Dental Implant Failures: Part 2.

ABSTRACT Asphalt pavements experience progressive deterioration from repeated traffic loads and environmental exposure, leading to premature failure and increased maintenance costs. Traditional monitoring methods fail to provide real-time insights into pavement health, limiting proactive maintenance strategies. This study establishes a framework for the development of a digital twin-enabled cyber-physical platform for the monitoring of asphalt pavements by leveraging the potential of modern sensors and physics engine software. The study combines embedded ‘smart rock’ sensors capable of capturing real-time mechanical responses of asphalt under varying loads and temperatures with physics informed virtual asphalt models developed using physics engines. Laboratory validation established strong agreement between the virtual model simulations and real asphalt performance data. This alignment provides a foundational breakthrough to correlate changes in mechanical behaviour with emerging distress patterns, enabling early damage detection and failure prediction. Overall, sensor-virtual model fusion can potentially enable proactive, self-updating road performance prediction via cyber-physical systems.

Background: Severe pediatric influenza remains a major clinical burden, yet its phenotype in the post-COVID-19 period has not been fully characterized. The pandemic’s infection-control measures created an “immunity gap” among children, altering viral epidemiology and severity. This multicenter study from Türkiye defines the clinical spectrum and outcomes of influenza cases requiring intensive care, providing one of the first regional datasets after the pandemic. Methods: We retrospectively analyzed 85 children with influenza admitted to five tertiary PICUs in İstanbul between 2024 and 2025. Demographics, clinical features and outcomes were compared across groups. Predictors of sepsis, pediatric ARDS, and mechanical ventilation were identified through multivariate logistic regression. Results: Influenza A + RSV co-infection occurred in 14% and affected significantly younger infants, presenting with more severe respiratory distress, hypoxemia, and bronchiolitis. Influenza B was associated with distinct neurotropic features—encephalopathy and seizures in 48%—and a higher risk of sepsis (OR 3.27, 95% CI 1.02–10.53). Hypoxemia, elevated vasoactive–inotropic score, and high PaCO2 independently predicted mechanical ventilation and poor outcomes. Only 2–4% of children had received influenza vaccination. Conclusions: This multicenter analysis reveals a post-pandemic surge of severe pediatric influenza characterized by dual respiratory and neurological phenotypes. RSV co-infection drives early respiratory failure in infants, whereas Influenza B carries a disproportionate risk of neuroinflammation and sepsis. The study provides evidence from Türkiye that the post-COVID “immunity gap” and critically low vaccination coverage contribute to increased PICU admissions. Strengthening pediatric influenza immunization and RSV prevention policies is urgently warranted to mitigate these outcomes.

BackgroundHemodynamic insufficiency occurs when tissue oxygen delivery fails to meet demand. Preterm infants are vulnerable to early circulatory failure after birth, impacting mortality and morbidity. Mean arterial pressure is not a reliable indicator of systemic blood flow. Low superior vena cava (SVC) flow, independent of fetal shunts, has been proposed as a robust biomarker of circulatory impairment in this population. Dobutamine, a selective β1 agonist with minimal effect on systemic vascular resistances, is considered the treatment of choice for this condition. However, information about its optimal dosing, efficacy, safety, and pharmacokinetic/pharmacodynamic (PK/PD) profile in preterm infants is limited.MethodsA multicenter, low-intervention, dose-finding trial will be conducted to establish the minimum effective dose of dobutamine to treat hemodynamic insufficiency, defined as SVC flow<51 mL/kg/min, in infants ≤32(+6) weeks of gestation during transitional circulation. Baseline echocardiography will be performed within 72 hours after birth. Single commercial dobutamine solution will be prepared and administered intravenously. Participants will be allocated to a dosage regimen by the study statistician, who will adjust probabilities of success based on therapeutic responses. Allocation will be guided by the dose with posterior probability closest to target (80%). PK/PD assessment will be done at 60 minutes after start of allocated dose and at 180 min of effective dobutamine dose infusion (that achieving stable SVC flow > 55 mL/kg/min). The proportion of patients achieving and maintaining adequate hemodynamic status with dobutamine alone during the first 72 hours (efficacy), side effects, and variables explaining interindividual PK/PD variability will be explored.DiscussionThis study aims to define the minimum dose of dobutamine with a relevant PD effect on circulation in infants with hemodynamic insufficiency during transitional circulation. This is the first step towards future randomized clinical trials on efficacy and safety of dobutamine for the proposed indication.Trial registrationEU Clinical trials register, EU CT 2023-504915-34-00, registered 18 April 2023.

Cadaveric biomechanical analysis. To compare the fatigue resistance and failure behavior of cortical bone trajectory (CBT) and traditional pedicle screw (TPS) constructs in severely destabilized lumbar segments under cyclic flexion-compression loading. CBT screw fixation is increasingly used for lumbar stabilization and offers theoretical biomechanical advantages over TPS, including higher insertional torque and increased cortical engagement. However, its fatigue behavior in unstable constructs remains poorly characterized, despite clinical reports of early failures following interbody reduction maneuvers. Fourteen lumbar motion segments (L2-L3 and L4-L5) from seven cadaveric spines were randomized to CBT or TPS fixation (n=7 per group) using a paired design. Following subtotal discectomy and bilateral facetectomy, constructs were cyclically loaded (200-750N, 2Hz, 50,000 cycles). Segment stiffness, flexion range of motion (ROM), and survival were compared. Bone mineral density (BMD) was quantified via dual-energy x-ray absorptiometry. In the intact state, CBT and TPS constructs showed no significant differences in stiffness or ROM. After destabilization and instrumentation, CBT constructs demonstrated reduced flexion ROM ( P =0.026), with similar end-range stiffness ( P =0.219). BMD significantly correlated with ROM and stiffness in the destabilized state (ρ=-0.72, P =0.007; ρ=0.65, P =0.014). Three of seven constructs in each group survived cyclic loading. While CBT constructs withstood more cycles on average (19,500±13,026 vs . 5,625±6,419), the difference was not statistically significant ( P =0.710). In a highly destabilized flexion-compression model, CBT and TPS constructs demonstrated similar fatigue performance. CBT screws offered greater resistance to ROM but no significant advantage in construct stiffness or survival. These results suggest that observed clinical failures of CBT may be attributable to surgical technique or placement sensitivity rather than inferior fatigue behavior.

IntroductionEarly kidney transplant failure has significant negative impact for individuals and healthcare systems. Contemporary data investigating early allograft failure are lacking. We undertook a retrospective observational cohort study of adult patients who underwent kidney transplantation at a single European centre.MethodsWe determined causes of allograft failure between 1 and 5 years after transplant and explored clinical variables present at 1 year that predicted allograft loss.Results591 patients (median age 50 years, 64.1% male, and 44% white) were included; 531 (89.8%) had graft survival and 60 (10.2%) had graft loss between 1- and 5-years. Rejection was the primary cause of graft failure in 24 (40%) cases and 54% had undetectable tacrolimus levels prior to failure event. Female sex, serum creatinine at 1 year, the occurrence of rejection, and undetectable tacrolimus levels were associated with increased odds of graft loss. In subsequent analysis of 787 patients alive with a functioning graft at 1 year, recipient age, serum creatinine, proteinuria, any rejection episode, and tacrolimus intrapatient variability (IPV) at 1 yearwere associated with an increased hazard of graft loss.DiscussionHence, graft losses were predominantly alloimmune mediated, often associated with non-adherence, and were predicted by tacrolimus IPV at 1 year.

Obesity is common among patients with end-stage renal disease; however, its impact on vascular access (VA) outcomes remains uncertain. We aimed to evaluate the association between body mass index (BMI) and VA patency. We retrospectively analyzed 396 patients who underwent arteriovenous fistula (AVF) or arteriovenous graft (AVG) creation (2021-2024), stratifying them by BMI (cutoff of 30 kg/m²). Primary outcomes included primary patency and assisted primary patency, secondary patency, and patient survival. We analyzed 396 patients (mean age 66.0 ± 14.2 years; 62.1% male). Comorbidities were frequent: hypertension 94.2%, diabetes 54.8%, coronary artery disease 35.6%, peripheral arterial disease 21.7%, cerebrovascular disease 23.0%, and cancer 25.0%. Prior kidney transplantation and renal replacement therapy were present in 12.6% and 69.9% of patients, respectively. Left-sided access and autologous access was predominated (89.9% and 68.2% each), while secondary vascular access at presentation was uncommon (6.6%). The average follow up period was 8.36 ± 9.27 months. Patients with obesity (BMI ⩾30) had significantly lower primary patency than those without obesity (25.0% vs 48.0%, p = 0.024), with comparable assisted patency and long-term outcomes. BMI ⩾30 was an independent predictor of primary patency loss (hazard ratio (HR) 1.707, p = 0.038). AVG formation was a risk factor for assisted patency failure (HR 8.983, p < 0.001). Obesity was associated with early access failure; not with long-term outcomes. Durable VA outcomes can be achieved in patients with obesity through surveillance and timely interventions.

With widespread implementation of rehabilitation by early active motion, preventing both early gap formation and failure are essential in flexor tendon repair. We studied the effect of various six-strand Tsuge techniques on early gap formation and strength in flexor tendon repair. Thirty porcine flexor digitorum profundus tendons were divided into three groups: the conventional six-strand Tsuge technique (the Tsuge normal group) and two modified versions, the Tsuge cross and Tsuge cross short groups, in which two of three sutures were crossed with different purchase lengths. Fatigue strength (newtons × cycles) was determined using cyclic tensile testing on the repaired tendons with gradually increasing loads. The load (newtons) and number of tensile testing cycles when a 2 mm gap or failure occurred at the repair site were recorded. Fatigue strength at 2 mm gap formation was significantly greater in the Tsuge cross and Tsuge cross short techniques than in the Tsuge normal technique. Fatigue strength at failure was significantly greater with the Tsuge cross short technique than with the Tsuge normal technique. Detailed analysis suggested that gap prevention using the Tsuge cross and Tsuge cross short techniques may be caused by tendon tightening by cross suturing. The Tsuge cross and Tsuge cross short suture techniques prevent gap formation, which could hinder tendon healing during early active motion rehabilitation. The Tsuge cross short technique demonstrated a lower failure rate compared with the Tsuge normal technique; nevertheless, both the Tsuge cross and Tsuge cross short techniques had sufficient strength for early active motion.

Distributed acoustic sensing (DAS) technology is gaining popularity for real-time monitoring during the hydraulic fracturing of unconventional reservoirs. By transforming a standard optical fiber into a dense array of acoustic sensors, DAS provides continuous spatiotemporal measurements along the entire wellbore. Although accurate DAS-based real-time diagnosis of multistage hydraulic fracturing is critical for optimizing the efficiency of stimulation operations and mitigating operational risks in horizontal tight oil wells, existing methods often fail to provide integrated qualitative and quantitative insights. To address this gap, we present an original diagnostic workflow that synergistically combines frequency band energy (FBE), low-frequency DAS (LF-DAS), and surface injection data for simultaneous fluid/proppant allocation and key downhole anomaly identification. Field application of the proposed framework in a 47-stage well demonstrates that FBE (50–200 Hz) enables robust cluster-level volume estimation, while LF-DAS (&lt;0.5 Hz) reveals fiber strain signatures indicative of mechanical integrity threats. The workflow can successfully diagnose sand screenout, diversion, out-of-zone flow, and early fiber failure—events often missed by conventional monitoring. By linking distinct acoustic fingerprints to specific physical processes, our approach transforms raw DAS data into actionable operational intelligence. This study provides a reproducible, field-validated framework that enhances understanding in the context of fracture treatment, supports real-time decision making, and paves the way for automated DAS interpretation in complex completions.

Intercalary allograft after resection of bone tumors is associated with low failure rates. However, literature on the long-term outcomes of this technique is limited, and long-term functional outcomes remain unknown. This study sought to assess allograft survival, risk factors for failure, and functional outcomes for patients with a minimum 10-year follow-up period. This study retrospectively identified patients treated with intercalary allograft of the femur or tibia for oncologic indications. Allograft failure was assessed using the Henderson classification for biologic reconstruction. Early, midterm, and late failures were defined as those occurring before 2 years, between 2 and 10 years, and after 10 years of follow-up evaluation, respectively. Of the 64 patients in the study, 29 had a femur allograft and 35 had a tibia allograft. The median follow-up period was 22 years. Complications developed in 34 patients (53%), with 79% having multiple complications. Non-union failures (type 2) comprised 42% of the early failures and 43% of the midterm failures, whereas structural failures (type 3) represented 100% of the late failures. The risk factors for allograft failure were neoadjuvant radiotherapy and chemotherapy. The median TESS-LE and LEFS scores were 97.3% and 76.3% for the patients with femur allografts and 98.3% and 86.3% for those with tibia allografts, respectively. The PROMIS Pain Interference and Physical Function scores were 51.2 and 45.2 for the patients with femur allografts and 40.7 and 50 for those with tibia allografts, respectively. Non-union and structural failures were the most common causes of early and late failure, respectively. Although complications occurred frequently, the long-term functional outcomes for femur and tibia intercalary allografts were good.

This study investigates the effectiveness of embedding fiber Bragg grating (FBG) sensors in power transmission towers to assess the remaining service life of the structures following impacts from strong winds and hurricanes. FBG sensors monitor the structural integrity of the tower using online measurement of strain variations at critical structural points. The novelty of this work lies in employing a compact long short-term memory (LSTM) framework to estimate the remaining useful lifetime (RUL) from real-time FBG sensor data under both stable and fluctuating wind conditions. To estimate RUL of the tower, LSTM neural network has been implemented, providing predictive insights for proactive maintenance and risk mitigation. A prototype transmission tower was built and experimentally evaluated in a wind tunnel to assess the effectiveness and performance of the proposed RUL model. To simulate different hurricane categories, the experiment was conducted across wind speeds between 0 and 150 mph. FBG sensors installed at critical locations continuously captured real-time strain data, which was transmitted via a low-power micro FBG interrogator to a computer for input into the RUL prediction model. The proposed three-layer LSTM converges rapidly, reducing training and validation loss by nearly two orders of magnitude within 40 epochs, and achieves robust RUL predictions with an average bias of about 50 s on the test set. To quantify structural health, a mathematical health indicator was formulated based on the observed strain responses. The FBG sensors demonstrated high effectiveness in accurately detecting strain variations and monitoring the tower's dynamic behavior under extreme wind loads. The findings support the implementation of condition-based maintenance strategies, enhance safety assessments, and enable early failure detection. This approach not only improves operational reliability but also facilitates timely intervention and maintenance during critical events. Received: 26 June 2025 | Revised: 12 September 2025 | Accepted: 11 November 2025 Conflicts of Interest The authors declare that they have no conflicts of interest to this work. Data Availability Statement Data are available from the corresponding author upon reasonable request. Author Contribution Statement Yu Shi: Methodology, software, formal analysis, data curation, writing – original draft, writing – review &amp; editing, visualization, supervision, and project administration. Abolghassem Zabihollah: Conceptualization, methodology, software, validation, investigation, resources, data curation, writing – original draft, writing – review &amp; editing, visualization, supervision, and project administration. Yao-Chi Yu: Methodology, software, formal analysis, data curation, and writing – original draft. Arunima Pathak: Investigation, writing – original draft, and visualization. Oluwaseyi Oyetunji: Investigation.

To explore the related risk factors of early failure of simple taper retentive implants, and to provide theoretical guidance for clinical work. Collect cases of patients who visited the Department of Stomatology of the Fourth Affiliated Hospital of Nanchang University from January 2021 to June 2024, received simple taper retentive implants, and had complete medical records. Taking the implants as the unit, analyze the influence of patient-related factors (gender, age, smoking history, hypertension history, diabetes history), implant-related factors (implant length, implant diameter, implant surface treatment), and surgical-related factors (implant site, implant timing, simultaneous maxillary sinus floor elevation, simultaneous bone augmentation) on the early failure of implants. Univariate analysis and multivariate analysis were adopted to explore the potential risk factors for early failure of simple taper retentive implants. A total of 3,533 simple taper retentive from 1,681 patients were included during the study period. Among them, 53 implants from 49 patients experienced early failure, with an early failure rate of 2.9% at the patient le-vel and 1.5% at the implant level. Multivariate analysis revealed that smoking (OR=2.148, P=0.021), the anterior mandibular region (OR=3.669, P=0.006), and the posterior maxillary region (OR=2.191, P=0.033) were risk factors for early failure of simple taper retentive implants. In the univariate analysis, simultaneous maxillary sinus floor elevation had a higher risk of early failure, but this effects was no longer significant in the multivariate analysis (P>0.05). Smoking, the anterior mandibular region, and the posterior maxillary region are risk factors for the early failure of simple taper retentive implants, and could be comprehensively considered in the preoperative treatment plan.

The long-term operation of plane steel gates under cyclic dry–wet conditions results in complex corrosion behaviour and significant mechanical degradation, particularly under static hydraulic pressure. However, current studies are limited by insufficient field data and the inability of laboratory tests to fully replicate in-service environments. To better understand the dynamic corrosion processes of steel gates, a cellular automata model was employed to simulate the time-dependent evolution of corrosion morphology. The model's accuracy was validated through comparison with experimental results. Furthermore, a finite element model incorporating corrosion-induced damage was established to evaluate the effects of corrosion on structural performance. Results show that the uniform corrosion rate exhibits an initial exponential increase before stabilising due to surface blockage by corrosion products. In contrast, pitting corrosion accelerates in the depth direction, driven by localised autocatalytic reactions. Uniform corrosion gradually reduces global structural integrity, while localised corrosion poses a higher risk of through-thickness penetration and early failure. These findings contribute to a more reliable basis for assessing the durability and maintenance needs of hydraulic steel structures operating in aggressive service conditions.

Impact of left ventricular assist device implantation on right ventricular-pulmonary arterial coupling assessed by high-fidelity hemodynamics.

Early Prediction Model for Antibiotic Treatment Failure in Bacteremia: Japan Bacteremia Inpatient Cohort Association.

ABSTRACTObjectiveTo compare the efficacy and safety of flow‐driver‐generated synchronized nasal intermittent positive‐pressure ventilation (SNIPPV) and biphasic positive airway pressure (BiPAP) after extubation in preterm infants.HypothesisSNIPPV delivered via a flow‐driver device improves post‐extubation outcomes compared with non‐synchronized BiPAP.Study DesignThis single‐center, retrospective, observational cohort study was conducted in the neonatal intensive care unit of Nagoya University Hospital, Nagoya, Japan.Patient SelectionPreterm infants born at < 34 weeks of gestation who underwent endotracheal ventilation after birth and were subsequently supported with either BiPAP (from October 2017 to March 2020) or SNIPPV (from April 2020 to September 2022) after extubation. Infants with major anomalies or surgical ventilator dependence were excluded.MethodologyData on demographic and clinical characteristics, respiratory outcomes, and complications were collected. The primary outcome was reintubation within 72 h. Secondary outcomes were bronchopulmonary dysplasia (BPD), respiratory support duration, and major complications.ResultsSixty‐seven infants were included (BiPAP n = 37, SNIPPV n = 30). Reintubation within 72 h occurred in 6.7% and 29.7% of infants in the SNIPPV and BiPAP groups, respectively (p = 0.028). The incidence of respiratory distress‐related failure was significantly lower in the SNIPPV group (3.3% vs. 24.3%, p = 0.019). There were no significant differences in BPD at 36 or 40 weeks, oxygen therapy duration, or complications such as necrotizing enterocolitis, retinopathy of prematurity, or severe neurological injury.ConclusionFlow‐driver‐generated SNIPPV significantly reduces early extubation failure in preterm infants compared to BiPAP without increasing the rate of adverse outcomes. This is a practical and effective alternative to noninvasive respiratory support.

Large endograft diameter is associated with poor outcomes following thoracic endovascular aortic aneurysm repair in Medicare beneficiaries.

Principal component analysis of antiseizure medication-induced hostility/aggression and factor analysis of levetiracetam using the food and drug administration adverse event reporting system.

Does time matter? Organ-specific stress responses to cobalt in Mytilus galloprovincialis across salinities.

Impact of Age-Related Bone Density Variations on Dental Implant Stability and Success Rates: A Retrospective Analysis.