CA Group Research Articles

Catheter Ablation for Atrial Fibrillation and Risk of Neurologic Disease

BackgroundCatheter ablation (CA) of atrial fibrillation (AF) has been proven to benefit patients with symptomatic AF and heart failure. However, the data on neurological outcomes including cerebrovascular accidents (CVA) and dementia remain controversial. ObjectiveWe aimed to determine the effect of CA on neurological events during long-term follow up. MethodsWe performed a systematic review and meta-analysis of patients with AF who underwent CA of AF. MEDLINE, EMBASE, and Web of Science databases were comprehensively searched from inception to January 2024. Studies that reported incidence of CVA and dementia in patients with AF were. Data from each study were combined by random effects model. The results were reported in risk ratios (RR) with 95% confidence intervals. ResultsA total of 29 studies and 379,993 patients (mean age: 58±4 years, 30% women) were included in the analysis. Mean follow up was 36±23 months (12-120). Patients who underwent CA of AF had a lower risk of developing CVA compared to medical management (OR 0.54; 95% CI 0.42 - 0 69, I2 = 91%). Moreover, the risk of dementia was lower in CA group compared to medical management (OR 0.51; 95% CI 0.4-0.66, I2 74%). The incidence of CVA in CA group was 1% (95% CI 1 - 2%, I2 = 97%) and incidence of dementia was 2% (95% CI 2-8%, I2 = 97%). ConclusionCatheter ablation of AF resulted in lower risk of CVA and dementia compared to medical management alone at long-term follow up.

Atrial fibrillation recurrence rates in patients with transthyretin cardiac amyloidosis undergoing pulmonary vein isolation: a comparative retrospective study with propensity score matching

Abstract Background Atrial fibrillation (AF) affects up to 70% of individuals diagnosed with transthyretin cardiac amyloidosis (ATTR CA) [1]. AF ablation is frequently considered in the management of these patients, but there is a lack of data about outcomes of the procedure in this population. Purpose This study aims to evaluate AF recurrence rates and long-term AF recurrence-free survival in patients with ATTR CA undergoing pulmonary vein isolation (PVI). Methods A single-center retrospective study was conducted, including all patients diagnosed with ATTR CA who underwent PVI from 2016 to 2023. We compared patients with amyloidosis (cases) to those without (controls), employing propensity score matching for age, gender, AF type (paroxysmal vs. persistent), BMI, diabetes, arterial hypertension diagnosis, antiarrhythmic drug therapy post-index ablation, and left atrium (LA) volume assessed by 3D rotational angiography (3DRA). Results 16 patients with CA were matched to 16 patients without (32 patients in total). After matching, the populations demonstrated comparable baseline characteristics (figure 1). The study consistently revealed a higher AF recurrence rate, after PVI, in the CA group (81.3%) compared to the control group (37.5%) at the last follow-up (p-value 0.01) (median follow-up 1255 ± 1055 days in CA and 1491 ± 464 days in control group), as well as a significantly lower long-term AF-recurrence free survival (log-rank p = 0.01 – figure 2). Additionally, the recurrence rate at 1-year post-procedure was 56.25% in the CA group and 18.75% in the control group (p-value 0.03). Conclusions Pulmonary vein isolation remains a viable treatment option for individuals with ATTR CA. However, it proved less effective (or less durable) than in the general population without the disease, both at 1-year follow-up and for longer periods, as shown also with recurrence-free survival rate. Further studies are warranted to determine the optimal treatment strategy for this specific population.Baseline Characteristics fig. 1Kaplan Meyer fig. 2

Concomitant cardiac arrest on cardiogenic shock patients. Differences in clinical profile and outcomes with non-cardiac arrest patients. The Shock CAT Study

Abstract Background Mortality on cardiogenic shock (CS) remains undesirable, although CS patients with or without concomitant CA may have different prognoses and clinical profile. Purpose The aim is to analyse differences in clinical profile, management, in-hospital prognosis and mid-term mortality in CS patients with and without cardiac arrest on admission in a Mediterranean cohort. Method Shock CAT study was a multicentre, prospective, observational study conducted between December 2018 and December 2019 in eight public University hospitals in Catalonia (Spain), including CS patients of different aetiologies. Data on clinical presentation, biomarkers, management, including mechanical cardiac/circulatory support (MCS), in-hospital and 6 months mortality were analysed comparing patients with and without CA at admission. Results A total of 382 CS patients (p) were included: CA 34.8% (n=133 p) and non-CA 65.2% (n=249 p). CA patients were younger than non-CA (61.9 vs 67.4 years, p<0.001) with higher prevalence of men (82% vs 71.8%, p= 0.024). Acute coronary syndrome was the main CS cause (60.7%) and ST elevation myocardial infarction (STEMI) was higher in CA patients than non-CA (55.6% vs 42.6%, p<0.001). In CA group, time to recover of spontaneous circulation was 24 min (IQR: 14-40 min) and hypothermia was performed in 55% of cases. CA patients had less prevalence of cardiovascular risk factors (hypertension, diabetes and dyslipidaemia) and lower pH at admission (7.19 vs 7.31, p<0.001) and higher lactate peak (6.9 vs 5.0, p=0.001) than non-CA patients. MCS was implanted in 35.3% of all CS patients, with lower use in CA patients (23.3% vs 41.8%, p<0.001), mainly due to lower intraaortic balloon pump (19.5% vs 35.5%, p=0.001), without differences in the use of extracorporeal membrane oxygenation (ECMO) (11.4% vs 8.7%, p=0.40) or Impella (10.6% vs 12.8%. p=0.54). Cardshock score was higher in CA patients than non-CA (4.68 vs 4.2, p=0.038), without differences in IABP score (2.31 vs 2.20, p= 0.621) or SCAI D/E (42.1% vs 33.3%, p= 0.090). In-hospital mortality was higher in CA patients (42.9% vs 27.7%, p=0<0.001). Moreover, 6-months mortality remains higher in CA than non-CA patients, although without statistical significance (47.7% vs 38.3%, p=0.079). Conclusions In a Mediterranean CS cohort, concomitant CA patients were younger, with higher prevalence in men with STEMI. MCS had a lower used in CA patients, although without differences in ECMO or Impella. In-hospital mortality was 35% higher in CA patients than non-CA, although 6-months mortality only trend to be higher in CA group.

Chronic postoperative pain syndrome and its neuropathic component in long-term period of coronary artery bypass grafting

Background: Along with increased safety and quality of the early postoperative period, 6.9% of patients who undergo sternotomy experience chronic pain at the surgical site. The significance of this issue is underestimated, with a third of these patients developing a neuropathic component of chronic pain syndrome. Aim: To assess the severity of acute and chronic postoperative pain following sternotomy and to identify predictors of the neuropathic component of chronic pain syndrome. Materials and methods: Out of 115patients who underwent elective coronary artery bypass grafting (CABG) randomized according to method of anesthesia, two study groups were formed based on the results of a telephone survey: a general anesthesia group (GA, n=28) and a combined anesthesia group (CA, n=34). As part of the posthoc analysis, a logistic regression model was built to predict chronic neuropathic pain syndrome based on gender, age, anesthesia method, and factors assessing the severity of the perioperative period and myocardial impairment. Results: Chronic postoperative pain syndrome was identified in 25.8% of patients, with a neuropathic component confirmed in 19.4% of cases. Pain severity at rest in the GA and CA groups was 2.0 (1.0) and 3.0 (3.0) points on a numeric rating scale one hour after extubation, and 2.0 (2.0) and 2.0 (2.0) points by the end of the first postoperative day (p=0.193 and 0.610, respectively). The logistic regression model achieved an AUROC of 0,82 (95% CI 0,68–0,96) with c2(10)=10.62, p=0.39. Conclusions: Neuropathic pain was diagnosed in 19.4% of patients following CABG. The use of regional anesthesia and the severity of acute pain did not impact the development of neuropathic pain syndrome in the long-term period after surgery. The proposed model for predicting the neuropathic component of chronic pain syndrome after CABG requires further improvement.

The Impact of Bilateral Cerebellar Transcranial Direct Current Stimulation on Balance Control in Healthy Young Adults.

Cerebellar transcranial direct current stimulation (tDCS) has been shown to influence movement functions, but little is known about the specific effects of stimulation polarity on balance control. This study investigated the impact of bilateral cerebellar tDCS on balance functions as a function of stimulation polarity. In this randomized, controlled trial, thirty-nine healthy young adults were assigned to one of three groups: right anodal/left cathodal cerebellar stimulation (AC group), right cathodal/left anodal cerebellar stimulation (CA group), and a control sham group. Each participant underwent a daily 30-minute session of tDCS at 2mA for one week. Balance function was assessed pre- and post-intervention and the data were analyzed using generalized estimating equations. The CA group exhibited a significant reduction in sway area when standing on the left leg and on both stable and unstable surfaces with eyes open, compared to both the AC and sham groups. However, there were no significant differences among the groups in terms of sway length, anteroposterior velocity, or mediolateral velocity. Our results indicate the polarity-dependent effects of bilateral cerebellar tDCS on balance functions, with enhanced stability observed only following cathodal tDCS over the right cerebellum paired with anodal tDCS over the left cerebellum. This polarity-specific modulation may have implications for developing cerebellar neuromodulation interventions for movement disorders.

Preliminary Evaluation of the Value of a Small-Molecule Probe Targeting DNMT1 in Detecting the Methylation of PAX1 in Cervical Cancer.

To investigate the screening value of a small-molecule probe to assess the methylation of PAX1 in cervical cancer. The diagnostic threshold of the grayscale values for cervical lesions was assessed by plotting the Receiver Operating Characteristic (ROC) curve of subjects. Grayscale values were significantly different among the four groups (p<0.05). Compared with the LSIL and cervicitis groups, a considerably higher grayscale value was found in the CA and high-grade squamous intraepithelial lesion (HSIL) groups (both p<0.05). The differential ROC curves of the grayscale values showed that the diagnostic Area Under Curve of the probe for cervicitis and low-grade squamous intraepithelial lesion (LSIL) was 0.8724 (95% CI=0.7762-0.9685, p<0.0001), for cervicitis and CA was 1.0000 (p<0.0001), for the LSIL and HSIL was 0.5484 (95% CI = 0.3826-0.7142, p=0.5755), and for the LSIL and CA was 0.7724 (95% CI = 0.6016-0.9432, p = 0.0138). The small molecular probe has certain application value in differentiating the type of cervical lesions and has better efficacy in distinguishing cervical inflammatory and precancerous lesions from carcinogenesis, but less efficacy in determining the type of precancerous lesions.

Enhanced gelation of sturgeon frozen surimi via egg white: Exploring the role of endogenous serine protease inhibition

AbstractThe degradation of frozen sturgeon surimi can be attributed to the endogenous serine protease. This study was first to examine the impact of egg whites on the frozen sturgeon surimi's gel properties from the perspective of inhibiting endogenous serine protease. The protease activity of egg whites group (CA + EW group, consisting of 4% egg whites and cryoprotectants) was 45.15% lower than that of cryoprotectants group (CA group, consisting of 3% sucrose, 3% sorbitol, and 0.3% sodium tripolyphosphate) at 12 weeks. From the results of inhibition kinetics, serine protease was inhibited by both anticompetitive and noncompetitive inhibition modes. Molecular docking analysis indicated that egg white achieves this inhibitory effect through ionic interactions and hydrogen bonding with serine protease. However, this inhibitory effect was absent when the freezing period was extended to 24 weeks. Compared with CA group, the CA + EW group exhibited 54.76% and 4.59% increase in gel strength and water‐holding capacity, and 32.42% reduction in cooking loss after 24 weeks of freezing. Egg whites also impeded water migration and enhanced the density and smoothness of the gel microstructure, reducing protein aggregation. These results indicated that egg whites serve a dual function: inhibiting serine protease and filling the gel network within 12 weeks, mitigating protein aggregation and ice crystal formation over 24 weeks. This study elucidated the mechanism underlying the impact of egg white on endogenous serine protease in sturgeon surimi during long‐term freezing, laying a theoretical foundation for the industrialization of sturgeon surimi.

Evaluation of white spot lesion (WSL) and periodontal (PDL) health between patients treated with clear aligners and conventional fixed orthodontic brackets: A systematic review

The primary objective of this systematic review is to evaluate and compare the incidence of white spot lesions between clear aligner and fixed Orthodontic therapy. Randomized clinical trials of parallel, block randomisation, computer based and stratified randomisation and split-mouth design, involving patients undergoing Orthodontic treatment are considered. Studies had to compare the WSLs and periodontal health between CA and FA groups were searched in the electronic databases PubMed and Cochrane Library. A summary of the overall strength of evidence available was assessed using the Grades of Recommendations Assessment. A total of 51 records were found, from which only 4 articles met the inclusion criteria and were subjected to analysis.Majority of the studies included in this review have positively correlated a potential decrease in WSLs and better periodontal health with the use of clear aligners. However, most of the studies lack a long-term duration and follow up. More clinical trials in this area are welcome in order to have a better conclusion in terms of which appliance therapy would provide optimal dental and periodontal health during and after Orthodontic therapy.

Quantification of respiratory sinus arrhythmia in control dogs and in dogs with various severity classes of myxomatous mitral valve disease

IntroductionLoss of respiratory sinus arrhythmia (RSA) is a negative prognostic factor in dogs with myxomatous mitral valve disease (MMVD). The aim of this study was to calculate the percentage (%) of RSA in healthy dogs and dogs in various MMVD classes. AnimalsControl and MMVD dogs were prospectively included in the study. Materials and methodsRespiratory sinus arrhythmia was calculated from a dual channel electrocardiography and breathing curve recording using the peak-to-trough method, in percent of the average heart rate. ResultsOne hundred and forty-nine dogs were studied, including 24 control and 125 MMVD dogs of different severity classes. An overall %RSA decrease was documented with increasing disease severity up to the Ca class along with a relative %RSA increase in the Cc class. The %RSA magnitude differed between B2 and Ca (P<0.001), and between Ca and Cc (P = 0.001) groups, respectively. The %RSA showed a medium negative correlation with the La:Ao ratio (r2 = −0.568, P<0.001) and with the E-wave velocity (r2 = −0.561, P<0.001). DiscussionsA decrease in %RSA was shown with increased disease severity up to acute congestive heart failure (CHF). Dogs receiving cardiac therapy leading to stabilized CHF might restore their ability to exhibit RSA, often revealing a higher %RSA compared to those in acute CHF. Study limitationsLow number of respiratory cycles for analysis. Therapy effect not evaluated. ConclusionsThe findings of this study can serve as the basis for future risk stratification and carry the potential of proving an additional clinical marker for diagnostic and therapeutic decisions making when managing MMVD dogs.

Early Vocal Development in Toddlers With Simultaneous Bilateral Cochlear Implants

Background and Objectives The purpose of this study is to investigate the vocal development in toddlers with simultaneous bilateral cochlear implants (bilateral CI group) and to compare their progress to that of chronological age-matched (CA group) and hearing agematched (HA group) toddlers who have normal hearing and typical development.Subjects and Method Thirteen toddlers who received bilateral CIs simultaneously before 18 months of age participated in this study. Twenty-six toddlers participated as the control groups (CA group and HA group). The spontaneous utterances were collected from each toddler during free play with their parents in the laboratory. A total of 2324 spontaneous utterances of 39 toddlers (13 toddlers in each of the three groups) were classified as either canonical vocalizations or noncanonical vocalizations.Results The bilateral CI group produced significantly fewer canonical vocalizations than the CA group. However, there was not a significant difference in the ratio of canonical vocalizations between the CI and the CA groups. There were no significant differences in the frequency and ratio of canonical vocalization between the CI and HA groups. In the CI group, the frequency of canonical and noncanonical vocalizations was significantly correlated with receptive and expressive language scores.Conclusion The findings of this study showed that toddlers with bilateral CIs make good advancements in vocal development compared to toddlers with normal hearing. However, toddlers with bilateral CIs seem to produce an insufficient quantity of canonical vocalizations compared to age-matched hearing toddlers. Information about vocal development following simultaneous bilateral CI helps speech therapists and parents recognize speech development before the use of intelligible speech in communication.

Cardiac amyloidosis worsens prognosis in patients with heart failure: findings from the PREVAMIC study

Background and objectivesCardiac amyloidosis (CA) is a common pathology in elderly patients that usually presents as heart failure (HF). However, it is not clear whether CA associated with HF has a worse prognosis compared with HF due to other etiologies. Material and methodsProspective, observational cohort study that recruited patients ≥65 years of age with HF in 30 Spanish centers. The cohort was divided according to whether the patients had AC or not. Patients were followed for 1 year. ResultsA total of 484 patients were included in the analysis. The population was elderly (median 86 years) and 49% were women CA was present in 23.8 % of the included patients. In the CA group, there was a lower prevalence of diabetes mellitus and valvular disease. At one year of follow-up, mortality was significantly more frequent in patients with CA compared to those without (33.0 vs.14.9%, p < 0.001). However, there were no differences between both groups in visits to the emergency room or readmissions. In the multivariate analysis, the variables that were shown to predict all-cause mortality at one year of follow-up were chronic kidney disease (HR 1.75 (1.01–3.05) p 0.045), NT-proBNP levels (HR 2.51 (1.46–4.30) p < 0.001), confusion (HR 2.05 (1.01–4.17), p 0.048), and the presence of CA (HR 1.77 (1.11–2.84), p 0.017). ConclusionThe presence of CA in elderly patients with HF is related to a worse prognosis at one year of follow-up. Early diagnosis of the pathology and multidisciplinary management can help improve patient outcomes.

Treatment of acute kidney injury with continuous renal replacement therapy and cytokine adsorber (CytoSorb®) in critically ill patients with COVID-19.

This retrospective study aimed to evaluate the 30 and 60-day survival of critically ill patients with COVID-19 and AKI. Inflammatory and biochemical biomarkers, length of intensive care unit (ICU) stay and mortality at Day 30 and Day 60 after ICU admission were analyzed. A total of 44 patients treated with continuous renal replacement therapy (CRRT) with cytokine adsorber (CA group) were compared to 58 patients treated with CRRT alone (non-CA group). Patients in CA group were younger, had better preserved kidney function prior to the beginning of CRRT and had higher levels of interleukin-6. There were no statistically significant differences in their comorbidities and in other measured biomarkers between the two groups. The number of patients who died 60 days after ICU admission was statistically significantly higher in non-CA group (p = 0.029). Treatment with CRRT and cytokine adsorber may have positively influenced 60-day survival in our COVID-19 ICU patients with AKI.

Catheter ablation compared to medical therapy for ventricular tachycardia in sarcoidosis: nationwide outcomes and hospital readmissions

BackgroundCatheter ablation (CA) for ventricular tachycardia (VT) can be a useful treatment strategy, however, few studies have compared CA to medical therapy (MT) in the sarcoidosis population. ObjectiveTo assess in-hospital outcomes and unplanned readmissions following CA for VT compared to MT in patients with sarcoidosis. MethodsData was obtained from the Nationwide Readmissions Database between 2010 and 2019 to identify patients with sarcoidosis admitted for VT either undergoing CA or MT during elective and non-elective admission. Primary endpoints were a composite endpoint of inpatient mortality, cardiogenic shock, cardiac arrest and 30-day hospital readmissions. Procedural complications at index admission and causes of readmission were also identified. ResultsAmong 1581 patients, 1217 with sarcoidosis and VT underwent MT compared to 168 with CA during non-elective admission. 63 patients admitted electively underwent CA compared with 129 managed medically. There was no difference in the composite outcome for patients undergoing catheter ablation or medical therapy during both non-elective (9.0 % vs 12.0 %, p = 0.312) and elective admission (3.2 % vs. 7.8 %, p = 0.343). The most common cause of readmission were ventricular arrhythmias (VA) in both groups, however, those undergoing elective CA were less likely to be readmitted for VA compared to non-elective CA. The most common complication in the CA group was cardiac tamponade (4.8 %). ConclusionVT ablation is associated with similar rates of 30-day readmission compared to MT and does not confer increased risk of harm with respect to inpatient mortality, cardiogenic shock or cardiac arrest. Further research is warranted to determine if a subgroup of sarcoidosis patients admitted with VT are better served with an initial conservative management strategy followed by VT ablation.

Insight into interaction among soil microbial community, soil metabolomics and enzyme activity after long-term PAH stress

The problem of soil polycyclic aromatic hydrocarbon (PAH) pollution in coking plant sites has been widely studied in recent years, but there is a lack of research on the correlation between soil microorganisms, soil metabolomics, and soil properties. Thus, in this study, the long-term impact of coke combustion on soil microbial community structure, enzyme activities, and metabolic pathways within a former coking plant site was investigated. Soil samples were collected from both the coking production area (CA group) and office area (OLA group), approximately 0 to 20 cm in depth. Compared with OLA group, elevated levels of 16 PAHs in the list of USA EPA were detected by gas chromatography-mass spectrometry in the CA group. Several dominant microorganisms, such as Altererythrobacter, Lysobacter, and Sulfurifustis, were identified by 16 s ribosomal DNA sequencing in the CA group. The fatty acid biosynthesis pathway exhibited specific inhibition, while the phenylalanine metabolic pathway was promoted in response to PAH stress. Long-term PAH exposure led to the inhibition of soil urease activity. The co-occurrence network of microorganisms revealed intricate patterns of co-metabolism and co-adaptation within complex bacterial communities, facilitating their adaptation to and decomposition of soil-borne PAHs. This research could provide valuable insights into the community characteristics and metabolic mechanisms of microorganisms inhabiting PAH-polluted soil within coking plant sites. The findings enhance our understanding of the indigenous soil microbiome and its intricate network dynamics under the persistent stress of PAHs, contributing to a more comprehensive knowledge of soil ecosystems in such environments.

Fully robotic side-to-side stapled anastomosis provides less anastomotic leakage than conventional minimally invasive approach in Ivor Lewis esophagectomy.

This study evaluates surgical outcomes of minimally invasive Ivor Lewis esophagectomy (ILE) for esophageal and esophagogastric cancer, with the comparison of the robotic approach (RA) and the conventional minimally invasive approach (CA). Selected patients who underwent minimally invasive ILE for esophageal cancer were included between January 2017 and December 2023. We retrospectively investigated the patients' background characteristics and the short-term surgical outcomes. In this period, among a total of 840 esophagectomies, 81 patients (9.6%) underwent minimally invasive ILE, consisting of 24 cases with RA and 57 with CA. The major indications for ILE were adenocarcinoma of the distal esophagus or esophagogastric junction and patients with prior head and neck cancer treatment. Among these thoracic approaches, there were no significant differences in the patients' indications and characteristics, including age, histology, tumor location, clinical TNM stage, and preoperative therapy. Compared with the CA group, no anastomotic leakage was observed in the RA group (17.5% vs. 0, p = .035). Rates of total postoperative complications and length of hospital stay also tended to be reduced in the RA group but did not reach significance. In the Ivor Lewis esophagectomy with a side-to-side linear-stapled anastomosis, the fully robotic approach has the potential to powerfully reduce anastomotic leakage compared to the conventional minimally invasive approach.

The Nephroprotective Effect of Nitric Oxide during Extracorporeal Circulation: An Experimental Study.

This study aims to determine the effectiveness of administering 80 ppm nitric oxide in reducing kidney injury, mitochondrial dysfunction and regulated cell death in kidneys during experimental perfusion. Twenty-four sheep were randomized into four groups: two groups received 80 ppm NO conditioning with 90 min of cardiopulmonary bypass (CPB + NO) or 90 min of CPB and hypothermic circulatory arrest (CPB + CA + NO), while two groups received sham protocols (CPB and CPB + CA). Kidney injury was assessed using laboratory (neutrophil gelatinase-associated lipocalin, an acute kidney injury biomarker) and morphological methods (morphometric histological changes in kidney biopsy specimens). A kidney biopsy was performed 60 min after weaning from mechanical perfusion. NO did not increase the concentrations of inhaled NO2 and methemoglobin significantly. The NO-conditioning groups showed less severe kidney injury and mitochondrial dysfunction, with statistical significance in the CPB + NO group and reduced tumor necrosis factor-α expression as a trigger of apoptosis and necroptosis in renal tissue in the CPB + CA + NO group compared to the CPB + CA group. The severity of mitochondrial dysfunction in renal tissue was insignificantly lower in the NO-conditioning groups. We conclude that NO administration is safe and effective at reducing kidney injury, mitochondrial dysfunction and regulated cell death in kidneys during experimental CPB.

Evaluation of thickness of 3D printed versus thermoformed aligners: A prospective invivo ageing experiment.

To compare and investigate the effects of intraoral ageing on the thickness of one group of directly printed and two groups of thermoformed aligners on the labial surface of maxillary central incisors. Six groups (12 samples per group) were included in this prospective invivo experiment. Groups DP-Clin, INV-Clin and CA-Clin consisted of directly printed (Tera Harz TC-85 DAC resin), thermoformed (Invisalign, PU based polymer) and in house thermoformed (CA-Pro, PET-G based polymer) aligners, retrieved after 1 week of intraoral service. Groups DP-Ctr, INV-Ctr and CA-Ctr included unused aligners samples. Thickness measurements were conducted using confocal laser scanning microscopy (CLSM). Data that underwent log-10 transformation was analysed by multiple linear regression analysis (p < .05). Statistically significant differences were found between the materials in both Clin and Ctr categories (p < .001). Group DP had the highest thickness among the groups and the least thickness was observed in the CA group (p < .001). However, intraoral ageing did not significantly affect the aligner thickness of any groups. Both thermoforming and direct printing of clear aligners led to thickness deviations in terms of increase for printed aligners and decrease for thermoformed aligners. Intraoral ageing did not affect the aligner thickness in any of the groups.

Overwintering Induces Ischemia-Tolerance of Synaptic Function in the Forebrain of Bullfrogs

Healthy brain function requires the continuous delivery of oxygen and glucose to nerve cells. Interruptions result in rapid cessation of normal circuit function in most vertebrates. The American bullfrog ( Lithobates catesbeianus) is an interesting model, as we have shown that brainstem synapses increase their capacity to function during hypoxia and ischemia by roughly 20-30 fold following aquatic overwintering (cold-acclimated, CA) compared to control conditions (warm-acclimated, WA). Here, we tested the hypothesis that other synapses, specially those in the forebrain, also improve their function to determine if extreme metabolic plasticity is specific to the brainstem, or a generalized response throughout the central nervous system. We used the synapse that carries thalamic input to dorsal pallium, which is involved in sensory processing and associative memory. To measure synaptic function, we stimulated thalamic axons and recorded evoked excitatory postsynaptic currents (eEPSCs) in the medial dorsal pallium, the proposed homolog to the mammalian hippocampus, in normoxic conditions and in oxygen and glucose deprivation (OGD). eEPSC amplitude at a baseline frequency of 0.5 Hz was depressed at OGD onset in WA frogs (paired t-test, p=0.0002, n=12) but not in CA animals (paired t-test, p=0.1602, n=6). This suggests that unlike WA frogs, overwintering allows maintained synaptic function in OGD within the forebrain, as well as the brainstem. Mechanistically, the maintenance of synaptic function in OGD appeared to be associated with dynamic increase in the probability of neurotransmitter release. Paired-pulse experiments to assess dynamics in neurotransmitter release in response to high-frequency stimulus pairs showed that synapses depressed in normoxic conditions in both WA (9 of 11 cells) and CA (4 out of 6 cells) groups. In OGD, synaptic depression was maintained in WA frogs (paired t-test, p=0.9192); however, synaptic depression reversed, whereby paired-pulse stimulation instead led to synaptic facilitation in 5 out of 6 neurons (paired t-test, p=0.0113). This suggests that synapses may alter the probability of glutamate release to act as a countermeasure to maintain forebrain function during energetic stress associated with emergence. Overall, these results show that metabolic plasticity to restart critical behaviors in hypoxia following hibernation is preserved across the brain and that altered synaptic dynamics may play a role in this response. This research was funded by the National Institutes of Health (R01NS114514, R15NS112920-01A1). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Duration of orthodontic treatment with clear aligners versus fixed appliances in crowding cases: a systematic review.

To critically appraise and assess the currently observed evidence about the difference in orthodontic treatment duration between clear aligners and fixed appliances in crowding cases. An electronic search without limitations was conducted from inception to June 2023 covering nine databases: The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, Web of Science, Google Scholar, Trip, CINAHL via EBSCO, EMBASE via OVID and ProQuest. Randomized controlled trials (RCTs) and matched non-randomized studies were included in this systematic review. Risk of Bias was assessed via Cochrane's tool (RoB 2) for RCTs and ROBINS-I tool for non-randomized studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was employed to evaluate the overall quality of evidence. Out of the 3537 articles initially identified, ten eligible studies were included in this systematic review; six were RCTs. Only one study offered extraction-based treatment, while the other nine adopted non-extraction treatments. According to the GRADE, there is low evidence that treatment duration in mild to moderate crowding cases with clear aligners is similar to that in fixed orthodontic appliances. Meta-analysis was not administered due to high inconsistency. Based on currently available information, there was no significant difference in the treatment duration between the CA and FA groups in mild to moderate crowding cases. Further well-performed RCTs, especially in severe cases, are required. Time efficiency is an essential outcome measure for clinical orthodontic practice. While the type of appliance used is a critical determinant of treatment duration, orthodontists should be aware of other factors that can significantly impact treatment time, such as patient and treatment-related factors.

Wilson curve modification in permanent dentition: a retrospective comparison between clear aligners and continuous archwire treatment.

To evaluate leveling of the Curve of Wilson (COW) by two different treatment appliances (clear aligners [CA] and continuous archwire fixed appliances [FA]) in a permanent dentition sample of patients. Digital casts of 40 patients (CA group = 20 patients; FA group = 20 patients) were collected. Angular values for COW, right and left vertical height difference of lower first molars, and linear distance between lower teeth and the WALA ridge were analyzed for pre- (T1), posttreatment (T2) and on final virtual (ClinCheck) models (T2-CC) of the CA group. An unpaired t-test was used to evaluate significant intergroup differences (P < .05), while a paired t-test was used for posttreatment CA intragroup comparison. FA group showed better control of second molar crown positions compared to CA group (47-WALA = -0.2 ± 0.1 mm, 37-WALA = -0.6 ± 0.3 mm). No significant difference was detected for linear distance of lower first molars and the WALA ridge or for vertical height difference. CA group showed a greater reduction of distance between lower premolars and the WALA ridge (mean difference: -0.5 mm for both 45-WALA and 35-WALA; mean difference: -0.5 mm for 44-WALA, -0.6 mm for 34-WALA). Predictability for the CA group was high for every measurement (87% Right COW, 89% Left COW, 88% 46 Vertical Diff, 87% 36 Vertical Diff). Clear aligner and continuous archwire mechanics were effective in leveling COW. FA was more effective in changing crown position of lower second molars with respect to the WALA ridge, while CA provided a greater distance reduction between lower premolars and WALA ridges compared to FA.