of 'double biopsy + double vitrification' and 'single biopsy + double vitrification' on clinical outcomes following euploid blastocyst transfers. Patients should be carefully consulted about the risks when offered such approaches. The biopsy process should be carried out as carefully and competently as possible to minimize an inconclusive diagnosis. STUDY FUNDING/COMPETING INTEREST(S) R.W. is supported by a National Health and Medical Research Council Emerging Leadership Investigator Grant (2009767). There is no other external funding to report. All authors report no conflict of interest. REGISTRATION NUMBER CRD42023469143. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Very low birth weight infants in the NICU are more susceptible to adverse outcomes. We recently described improving survival without major morbidity among very low birth weight infants in California. This study aims to examine whether this improvement was equitable across racial and ethnic groups. METHODS: We included 66 786 infants from the California Perinatal Quality Care Collaborative who weighed <1500 grams or were <29 weeks' gestational age at birth and were cared for between January 1, 2008 and December 31, 2021. We examined rates of survival without major morbidity over time, stratified by safety net NICUs (snNICUs), as well as racial and ethnic groups. RESULTS: Between 2008 and 2021, survival without major morbidity increased from 62.2% to 66.1% (P < .001), although improvement plateaued after 2017. All racial and ethnic groups saw improvement, with Native Hawaiian/Pacific Islander and Black infants improving the most (12.4% and 9.8%, respectively). However, during the last 3 years, Hispanic infants had the lowest rates of survival without major morbidity (64.3%), compared with non-Hispanic white (67.6%), Black (67.8%), Asian (68.9%), Native Hawaiian/Pacific Islander (68.5%), and American Indian/Alaskan Native (69.9%) infants. Black and Hispanic infants were disproportionately cared for in snNICUs, which experienced significantly lower survival without major morbidity than non-snNICUs at all time points. CONCLUSIONS: We observed improvement in survival without major morbidity over 14 years, with progress stalling in recent years. Opportunities to address health inequities in NICU outcomes remain, particularly in snNICUs, while identifying strategies for continued improvement overall. [ABSTRACT FROM AUTHOR]