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Neospora caninum is an obligate intracellular parasite that causes abortion in ruminants. Different strains produce differences in the severity of disease outcomes. These differences may cause physiological or pathological changes in cells, modifying the intercellular interactions and intracellular transport pathways that could be evidenced by identifying the terminal sugars. This study aimed to characterize the oligosaccharide pattern in the bovine placenta and uterus after infection with tachyzoites of three different strains of N. caninum (Nc-1, Nc-6 Argentina and Nc Spain-7) during early gestation. Fourteen heifers were inoculated intravenously on day 70 of gestation with 2 × 108 N. caninum tachyzoites and samples of placentae and uteri were analysed by histology and lectin histochemistry. In the infected groups, severe placentitis was associated with changes in lectin binding in the vascular endothelium by Lens culinaris agglutinin (LCA), Pisum sativum agglutinin (PSA) and Ricinus communis I (RCA-I) lectins, in the epithelial cells of the endometrial glands by RCA-I, Dolichos biflorus agglutinin (DBA), succinylated wheat germ agglutinin, peanut agglutinin (PNA), concanavalin-A (CON-A), LCA, PSA and Phaseolus vulgaris erythroagglutinin (PHA-e), and in the trophoblast layer by PNA, CON-A, LCA, PSA, PHA-e, soybean agglutinin, RCA-I, DBA and Bandieraea simplicifolia agglutinin (BSA-I). The results suggest that N. caninum causes changes in the glycosylation pattern in the maternofetal interface tissues and might cause abortions in early gestation due to changes in the cellular structure of the placenta. [ABSTRACT FROM AUTHOR]

Neutrophil extracellular traps (NETs) have been described as structures composed of DNA and proteins, such as elastase and myeloperoxidase, that are able to kill bacteria extracellularly. The aim of the present study was to evaluate the role of NETs in bone resorption observed in pulp infection–induced apical periodontitis in mice. Apical periodontitis was experimentally induced by exposing the dental pulp of the mandibular first molar of mice to the oral microenvironment. The expression of NETs was evaluated by immunofluorescence in mice and biopsies of apical periodontitis. Mice were treated with vehicle or DNase I to degrade NETs, and the samples were collected after 7 days. The size of the apical lesion and the osteoclast number were determined in hematoxylin-eosin– and tartrate-resistant acid phosphatase–stained sections, respectively. Osteoclast differentiation and function markers were evaluated by quantitative polymerase chain reaction. The level of NETs in the serum was determined by the myeloperoxidase-DNA PicoGreen assay. We first confirmed the presence of neutrophils and NETs at the site of the lesion in mice and in biopsies of patients with apical periodontitis. The treatment of mice with DNase I reduced the level of NETs in the serum and led to a reduction in apical lesion size and alveolar bone resorption. This effect was associated with a reduction of local inflammatory infiltrate and a reduced number of osteoclasts. We found that the increased expression of Acp5 , Ctsk , and Rankl genes associated with osteoclast formation and function were abrogated by the absence of NETs. Our data highlight NETs as an important player in the pathogenesis of apical periodontitis with regard to the local inflammation and consequent bone resorption after pulp infection. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the relational architecture of the Intergovernmental Panel on Climate Change (IPCC) focussing on the individuals that, in the thirty years of its existence, have assured the connection between its different components. To study relational bridging within the IPCC, we created a unique database of all the individuals who have contributed to the organisation since its establishment and noted in which workstream they participated (i.e., function + Working Group + Assessment Report). From this database we extract the participants-workstreams affiliation network and use it to compute several metrics of bridgeness, which we discuss, validate, and compare. We use these metrics to investigate the general distribution and evolution of bridging in the IPCC, but also to identify individuals who more actively provided connections between its authors and government representatives (functional bridges), its Working Groups (thematic bridges) and its assessment cycles (temporal bridges). Focussing on the role of key bridge individuals and their trajectories within the organisation, we provide insights on the IPCC as a network organisation. • The paper is based on an original dataset of more than 8000 individuals who have contributed to the IPCC since 1988. • The paper investigates the individuals who have contributed to keeping together the different components of the IPCC. • The paper identifies temporal, thematic and functional bridge individuals and qualitatively analyses their career in the IPCC. [ABSTRACT FROM AUTHOR]

Tuned mass dampers (TMD) are an established method to reduce self-excited chatter vibrations in turning. Regarding boring bars, the susceptibility to chatter increases with increasing length and, even more, with decreasing tool diameter. A novel TMD for boring bars with diameters down to 10mm is presented. The TMD-design, consisting of a mass and a spring-damper combination, is based on analytical and numerical modelling. By using a futed boring bar design, the available design space allows to place a damping mass of sufcient mass ratio at the tool tip. Cutting tests showed the reduction of vibrations. [ABSTRACT FROM AUTHOR]

The coastal areas of Montevideo-Canelones, Uruguay, are strongly affected by anthropogenic activities. Polycyclic aromatic hydrocarbons (PAHs) are of especial ecological concern due to their acute toxicity. The study aimed to evaluate the relationship between different pollution levels and the ecological structure of macrobenthic communities of the subtidal coastal zone and to assess the ecological risk of the 16 PAHs identified by US EPA for these communities. Communities in Montevideo Bay are under the influence of combined effects of natural oscillations and anthropic pollution, while the adjacent coastal areas communities are strongly influenced by El Niño Southern Oscillation. Toxicity assessments classified two sites in Montevideo Bay as medium to low risk. This study allowed recognizing the complex nature of the responses of benthic organisms to multiple stressors and the importance of considering different approaches. • The macrobenthos is influenced by natural oscillations and hydrocarbon pollution. • Toxicity assessments classified two sites in Montevideo Bay as medium to low risk. • Generalized Linear Model was useful to explain Heleobia australis densities. [ABSTRACT FROM AUTHOR]

[Display omitted] • DOCA-salt hypertension promotes loss of the anticontractile effect of m PVAT in resistance arteries. • EWH prevents the m PVAT damage caused by DOCA-salt hypertension. • EWH modulates RAS axis and reduces redox balance and inflammatory state in DOCA-salt hypertensive rats. Perivascular adipose tissue (PVAT) regulates vascular tonus with an anticontractile effect, which may be dysfunctional in hypertension. An Egg White Hydrolysate (EWH), a bioactive food, restores endothelium dysfunction and reduces blood pressure levels in malignant hypertension. We aimed to evaluate whether dietary supplementation with EWH interferes with the PVAT function in the mesenteric resistance arteries (MRA) of DOCA-salt hypertensive animals and the mechanisms involved. Male rats were divided into 4 groups and treated for 8 weeks. For 4 weeks, DOCA-salt or vehicle-treated rats (SHAM) were induced, and after that, some rats were co-treated with DOCA-salt or vehicle plus EWH (1 g/kg/day) for 4 weeks more. MRA and/or their PVAT (m PVAT) were used for functional, molecular, and biochemical analysis. The anticontractile effect of m PVAT in response to norepinephrine (NE) was observed only in MRA rings with PVAT of the SHAM group, while this effect was abolished in DOCA-salt rings. The EWH treatment did not change the anticontractile effect of m PVAT in SHAM but partially restored it in DOCA-salt rats. Acute aliskiren incubation reduced NE-induced contraction only in MRA with PVAT of DOCA-salt rats. EWH prevented the overactivation of the renin levels and ACE activity in m PVAT of DOCA-salt rats; while did not change AT1R expression, but increased AT2R expression. In m PVAT, EWH blocked the increase of MDA, ROS and pro-inflammatory cytokines observed in DOCA-salt rats. EWH improved PVAT dysfunction in MRA of severe hypertension. This beneficial effect could be mediated by an ameliorated redox balance, inflammatory state, and RAS axis. [ABSTRACT FROM AUTHOR]

The reliability of gas turbine diagnostics clearly relies on reliable measurements. However, raw data reliability can be corrupted by label noise issues, as for instance an erroneous association between data and the respective unit of measure. Such issue, rarely investigated in the literature, is named Unit of Measure Inconsistency (UMI). Machine Learning classifiers are suitable tools to tackle the challenge of UMI detection. Thus, this paper investigates the capability of four Support Vector Machine approaches to detect UMIs. All approaches are tested on a dataset composed of field data taken on a fleet of Siemens gas turbines. The results of this study demonstrate that the Radial Basis Function with One-vs-One decomposition allows higher diagnostic accuracy. • Detection of Unit of Measure Inconsistency (UMI) in gas turbine sensors. • Comparison of four Support Vector Machine (SVM) approaches. • Exploitation of experimental data acquired from a fleet of gas turbines. • Challenging analyses for assessing the best SVM approach for UMI detection. [ABSTRACT FROM AUTHOR]

Pain after lower limb orthopedic surgery can be severe. Poorly controlled pain is associated with adverse outcomes. Peripheral nerve blocks (PNB) have become popular in foot and ankle surgery for their effective pain control and low complication rates. It has always been assumed that hindfoot procedures are more painful than midfoot/forefoot procedures often requiring inpatient stay for pain relief. There are no published studies evaluating this assumption. To investigate whether hindfoot procedures are more painful than forefoot/midfoot procedures by measuring pain scores, assessing effectiveness of PNBs and patient satisfaction. One hundred forty patients undergoing elective foot and ankle surgery were prospectively studied. Inclusion criteria: Adults undergoing elective foot and ankle surgery. Exclusion criteria: Patients 16 years or under, those with alternate sources of pain, peripheral neuropathy, known substance abuse, psychiatric illness and incomplete pain scores. Pain was measured via the Visual Analog Scale at 3 time intervals: immediately, 6 hours and at 24 hours postoperatively. Analysis was via t-test. A p value of <.05 demonstrated a statistical significance. Forefoot/midfoot versus hindfoot surgery pain scores showed that there was no significant difference at any postoperative interval. PNB versus no PNB pain scores showed there was no significant difference, except at 24 hours postoperatively (p value.024). Patients who had a PNB experienced rebound pain at 24 hours. Hindfoot surgery is not more painful than forefoot/midfoot surgery. Patients who had a PNB experienced rebound pain at 24 hours postoperatively, a finding that requires further research. [ABSTRACT FROM AUTHOR]

Objectives: Recently emerging SARS-CoV-2 variants have been associated with an increased rate of transmission within the community. We sought to determine whether this also resulted in increased transmission within hospitals.Methods: We collected viral sequences and epidemiological data of patients with community and healthcare associated SARS-CoV-2 infections, sampled from 16th November 2020 to 10th January 2021, from nine hospitals participating in the COG-UK HOCI study. Outbreaks were identified using ward information, lineage and pairwise genetic differences between viral sequences.Results: Mixed effects logistic regression analysis of 4184 sequences showed healthcare-acquired infections were no more likely to be identified as the Alpha variant than community acquired infections. Nosocomial outbreaks were investigated based on overlapping ward stay and SARS-CoV-2 genome sequence similarity. There was no significant difference in the number of patients involved in outbreaks caused by the Alpha variant compared to outbreaks caused by other lineages.Conclusions: We find no evidence to support it causing more nosocomial transmission than previous lineages. This suggests that the stringent infection prevention measures already in place in UK hospitals contained the spread of the Alpha variant as effectively as other less transmissible lineages, providing reassurance of their efficacy against emerging variants of concern. [ABSTRACT FROM AUTHOR]

Editor: Endovascular treatment of visceral artery aneurysms and visceral artery pseudoaneurysms might be performed with a wide range of devices. Because of suspected bleeding, a CT angiography was performed, revealing a 3-cm splenic artery pseudoaneurysm. Final angiograms and postprocedure CT angiography confirmed the correct positioning of the aortic endoprosthesis and the absence of the hepatic artery's SG (Fig 2a-c). [Extracted from the article]

Purpose: To report the safety and efficacy of the embolization of splenic artery aneurysms (SAAs) with coils plus ethylene vinyl alcohol copolymer (EVOH) agent.Materials and Methods: A single-center retrospective study was conducted from 2016 to 2019 to collect SAAs. Twelve asymptomatic patients (mean age, 59 years) with 15 SAAs (mean size, 23.6 mm; size range, 15-40 mm) were treated with embolization. Embolization was performed with EVOH (Squid 8/34) and fibered detachable coils. Transfemoral embolization was performed with a microcatheter to achieve a splenic artery occlusion embolizing the SAA and its efferent and afferent branches. Follow-up was based on color Doppler ultrasound at 24 hours and on computed tomography (CT) angiography at 1 (n = 12) and 6 months (n = 12) after embolization. Mean number of coils and Squid vials used for each patient, major/minor complications, technical success, 30-day clinical success, cases of revascularization/reintervention, and mortality were assessed. Technical success was defined as complete exclusion of the aneurysmal segment and cessation of blood flow into the sac. Clinical success at 1 month was based on the absence of clinical symptoms and the exclusion of aneurysm revascularization on CT angiography.Results: The mean number of coils and Squid vials was 5.75 (standard deviation [SD], 1.58; range, 3-9) and 1.41 (SD, 0.49; range, 1-2), respectively. Both technical and 30-day clinical success were 100%, with no cases of aneurysm revascularization (CT angiography performed in all patients at 1 month and 6 months and in 3 patients at 24 months). No major complications or fatal events were recorded. In terms of minor complications, 2 cases of mild pancreatitis (transient amylases increase) and 1 case of focal splenic ischemia without clinical sequelae were recorded.Conclusions: Embolization in SAAs using coils plus EVOH was safe and effective without SAA revascularization. [ABSTRACT FROM AUTHOR]

In search of novel prognostic biomarkers for clear cell renal carcinoma (ccRCC), we analysed the expression of several proteins related to angiogenesis and hypoxia. A monocentric study on 30 consecutive surgical samples from surgically-treated ccRCC patients with a 10-year follow up was performed. The following proteins were analysed by immunohistochemistry: Vascular Endothelial Growth Factor- A (VEGF-A), Platelet-Derived Growth Factor β Receptor (PDGFRβ), VEGF-receptor 1 (Flt1), VEGF-receptor 2 (KDR), Glucose Transporter 1 (GLUT1), Carbonic anhydrase IX (CA-IX) and the hERG1 potassium channel. Data were analysed in conjunction with the clinico-pathological characteristics of the patients and follow up. All the proteins were expressed in the samples, with statistically significant associations of VEGF-A with PDGFRβ and Flt1 and hERG1 with CA IX. Notably, hERG1 and CAIX co-immunoprecipitated in primary ccRCC samples and survival analysis showed that the positivity for hERG1 and CA IX had a negative impact on Recurrence Free Survival (RFS) at the univariate analysis. At the multivariate analysis only hERG1 maintained its statistically significant negative impact. Conclusions: hERG1 expression can be exploited to predict recurrence in surgically-treated ccRCC patients. hERG1 channels form a multiprotein complex with the pH regulator CA IX in primary ccRCC samples their potential use as therapeutic target might be suggested. [ABSTRACT FROM AUTHOR]

Malignant melanomas (MMs) represent 7% of all malignant neoplasms in dogs. Oral melanocytic neoplasms are often malignant and associated with poor prognosis. There are no universally accepted prognostic markers for canine oral melanoma. Galectin (Gal)-3 is a prognostic marker for human neoplasms such as thyroid, gastric, colorectal and prostate cancers. The protein is related to processes that favour cancer progression, such as angiogenesis, proliferation and apoptosis. The aim of the present study was to characterize the immunohistochemical expression of Gal-3 in canine oral melanomas and to compare it with post-surgical survival, the expression of apoptosis-related proteins and other known prognostic tools. Twenty-seven samples of canine oral melanomas were evaluated for Gal-3, B-cell lymphoma (BCL) 2, caspase (CASP) 3 and Ki67 expression, mitotic index and degree of nuclear atypia. Gal-3 cytoplasmic positivity was correlated positively, while nuclear positivity was correlated negatively, with survival. The intensity of BCL2 labelling was also correlated positively with Gal-3 cytoplasmic positivity. Higher nuclear atypia was observed in dogs with melanoma that died due to the tumour, as well as in dogs that survived for <1 year after surgery. We have confirmed the importance of nuclear atypia for MMs and suggest that Gal-3 is a valuable prognostic indicator for this neoplasm. More in-depth studies are needed to unveil Gal-3 functions in canine MMs using larger sample sizes. [ABSTRACT FROM AUTHOR]

Background: The performance of QuantiFERON-TB Gold In-Tube (QTF-IT) in children is under debate, especially in those under 5 years of age. Moreover, interpretation of discordant QFT-IT/Tuberculin-Skin-Test (TST) results remains controversial. This study aims at studying the sensitivity of QFT-IT and TST in children with active TB cases and exploring risk factors associated with discordant TST+/QFT-IT-.Methods: Children consecutively referred to one single pediatric center between 2010 and 2017 for suspected tuberculosis infection (TB) were enrolled. All children underwent clinical evaluation, TST and QFT-IT. Sensitivity of QFT-IT and TST in active TB cases and risk factors associated with discordant TST+/QFT-IT- results were assessed. Uni- and multi-variate logistic regression analyses were performed.Results: Overall, 4631 children (median age 5.67 years) were enrolled, and 205 active TB cases were diagnosed (83 microbiologically confirmed). A high QFT-IT sensitivity was observed in children between 2 and 4 years of age (95.0%; 95%CI: 85.4-100) and in those between 5 and 18 years (89.1%; 95%CI:79.2-99.2) with microbiologically confirmed active TB. However, sensitivity was suboptimal in children younger than 2 years (84.6%; 95%CI: 65.0-100). Independent risk factors associated with discordant TST+/QFT-IT- results in children with latent tuberculosis infection (LTBI) were previous BCG vaccination (aOR:2.18; 95%CI:1.33-3.58; p = 0.002), age <2 years vs. 5-18 years (aOR:7.54; 95%CI:2.52-22.59; p < 0.0001), age 2-4 years vs. 5-18 years (aOR:4.63; 95%CI:2.66-8.06; p < 0.0001), and investigation for screening rather than for contact with a suspected or confirmed case (aOR:3.58; 95%CI:2.30-5.59; p < 0.0001).Conclusion: Our data suggest that QFT-IT might be used as unique assay in children over 2 years of age investigated for recent immigration/adoption screening and in cases of recent low risk TB contact. This approach could considerably reduce the number of children undergoing pharmacological treatment. Conversely, both tests are recommended in cases of strong clinical suspicion or high risk TB contact in children less than 5 years of age, in order to avoid misdiagnosis. [ABSTRACT FROM AUTHOR]

to map (a) methodological features, (b) Haemorrhagic Cystitis (HC) preventive and treatment interventions scrutinized to date, (c) outcomes measured, and (d) trends in effectiveness as documented among Haematopoietic Stem Cell Transplanted (HSCT) adults. A scoping review was performed in 2018. Medline, CINAHL, and Cochrane Systematic Reviews databases were researched using "haemorrhagic cystitis", "prevention", "treatment", "prevent*" and "treat*" as search terms. Handsearching was also performed. Clinical trials, randomized controlled trials, comparative and observational studies, reviews, systematic reviews and meta-analyses published in English and concerning adults were all included. Fifteen primary studies, mainly monocentric, retrospective and with a sample size <200, were identified. Seven focused on preventive (mainly continuous bladder irrigation and mesna) and eight on treatment interventions (mainly intravenous and intravesical cidofovir). The onset of micro and macrohaematuria and the clinical resolution of HC were the main measured outcomes. Positive effectiveness trends were apparent for mesna and cidofovir. In HC prevention and treatment, published primary studies are sparse and further research is required with larger, multicenter, and longitudinal designs conducted at international levels, with standardized methods, interventions, outcome measures, and reported data. • In patients undergoing Haematopoietic Stem Cell Transplantation (HSCT), Haemorrhagic Cystitis (HC) has been documented as a severe complication. • Various reviews have been conducted to date; however, no clinical recommendations have been established in the field. • The aim of the scoping review was to map available studies to inform the development of more focused lines of research on both HC prevention and treatment. • Nurses can have a great role in designing further studies all require methodologically sound studies using homogeneous outcomes, with more standardized approaches in preventive and treatment intervention administration procedures. [ABSTRACT FROM AUTHOR]

European and international guidelines advice against initiating tube-feeding in patients with severe dementia. These recommendations are based on studies with important methodological limitations that evaluated the benefits of artificial nutrition in patients with percutaneous endoscopic gastrostomy almost exclusively in terms of the prolongation of survival. The aims of this study were to assess the harmful effects of home enteral nutrition administered via the nasogastric tube and percutaneous endoscopic gastrostomy in patients with advanced dementia in terms of mechanical, gastrointestinal and metabolic complications, to estimate the survival, to explore the risk factors for mortality and to compare the outcomes of patients with advanced dementia with those of patients without dementia. The retrospective observational study was carried out on 585 consecutive patients of the mean age of 85.6 ± 6.9 years. They were treated using home enteral nutrition from 2010 to 2015 according to follow-up protocols adopted by the Clinical Nutrition Unit of an Italian geriatric research hospital (IRCCS-INRCA, Ancona). Incidence rates of mechanical, gastrointestinal and metabolic complications and survival rates in patients with severe dementia were compared to those in patients without dementia. The Cox proportional hazards model was used to evaluate the mortality risk factors. There was no difference between the incidence rates of complications in patients with severe dementia and those in patients without dementia. The incidence of mechanical complications was 1.35/1000 days for patients without dementia vs. 1.53/1000 days for patients with dementia (p = 0.270), the incidence of gastrointestinal complications was 1.30/1000 days for patients without dementia vs. 1.35/1000 days for patients with dementia (p = 0.984) and the incidence of metabolic complications was 0.36/1000 days for patients without dementia vs. 0.35/1000 days for patients with dementia (p = 0.252). The Kaplan Mailer analyses showed that there was no evidence to support the theses on poorer prognosis of survival of patients with dementia (median survival was 193 days for patients without dementia vs. 192 days for patients with dementia, (p > 0.05)). The female gender, advanced age, nasogastric tube, diabetes mellitus and chronic renal failure were identified as risk factors. Subjects whose Geriatric Nutritional Risk Index values were higher had a lower risk of mortality. The discussion on the appropriateness of enteral nutrition in patients with severe dementia is still open. Our results show that, if there is a medical prescription for tube-feeding and a patient's surrogate decision-makers express free and informed consent to the tube-feeding of the patient, enteral nutrition should not be contraindicated a priori if the patient has severe dementia. Regular follow-up is mandatory to guarantee adherence to the therapy and achieve its initial aims and to ensure that the principles of beneficence and nonmaleficence are respected. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of the CAD/CAM burs experience (newer vs older as consequence of the milling sequence) on fatigue failure load (FFL), number of cycles for failure (CFF), and survival rates of lithium disilicate glass-ceramic simplified restorations adhesively cemented to a dentin analogue substrate. Three sets of CAD/CAM burs were used to mill disc-shaped ceramic specimens (1 bur set – 18 milled discs with 10 mm diameter and 1.5 mm thickness), considering the bur experience as a result of the milling sequence to compose the study groups: G1-6 – discs obtained from the 1st to 6th milling of each bur set; G7-12 – specimens from the 7th to 12th milling; G13-18 – discs from the 13th to 18th. Discs of dentin analogue (G10, 10 mm diameter and 2.0 mm thickness) were made to serve as substrate (base material) and randomly assigned into pairs with the respective ceramic discs. Then, the ceramic discs were adhesively cemented onto the dentin analogue substrate, composing a three-layer specimen that mimics a monolithic restoration of a posterior tooth. Specimens were tested under stepwise fatigue approach: frequency = 20 Hz, 5000 cycles at maximum load of 400 N to accommodate the testing assembly, followed by incremental steps of 200 N with initial load ranging from 10 to 1000 N, to a maximum of 20,000 cycles/each step, until the occurrence of failure (radial crack). FFL and CFF were recorded at the end of the testing and subjected to statistical analysis. Supplementary roughness analysis of the milled surface was performed (n = 18) using a contact profilometer. Residual stress after milling and acid etching were accessed via X-ray Diffractometry analysis. FFL and CFF were not affected by increase on bur experience (no statistical differences among groups), despite that, it affected both Ra and Rz parameters (G1-6 had the smoothest surface). The residual stress concentration was negligible (milling did not induce residual stress concentration). It is concluded that the fatigue behavior of adhesively cemented lithium-disilicate glass-ceramic restorations was not influenced by CAD/CAM bur experience (newer vs older as consequence of the milling sequence), and so the residual stress concentration induced by milling was negligible. • Simplified lithium-disilicate restorations were cemented to dentin analogue substrate. • The fatigue failure load and the number of cycles to failure were evaluated. • Increase in bur experience (as a result of the milling sequence) had no effect on fatigue performance. • The first six milled lithium-disilicate restorations presented smoother surface. • The residual stress concentration induced by milling was negligible. [ABSTRACT FROM AUTHOR]

To evaluate the fatigue failure load (FFL), number of cycles for failure (CFF) and survival probabilities of lithium-disilicate (LD) monolithic crowns manufactured by two processing techniques (pressing vs. CAD/CAM) adhesively cemented to a dentin-analogue material, considering two surface treatments (conventional vs. simplified). Surface characteristics (topography, roughness and fractal dimensions) were also assessed. Forty (40) monolithic crowns were manufactured considering two specific processing techniques for each ceramic system: LDCAD – CAD/CAM lithium-disilicate (IPS e.max CAD, Ivoclar Vivadent); LDPRESS – pressed lithium-disilicate (IPS e.max Press, Ivoclar Vivadent). The crowns were adhesively cemented (Multilink Automix System, Ivoclar Vivadent) onto dentin analogue preparations considering two distinct protocols of surface treatments (conventional – hydrofluoric acid etching + silane application [HF+Sil] or simplified – etching with one-step primer (Monobond Etch&Prime, Ivoclar Vivadent) [EP]). The cemented assembly was stored in distilled water at 37 °C for 3 days and fatigue tests were run (step-stress approach: load ranging from 400 to 2000 N, step-size of 100 N, 15,000 cycles/step, 20 Hz). Fractography, surface topography, roughness, and fractal dimension analyses were performed. LDPRESS[EP] group depicted higher FFL, CFF and survival probabilities in comparison to LDCAD groups, regardless of the conditioning method. A tendency of higher Weibull modulus (mechanical reliability) was observed when using [EP] for both LDPRESS and LDCAD. SEM and AFM analysis showed very distinct initial surface patterns for the distinct processing techniques considered (LDCAD with higher fractal dimension and lower roughness than LDPRESS), and both surface treatments distinctly affected these surface characteristics. All failures were radial cracks originating at the ceramic-cement interface. Pressed lithium-disilicate monolithic crowns showed better fatigue performance in comparison to CAD/CAM milled crowns, especially when they were treated with self-etching ceramic primer. The surface treatment with self-etching primer led to similar fatigue performance when compared to hydrofluoric acid plus silane application for the same processing technique, but it tended to provide higher mechanical reliability. • Pressed crowns led to better fatigue performance than milled crowns when using a self-etching primer conditioner; • Pressed crowns presented higher survival probabilities regardless of the conditioning method; • The surface treatments influenced the surface characteristics of lithium-disilicate ceramic; • The fatigue performance of either pressed or milled crowns were not affected by the surface treatments; • The self-etching primer tended to lead to higher mechanical reliability. [ABSTRACT FROM AUTHOR]

Background and Aim: Protein supplementation and resistance training (RT) are interventions that may counteract decline in muscle mass and increase in fat mass, thus reducing the risk of developing chronic diseases during the aging process. The objective of this study was to investigate the effect of whey protein (WP) pre- or post-RT on metabolic and inflammatory profile in pre-conditioned older women.Methods and Results: Seventy older women participated in this investigation and were randomly assigned to one of three groups: WP pre-RT and placebo post-RT (WP-PLA, n = 24), placebo pre-RT and WP post-RT (PLA-WP, n = 23) and placebo pre and post-RT (PLA-PLA, n = 23). Each group ingested 35 g of PLA or WP pre- and post-RT. RT was carried out over 12 weeks (three times/week; 3 x 8-12 repetition maximum). Body composition, blood pressure, blood samples and dietary intake were assessed pre- and post-intervention. After the intervention, WP groups showed greater improvements in appendicular lean soft tissue (ALST: WP-PLA, 3.1%; PLA-WP, 3.9%; PLA-PLA, 1.8%) and total cholesterol/high density lipoprotein cholesterol ratio (TC/HDL-C: WP-PLA, -12.11%; PLA-WP, -13.2%; PLA-PLA, -0.7) when compared with PLA-PLA. WP post-RT also showed improvements (P < 0.05) in ALST/appendicular fat mass ratio (PLA-WP, 5.8%; PLA-PLA, 1.3%), total body fat (PLA-WP, -3.8%; PLA-PLA: -0.1) and trunk fat mass (PLA-WP, -3.1%; PLA-PLA, -0.3%) when compared with PLA-PLA.Conclusion: WP pre- or post- RT promotes improvements in ALST and TC/HDL-C ratio in pre-conditioned older women. WP administered after RT was more effective in improving metabolic health Z-score and in reducing body fat compared to placebo group. [ABSTRACT FROM AUTHOR]

Abstract In this study we evaluated the photolarvicidal activity of different curcuminoids forms: Natural Turmeric (NT), Synthetic Curcumin (SC) and Synthetic curcumin formulated with sucrose (SCS) against Aedes aegypti larvae which is the major vector of dengue, chikungunya and Zika viruses. Two strategies for curcuminoids delivery were chosen for the experiments: (i) larvae exposed to aqueous solutions of curcuminoids in the concentration range of 5–25 mg/L (w/v) and (ii) larvae exposed to two different types of curcuminoids carriers (pet food). Phototoxic effects of the curcuminoids were evaluated by counting the dead larvae after sunlight exposure, at irradiance range of 30–60 mW/cm2. The characteristic photobleaching time for each curcuminoids in solution was also determined in order to infer the safety of these molecules in the natural environment. Curcuminoids solutions showed high photolarvicidal activity after 30 min of sunlight irradiation, with LC 50 values of 20.0, 11.6 and 2.2 mg/L for NT, SC and SCS, respectively. The curcuminoids carriers, despite showing high mortality (about 90%), presented photodynamic activity only after 8 h of sunlight irradiation. The curcuminoids remained in the aqueous solution for up to 3 h; subsequently, the maximum absorption peak of these pigments was completely modified. The characteristic photobleaching time for each sample was 6, 32 and 60 min for NT, SC and SCS. These original and relevant results show that the combination of curcuminoids pigments with sunlight establishes an extremely effective alternative for Ae. aegypti larvae control, ensuring high environmental safety due to the low persistence of these molecules in the presence of light. Graphical abstract Unlabelled Image Highlights • Curcuminoids act as photoactivatable insecticides. • Photobleaching time of curcuminoids is long enough to kill Ae. aegypti larvae. • Curcuminoids accumulate mainly in the alimentary canal of Ae. aegypti larvae. [ABSTRACT FROM AUTHOR]

Abstract One of the main challenges related to the renewable energy labour market is that of human capital and as a consequence the educational profile of future employees is of paramount importance. Unfortunately, the skill level gained at University does not always fit with the practical needs of industry thus reducing the benefit-cost ratio of new employees and slowing down the transition to a green economy. Within this context, 'The Crux' project co-funded by EU under the framework of the Erasmus + programme aims at improving the renewable energy engineering curriculum at different university levels in several Universities of Latin America and Europe. In order to better appreciate the potential impact of the project, a survey on the labour market need for specialists with enhanced knowledge and skills in renewable and sustainable energy technologies has been conducted in the related EU and Latin America countries. More precisely, 60 organizations have been interviewed and almost 70% of them are interested in employing engineers with enhanced knowledge on renewable energy in the next three years. The analysis has shown significant discrepancies between EU and Latin American organizations. In fact, while future employees in EU countries will be mainly related to solar energy and management, the former together with wind and biomass will represent the main renewable energy working sector in Latin American countries. Moreover, MSc level will be the most demanded in EU while bachelor education seems to satisfy the future industry requirements in Latin America. Despite each country having its own needs, the research carried out under this EU project confirms the potential of renewable energy education on the global labour market in the near future. [ABSTRACT FROM AUTHOR]

Abstract In this paper, the optimal design of a hybrid energy plant composed of a solar thermal collector, a photovoltaic panel, a combined heat and power system, an absorption chiller, an air source heat pump, a ground source heat pump and a thermal energy storage is studied. The size of each technology is optimized by applying a model implemented in Matlab® environment. The optimization goal is the minimization of the primary energy consumed throughout the life cycle of the hybrid energy plant by using a genetic algorithm. The primary energy consumed during the manufacturing phase of the hybrid energy plant is represented by the cumulative energy demand and is calculated by carrying out a cradle to gate life cycle assessment. The primary energy consumed during the operation phase is evaluated by simulating the system throughout one year. The cumulative energy demand of each system composing the hybrid energy plant is calculated as a function of the technology size. Therefore, the problem of life cycle assessment scaling of renewable and non-renewable energy systems is also taken into account in this paper. A tower located in the north of Italy is selected as a case study and two different approaches are evaluated. The first approach consists of solving the sizing optimization problem by minimizing the primary energy consumption only during the operation phase, while in the second approach the primary energy consumption is minimized throughout the life cycle of the plant by integrating the life cycle assessment into the optimization process. The results show that, if life cycle assessment is accounted for, the optimal hybrid energy plant configuration is different and a higher primary energy saving (approximately 12%) is achieved. [ABSTRACT FROM AUTHOR]

Abstract This study evaluated the fatigue failure load, number of cycles for failure and survival probability of 2nd and 3rd generation yttrium-stabilized zirconia (YSZ) adhesively cemented to a dentin analogue substrate. Disc-shaped specimens (n = 10; Ø = 10 mm; thickness = 1.0 mm) were produced from four 2nd generation YSZs (Lava Plus, 3M ESPE; Vita In-Ceram YZ-HT, VITA Zahnfabrik; Zirlux FC, Ivoclar Vivadent; Katana ML-HT, Kuraray) and two 3rd generation YSZs (Katana UTML and Katana STML, Kuraray). Each YSZ disc was adhesively cemented (Multilink Automix System) onto its dentin analogue pair (epoxy resin, Ø = 10 mm; thickness = 2.5 mm). Fatigue tests were conducted through step-stress approach (load ranging from 400 to 2600 N; step-size of 200 N; 20,000 cycles per step, 20 Hz) and the obtained data were analyzed using Kaplan Meier and Mantel-Cox tests. Surface topography and phase transformation (m-, t-, and c -phases) inspections after particle air-abrasion of the YSZs were performed, as well as fractographic analysis of the failed specimens. Second-generation zirconia materials presented higher fatigue failure load, number of cycles for failure, and survival probability than 3rd generation. Similar topographical characteristics of the YSZs could be noted. Phase transformation (t- to m-phase) after YSZ air-abrasion was only observed for 2nd generation materials. All failures started from the surface/sub-surface defects located at the cementation interface. 2nd generation zirconia presented higher load-bearing capacity under cyclic loading than 3rd generation materials. Highlights • 2nd generation YSZ presented better fatigue performance than 3rd generation YSZ. • 2nd generation YSZ metastability enables phase transformation mechanisms. • 3rd generation YSZ are fully stabilized zirconia and have no toughening mechanism via phase transformation. [ABSTRACT FROM AUTHOR]

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Additive Manufacturing has proved to be suitable for supporting or even replacing traditional manufacturing approaches in some industrial contexts. Among the various processes that can be used to produce metal parts, Wire Arc Additive Manufacturing (WAAM) is known to be an economically convenient, welding-based direct energy deposition technique for large parts with reduced complexity. The present paper proposes a structured modelling framework to assess whether WAAM could successfully substitute machining processes. The costs, manufacturing times, energy demand and carbon footprint are considered. A case study is presented to clarify and demonstrate the applicability of the proposed methodology. [ABSTRACT FROM AUTHOR]

Abstract The increase of production and consumption of copper oxide nanostructures in several areas contributes to their release into aquatic ecosystems. Toxic effects of copper oxide nanoparticles (CuO NPs), in particular, on tropical aquatic organisms are still unknown, representing a risk for biota. In this study, the effects of rod-shaped CuO NPs on the Neotropical species Ceriodaphnia silvestrii and Hyphessobrycon eques were investigated. We also compared the toxicity of CuO NPs and CuCl 2 on these species to investigate the contribution of particles and cupper ions to the CuO NPs toxicity. Considering the low copper ions release from CuO NPs (<1%), our results revealed that the toxicity of CuO NPs to C. silvestrii and H. eques was mainly induced by the NPs. The 48 h EC 50 for C. silvestrii was 12.6 ± 0.7 μg Cu L−1 and for H. eques the 96 h LC 50 was 211.4 ± 57.5 μg Cu L−1 of CuO NPs. There was significant decrease in reproduction, feeding inhibition and increase in reactive oxidative species (ROS) generation in C. silvestrii exposed to CuO NPs. In fish H. eques , sublethal exposure to CuO NPs caused an increase in ROS generation in gill cells and an increase in cells number that were in early apoptotic and necrotic stages. Our results showed that CuO NPs caused toxic effects to C. silvestrii and H. eques and ROS play an important role in the toxicity pathway observed. Data also indicated that C. silvestrii was among the most sensitive species for CuO NPs. Based on predicted environmental concentration in water bodies, CuO NPs pose potential ecological risks for C. silvestrii and H. eques and other tropical freshwater organisms. Graphical abstract Image 1 Highlights • CuO NPs caused negative effects on feeding, reproduction and survival of C. silvestrii. • CuO NPs increased apoptosis and necrosis in H. eques gill cells. • ROS played an important role in the toxicity pathway. • CuO NPs pose potential ecological risks for Neotropical freshwater organisms. CuO NPs cause toxic effects to C. silvestrii and H. eques in environmentally relevant concentrations, posing potential risks for these species and the Neotropical biota. [ABSTRACT FROM AUTHOR]

Abstract This study investigated the effect of etching with distinct hydrofluoric (HF) acid concentrations on the cyclic load-to-failure (C Lf) of simplified lithium disilicate glass-ceramic restorations adhesively cemented to a dentin analogue (n = 20): non-etched/control (CTRL), or etched for 20 s with HF acid at 3% (HF3), 5% (HF5), or 10% (HF10). A silane coating was then applied onto the ceramic surfaces. Fatigue tests followed the staircase approach (initial load= 720 N; step-size= 70 N; 500,000 cycles per sample; 20 Hz) using a hemispheric stainless-steel piston (Ø= 40 mm) under water. The C Lf data were analyzed using Dixon and Mood method. Topographic and fractographic analyses were conducted. C Lf (in N) of HF3 (1355 ± 32.0) and HF5 (1335 ± 58.8) groups were the highest and statistically similar; HF10 presented intermediate C Lf (1175 ± 132.9), while the non-etched group had the lowest one (965 ± 145.0). Topographical analysis showed that the higher the HF acid concentration, the more pronounced the topographical changes. All failures (radial cracks) started from the inner surface of the ceramic discs. Topographical changes promoted by intermediate HF acid concentrations (3% and 5%) may improve fatigue performance for adhesively-cemented lithium disilicate restorations. Highlights • The effect of HF acid on fatigue behavior of adhesively cemented simplified lithium disilicate ceramic restorations was evaluated. • The higher the HF acid concentration, the more pronounced the topographical changes. • Intermediate HF acid concentrations (3% and 5%) depicted the best load-bearing capability under fatigue. [ABSTRACT FROM AUTHOR]

Statement of problem Hydrofluoric acid etching modifies the cementation surface of ceramic restorations, which is the same surface where failure is initiated. Information regarding the influence of hydrofluoric acid etching on the cyclic loads to failure of ceramic crowns is lacking. Purpose The purpose of this in vitro study was to evaluate the influence of different hydrofluoric acid concentrations on the fatigue failure loads of feldspathic ceramic crowns. Material and methods Eighty feldspathic ceramic crowns were cemented with resin cement to identical simplified complete crown preparations machined in a dentin-like polymer. The preparations were etched with 10% hydrofluoric acid for 60 seconds and received a primer coating. Before cementation, the intaglio of the ceramic crowns was treated with 1 of 4 surface conditionings (n=20): nonconditioned (control, CTRL), or etched for 60 seconds with different hydrofluoric acid concentrations: 1% (HF1), 5% (HF5), and 10% (HF10). A silane coupling agent was applied on this surface of all crowns, which were cemented to the preparations. Each crown was cyclically loaded in water with a G10 epoxy-glass piston positioned in the center of the occlusal surface. Fatigue failure loads of ceramic crowns were obtained by the staircase approach after 500 000 cycles at 20 Hz. Mean failure loads were analyzed by 1-way ANOVA and the Tukey test (α=.05). Results Mean failure loads of groups CTRL (245.0 ±15.1 N), HF1 (242.5 ±24.7 N), and HF10 (255.7 ±53.8 N) were statistically similar ( P >.05), while that of the HF5 group (216.7 ±22.5 N) was significantly lower ( P <.05). Conclusions HF5 acid had a negative effect on the fatigue loads of the tested feldspathic ceramic crowns, while HF1 and HF10 acids did not change the fatigue resistance. [ABSTRACT FROM AUTHOR]

The availability of large-scale SNP genotyping panels for horses has opened up new possibilities for genetic studies of the species. The first panel version contained around 54,000 SNPs (54k). The current second generation panel possesses approximately 65,000 SNPs (65k), which 19,000 of them are new markers and 45,000 were present in the first panel. The objectives of this study were to perform two-step genotype imputation between individuals in a relatively small population sample of racing Quarter Horses genotyped with the 54k or 65k panel and to evaluate the accuracy of imputation in a practical situation. Genotypes were imputed using 116 horses genotyped with the 54k SNP array and 233 animals genotyped with the 65k array. For the simulations, random samples were chosen to compose the imputed (about 50% samples) and reference populations in two scenarios. Scenario A simulated the genotype imputation in the first step (from 65k to 54k) and the scenario B in the second step (from 54k to 65k). For each scenario, the individuals genotyped with the same panel were considered as the reference population but that were included in the imputed group had their exclusive genotypes masked for subsequent evaluation of imputation accuracy. Thus, after quality control, the 54k and 65k panels contained 7,048 and 16,940 exclusive markers, respectively. The mean concordance rate was 0.9815 and 0.9751 for scenarios A and B, and the mean allelic r 2 was 0.9791 and 0.974, respectively. No important influences of the genomic relationship coefficients on imputation accuracy were observed between the imputed and reference samples. Thus, two-step imputation of exclusive genotypes between the 54k and 65k equine panels resulted in a considerable increase of SNPs for all samples (12%–26%) without losses in the quality of information. [ABSTRACT FROM AUTHOR]

This paper presents a Coastal Risk Index (CRI-MED) developed to assess coastal risks and vulnerabilities associated with the physical and socio-economic impacts of climate change in all Mediterranean coastal zones. CRI-MED is a spatial risk index, which combines variables (multiple data layers) representing different aspects of risk in such a way that coastal areas of relatively higher risk emerge from the integration of the variables. It creates an interface between theoretical concepts of risk and the decision-making process relating to disaster risk reduction. Based on a GIS application, CRI-MED provides relative hazard, exposure, vulnerability and risk maps of the Mediterranean region that allow researchers and policy-makers to identify coastal areas most at risk from coastal erosion and coastal flooding, the so-called “hot-spots”. Through the application of CRI-MED on 21 Mediterranean countries, coastal hot-spots are found to be predominantly located in the south-eastern Mediterranean region. Countries with the highest percentage of extremely high risk values are Syria (30.5%), Lebanon (22.1%), Egypt (20.7%), and Palestine (13.7%). The CRI-MED method is intended as a scientific tool which produces easily understandable outcomes, to support international organizations and national governments to enhance and mainstream decision-making based on information that is accessible and useful. The definition of coastal hot-spots aims to support the prioritization of policies and resources for adaptation and Integrated Coastal Zone Management (ICZM). In particular, the resulting risk maps enable identification of suitable and less suitable areas for urban settlements, infrastructures and economic activities. [ABSTRACT FROM AUTHOR]

Summary Background & aims The purpose of this study was to comprehend and describe the views, experiences and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition. The objective was to gather empirical evidence to improve the delivery of Home Enteral Nutrition for old patients taking into account the caregivers' support needs. Methods A qualitative methodology with focus groups as data collection method was used to collect the testimonies of 30 informal and formal caregivers of older patients treated with Home Enteral Nutrition by the Clinical Nutrition Service of INRCA (Ancona) during 2014. Quantitative methodology was used to collect socio-demographic data. Partially modified Silver's “Home Enteral Nutrition Caregiver Task Checklist” was used to identify training needs. The constant comparison method was used to code and categorize data and to develop themes of focus groups. Simple descriptive statistics were used to summarize questionnaires. Results Five main themes were identified from focus groups: acceptance of the therapy, skill acquisition process, need for psychological and practical support at home from healthcare professionals, lifestyle adaptation, affirmation of life and family. All caregivers testified the initial fear and refusal to manage the nutrition pump and the therapy. They expressed the need to be trained gradually, starting during a patient's hospitalization, and continuing in the community. With reference to their overall QoL, it emerged that informal caregivers suffered mostly from the reduction of their free time while formal caregivers suffered social isolation and psychological burden. For both groups the monthly home visit was the most important element of the HEN service. Informal caregivers highlighted the importance of having their loved ones at home. Unsatisfied training needs were identified by the modified Silver's “Home Enteral Nutrition Caregiver Task Checklist”. Conclusions This qualitative study underlined the challenges and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition, which should be considered when defining clinical protocols and supporting caregivers. [ABSTRACT FROM AUTHOR]

Summary The evolution of techniques and materials has made gluteoplasty a safe and reproducible operation with high acceptance among surgeons and patients. Functional aspects should be considered in gluteoplasty but are poorly studied. The sensitivity of the buttocks is fundamental as it represents an erogenous zone and provides protection through sensory stimuli for the prevention of pressure sores and burns. This study aimed to evaluate the sensitivity of the gluteal region in patients undergoing gluteal augmentation with implants. We included 20 consecutive patients undergoing gluteoplasty and 20 controls not undergoing gluteal surgery. All patients are females and were being treated at the Division of Plastic Surgery of the Rio de Janeiro State University. The right and left gluteal regions were delimited, and each one was divided into four quadrants numbered 1–8. Sensitivity tests were performed in all quadrants for six different stimuli: touch, heat, cold, pain, vibration, and pressure. The mean age and BMI were 36.3 years and 26.3, respectively. No difference in sensitivity was observed in the gluteal region after augmentation gluteoplasty when compared with those patients who had no operation in this series. Prospective and controlled studies are needed to better assess these issues. [ABSTRACT FROM AUTHOR]

This paper is about the optimal selection of process parameters for Wire Arc Additive Manufacturing technology, an emerging solution for additive production of metal parts. In particular, the selection of the process parameters is based on the evolution of the microstructure and on the mechanical properties of the final samples obtained through the successive deposition weld beads of a ER70S-6 steel, according to the AWS legislation. The feed rate and the heat input during the deposition of the weld beads have been varied, in order to understand how the temperature reached by the samples can affect the final product mechanical characteristics. The final cooling has been carried in calm air at room temperature and between the deposition of a weld bead and the following one it has been imposed a pause of 60s. The tests on mechanical properties carried out have been: A full experimental campaign that includes: macrographic observations, micrographic observations and Vickers microhardness. The analysis of these tests has highligthed that by varying the process parameters, the samples do not have substantial differences between them. Instead, a microstructure that evolves from pearlitic-ferritic grains until bainitic lamellae along the vertical direction of the samples has been observed by micrographic analysis and confirmed by microhardness measurements. [ABSTRACT FROM AUTHOR]

The dearth of long-time series hampers the measurement of the ecosystem change that followed the global marine climate shift of the 1980–90s. The sessile communities of Portofino Promontory reefs (Ligurian Sea, NW Mediterranean) have been discontinuously studied since the 1950s. Collating information from various sources, three periods of investigations have been distinguished: 1) 1950–70s; 2) 1980–90s; 3) 2000–10s. A cooler phase in time 1 was followed by a rapid warming in time 2, to stabilize at about 0.5 °C higher in time 3. Human pressure grew impressively, especially after the establishment of a MPA in 1999. Multivariate analyses evidenced a major change of community composition in time 2. Some species disappeared or got rarer, many found refuge at depth, and among the newcomers there were recently introduced alien species. This study demonstrated the importance of descriptive historical data to understand magnitude and pattern of change in the long term evolution of marine ecosystems. [ABSTRACT FROM AUTHOR]

To characterize the effect of the occlusal contact region on the mechanical fatigue performance and on the fracture region of monolithic lithium disilicate ceramic crowns. Monolithic lithium disilicate ceramic crowns were machined in a CAD/CAM system and adhesively luted onto glass-fiber reinforced epoxy resin preparations with resin cement. The crowns were divided into three groups (n = 16) according to load application region (cusp tip: restricted to cusp tips; cusp plane: restricted to cuspal inclined plane; or mixed: associating tip cusp and cuspal inclined plane). The specimens were submitted to a cyclic fatigue test (initial load: 200 N; step-size: 100 N; cycles/step: 20,000; loading frequency: 20 Hz; load applicator: 6 mm or 40 mm diameter stainless steel) until observing cracks (1st outcome) and fracture (2nd outcome). The data were analyzed by the Kaplan-Meier + Mantel-Cox post-hoc tests for both outcomes (cracks and fracture). Finite element analysis (FEA), occlusal contact region, contact radii measurements, and fractographic analyzes were performed. The mixed group presented worse fatigue mechanical behavior (550 N / 85.000 cycles) compared to the cuspal inclined plane group (656 N / 111,250 cycles) (p < 0.05) for the first crack outcome, while the cusp tip group was similar to both groups (588 N / 97,500 cycles) (p > 0.05). The mixed group had the worst fatigue behavior (1413 N / 253,029 cycles) in relation to the other groups (Cusp tip: 1644 N / 293,312 cycles; Cuspal inclined plane: 1631 N / 295,174 cycles) considering the crown fracture outcome (p < 0.05). FEA showed higher tensile stress concentration areas just below the load application region. In addition, loading on the cuspal inclined plane induced a higher tensile stress concentration in the groove region. The most prevalent type of crown fracture was the wall fracture. Groove fracture was observed in 50% of the loading specimens exclusively on the cuspal inclined plane. Load application on distinct occlusal contact regions affects the stress distribution pattern and consequently the mechanical fatigue performance and fracture region of the monolithic lithium disilicate ceramic crowns. A combination of loading at distinct regions is recommended to promote better evaluation of the fatigue behavior of a restored set. • The loading pattern influences the fatigue performance of lithium disilicate crowns. • The fracture region of monolithic crowns changes according to the adopted loading pattern. • The combination of occlusal loading at distinct regions leads to better evaluation of the fatigue behavior of a restored set. [ABSTRACT FROM AUTHOR]