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The alveolar bone is an essential consideration when planning treatment for patients with tooth agenesis. This study evaluated the changes in the alveolar bone and adjacent teeth in patients with a congenitally missing mandibular lateral incisor using cone-beam computed tomography.Twenty-three nonorthodontically treated adults with a unilateral congenitally missing mandibular lateral incisor were the missing group (M group). The control group (C group) consisted of 23 nonorthodontically treated adults with normal occlusion and no missing teeth. First, the difference in the arch perimeter between the groups was compared at the cementoenamel junction (CEJ) level and the root apex (RA) level. Next, the root divergence of the anterior teeth in the M group was observed. Finally, the alveolar bone thickness ratio was compared between the M and C groups at different vertical levels.The arch perimeter was significantly decreased in the M group at the CEJ and RA levels (P 0.05). Root divergence was observed adjacent to the missing site (P 0.0001). There were a reduction in total and cancellous cortical alveolar bone thickness (ABT) ratios at the 3-, 6-, and 9-mm positions (P 0.05). The buccal cortical ABT ratios decreased at the 3-and 6-mm positions. The lingual ABT ratio increased at the 9-mm position (P 0.05).The congenitally missing mandibular lateral incisor caused a reduction in the arch perimeter in the CEJ area and the RA area. The root divergences were observed in the teeth adjacent to the missing areas. A significant decrease in the buccal cortical bone and cancellous bone was observed in the missing area.

Inflammatory bowel diseases (IBD) are affected by dietary factors, including nondigestible carbohydrates (fibers), which are fermented by colonic microbes. Fibers are overall beneficial, but not all fibers are alike, and some patients with IBD report intolerance to fiber consumption. Given reproducible evidence of reduced fiber-fermenting microbes in patients with IBD, we hypothesized that fibers remain intact in select patients with reduced fiber-fermenting microbes and can then bind host cell receptors, subsequently promoting gut inflammation.Colonic biopsies cultured ex vivo and cell lines in vitro were incubated with oligofructose (5 g/L), or fermentation supernatants (24-hour anaerobic fermentation) and immune responses (cytokine secretion [enzyme-linked immunosorbent assay/meso scale discovery] and expression [quantitative polymerase chain reaction]) were assessed. Influence of microbiota in mediating host response was examined and taxonomic classification of microbiota was conducted with Kraken2 and metabolic profiling by HUMAnN2, using R software.Unfermented dietary β-fructan fibers induced proinflammatory cytokines in a subset of IBD intestinal biopsies cultured ex vivo, and immune cells (including peripheral blood mononuclear cells). Results were validated in an adult IBD randomized controlled trial examining β-fructan supplementation. The proinflammatory response to intact β-fructan required activation of the NLRP3 and TLR2 pathways. Fermentation of β-fructans by human gut whole microbiota cultures reduced the proinflammatory response, but only when microbes were collected from patients without IBD or patients with inactive IBD. Fiber-induced immune responses correlated with microbe functions, luminal metabolites, and dietary fiber avoidance.Although fibers are typically beneficial in individuals with normal microbial fermentative potential, some dietary fibers have detrimental effects in select patients with active IBD who lack fermentative microbe activities. The study is publicly accessible at the U.S. National Institutes of Health database (clinicaltrials.gov identification number NCT02865707).

The increasing prevalence of multidrug-resistant organism (MDRO) carriage poses major challenges to medicine as healthcare costs increase. Recently, faecal microbiota transplantation (FMT) has been discussed as a novel and effective method for decolonising MDRO.To compare the efficacy of different FMT methods to optimise the success rate of decolonisation in patients with MDRO carriage.This prospective cohort study enrolled patients with MDRO carriages from 2018 to 2021. Patients underwent FMT via one of the following methods: oral capsule, oesophagogastroduodenoscopy (EGD), colonoscopy, or gastric tube.A total of 57 patients underwent FMT for MDRO decolonisation. The colonoscopy group required the shortest time for decolonisation, whereas the EGD group required the longest (24.9 vs. 190.4 days, p = 0.022). The decolonisation rate in the oral capsule group was comparable to that in the EGD group (84.6% vs. 85.7%, p = 0.730). An important clinical factor associated with decolonisation failure was antibiotic use after FMT (odds ratio = 6.810, p = 0.008). All four groups showed reduced proportions of MDRO species in microbiome analysis after FMT.Compared to other conventional methods, the oral capsule is an effective FMT method for patients who can tolerate an oral diet. The discontinuation of antibiotics after FMT is a key factor in the success of decolonisation.

Although the hydrolysis mechanism of the nerve agents, which is the main decontamination pathway, has been studied experimentally and theoretically, the reliable theoretical prediction method for the hydrolysis rate is not studied yet. Furthermore, after the CWC (Chemical Warfare Agent) list is updated, Novichok candidate structures can be more than 10,000 structures, for which it is not possible to perform the experiment for all of them for synthesizing and getting the hydrolysis rate. Therefore, developing a reliable theoretical method for hydrolysis rate prediction is crucial to prepare for the forthcoming usage of new types of nerve agents. Herein, by using DFT (Density Functional Theory), we successfully developed a new method of predicting the hydrolysis rate on nerve agents by investigating the electrophilicity index (EI) of the various A-, V-, and G-series nerve agents and found a suitable correlation with the experimental hydrolysis rate. Among the several DFT methods, wb97xD predicts the EI with the lowest % deviation of the studied nerve agents. Our results show that EI can be a good indicator to predict the hydrolysis rate of the anticipated nerve agents. Based on the result, we predicted the hydrolysis rate on another type of Novichok candidates, which could be the firm basis for developing a decontaminant and antidote with much fewer experimental efforts on new types of nerve agents.

Although the density of tumor-infiltrating lymphocytes (TILs) is known to be linked to prognosis in various cancers, the prognostic impact and immunologic significance of the spatial heterogeneity of TILs have been rarely investigated. In this study, CD3+ and CD8+ TILs were quantified in independent cohorts (discovery, n = 73; and external validation, n = 93) of colorectal carcinomas (CRCs) with microsatellite instability-high (MSI-H) utilizing whole-slide image analysis of CD3/CD8 immunohistochemistry. The Shannon and Simpson indices, which measure intratumoral patch-to-patch evenness of TIL densities, were used to quantitatively assess the spatial heterogeneity of TILs in each case. To uncover immune-related gene expression signatures of spatial heterogeneity-based TIL subgroups of MSI-H CRCs, representative cases were subjected to GeoMx digital spatial profiler (DSP) analysis. As expected, a low density of TILs was significantly associated with poor disease-free survival (DFS) in MSI-H CRCs. The TIL-low tumors were further classified into two subgroups based on the spatial heterogeneity of TILs: TIL-low/heterogeneity-high and TIL-low/heterogeneity-low subgroups. In both discovery and validation cohorts, the TIL-low/heterogeneity-high, TIL-low/heterogeneity-low, and TIL-high subgroups were significantly associated with poor, intermediate, and good DFS, respectively. In the DSP analysis, the TIL-low/heterogeneity-high subgroup showed higher spatial diversity in the expression of immune-related genes than that of the TIL-low/heterogeneity-low subgroup and exhibited upregulation of genes related to immune checkpoints, chemokine/cytokine receptors, and myeloid cells. TIL-low/heterogeneity-high tumors were also enriched with gene sets related to good response to immune checkpoint inhibitor therapy. In conclusion, TIL-low MSI-H CRCs are prognostically heterogeneous and can be divided into prognostically and immunologically distinct subgroups by considering the spatial heterogeneity of TILs. Our data suggest that intratumoral spatial heterogeneity of TILs can be used as a key element for clinically relevant immunologic subtyping of tumors.

Infective endocarditis is a life-threatening condition and is associated with embolic events. We aimed to evaluate the association of vegetation size, multiplicity, and position with cerebral embolism and late mortality in patients with infective endocarditis.We retrospectively reviewed patients with infective endocarditis who were admitted to a single institution between November 2005 and August 2017. A total of 419 patients with infective endocarditis were included in the study, 273 of whom had undergone surgery. The primary endpoint was all-cause mortality, and the secondary endpoint was cerebral embolism. Multivariate Cox regression and logistic regression analyses were performed to identify independent risk factors for 30-day mortality, late mortality, and cerebral embolism.Age (hazard ratio [HR] 1.02; 95% confidence interval [CI], 1.00 to 1.04), renal failure (HR 4.21; 95% CI, 2.67 to 6.65), surgery (HR 0.31; 95% CI, 0.21 to 0.46), and Acute Physiology and Chronic Health Evaluation II score (HR 1.08; 95% CI, 1.01 to 1.15) were associated with late mortality. Vegetation size, multiplicity, and position were not significantly associated with late mortality, but a mitral vegetation size of greater than 10 mm (odds ratio 2.25; 95% CI, 1.32 to 3.84) was an independent risk factor for cerebral embolism.A vegetation size of greater than 10 mm and the mitral position were found to be significant risk factors for cerebral embolism, and for this group, early surgery might be considered to prevent cerebral embolism.

Distinct, irregular, and hard, nodular labial protuberances (LPs) that were due to differential alveolar bone modeling can be noted on the labial gingival surface of the incisors after orthodontic treatment. Clinically, LPs cause patient discomfort and esthetic issues, but information on this phenomenon is limited. This study aimed to evaluate the incidence of LPs and demonstrate the etiology and clinical risk factors associated with this phenomenon.Differential alveolar bone modeling was defined as present (+) when ≥1 distinct LPs (diameter 1 mm) developed after orthodontic treatment by comparing pretreatment and posttreatment intraoral photographs and casts of an orthodontic patient cohort treated with fixed appliances (n = 872). The incidence rate, affected sites, and their association with age, sex, and orthodontic treatment modalities were evaluated.The incidence rate of differential alveolar bone modeling among orthodontic patients was 3.2% (28 out of 872). The maxillary lateral incisor region was the most frequently affected site. Males (vs females) (odds ratio, 2.56 [95% confidence interval, 1.155-5.604]), adults (aged ≥ 20 years) (vs teens) (12.84 [3.003-54.866]), and those who had orthodontic extraction (vs nonextraction) (11.60 [3.434-39.156]) demonstrated significantly higher odds of developing LPs after orthodontic treatment (P 0.05).The incidence rate of the development of notable LPs after orthodontic treatment was 3.2%. Adult males and those who undergo orthodontic extraction have a higher risk of developing LPs. Clinicians should be aware that distinct LPs may develop when large amounts of incisal retraction are planned in adults.

Streptococcus parauberis, a gram-positive cocci, causes bacterial disease in farmed fish. The recent increase in S. parauberis infection in aquatic farms in South Korea has justified the importance of vaccine development for the prevention of this disease. In this study, we evaluated the effect of subunit vaccines prepared from recombinant M-like protein (SimA) and fibrinogen-binding protein (FBP) candidates with an aluminum hydroxide adjuvant against S. parauberis infection in olive flounder Paralichthys olivaceus. For the in vivo experiment, fish (average length, 7.18 cm; average weight, 3.5 g) were injected intraperitoneally with: phosphate buffer saline (PBS, group 1), PBS/aluminum hydroxide (group 2), FBP/aluminum hydroxide (group 3), SimA/aluminum hydroxide (group 4), and SimA/FBP/aluminum hydroxide (group 5). After 3 weeks, the fish in each group were boosted using PBS (group 1 and 2), FBP (group 3), SimA (group 4), and SimA/FBP (group 5) without adjuvant. We found that the relative percent survival of fish after S. parauberis exposure in group 2, 3, 4, and 5 was 6.25%, 18.75%, 50%, and 12.5%, respectively, whereas the mortality in groups 1 was 80%, respectively. We performed Western blot, ELISA, and quantitative real time RT-PCR (qRT-PCR) after vaccination to investigate the further efficacy of the vaccine. Western blot and ELISA of vaccinated fish serum confirmed the production of specific antibodies against SimA and FBP. Furthermore, results of qRT-PCR showed that recombinant protein SimA induced a remarkably specific-antibody response compared with that in FBP or control and increased the expression of various immune response-related genes including interleukin-8 (IL-8), toll-like receptor 2 (TLR2), tumor necrosis factor-α (TNF-α), CD4-1, and MHC II. Thus, these results indicate that SimA is a potent vaccine candidate for protection against S. parauberis infection.

In Wireless Multimedia Sensor Networks (WMSNs), nodes capable of retrieving video, audio, images, and small scale sensor data, tend to generate immense traffic of various types. The energy-efficient transmission of such a vast amount of heterogeneous multimedia content while simultaneously ensuring the quality of service and optimal energy consumption is indispensable. Therefore, we propose a Power-Efficient Wireless Multimedia of Things (PE-WMoT), a robust and energy-efficient cluster-based mechanism to improve the overall lifetime of WMSNs. In a PE-WMoT, nodes declare themselves Cluster Heads (CHs) based on available resources. Once cluster formation and CH declaration processes are completed, the Sub-Cluster (SC) formation process triggers, in which application base nodes within close vicinity of each other organize themselves under the administration of a Sub-Cluster Head (SCH). The SCH gathers data from member nodes, removes redundancies, and forwards miniaturized data to its respective CH. PE-WMoT adopts a fuzzy-based technique named the analytical hierarchical process, which enables CHs to select an optimal SCH among available SCs. A PE-WMoT also devises a robust scheduling mechanism between CH, SCH, and child nodes to enable collision-free data transmission. Simulation results revealed that a PE-WMoT significantly reduces the number of redundant packet transmissions, improves energy consumption of the network, and effectively increases network throughput.

This meta-analysis assessed the impact of off-hour hospitalization (weekends, and evenings or nighttime on weekdays) on mortality and morbidity in patients with nontraumatic subarachnoid hemorrhage (SAH).Electronic databases were systematically searched for studies comparing outcomes between patients with nontraumatic SAH hospitalized during off-hour and on-hour periods (daytime on weekdays). The primary outcome was mortality (in-hospital and at different follow-up periods after hospitalization). Secondary outcomes included delays in treatment, and complications. Sensitivity analysis including only studies in which adjusted multivariate analyses were performed for any of the outcomes, and meta-regression controlling for clinically important patient factors, were also performed.Sixteen studies were included. There was no significant difference in in-hospital mortality (adjusted odds ratio, 1.03; 95% confidence interval [CI], 0.97-1.09; P = 0.30) and at all follow-up periods (7/14 days and 1/3/6 months) after hospitalization between SAH patients who were admitted during off-hour compared with on-hour periods, despite adjusted multivariate meta-analysis being performed. However, patients who were admitted during off-hour periods experienced greater delays from their initial scan to treatment (mean difference, 42.7, 25.2-60.1 hours; P0.0001) and had higher rates of pneumonia (odds ratio, 1.65, 1.12-2.44; P = 0.011).This meta-analysis has not shown an increased risk of mortality in the short-term and long-term among patients with nontraumatic SAH who were hospitalized during off-hour compared with on-hour periods, despite adjusting for potentially confounding patient factors. The delays to treatment and higher observed rates of pneumonia highlight areas in which hospital services and resources should be targeted during these off-hour periods in patients presenting with nontraumatic SAH.