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Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that causes acute, subacute, and chronic human arthritogenic diseases and, in rare instances, can lead to neurological complications and death. Here, we combined epidemiological, virological, histopathological, cytokine, molecular dynamics, metabolomic, proteomic, and genomic analyses to investigate viral and host factors that contribute to chikungunya-associated (CHIK) death. Our results indicate that CHIK deaths are associated with multi-organ infection, central nervous system damage, and elevated serum levels of pro-inflammatory cytokines and chemokines compared with survivors. The histopathologic, metabolite, and proteomic signatures of CHIK deaths reveal hemodynamic disorders and dysregulated immune responses. The CHIKV East-Central-South-African lineage infecting our study population causes both fatal and survival cases. Additionally, CHIKV infection impairs the integrity of the blood-brain barrier, as evidenced by an increase in permeability and altered tight junction protein expression. Overall, our findings improve the understanding of CHIK pathophysiology and the causes of fatal infections., Competing Interests: Declaration of interests M.S.D. is a consultant or advisor for Inbios, Ocugen, Vir Biotechnology, Topspin Therapeutics, Moderna, Merck, and Immunome. The Diamond laboratory has received funding support from Emergent BioSolutions, Moderna, and Vir Biotechnology., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

This split-mouth randomized controlled trial aimed to evaluate the primary and secondary stability of hybrid implants with different thread configurations and hydrophilic surfaces. Twenty patients with a partially edentulous maxilla were selected. These patients received two types of implants with the same hydrophilic surface: CTP group: Cylindrical-Tapered implant with perforating threads; CTH: Cylindrical-Tapered implant with hybrid threads configuration (perforating and condensing threads). The primary and secondary stability parameters were measured by insertion torque and resonance frequency analysis at the time of implant placement and 7, 28, 56, and 90 days after the surgical procedure. The paired t-test was used to compare the data on the implant's stability between the groups. The statistical analysis was performed with a confidence level set at 95%. It was found that the implants in the CTH group presented higher primary stability values ​​at the time of implant placement, due to the higher ISQ (63.61 ± 9.44 vs. 40.59 ±7.46) and insertion torque (36.92 ± 16.50 Ncm vs. 28.00 ± 14.40 Ncm), than the implants in the CTP group. The CTH group presented higher ISQ values ​​in all follow-up periods: 7 days (68.67 ± 7.60 vs. 41.55 ± 9.07), 28 days (68.61 ± 5.98 vs. 47.90 ±13.10), 56 days (74.09 ± 3.96 vs. 55.85 ± 13.18), and 90 days (75.45 ± 4.02 vs. 63.47 ± 6.92) after implant placement. Hybrid implants with perforating and condensing threads demonstrated greater stability than hybrid implants with only perforating threads.