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Patients treated with antineoplastic therapy often develop thrombocytopenia requiring platelet transfusion, which has potential to exacerbate pulmonary injury. This study tested the hypothesis that amotosalen-UVA pathogen-reduced platelet components (PRPCs) do not potentiate pulmonary dysfunction compared with conventional platelet components (CPCs). A prospective, multicenter, open-label, sequential cohort study evaluated the incidence of treatment-emergent assisted mechanical ventilation initiated for pulmonary dysfunction (TEAMV-PD). The first cohort received CPC. After the CPC cohort, each site enrolled a second cohort transfused with PRPC. Other outcomes included clinically significant pulmonary adverse events (CSPAE) and the incidence of treatment-emergent acute respiratory distress syndrome (TEARDS) diagnosed by blinded expert adjudication. The incidence of TEAMV-PD in all patients (1068 PRPC and 1223 CPC) was less for PRPC (1.7 %) than CPC (3.1%) with a treatment difference of -1.5% (95% confidence interval [CI], -2.7 to -0.2). In patients requiring ≥2 PCs, the incidence of TEAMV-PD was reduced for PRPC recipients compared with CPC recipients (treatment difference, -2.4%; 95% CI, -4.2 to -0.6). CSPAE increased with increasing PC exposure but were not significantly different between the cohorts. For patients receiving ≥2 platelet transfusions, TEARDS occurred in 1.3% PRPC and 2.6% CPC recipients (P = .086). Bayesian analysis demonstrated PRPC may be superior in reducing TEAMV-PD and TEARDS for platelet transfusion recipients compared with CPC recipients, with 99.2% and 88.8% probability, respectively. In this study, PRPC compared with CPC demonstrated high probability of reduced severe pulmonary injury requiring assisted mechanical ventilation in patients with hematology disorders dependent on platelet transfusion. This trial was registered at www.ClinicalTrials.gov as #NCT02549222.

Purpose: To evaluate the effect of restora0on design on fracture resistance and stress distribu0on of veneered and monolithic three-unit zirconia fixed par0al dentures (FDPs) using finite element analysis (FEA). Materials and Methods: Iden0cal epoxy resin replicas of mandibular second premolars and second molars (to serve as abutments for the three-unit bridges) were divided into four groups (n = 10): monolithic zirconia (MZ) restora0ons; conven0onal layering veneering technique (ZL); heat pressed-on technique (ZP); or CAD/CAM lithium-disilicate glass-ceramics (CAD-on). Specimens were subjected to compressive cyclic loading on the mesio-buccal cusp of the pon0c (load range 50 to 600 N; aqueous environment; 500,000 cycles) in a universal tes0ng machine. Data were sta0s0cally analyzed at 5% significance level with Fisher exact test and Kaplan-Meier survival analysis. 3D models were constructed in accordance with experimental groups. The stress distribu0on in each model was analyzed and evaluated according to the loca0on and magnitude of the maximum principal stresses (MPSs) using ANSYS so\ware. Results: Specimens from ZL and ZP groups failed at different stages of the 500,000 cycles fa0gue, while CAD-on and MZ restora0ons survived the fa0gue test. Sta0s0cally, there was a significant difference between the groups (P < .001). The MPS were located under the mesial connector in both monolithic and bilayered three-unit zirconia FDPs. These stresses were found to be higher in monolithic geometries compared to bilayered zirconia FDPs. Conclusions: Monolithic threeunit zirconia and CAD-on zirconia frameworks resulted in superior fracture resistance. Restora0on design significantly affected the stress distribu0on of three-unit zirconia FDPs. [ABSTRACT FROM AUTHOR]

BackgroundPlatelet transfusion carries risk of transfusion-transmitted infection (TTI). Pathogen reduction of platelet components (PRPC) is designed to reduce TTI. Pulmonary adverse events (AEs), including transfusion-related acute lung injury and acute respiratory distress syndrome (ARDS) occur with platelet transfusion.Study designAn open label, sequential cohort study of transfusion-dependent hematology-oncology patients was conducted to compare pulmonary safety of PRPC with conventional PC (CPC). The primary outcome was the incidence of treatment-emergent assisted mechanical ventilation (TEAMV) by non-inferiority. Secondary outcomes included: time to TEAMV, ARDS, pulmonary AEs, peri-transfusion AE, hemorrhagic AE, transfusion reactions (TRs), PC and red blood cell (RBC) use, and mortality.ResultsBy modified intent-to-treat (mITT), 1068 patients received 5277 PRPC and 1223 patients received 5487 CPC. The cohorts had similar demographics, primary disease, and primary therapy. PRPC were non-inferior to CPC for TEAMV (treatment difference -1.7%, 95% CI: (-3.3% to -0.1%); odds ratio = 0.53, 95% CI: (0.30, 0.94). The cumulative incidence of TEAMV for PRPC (2.9%) was significantly less than CPC (4.6%, p = .039). The incidence of ARDS was less, but not significantly different, for PRPC (1.0% vs. 1.8%, p = .151; odds ratio = 0.57, 95% CI: (0.27, 1.18). AE, pulmonary AE, and mortality were not different between cohorts. TRs were similar for PRPC and CPC (8.3% vs. 9.7%, p = .256); and allergic TR were significantly less with PRPC (p = .006). PC and RBC use were not increased with PRPC.DiscussionPRPC demonstrated reduced TEAMV with no excess treatment-related pulmonary morbidity.

Creativity is negatively associated with certain personality traits (e.g., conformity) and social influences (e.g., group pressure). In this study, creativity was examined in relation to unconventionality, which was expected to correlate positively with creativity, especially originality. This hypothesis was based on the theory that unconventional people hold uncommon views and attitudes and develop more diverging concepts and associations, which build the foundation for creative thinking. To examine the hypothesis, an online study with N = 90 participants was conducted. Unconventionality was measured with a new self-rating questionnaire, and creativity was measured with unusual uses, consequences, and explanations measures, which assessed both originality (rarity and uniqueness) and flexibility (diversity). The association of unconventionality with originality, after controlling for flexibility, was compared to other constructs (openness, conservatism, education). Path analysis revealed strong effects of unconventionality on originality (latent ß = 0.58, r = 0.64). Unconventionality continued to predict originality after controlling for openness, which was weakly related to originality (ß = 0.08, r = 0.49). Unconventionality weakly predicted flexibility (ß = 0.09, r = 0.26). Supplemental analyses indicated that the effects of unconventionality on originality were not attributable to confounds (e.g., conservatism or education). The results indicate that the effects of unconventionality are positive, specific, substantial, and independent of related constructs (e.g., openness).

This in vitro study evaluated the influence of restoration design (bi-layered vs. monolithic) and manufacturing technique on the marginal discrepancy and internal fit of 3-unit zirconia fixed dental prostheses (FDPs). Mandibular second premolars and second molars were prepared as abutments in a 3-unit zirconia bridge to develop four groups (n = 10 FDPs): MZ: Monolithic zirconia FDPs, ZL: zirconia framework veneered by the hand-layering technique, ZP: zirconia framework veneered by the heat-pressed technique, and CAD-on: zirconia framework veneered by CAD/CAM lithium-disilicate glass–ceramic. All the zirconia FDPs were cemented to their corresponding die replicas using dual-cure resin cement and were subjected to compressive cyclic loading at a load range for half a million cycles using a universal testing machine. FDPs were sectioned mesiodistally to measure the marginal gap and internal fit using scanning electron microscopy. The measurements were taken at pre-assigned points of each abutment. Data were statistically analyzed via a Kruskal–Wallis test (α = 0.05). No significant differences were found between the monolithic and bi-layered zirconia groups in terms of the marginal discrepancy. However, there was a significant difference in the marginal gap between the zirconia groups. The marginal gap between monolithic and bi-layered zirconia FDPs was within the clinically acceptable range (<100 μm). Comparable mean values of the marginal gaps of 3-unit monolithic and veneered zirconia FDPs were found. Therefore, the FDP design and veneering methods did not affect the marginal discrepancy. However, the mean internal gap varied among the experimental groups. As the current in vitro investigation demonstrated equivalent mean values of marginal gaps of both 3-unit monolithic and bi-layered zirconia FPDs, the use of monolithic 3-unit zirconia FPDs would be a viable alternative fabrication technique. [ABSTRACT FROM AUTHOR]