Higher Survival Research Articles

Multiple bouts of blood feeding in mosquitoes allow prolonged survival and are predicted to increase viral transmission during drought.

Survival through periods of drought is critical for mosquitoes to reside in semi-arid regions with humans, but water sources may be limited. Previous studies have shown that dehydrated mosquitoes will increase blood feeding propensity, but how this would occur over extended dry periods is unknown. Following a bloodmeal, prolonged exposure to dry conditions increased secondary blood feeding in mosquitoes by nearly two-fold, and chronic blood feeding allowed mosquitoes to survive twenty days without access to water sources. This refeeding did not alter the number of eggs generated, suggesting this refeeding is for hydration and nutrient replenishment. Exposure to desiccating conditions following a bloodmeal resulted in increased activity, decreased sleep levels, and prompted a return of CO2 sensing before egg deposition. The increased blood feeding during the vitellogenic stage and higher survival during dry periods are predicted to increase pathogen transmission and explain the elevated levels of specific arbovirus cases during dry conditions. These results solidify our understanding of the role of dry periods on mosquito blood feeding and how mosquito dehydration contributes to vectorial capacity and disease transmission dynamics.

Community-based, cost-effective multispecies mangrove restoration innovation to maximize soil blue carbon pool and humic acid and fulvic acid concentrations at Indian Sundarbans.

Sundarbans is the world's largest and most diverse contiguous mangrove ecosystem. In this pilot study, three plots (around1ha each) were selected, where one site (S1) had 1year of community involvement, another site (S2) had a community network to support the restoration initiatives for 2years, while a control site (C) was devoid of any post plantationcommunity protection. Rhizophora mucronata (Rhizophoraceae), Sonneretia caseolaris (Lythraceae) and Avicennia marina (Acanthaceae) were planted at the sites in 2012. After 6years (in 2017), at S1, the monitoring showed low survival rate for salinity-sensitive species, 2% for R. mucronata and 4% for S. caseolaris. At S2, R. mucronata has high survival rates, i.e. 71%, followed by S. caseolaris with 40%, whereas at C, the survival rate of both species was 0%. At S1 and C, the salinity-tolerant A. marina replaced the planted mangroves partially (S1) or entirely (C). At S2, available soil P increased by 17.5%, in 6years, and the overall blue carbon pool showed a linear increase from 64.4 to 88.6Mg C ha-1 (34.3% rise). S1 showed a minimum increment in P and the blue carbon pool (6.9% rise), while site C showed fluctuations in the blue carbon pool with only a 3.1% increase. Humic acid and fulvic acid concentrations in the S2 site indicate positive functional carbon sequestration in the edaphic environment. The community involvement increased the plantation cost (567.70 USD) of S2, in comparison to S1 (342.52 USD) and C (117.34 USD), but it has resulted in better restoration and survival of the mangroves. The study concludes that community participation for at least 2years can play a significant role in the conservation of mangrove ecosystems and the success of restoration initiatives in tidal, saline wetlands and would aid in compliance with the United Nations Sustainable Development Goal 14 (Life Below Water) targets.

Pathogenicity and induced resistance in Larix kaempferi and Larix olgensis inoculated with Endoconidiophora fujiensis.

With climate warming and economic globalization, insect-microbe assemblages are becoming increasingly responsible for various devastating forest diseases worldwide. Japanese larch (Larix kaempferi) is extensively cultivated in China because of its high survival rate, rapid maturation and robust mechanical properties. Endoconidiophora fujiensis, an ophiostomatoid fungus associated with Ips subelongatus, has been identified as a lethal pathogen of L. kaempferi in Japan. However, there is a dearth of research on the pathogenicity of E. fujiensis in larches in China. Therefore, we investigated the pathogenicity of E. fujiensis in introduced L. kaempferi and indigenous larch (Larix olgensis) trees and compared the induced resistance responses to the pathogen in both tree species in terms of physiology and gene expression. Five-year-old saplings and 25-year-old adult trees of L. olgensis and L. kaempferi were inoculated in parallel during the same growing season. Endoconidiophora fujiensis exhibited high pathogenicity in both larch species, but particularly in L. kaempferi compared with L. olgensis adult trees; adult L. olgensis was more resistant to E. fujiensis than adult L. kaempferi, which was reflected in higher accumulation of defensive monoterpenes, such as myrcene, 3-carene and limonene and the earlier induction of defense genes catalase (CAT) and pathogenesis-related protein 1 (PR1). This study contributes to our understanding of the interactions between bark beetle-associated ophiostomatoid fungi and host larches, from phenotypic responses to alterations in secondary metabolites via defense- and metabolism-related gene activation, providing a valuable foundation for the management of larch diseases and pests in the future.

Designing Decentralized Systems with High Survivability Inspired by Altruistic Social Interactions of Vampire Bats

Altruism is a key concept in the design of decentralized systems with high survivability. We focus on a community of vampire bats to reveal how intra-group altruism produces group-wide survivability. Although these bats die within three days if food is unavailable, they can survive for over 10 years by developing a highly sophisticated social community in which they share food. This food-sharing behavior occurs not only among blood relatives, but also among unrelated individuals through self-organizing social relationships based on grooming behavior. We propose a simple network model that focuses on the relationship between food sharing and grooming. We performed simulations under periodic, stationary, and irregular feeding environments, and found that suitable update rules for social relationships depend on the type of environment. Our findings provide insights into how decentralized systems with high survivability can be designed based on altruism.

Is the percentage of hormone receptor positivity in HR+ HER2-metastatic breast cancer patients receiving CDK 4/6 inhibitor with endocrine therapy predictive and prognostic?

There is no clear information in the literature about the relationship between the efficacy of CDK 4/6i combined with ET and HR positivity. However, we know that the longest overall survival was in the ER-strong positive/PR intermediate or strong positive groups. Therefore, we aimed to investigate CDK4/6i treatments that create positivity in HR. Patients with the diagnosis of HR+/HER2- MBC who were treated with CDK 4/6i and HR >10% were retrospectively evaluated. To analyze the role of HR positivity, ER was moderately positive (10-49%) and ER was strongly positive (50-100%); PR was grouped as moderately positive (10-49%) and PR strongly positive (50-100%). Median follow-up of 150 patients included in the study was 15.2 months (95% CI, 2.1-40.9 months). The highest response in the whole group was obtained in the ER-strong positive/PR moderate or strong positive group, and the ER moderate positive/PR moderate or strong group. This was followed by the ER strong positive/PR negative group, and then the ER moderate positive/PR negative group. Although these advantages were not statistically significant, they were numerically higher (ORR: 83.8% vs. 83.3% vs. 77.4% vs. 62.5%, p=0.488, respectively). The highest survival in the whole group was achieved in the ER strong positive/PR moderate or strongly positive group, followed by the ER moderately positive/PR moderate or strongly positive group, the ER strongly positive/PR negative group followed by the ER moderate positive/PR negative group, respectively(p=0.410). However, these advantages were not statistically significant. As a result, HR+/HER2- MBC patients receiving CDK 4/6i combined with ET suggest that the percentage of HR positivity may have a predictive and prognostic role.

MDB-92. EFFECT OF REDUCED-DOSE CRANIOSPINAL IRRADIATION AND REDUCED-DOSE ADJUVANT CHEMOTHERAPY ON CHILDREN AND ADOLESCENTS WITH WNT MEDULLOBLASTOMA WITHOUT RESIDUAL OR METASTATIC DISEASE: RESULTS FROM THE SJMB12 CLINICAL TRIAL

Abstract BACKGROUND In response to studies showing medulloblastoma (MB) survival is not only contingent on clinical factors (e.g. metastases, residual disease) but also on molecular factors (e.g. molecular group, gene aberrations), we launched the SJMB12 (NCT01878617) trial to stratify treatment using both clinical and molecular risk factors. Specifically, we sought to evaluate if patients with WNT-group MB, without metastatic (M0) or residual disease (R0), treated with reduced-dose craniospinal irradiation (CSI) and reduced-dose cyclophosphamide-based chemotherapy could maintain a high survival with fewer treatment-related side effects. METHODS Tumors were molecularly stratified via immunohistochemistry and fluorescence in-situ hybridization. Patients with WNT tumors were grouped into 3 strata: W1 (M0, R0, classic histology, monosomy of chromosome 6); W2 (M0, R0, without monosomy 6 or classic histology); W3 [metastatic (M+), residual disease (R+), or MYC/MYCN amplification]. Treatment of W1 consisted of 15-Gy CSI/51-Gy primary site (0.5cm CTV margin) followed by 4 cycles of chemotherapy resulting in cumulative doses of 8 mg/m2 vincristine, 300 mg/m2 cisplatin, 12 gm/m2 cyclophosphamide. Serial audiology, neurocognitive, and endocrine evaluations were conducted over a six-year follow-up period. RESULTS From 2013-2022, 72 patients enrolled onto the W1 stratum: median age was 10.3 years (4.9-22.0); 62.5% female; median time of follow-up was 4.5 years (1.1-10.1). 5-year progression-free survival (PFS) and overall survival were 90.4 ± 5.1% and 98.6 ± 2.1%, respectively. Five patients had PFS events: 4 relapses and 1 accidental death. Relapsed disease was local in 2, distant in 1, and mixed in 1. Time to relapse was > 2 years from enrollment for 3 patients. Severe ototoxicity (SIOP grade ≥ 3) at the end of therapy occurred in 14.4 ± 4.5%. Neurocognitive, endocrine, and detailed molecular data are forthcoming. CONCLUSIONS Patients with low-risk WNT-MB maintained a high PFS (>90%) when treated with reduced-dose CSI and reduced-dose cyclophosphamide-based chemotherapy. Preliminary data suggests fewer treatment-related side effects.

Posterior two-unit cantilevered zirconia resin-bonded fixed partial dentures: A 3-year prospective single-arm clinical trial

ObjectivesTo evaluate the longevity of cantilevered zirconia-based resin-bonded fixed partial dentures (RBFPDs) in replacing missing posterior teeth, as well as the quality of life and patient satisfaction experienced by those receiving zirconia RBFPDs. MethodsA prospective single-arm uncontrolled clinical trial was conducted to replace one or more missing premolars or molars with a span of 5 to 8 mm using cantilevered zirconia RBFPDs. Thirty-six participants with 40 prostheses were recruited and underwent a 3-year clinical evaluation. The retainer designs included a minimum thickness of 0.8 mm, a minimum of 200° circumferential wraparound with an occlusal bar, and a connector dimension of 3 × 3 mm. Patient-reported outcomes, including patient satisfaction and Oral Health Impact Profile (OHIP), were assessed. ResultsThe average age of participants was 45.8 years, and 72.5 % were women. The success rate of the posterior zirconia RBFPDs was 76.2 %, with an estimated mean success duration of 46.1 months. The survival rate was 88.1 %, with an estimated mean survival duration of 49.4 months. Participants were highly satisfied with the treatment, achieving an average satisfaction score of 80.8 ± 11.9. Participants' total OHIP scores decreased from 52.3 to 39.6 after 3 years, indicating a significant improvement in oral health-related quality of life (P = 0.009). ConclusionsAfter 3 years, a moderately high survival rate and favourable patient-reported outcomes of posterior cantilevered zirconia RBFPDs were achieved. Therefore, it can be recommended as a conservative treatment option to replace missing posterior teeth, provided that retainer design considerations are taken into account. Clinical significanceCantilevered zirconia RBFPDs for posterior teeth can serve as a conservative treatment option that is both aesthetically pleasing and biocompatible. It offers a more cost-effective alternative compared to dental implants, which are often prohibitively expensive for the majority of patients. This approach has the potential to greatly improve patient-reported outcomes.

Achieving a Brighter Future: A Career-Focused Mentoring Program Designed for Adolescents and Young Adults with Cancer.

Despite high survival rates for many adolescent or young adult (AYA) cancer diagnoses, the psychosocial, academic, and vocational repercussions for survivors are profound and enduring. Hospital systems are able to address many AYA needs, but the ability to provide the human connectedness and knowledge that drive long-term school and career planning is lacking. This study assessed a group of AYAs who have or had cancer (n = 108, 54% female, 71% white, mean age 20.6 ± 4.4) to determine the school, career, medical, emotional, and psychosocial needs that are not currently being met by hospital staff and support networks. We identified the most common unmet needs of AYAs, differences between needs of AYAs in active treatment and survivorship, and the role of a career-focused mentoring program developed by the nonprofit organization Connecting Champions (CC) to address the array of unmet AYA needs. We found that the most commonly reported needs were all related to career and school, and that the top needs did not differ significantly throughout the cancer journey. These findings suggest that career and school-based needs are a high priority for AYAs, yet social isolation can make the necessary people or resources inaccessible. The CC mentoring program was reported as effective in attending to unmet needs (with an average score of 95.1/100) and can be a valuable resource for hospital systems, nonprofit organizations, and health insurers to provide personalized, career-focused support to AYAs during cancer treatment and survivorship.

Deep learning-based approach for 3D bone segmentation and prediction of missing tooth region for dental implant planning

Recent studies have shown that dental implants have high long-term survival rates, indicating their effectiveness compared to other treatments. However, there is still a concern regarding treatment failure. Deep learning methods, specifically U-Net models, have been effectively applied to analyze medical and dental images. This study aims to utilize U-Net models to segment bone in regions where teeth are missing in cone-beam computerized tomography (CBCT) scans and predict the positions of implants. The proposed models were applied to a CBCT dataset of Taibah University Dental Hospital (TUDH) patients between 2018 and 2023. They were evaluated using different performance metrics and validated by a domain expert. The experimental results demonstrated outstanding performance in terms of dice, precision, and recall for bone segmentation (0.93, 0.94, and 0.93, respectively) with a low volume error (0.01). The proposed models offer promising automated dental implant planning for dental implantologists.

Exploring the Effects of Freeze-Dried Sourdoughs with Lactiplantibacillus pentosus 129 and Limosilactobacillus fermentum 139 on the Quality of Long-Fermentation Bread.

Sourdough production is a complex fermentation process. Natural sourdough fermentation without standardization causes great variability in microbial communities and derived products. Starter cultures have emerged as alternatives to natural fermentation processes, which could improve bakery quality and produce bioactive compounds. This study aimed to evaluate the impacts of freeze-drying on the production and viability of sourdoughs with Lactiplantibacillus pentosus 129 (Lp) and Limosilactobacillus fermentum 139 (Lf), as well as their effects on the quality of long-fermentation bread. These strains were selected based on their better performance considering acidification and exopolysaccharide production capacity. Sourdough with Lp and Lf were propagated until the 10th day, when physicochemical and microbiological parameters were determined. The produced sourdoughs were freeze-dried, and bread samples were produced. The freeze-drying process resulted in high survival rates and few impacts on the metabolic activity of Lp and Lf until 60 days of storage. Incorporating Lp and Lf improved the microbiological and physicochemical properties of sourdough and long-fermentation breads. Tested freeze-dried sourdoughs led to reduced bread aging (higher specific volume and decreased starch retrogradation) and increased digestibility. The results show the potential of the freeze-dried sourdoughs produced with Lp and Lf as innovative strategies for standardizing production protocols for the bakery industry, especially for producing long-term fermentation bread.

The Use of Photo-Biological Parameters to Assess the Establishment Success of Posidonia oceanica Cuttings after Transplantation

Seagrass meadows are increasingly threatened by anthropogenic activities and climate change, necessitating restoration efforts such as cutting transplantation. Understanding the complex interactions between plant morphology and physiology is crucial for designing robust restoration strategies and assessing the success of transplantation and recovery processes. A pilot transplantation experiment with the Mediterranean seagrass Posidonia oceanica (L.) Delile was conducted in Northwestern Corsica (Calvi, France) to evaluate the feasibility of meadows degraded due to boat anchoring. The effects of the cuttings’ origin and transplanting depth were investigated. The establishment success of transplanted fragments was assessed by investigating the photo-physiological parameters, carbohydrate content, and biometric parameters of both transplanted and control plants one year after transplantation at depths of 20 and 28 m. After one year, there was a high survival rate (90%) of the transplants, but their leaf surface area and biomass were significantly reduced compared to the control plants. Photosynthetic activity remained consistent between both depths, emphasizing the ability of P. oceanica cuttings to acclimate to a new light environment in a relatively short period of time (<3 months). Furthermore, light-harvesting pigments, photoprotective pigments, and carbohydrate concentration were greater at the deeper sites. This implies that transplantation at greater depths might be more effective. Furthermore, additional research is necessary to enhance our understanding of the relationship between photosynthesis and the overall health of the plant. This study emphasizes the essential integration of morphological and physiological investigations to offer an ecologically meaningful understanding of how marine ecosystems respond to various restoration methods.

Communicating prostate cancer outcomes data to consumers[sbnd] A brief communication

ObjectiveTo translate and communicate outcomes data for prostate cancer from a clinical registry data into a consumer-friendly resource. MethodsFirst, we analyzed real-world data from the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC) registry for men diagnosed from 2008 to 2018 including clinical and functional outcomes following surgery, external beam radiotherapy, brachytherapy, hormone therapy, active surveillance and watchful waiting. These outcomes included overall survival, cancer specific survival, biochemical recurrence, decline in functional outcomes, and transition to active treatment following active surveillance. Second, we translated outcomes into a summary text and pictographic format and present in one document that consumers found easy to understand and interpret. This “Prostate Cancer Outcomes Report Card” was developed in consultation with a consumer advisory group and further improved through exploratory interviews with people affected by prostate cancer, an online survey among the general public, and clinician feedback. ResultsThe 5-year prostate cancer-specific survival rate was 97%. There is a reasonably high chance of cancer returning within 5 years (17% after surgery and 14% after radiotherapy) while 1 in 3 men on active surveillance transitioned to other treatments within 5 years. Sexual function was negatively affected following all treatment types. Men with higher risk disease had a worse prognosis, a higher chance of recurrence and greater decline in physical function. Consumers required trustworthy, comprehensive, simple and up-to-date information collated in one place, and valued having access to this resource. Data on high survival rates were considered reassuring. There were high levels of unmet psychosocial and supportive care needs, especially in relation to mental health and sexual function. The report card was well received by patients and health care workers. ConclusionsThis relatively simple and easily understandable consumer-oriented outcome report serves to better inform men with prostate cancer and facilitate patient-provider communication and shared decision-making.

Risk of Lymphoma and Leukemia in Thyroid Cancer Patients: A Retrospective Cohort Study in Germany.

Thyroid cancer is the ninth most common cancer worldwide. While differentiated thyroid cancer (DTC) has a high survival rate, concerns arise regarding optimal treatment strategies and potential long-term risks, including second primary malignancies (SPMs), associated with therapies such as radioiodine (RAI). The aim of the present study was to investigate the association between thyroid cancer and the incidence of subsequent lymphoma and leukemia in Germany. This retrospective cohort study used the IQVIA TM Disease Analyzer database and included adults with a first documented diagnosis of thyroid cancer between January 2005 and December 2021 as well as propensity score matched individuals without thyroid cancer in 1284 general practices. Univariate Cox regression models were performed to examine the association between thyroid cancer and the incidence of subsequent lymphoma and leukemia. A total of 4232 thyroid cancer patients (mean age: 54.2 years; 73.6% female) and 21 160 controls (mean age: 54.2 years; 72.6% female) were available for analyses. Thyroid cancer was significantly associated with a higher lymphoma incidence (HR: 3.35, 95% CI: 2.04-5.52), especially in men (HR: 5.37) and those aged 61-70 years. Leukemia incidence was not significantly associated with thyroid cancer (HR: 1.79, 95% CI: 0.91-3.53), although associations were notable in younger age groups. Thyroid cancer is positively associated with a risk of subsequent lymphoma, highlighting the need for vigilant surveillance and tailored treatment strategies. While the association with leukemia is less pronounced, close surveillance remains critical, especially in younger patients.

Nimodipine Protects Vascular and Cognitive Function in an Animal Model of Cerebral Small Vessel Disease.

Cerebral small vessel disease is a common cause of vascular cognitive impairment and dementia. There is an urgent need for preventative treatments for vascular cognitive impairment and dementia, and reducing vascular dysfunction may provide a therapeutic route. Here, we investigate whether the chronic administration of nimodipine, a central nervous system-selective dihydropyridine calcium channel blocking agent, protects vascular, metabolic, and cognitive function in an animal model of cerebral small vessel disease, the spontaneously hypertensive stroke-prone rat. Male spontaneously hypertensive stroke-prone rats were randomly allocated to receive either a placebo (n=24) or nimodipine (n=24) diet between 3 and 6 months of age. Animals were examined daily for any neurological deficits, and vascular function was assessed in terms of neurovascular and neurometabolic coupling at 3 and 6 months of age, and cerebrovascular reactivity at 6 months of age. Cognitive function was evaluated using the novel object recognition test at 6 months of age. Six untreated control animals were terminated prematurely due to strokes, including one due to seizure, but no treated animals experienced strokes and so had a higher survival (P=0.0088). Vascular function was significantly impaired with disease progression, but nimodipine treatment partially preserved neurovascular coupling and neurometabolic coupling, indicated by larger (P<0.001) and more prompt responses (P<0.01), and less habituation upon repeated stimulation (P<0.01). Also, animals treated with nimodipine showed greater cerebrovascular reactivity, indicated by larger dilation of arterioles (P=0.015) and an increase in blood flow velocity (P=0.001). This protection of vascular and metabolic function achieved by nimodipine treatment was associated with better cognitive function (P<0.001) in the treated animals. Chronic treatment with nimodipine protects from strokes, and vascular and cognitive deficits in spontaneously hypertensive stroke-prone rat. Nimodipine may provide an effective preventive treatment for stroke and cognitive decline in cerebral small vessel disease.

Effect of Age at Diagnosis on the Prognosis of Gastric Cancer Patients: A Population-Based Study in Georgia.

The national burden of gastric cancer (GC) is high in Georgia, which is determined by its high mortality and low survival. The study aimed to estimate the effect of age at diagnosis on the prognosis of GC patients diagnosed between 2015 and 2020 in Georgia. We obtained data for the study from the national population-based cancer registry. All patients 15 years of age or older, diagnosed during 2015-2020 with invasive GC (site codes C16.0 to C16.9, International Classification of Diseases for Oncology), were eligible for inclusion in the analysis. We produced survival curves using the Kaplan-Meier method, and the log-rank test was used to compare survival between groups. Hazard ratios (HR) were estimated using univariate Cox proportional models and multivariate Cox proportional hazard models. The endpoint of the study was overall survival (OS). The level of statistical significance of the study findings was estimated using p-values and 95% confidence intervals (CI). A p-value<0.05 was considered statistically significant. Results: A total of 1,828 gastric cancer cases were included in the statistical analysis. The average age of patients was 65 years. The bivariate Cox's regression analysis demonstrated that the risk of gastric cancer mortality increased gradually with the age of cancer patients. The HR and 95% CI were as follows: 1.5 (1.1-1.8) and 2.1 (1.5-2.5) in the 46-65 years and >65 years groups, respectively, with the <46 years group as a reference. Moreover, multivariable Cox's regression analysis proved that age is an independent risk factor for GC mortality (HR = 1.4; 95% CI = 1.2-1.8; p<.001). Conclusion: We found that age at diagnosis was a significant predictor of the worse survival of GC patients diagnosed between 2015 and 2020 in Georgia.

Eight-Year Survival and Growth of Sakhalin Fir (Abies sachalinensis) Seedlings with One Weeding Operation: Impact of Mechanical Site Preparation, Vegetation Release, Summer Planting, Stock Type, and Forwarder Trail

In Hokkaido, northern Japan, bareroot Sakhalin fir seedlings are conventionally planted in spring and fall, following strip site preparation that alternates managed and unmanaged strips. However, this method requires seven years of weeding due to encroachment of evergreen dwarf bamboo. Given diminishing forest labor availability, a shortage of workers for planting and weeding operations has become a problem in reforestation following clearcutting. We examined whether comprehensive mechanical site preparation (MSP) could reduce weeding frequency by preventing regrowth of dwarf bamboo and whether container seedlings could extend the planting season into summer. Over eight years, the survival and growth of summer-planted bareroot and container seedlings were examined on a fully MSP-treated site with only one weeding operation in the fifth year. Full-site MSP resulted in a shift of the vegetation from dwarf bamboo to deciduous plants, leading to high survival and growth rates of Sakhalin fir seedlings despite minimal weeding. Container seedlings exhibited superior establishment and maintained higher survival rates over eight years than bareroot seedlings. However, planting on the forwarder trail decreased seedling growth, and ultimately decreased survival under rare summer drought. Our findings indicate that container seedling summer planting and full-site MSP may represent an alternative approach to reforestation of Sakhalin fir, potentially reducing the need for weeding and extending the planting season.

Clinical and radiographic outcomes of implant‐supported fixed prostheses with cantilever extension in anterior mandible: A retrospective study

AbstractObjectivesThe objective of this study is to analyze the clinical and radiographic outcomes of implant‐supported fixed protheses with cantilever extensions (ISFPCs) in the partially edentulous anterior mandible.Materials and MethodsPatients who received anterior mandible implant restoration between January 2016 and December 2021 were included. Patients with two, three, or four continuous missing teeth receiving adjacent implant supported single‐unit crowns (ISSCs), ISFPCs, implant‐supported fixed protheses without cantilever extensions (ISFPNs) were divided into groups: ISSC+ISSC, ISFPC, ISSC+ISFPC, three‐unit ISFPN, ISFPC+ISFPC, or four‐unit ISFPN, respectively. We recorded and evaluated survival rates, mechanical and biological complications, peri‐implant marginal bone loss (MBL), esthetic outcomes, and patient perceptions. Statistical analysis was performed using linear mixed models (LMM).ResultsThe study included 87 patients and 152 implants. No implant loss occurred during an average follow‐up of 3.48 ± 1.85 years (range: 1–7 years). According to LMM models, prosthetic type had a statistically significant impact on MBL during follow‐up periods, in favor of the ISFPC and ISFPC+ISFPC groups (0.16 ± 0.48 mm vs. 0.51 ± 0.49 mm, p = .034; 0.22 ± 0.49 mm vs. 0.60 ± 0.62 mm, p = .043, respectively). Mechanical and biological complications were relatively low and comparable. The four‐unit ISFPC group had higher subjective esthetic scores compared with the ISSC+ISSC group (98.6 vs. 83.8, p &lt; .05), and patients in the ISFPC+ISFPC group expressed greater satisfaction with cleanability than the ISFPN group (98.8 vs. 80.6).ConclusionISFPCs offer a highly predictable treatment option in the anterior mandible, characterized by high survival rates, and comparable complication rates, peri‐implant bone stability and esthetics to adjacent ISSCs or ISFPNs.

Investigating the spray drying damage mechanism of baijiu yeast with combined drying process and equipment

Abstract Traditional drying processes used to dry high-quality baijiu yeast-Sporidiobolus johnsonii A do not offer advantages such as high efficiency, high survival rate, and low energy consumption. Therefore, we investigated the damage inactivation mechanism of S. johnsonii A for the spray drying process. Subsequently, the combined drying process and equipment for spray + vacuum-microwave-vibration were designed. The results reveal selective permeability damage and collapse owing to gel and anti-hexagonal phase transitions of the cell membrane, resulting in S. johnsonii A inactivation and massive inactivation at 52 °C with a water content of 0.21 and at 71 °C with a water content of 0.07, respectively. The combined drying process developed in this study successfully dried S. johnsonii A with high efficiency (1.1 h) and excellent quality (85.4 ± 2 %).

Challenges in prompt identification and surgical correction of Marfan Syndrome aortic disease in a middle-income country: a case series study

BackgroundMarfan Syndrome is an autosomal dominant disease caused by pathogenetic variants in the FBN1 gene. The progressive dilatation of the aorta and the potential risk of acute aortic syndromes influence the prognosis of these patients. We aim to describe population characteristics, long-term survival, and re-intervention patterns in patients who underwent aortic surgery with a previously confirmed clinical diagnosis of Marfan Syndrome in a middle-income country.MethodsA retrospective single-center case series study was conducted. All Marfan Syndrome patients who underwent aortic procedures from 2004 until 2021 were included. Qualitative variables were frequency-presented, while quantitative ones adopted mean ± standard deviation. A subgroup analysis between elective and emergent procedures was conducted. Kaplan-Meier plots depicted cumulative survival and re-intervention-free. Control appointments and government data tracked out-of-hospital mortality.ResultsFifty patients were identified. The mean age was 38.79 ± 14.41 years, with a male-to-female ratio of 2:1. Common comorbidities included aortic valve regurgitation (66%) and hypertension (50%). Aortic aneurysms were observed in 64% without dissection and 36% with dissection. Surgical procedures comprised elective (52%) and emergent cases (48%). The most common surgery performed was the David procedure (64%), and the Bentall procedure (14%). The in-hospital mortality rate was 4%. Complications included stroke (10%), and acute kidney injury (6%). The average follow-up was 8.88 ± 5.78 years. Survival rates at 5, 10, and 15 years were 89%, 73%, and 68%, respectively. Reintervention rates at 1, 2.5, and 5 years were 10%, 14%, and 17%, respectively. The emergent subgroup was younger (37.58 ± 14.49 years), had the largest number of Stanford A aortic dissections, presented hemodynamic instability (41.67%), and had a higher requirement of reinterventions in the first 5 years of follow-up (p = 0.030).ConclusionIn our study, surveillance programs played a pivotal role in sustaining high survival rates and identifying re-intervention requirements. However, challenges persist, as 48% of the patients required emergent surgery. Despite not affecting survival rates, a greater requirement for reinterventions was observed, emphasizing the necessity of timely diagnosis. Enhanced educational initiatives for healthcare providers and increased patient involvement in follow-up programs are imperative to address these concerns.

A multi-functional 3D-printable gel-in-gel system for the delivery of probiotics to the intestine

Bacterial encapsulation has been successfully utilized to either protect probiotics from the harsh gastrointestinal (GI) environment or to provide them with mucoadhesive properties, thereby enhancing their health benefits. However, it is challenging to balance multiple functions within one system, especially when facing the spatially changing environment of the GI tract. Here, we develop a gel-in-gel system with self-adjusting properties for the delivery of probiotics to the intestine. By employing a simple mixing step, mucoadhesive, probiotic-laden microgels are embedded into a protective ‘macro-gel’, i.e., a gelatin matrix enriched with CaCO3 crystals. This macrogel provides high bacterial survival rates in acidic environments while ensuring a temperature-responsive liberation of the microgels as they travel to the intestine. In vitro and ex vivo experiments demonstrate the high mucoadhesion and stability of the microgels as required for prolonged intestinal retention. The gel-in-gel system not only offers a strategy to encapsulate probiotics in a simple yet multifunctional platform but can also be 3D-printed into chewable shapes for the development of personalized, next-generation oral medicine.