Higher Survival Rate Research Articles

Alternatives to the Gold Standard: A Systematic Review of Profunda Artery Perforator and Lumbar Artery Perforator Flaps for Breast Reconstruction.

Breast reconstruction with the deep inferior epigastric perforator (DIEP) flap is the current gold-standard autologous option. The profunda artery perforator (PAP) and lumbar artery perforator (LAP) flaps have more recently been described as alternatives for patients who are not candidates for a DIEP flap. The aim of this study was to review the survival and complication rates of PAP and LAP flaps, using the DIEP flap as a benchmark. A literature search was conducted using PubMed, MEDLINE, Embase, BIOSIS, Web of Science, and Cochrane databases. Papers were screened by title and abstract, and full texts reviewed by three independent blinded reviewers. Quality was assessed using MINORS criteria. Sixty-three studies were included, for a total of 745 PAP, 62 stacked PAP, 187 LAP, and 23,748 DIEP flap breast reconstructions. The PAP (98.3%) had comparable success rate to DIEP (98.4%), and the stacked PAP (88.7%) and LAP (92.5%) success rate was significantly lower (P < 0.0001). The PAP and LAP groups both had a low incidence of fat necrosis. However, the revision rate for the LAP group was 16.1% whereas the PAP group was 3.3%. Donor site wound dehiscence rate was 2.9 in the LAP group and 9.1% in the PAP group. Profunda artery perforator and DIEP flaps demonstrate very high rates of overall survival. The LAP flap has a lower survival rate. This review highlights the survival and complication rates of these alternative flaps, which may help clinicians in guiding autologous reconstruction technique when a DIEP flap is unavailable.

Survival, Growth, and Food Resources of Juvenile Sea Cucumbers Holothuria forskali (Echinodermata, Holothuroidea) in Co-Culture with Shellfish in Brittany (France)

We conducted experiments with various growing conditions, both at sea and indoors, to explore the growth potential of Holothuria (Panningothuria) forskali Delle Chiaje, 1823 juveniles. Sea trials involved co-culture with European abalones (EA) or placement underneath European flat oysters (EO) or Pacific oysters (PO), using juveniles of 6–8 g initial weight. In sea-based conditions around summer (Apr–Sep), sea cucumbers grew best in EO at 0.94% d−1, followed by EA (0.88% d−1), both being in deep water (8–12 m), while sea cucumbers in the foreshore of a mega-tidal environment (PO) had the lowest growth (0.24% d−1). The indoor trial (IM) was performed with smaller individuals (≈0.3 g) and yielded a remarkable growth of 2.76% d−1 during summer (May–Sep). All experiments resulted in high survival rates, exceeding 80%. Additionally, we analysed fatty acid, amino acid, and stable isotope compositions of sea cucumbers’ body walls, along with the pigment composition of their stomach contents. These analyses provided evidence that juveniles had distinct diets in each rearing condition, all differing from the diet of adults found in the wild. Our results also demonstrate that sea cucumbers do not compete for food resources in the shellfish production, which is crucial for their integration into multi-trophic aquaculture systems. However, whether sea cucumbers may have benefitted from the organic matter from shellfish faeces and pseudofaeces and/or grew on the biofilm growing on the cage walls remains to be elucidated.

Probiotic Bacteria Survival and Shelf Life of High Fibre Plant Snack - Model Study.

The study aimed to develop plant-based model snacks that are high in fibre, contain probiotic bacteria and are convenient for long-term storage. The research focused on selecting a suitable form of probiotic bacteria (active biomass, microencapsulated, freeze-dried), inoculation method (in the base mass or in the filling of a snack) and appropriate storage conditions (4°Cor 20°C). The potential synbiotic properties were evaluated. The microencapsulated bacteria had the highest survival rate at 4°C, while the freeze-dried bacteria showed better survival rates at 20°C. Probiotics had a higher survival rate when enclosed inside snacks with a low water activity (aw = 0.27) peanut butter filling than in snacks without filling (aw = 0.53). Enclosing the probiotics in a low aw filling ensures their survival at ambient temperature for 5months at a count higher than 6 log CFU/g. The snacks exhibited high antioxidant capacity (average 300mg ascorbic acid equivalent/100g), polyphenol content (average 357mg gallic acid equivalent/100g) and high fibre content (average 10.2g/100g). The sensory analysis showed a high overall quality of the snacks (average 7.1/10 of the conventional units). Furthermore, after six months of storage, significant changes were observed in the antioxidant properties, polyphenol content and texture of the snacks, while their sensory quality remained unchanged. Moreover, a potential synbiotic effect was observed. The method used to assess bacterial growth indicated significantly higher values in the model snacks compared to a control sample. Therefore, this study has effectively addressed the gap in knowledge regarding the survival of probiotics in snacks of this nature.

In vitro propagation of theDendrobium wardianum

In the present study, we investigatedthepropagation of Dendrobium wardianum by in vitro culture technique. The results showed that:the most suitable protocorm multiplication medium is MS mediumsupplemented with 2 mg/l BAP, 1 mg/l IBA, 40 g/l mashed banana after 8 weeks of culture, with a protocorm multiplier of 18.8;MS medium supplemented with 1.5 mg/l KIN, 30 g/l mashed carrot gave the best on in vitro shoot regeneration after 8 weeks of culture, with 32.58 shoots/explant, shoot height of 2.5 cm and 3.5 leaves/shoot. Shoots were rooted well on MS medium supplemented with 1 mg/l αNAA, 30 g/l mashed carrot with the highest mean number of roots (10.8 roots per shoot) and the longest mean root length (3.01 cm) after 6 weeks of culture.In the nursery, a mixture of forest moss, volcanic pumice, and coconut fibre (30:30:40) ratio was regarded as the best substrate due to the high survival rate of plantlets (96.6%) and healthy plantlets (9.10 cm in height with 8.7 leaves and 3.8 new roots/plantlet) at 6 weeks after planting.

Pulsed field ablation for atrial fibrillation: efficacy, safety and lesion durability in patients with recurrences

Abstract Background Initial findings from feasibility studies regarding pulsed field ablation (PFA) for atrial fibrillation (AF) indicated substantial efficacy and safety of the procedure, including high rates of lesion durability upon systematic remapping. However, data regarding PFA for AF in real-life settings remains scarce. Objective This pooled analysis was conducted to provide insights into PFA’s practical performance and safety profile in real-life settings, as well as information regarding lesion durability in patients with arrhythmia recurrences. Methods MEDLINE/EMBASE databases were searched up to August 31, 2023 for studies including patients undergoing catheter ablation for AF using PFA. Independent searches were performed by 2 investigators (K.B. and K.V.). Feasibility studies, first-in-human studies, small studies with population overlap, and those with a follow-up duration shorter than one year were excluded from the analysis. Authors were contacted for missing information or to confirm the absence of population overlap. Two investigators (K.B. and K.V.) independently extracted data from studies meeting inclusion criteria. Any discrepancies were resolved by a third experienced reviewer. Results We assessed for relevance a total of 952 references. Five studies met the inclusion criteria (comprising of 1 randomized trial, 2 single arm prospective trials, and 2 post-market registries), with a combined cohort of 2,359 patients who underwent PFA for AF. The pooled rate of acute PVI was 99.6% (95%CI 99.2-99.8, I2:7%). The pooled one-year rates of freedom from atrial arrhythmia for individuals with paroxysmal or persistent AF were 79.5% (95%CI 75.7-83.1, I2:70%) and 67.5% (95%CI 60.9-73.7, I2:60%), respectively. Among patients who underwent repeat catheter ablation for AF recurrences (n=197), the pooled rate of durable PVI per patient was 48.9% (95%CI 30.4-67.7, I2:71%), while durable PVI per vein was 74.1% (95%CI 65.1-82.2, I2: 75%). Incidence of overall complications and serious procedure-related complications were 1.8% (95% CI: 0.2-4.8, I2: 92%) and 0.9% (95% CI: 0.3-1.7, I2:59%), respectively. The most prevalent complication types were access site complications (48.6%), pericardial effusions/tamponades (24.8%) and stroke/transient ischemic attack (9.5%). No esophageal damage or PV stenosis were reported . There was one case of persistent phrenic nerve palsy and two cases of reversible coronary spasm (during ablation along the posterior mitral isthmus, and during PVI, both resolving with intracoronary nitroglycerin). Conclusion This pooled analysis confirms that catheter ablation of atrial fibrillation using pulsed field ablation is associated with high rates of atrial arrhythmia-free survival at one year while maintaining low rates of procedure-related complications. Durable pulmonary vein isolation is observed in approximately half of the patients undergoing a repeat procedure for atrial fibrillation recurrence.

The multicenter ablate-by-LAW study: personalized paroxysmal atrial fibrillation ablation according to the local left atrial wall thickness

Abstract Background Personalized radiofrequency (RF) catheter ablation for paroxysmal atrial fibrillation (PAF), tailoring the ablation index (AI) to the local left atrial wall thickness (LAWT), has proven to be an efficient procedure with high arrhythmia-free survival rates. However, to date, only monocentric experiences have been reported in the literature. Purpose The present study sought to report a multicenter experience in order to assess the safety, efficacy, and efficiency, of a LAWT-guided personalized pulmonary vein isolation (PVI) approach for PAF ablation (ClinicalTrials.gov, NCT04218604). Methods We conducted an international multicenter prospective study at five tertiary hospitals (two in Spain, one in Italy, one in Germany, and one in the United States). Consecutive patients referred for first-time RF catheter ablation of PAF were prospectively enrolled from November 2020 to September 2022. In all patients a three-dimensional map of LAWT were obtained from preprocedural multidetector computed tomography (MDCT)-derived data postprocessing. LAWT was categorized into 1 mm layers and AI was titrated according to the LAWT. All procedures were performed under general anesthesia, utilizing high-rate low-tidal volume (HR-LTV) ventilation (Figure 1). All antiarrhythmic drugs were discontinued following the 3-month blanking period. The primary endpoint was freedom from any documented sustained atrial arrhythmia at 12-month follow-up, regardless of symptoms. Results One hundred and nine patients (60.1±9.4 years, 64.2% male) were prospectively enrolled. The mean LA diameter was 38.7±5.8 mm and the mean left ventricular ejection fraction was 60.7±4.7%. The median procedure time was 61.7 minutes (IQR 48.4–83.8), and the median RF application time was 13.9 minutes (IQR 12.3–16.8). The mean number of VisiTags was 63.2 ± 18. First-pass PVI was achieved in the 83.5% of patients. The median fluoroscopy time was 61.5 seconds (IQR 22.5–197.5). In 94 (86.2%) patients, ablation was performed with a single femoral venous puncture. At 12-month follow-up, the rate of freedom from any documented atrial arrhythmia was 93.4% (Figure 1). Two (1.8%) patients died during follow-up, one from unknown cause three months after the procedure, and another from complications following multiple trauma after falling from a ladder. One patient (0.9%) developed femoral artery pseudoaneurysm, with no other serious procedure-related complications. Conclusion The Ablate-by-LAW multicenter study proved that a personalized PAF ablation protocol, tailoring the AI to the local LAWT is highly efficient and achieved a high acute first-pass PVI rates. The study reported a high 12-month survival-free from any documented sustained atrial arrhythmias, exceeding 90%, and an exceptionally low incidence of serious procedure-related complications.

#934 Mortality predictors in advanced chronic kidney disease patients on conservative kidney management: insights from a retrospective multicenter study

Abstract Background and Aims In general, patients with advanced chronic kidney disease (ACKD) on dialysis have a better survival than patients on conservative kidney management (CKM). However, in elderly and frail individuals, with multiple comorbidities, the survival benefits of dialysis seem to be lost. Although the focus of CKM is not quantity but quality of life (QoL), it is important to identify survival modifiers and mortality predictors that may eventually influence QoL and the development of symptoms. Method An observational retrospective and multicenter study of ACKD patients on CKM was conducted from July/2015 to December/2023. Data was retrieved from electronic records, encompassing kidney function, analytical parameters, functional and fragility state, and symptoms evaluation (using Palliative Outcome Scale—Renal). The Kaplan-Meier curves and Cox proportional hazards multivariable regression were used for survival analysis and to evaluate 180-day mortality predictors. Results A total of 212 patients (56.6% females), with a mean age of 83 years old and a mean follow up time of 220 ± 239 days, were included. The follow-up time was determined by the end of the observational period or the patient's death. 56.1% died before a 180-day follow-up period. The main causes for the ACKD were multifactorial (29.7%) and indeterminate (25.9%). The majority (80.7%) had nephrologist oversight before a CKM team initiated its follow-up, and 63.6% opted for CKM as their first treatment choice. Survival at 180 days (Fig. 1) differed significantly depending on sex (51.3 vs 65.6, p = 0.021), age under 80 years-old (51.3 vs 73.9, p = 0.000), provenance (0 vs 39.4 vs 83 vs 93.8, p = 0.000), albumin value (32.7 vs 65.5, p = 0.032), and symptoms such as anorexia and pain (53 vs 95.5, p = 0.000; and 54.5 vs 88.9, p = 0.000). Regarding to mortality predictors (Table 1), albumin under 3g/dL, anorexia and pain were independent predictors of mortality. Conclusion Understanding factors associated with increased mortality and higher rates of survival in CKM patients is crucial to better manage this population. Pain, albumin &amp;lt;3g/dL and anorexia, which may reflect patients with worse nutritional status, were shown to be independent predictors of mortality. Therefore, controlling these symptoms, which often impair QoL, and improving nutritional status appears to have an impact not only on QoL but also on survival of ACKD patients on CKM.

#1524 SKLB023 alleviates kidney inflammation and apoptosis via inhibiting TLR4-mediated NF-κB p65 and MAPK signaling pathways in septic AKI mice

Abstract Background and Aims Sepsis is a severe and complex clinical syndrome resulting from the host's inflammatory response to infection. Acute kidney injury (AKI) is one of the major complications of sepsis with high morbidity and mortality, namely sepsis-associated acute kidney injury (S-AKI). Despite current advances, effective drugs for treatment of S-AKI are scarce. SKLB023 is a small molecule compound designed based on 5-benzylidene-thiazolidine-2,4-dione, which has a potent anti-inflammatory effect with favorable efficacy in rheumatoid arthritis. This study aims to evaluate the efficacy of SKLB023 in treating S-AKI and to explore the underlying mechanisms. Method S-AKI was induced by cecal ligation puncture (CLP) and intraperitoneal injection of LPS (10 mg/kg) in male C57BL/6 mice. SKLB023 (25 mg/kg, 50 mg/kg) was administrated by gavage three days in advance and 30 minutes earlier on the day of modeling. Mice death per group was recorded for 100 hours after CLP to evaluate the effect of SKLB023 on the survival rate of S-AKI mice. Other mice were sacrificed 16 hours after model establishment, blood and kidney specimens were collected. Renal function was measured by the detection of serum creatinine (SCr) and blood urea nitrogen (BUN). Kidney pathological injury was evaluated by the expression of kidney injury markers and the assessment of PAS/HE stainings. In vitro experiments were performed with LPS stimulation of TCMK-1 cells and SKLB023 intervention, and the doses were determined by CCK-8 assay. Possible molecular mechanisms involved in SKLB023 against S-AKI were screened by bioinformatics analysis and further validated in vivo and vitro. RT-PCR, western blot, immunofluorescence, and immunohistochemistry were applied to detect renal inflammation and apoptosis. To determine the role of TLR4, TLR4 siRNA and TLR4-KO mice were applied in S-AKI model, and TLR4 expression and the activities of NF-κB p65 and MAPK signaling pathway were assessed. One-way ANOVA was performed for comparison between groups, and logrank analysis was used for comparison of survival curve. P &amp;lt; 0.05 was considered as statistically significant. Results The S-AKI model was successfully established by CLP and LPS injection with obvious renal dysfunction and kidney pathological damage. The mice administrated with SKLB023 had a higher survival rate, lower levels of Scr and BUN, and improved kidney pathological injury than the mice in the CLP group. Transcriptomic analysis identified TLR4-mediated downstream signaling pathways as the potential mechanism of SKLB023 and further experiments in vivo and in vitro proved that SKLB023 regulated the expression of TLR4 and the activities of NF-κB p65 and MAPK signaling pathway in S-AKI mice and LPS-stimulated TCMK-1 cells. Moreover, TLR4 inhibited the expression of inflammatory cytokines including TNF-α, IL-1β, IL-6, iNOS, COX-2, HMGB-1 and alleviated kidney apoptosis in S-AKI mice and LPS-treated TCMK-1 cells. Additionally, knockout of TLR4 remarkably improved inflammation, apotosis, and kidney injury in LPS-treated mice and TCMK-1 cells. Conclusion SKLB023 confers renoprotective effects in S-AKI by modulating inflammation and apoptosis. TLR4 is a key target in S-AKI, and SKLB023 inhibits inflammation and apoptosis by inhibiting the activities of TLR4 mediated NF-κB p65 and MAPK pathways. SKLB023 may be proposed as one of the potential preventive and therapeutic agents for S-AKI.

#1487 Preoperative ultrasound vascular mapping as a predictor of arteriovenous fistula survival: a prospective cohort study

Abstract Background and Aims The morbidity and mortality of hemodialysis (HD) patients is directly related to the vascular access (VA) type. The arteriovenous fistula (AVF) is considered the VA of choice. When compared to the use of catheter, the use of AVF encompasses a lower infectious complications rate and a higher survival rate. The use of catheter has been independently associated with an increased risk of morbidity and mortality, especially during the first year of treatment. It is essential that HD programs maintain a high incidence and prevalence of AVF as a VA. For that reason, a multidisciplinary management is mandatory, with the collaboration of nephrologists, vascular surgeons, radiologists, and nurses. All patients who have an indication of AVF should have a prior ultrasound vascular mapping performed by the nephrologist to determine the most appropriate type of AVF. According to guidelines, there are several factors that increase the risk of AVF failure including advanced age, history of smoking, diabetes mellitus and peripheral vascular disease, among others. Therefore, the aim of this study is to determine the benefits of performing a preoperative ultrasound vascular mapping in terms of AVF survival. The secondary objective is to associate some risk factors to a higher rate of AVF failure. Method We conducted a prospective cohort study between January 2020 and December 2023. The viability of AVF was compared between AVF resulting from a preoperative ultrasound vascular mapping and those AVF without previous mapping. A multivariate analysis was performed with the entire population to determine the factors related to AVF survival. Results This study analyzed a total of 136 AVF, both native and prosthetic. Our population included 106 patients, mostly men (69.79%), with a median age of 68 years old (IR: 56-76), and history of smoking in a 39.10%, of diabetes in a 42.43%, and of peripheral vascular disease in a 17.54%. A preoperative ultrasound vascular mapping was previously performed in 107 AVF (78.7%). A total of 93 AVF were functional (68.4%). Regarding the analyzed risk factors of AVF failure (including advanced age and history of smoking, diabetes mellitus and peripheral vascular disease, and elbow/wrist AVF), we observed that advanced age and elbow AVF were related to higher survival of the AVF (p = 0.048 and p = 0.01 respectively). In the multivariate analysis we observed that advanced age and elbow AVF were independent predictors of AVF survival (p = 0.038 and p = 0.001, respectively). When comparing the cohorts, in the AVFs were the preoperative vascular ultrasound was performed, 78 AVF were functional (72.9%). In the AVFs were no mapping was performed, 15 AVF were functional (51.7%). This difference was statistically significant (p = 0.03). This implies a 21.2% increase in the probability of AVF survival when performing our AVF mapping. Conclusions The performance of a preoperative ultrasound vascular mapping by the nephrologist in our population has been associated to a significant increase in AVF survival. For that reason, we consider that it is an indispensable tool for the creation and monitoring of VA. When analyzing risk factors classically associated to AVF failure, we found that advanced age and elbow AVF were independent predictors of higher AVF survival. Other risk factors, such as history of diabetes mellitus, smoking, and peripheral arterial disease, were not significantly related to AVF failure in our population.

#2603 Focus on a crucial moment in decision making: evaluate peritoneal dialysis as incident renal replacement therapy

Abstract Background and Aims Chronic kidney disease affects 10% of the world population (15.1% in Spain, ENRICA 2019 study), being a health problem with important physical, emotional, and socio-occupational repercussions. Deciding on the most appropriate renal replacement therapy (RRT) for each patient, according to their lifestyle and family environment, represents a considerable challenge. Peritoneal dialysis (PD) offers several benefits, including greater independence, preserved kidney function, less restrictive diet, and better adaptation to the patient's lifestyle. It also improves the capacity for self-training and learning. Although kidney transplantation is the best RRT option, PD has demonstrated better quality of life, patient autonomy, and higher survival rates. Despite these advantages, PD as a technique for starting RRT represents 16.4% among incident patients in Spain, reaching 25% in our community, similar data to that of other northern European countries (ERA EDTA Report 2021). Method We carried out a retrospective descriptive study of patients followed in Advanced Chronic Kidney Disease (ACKD) over a period of five years (2017-2021). The inclusion criteria considered the acceptance of the technique in optimal candidates, with integrity of the peritoneal membrane and/or functional abdominal cavity, as well as the ability to learn the technique and family support. The study aimed to assess the percentage of patients who, meeting optimal criteria for PD candidacy, successfully initiated the technique. Results The analyzed population consisted of 113 patients, 73.4% males, with a mean age of 77 years. 59% of ACKD patients were considered candidates, and of these, 73% (n 38) chose PD as the modality, successfully initiating the technique. The main causes of abandonment or failure of the technique were: Out of the 38 patients successfully initiating PD as RRT, 34% continued with this modality. Conclusion PD provides quality of life and autonomy to patients who choose this technique. Individualized and ongoing training through updated information is essential during this process, as it helps reduce most complications and reinforces patient autonomy.

Immunogenic Treatment for Metastatic Breast Cancer Using Targeted Carbon Nanotube Mediated Photothermal Therapy in Combination with Anti-PD-1.

The high prevalence of breast cancer is a global health concern, but there are no safe or effective treatments for it at its advanced stages. These facts urge the development of novel treatment strategies. Annexin A5 (ANXA5) is a natural human protein that binds with high specificity to phosphatidylserine, a phospholipid tightly maintained in the inner leaflet of the cell membrane on most healthy cells but externalized in tumor cells and the tumor vasculature. Here, we have developed a targeted photosensitizer for photothermal therapy (PTT) of solid tumors through the functionalization of single walled carbon nanotubes (SWCNTs) to ANXA5-the SWCNT-ANXA5 conjugate. The ablation of tumors through the SWCNT-ANXA5-mediated PTT synergizes with checkpoint inhibition, creating a systemic anti-cancer immune response. In vitro ablation of cells incubated with the conjugate promoted cell death in a dose-dependent and targeted manner. This treatment strategy was tested in vivo with the orthotopic EMT6 breast tumor model in female balb/cJ mice. Enhanced therapeutic effects were achieved by using intratumoral injection of the conjugate and treating tumors at a lower PTT temperature (45oC). Intratumoral injection prevented the accumulation of the SWCNTs in major clearance organs. When combined with checkpoint inhibition of anti-PD-1, SWCNT-ANXA5-mediated PTT increased survival and 80% of the mice survived for 100 days. Evidence of immune system activation by flow cytometry of splenic cells strengthens the hypothesis of an abscopal effect as a mechanism of prolonged survival. Significance Statement This study demonstrated a relatively high survival rate (80% at 100 days) of mice with aggressive breast cancer when treated with photothermal therapy using the SWCNT-ANXA5 conjugate injected intratumorally and combined with immune stimulation using the anti-PD-1 checkpoint inhibitor. Photothermal therapy was accomplished by maintaining the tumor temperature at a relatively low level of 45oC and avoiding accumulation of the nanotubes in the clearance organs by using intratumoral administration.

Outcomes of nonsurgical endodontic treatment under general anesthesia in special health care needs: An observational study

Background and aimThe alarming rise in the number of people with special health care needs (SHCNs) necessitates a paradigm shift in how to approach their oral health needs. General anesthesia (GA) is a valuable technique for facilitating dental procedures in patients with SHCNs who may not be able to tolerate treatment without it. The aim was to assess nonsurgical endodontic treatment and outcomes in patients with SHCNs performed under GA.MethodSeventy-eight permanent teeth in 33 patients who received nonsurgical endodontic treatment under GA were included between 2018 and 2022 in SHCNs hospital clinics. The demographic data, types of SHCNs, pulpal and periapical diagnosis, type of treatment, and material used were analyzed. All patients were recalled for clinical and radiographic examinations. Pre-treatment and recall periapical radiographs were evaluated and scored using the Periapical Index (PAI).ResultsAutism and Attention deficit hyperactivity disorder were 39.4% of patients treated. Most treatments delivered were primary nonsurgical root canal treatment (95%). Warm vertical compaction of gutta-percha for obturation accounted for 88% of cases treated. Single cone obturation technique was used in 9 cases (12%) utilizing tricalcium silicate sealer. At the recall visits, 98.7% of teeth treated had survived. Twelve teeth have pre-treatment periapical lesions, and all healed except one. Female patients were found to have higher scores of PAI compared to male patients (23.7% vs 7.5%), yet insignificant. Only 10 patients with nonsurgical root canal treatment reported recurrent caries.ConclusionThis study demonstrates a high survival rate for nonsurgical endodontic treatment performed under GA in a cohort of patients with SHCNs. Interestingly, patients with social and communication disorders received the highest proportion of treatments under GA. These findings highlight the potential of GA-facilitated endodontics for this population. However, further research is warranted to explore additional methods for optimizing oral health outcomes in SHCNs.

Unicompartmental osteoarthritis: High survival rate with a combined mechanical and biological salvage approach as alternative to metal resurfacing: Results at minimum 10 years of follow-up.

The aim of this study was to prospectively evaluate the long-term clinical results and failure rate of patients treated with complex salvage procedures using a combined mechanical and biological approach to address unicompartmental knee osteoarthritis (OA) and postpone the need for joint replacement. Thirty-nine patients (40.3 ± 10.9 years old) affected by unicompartmental OA (Kellgren-Lawrence 3) in stable joints underwent a personalized surgical treatment depending on the specific requirements of the affected compartment, including high tibial osteotomy, osteochondral scaffold, meniscal scaffold and meniscal allograft transplantation. Patients were evaluated with the International Knee Documentation Committee (IKDC), Visual Analogue Scale (VAS) and Tegner scores before surgery, at 3 years and a minimum of 10 years of follow-up. A significant improvement was observed over time in all scores but worsened at the final follow-up. The IKDC subjective score improved from 46.9 ± 16.2 to 79.8 ± 16.4 at 3 years (p < 0.0005) and then decreased to 64.5 ± 21.4 (p = 0.001) at 12 years. A similar trend was confirmed for VAS and Tegner scores. Only two patients subsequently underwent knee arthroplasty, and nine more patients were considered clinical failure, for a cumulative surgical and clinical failure rate of 28.2% at the final follow-up. A personalized, joint-preserving, combined mechanical and biological approach, addressing alignment as well as meniscal and cartilage lesions, is safe and effective, providing a clinical benefit and delaying the need for arthroplasty in young patients affected by unicompartmental knee OA. At the final evaluation, the clinical improvement decreased, but more than two-thirds of the patients still benefited from this treatment at a long-term follow-up. Level IV case series.

Microencapsulation of Origanum heracleoticum L. and Thymus vulgaris L. essential oils – novel strategy to combat multi-resistant Acinetobacter baumannii

Within the global rise of antimicrobial resistance enhanced by the COVID-19 pandemic, where Acinetobacter baumannii has been distinguished as an emerging multi-resistant pathogen, essential oils, become the focus of novel therapeutic approaches. Hypothesizing that encapsulated Origanum heracleoticum L. and Thymus vulgaris L. essential oils could express multi-target approach against A. baumannii, this study aimed to develop microencapsulated systems with optimal technological qualities using 2-hydroxypropyl-β-cyclodextrin as a carrier, and to evaluate their pharmacological potential against A. baumannii, and their morphological and physicochemical characteristics, safety and stability profiles. The highest yield and encapsulation efficiency were obtained with 1:10 essential oil to carrier, and 1.5:10 carrier to water w/w ratios. The formation of inclusion complexes was confirmed by Fourier Transform Infrared Spectroscopy. Both microencapsulates achieved improved homogeneity, particle surface, and thermal stability compared with the pure carrier. Dominant bioactive compounds (carvacrol and p-cymene in O. heracleoticum essential oil, and thymol and p-cymene in T. vulgaris essential oil) remained the most abundant after encapsulation. While non-encapsulated essential oils revealed similar antimicrobial activity towards clinical A. baumannii isolates obtained from COVID-19 patients, encapsulated O. heracleoticum essential oil inhibited the bacterial growth at lower concentrations than T. vulgaris essential oil microencapsulate. All samples significantly reduced the formation of A. baumannii biofilm, for at least 53.90% towards the most infective isolate according to the Caenorhabditis elegans assay. Further, in silico molecular docking study revealed strong interaction pattern of carvacrol and thymol with the outer membrane protein A, which is the main factor for the A. baumannii biofilm formation. Cytotoxicity investigation on human lung A549 cells showed high survival rate in the presence of all tested concentrations, and the stability study revealed notable preservation of the bioactives’ content and pharmacological potential. Altogether, microencapsulated essential oils exhibited a multi-target approach towards A. baumannii, with satisfactory preserving capability during storage.

In Vitro Probiotic Characterization of Lactiplantibacillus plantarum Strains Isolated from Traditional Fermented Dockounou Paste

This study aimed to evaluate the probiotic properties of 10 lactic acid bacteria (LAB) isolated from artisanal fermented plantain dockounou paste. A preliminary characterization of the LAB isolates was performed based on phenotypic and several biochemical properties, which was subsequently confirmed through 16S rRNA gene sequencing analysis, indicating that these isolates belonged to the species Lactiplantibacillus plantarum. With regard to safety criteria, the strains exhibited no alpha or beta hemolysis activity. Nevertheless, the majority of LAB strains demonstrated high sensitivity to the antibiotics tested. The results demonstrated that the majority of the strains exhibited remarkably high survival rates under simulated gastrointestinal conditions, such as pH = 1.5 (81.18–98.15%), 0.3% bile salts (68.62–100.89%), 0.4% phenol (40.59–128.24%), as well as 0.1% pepsin and pH = 2.5 (88.54–99.78%). The LAB strains demonstrated elevated levels of cell surface properties, indicative of the presence of a considerable defensive mechanism against pathogens. Intact LAB cells exhibited significant antioxidant abilities (48.18–83.58%). They also demonstrated a pronounced inhibitory effect on the growth of foodborne pathogens. Enzyme pattern analysis revealed that the LAB isolates produced both proteases and cellulases, as well as pectinase and/or amylase activity. The potential of the L. plantarum strains FS43, FS44, and FS48, as indicated by the results obtained from the standard in vitro assays, makes them suitable for further study as potential probiotics.

The Effect of Neoadjuvant Systemic Therapy on Surgical Outcomes After Lymph Node Dissections for Stage III Melanoma; An Australian Cohort.

Neoadjuvant systemic therapy (NAST) for patients with stage III melanoma achieves high major pathologic response rates and high recurrence-free survival rates. This study aimed to determine how NAST with targeted therapies (TTs) and immune checkpoint inhibitors (ICIs) influences surgical outcomes after lymph node dissection in terms of complications, morbidity, and textbook outcomes. Patients who underwent a lymph node dissection after either NAST in a clinical trial or upfront surgery for stage III melanoma between 2014 and 2022 were identified from an institutional research database. The study included 89 NAST-treated patients and 79 upfront surgery-treated patients. The rate of postoperative complications did not differ between the NAST- and upfront surgery-treated patients (55% vs. 51%; p = 0.643), and steroid treatment for drug toxicity did not influence the complication rate (odds ratio [OR], 1.1; 95% confidence interval [CI], 0.4-3; p = 0.826). No significant differences in postoperative morbidity were observed in terms of seroma (23% vs. 11%; p = 0.570) or lymphedema (36% vs. 51%; p = 0.550). The rate of achievinga textbook outcome was comparable for the two groups (61% vs. 57%; p = 0.641). The surgical outcomes after lymph node dissections were comparable between the patients who received NAST and those who had upfront surgery, indicating that surgery can be safely performed after NAST with TT or ICI for stage III melanoma.

Environmental adaptation, growth performance and nutrient content of the clam Cyclina sinensis from different geographic locations

The clam Cyclina sinensis is an economically important marine species in China. However, overfishing, habitat destruction, and inbreeding have led to the destruction of genetic resources. In this study, five natural populations [Dandong (DD), Dongying (DY), Tianjin (TJ), Wenzhou (WZ), and Yancheng (YC)] from different geographical locations were relocated and cultured homogeneously to study their potential for translocation and environmental adaptation by observing growth performance and nutrient content. There were significant differences in the growth rates of shell length (SL), shell height (SH), and shell width (SW) among the five populations (P&amp;lt;0.05). The DD, TJ, and YC populations exhibited the highest SL and SH growth rates, whereas these were lowest in the WZ population. The survival rate was highest in the YC population and lowest in the WZ population, which was significantly lower than the other four populations (P&amp;lt;0.05). The DD population exhibited superior plumpness and glycogen content, and the overall glycogen content in male C. sinensis was higher compared with that in females (P&amp;lt;0.05). All populations displayed a high total amino acid content and the essential amino acid/Total Amino Acid (EAA/TAA) and Non-essential amino acid/Total Amino Acid (NEAA/TAA) ratios in the soft tissue of all five populations aligned with the FAO/WHO ideal protein evaluation standards. Despite the same aquaculture environment, however, the nutrient composition of C. sinensis sampled from different populations varied significantly (P&amp;lt;0.05).Therefore, ex situ conservation did not eliminate nutritional differences between the different populations of C. sinensis. These findings highlight the importance of considering environmental and ecological factors in the nutritional assessment and cultivation of shellfish. In addition, C. sinensis from sampling sites closer to the transplantation sites had higher survival rates and growth rates, and the gonadal development of all populations showed adaption to the local environment, resulting in synchronization of the reproductive period.

Granulocyte dynamics: a key player in the immune priming effects of crickets

This study investigates immune priming effects associated with granulocytes in crickets through a comprehensive analysis. Kaplan-Meier survival analysis reveals a significant contrast in survival rates, with the heat-killed Bacillus thuringiensis (Bt)-primed group exhibiting an impressive ~80% survival rate compared to the PBS buffer-primed group with only ~10% survival 60 hours post live Bt infection. Hemocyte analysis underscores elevated hemocyte counts, particularly in granulocytes of the killed Bt-primed group, suggesting a correlation between the heat-killed Bt priming and heightened immune activation. Microscopy techniques further explore granulocyte morphology, unveiling distinctive immune responses in the killed Bt-primed group characterized by prolonged immune activation, heightened granulocyte activity, phagocytosis, and extracellular trap formation, contributing to enhanced survival rates. In particular, after 24 hours of injecting live Bt, most granulocytes in the PBS buffer-primed group exhibited extracellular DNA trap cell death (ETosis), while in the killed Bt-primed group, the majority of granulocytes were observed to maintain highly activated extracellular traps, sustaining the immune response. Gene expression analysis supports these findings, revealing differential regulation of immune-related genes such as antibacterial humoral response, detection of bacterial lipopeptides, and cellular response to bacteria lipopeptides. Additionally, the heat-killed Bt-primed group, the heat-killed E. coli-primed group, and the PBS-primed group were re-injected with live Bt 2 and 9 days post priming. Two days later, only the PBS-primed group displayed low survival rates. After injecting live Bt 9 days later, the heat-killed E. coli-primed group surprisingly showed a similarly low survival rate, while the heat-killed Bt-primed group exhibited a high survival rate of ~60% after 60 hours, with actively moving and healthy crickets. In conclusion, this research provides valuable insights into both short-term and long-term immune priming effects in crickets, contributing to our understanding of invertebrate immunity with potential applications in public health.

Clinical Survival Rate and Laboratory Failure of Dental Veneers: A Narrative Literature Review.

There is a vast amount of published literature concerning dental veneers; however, the effects of tooth preparation, aging, veneer type, and resin cement type on the failure of dental veneers in laboratory versus clinical scenarios are not clear. The purpose of the present narrative review was to determine the principal factors associated with failures of dental veneers in laboratory tests and to understand how these factors translate into clinical successes/failures. Articles were identified and screened by the lead author in January 2024 using the keywords ''dental veneer", "complication", "survival rate", "failure", and "success rate" using PubMed/Medline, Scopus, Google Scholar, and Science Direct. The inclusion criteria included articles published between January 1999 and January 2024 on the topics of preparation of a tooth, aging processes of the resin cement and veneer, translucency, thickness, fabrication technique of the veneer; shade, and thickness of the resin cement. The exclusion criteria included articles that discussed marginal and internal fit, microhardness, water sorption, solubility, polishability, occlusal veneers, retention, surface treatments, and wear. The results of the present review indicated that dental veneers generally have a high survival rate (>90% for more than 10 years). The amount of preserved enamel layer plays a paramount role in the survival and success rates of veneers, and glass-ceramic veneers with minimal/no preparation showed the highest survival rates. Fracture was the primary failure mechanism associated with decreased survival rate, followed by debonding and color change. Fractures increased in the presence of parafunctional activities. Fewer endodontic complications were associated with veneer restorations. No difference was observed between the maxillary and mandibular teeth. Clinical significance: Fractures can be reduced by evaluation of occlusion immediately after cementation and through the use of high-strength veneer materials, resin cements with low moduli, and thin layers of highly polished veneers. Debonding failures can be reduced with minimal/no preparation, and immediate dentin sealing should be considered when dentin is exposed. Debonding can also be reduced by preventing contamination from blood, saliva, handpiece oil, or fluoride-containing polishing paste; through proper surface treatment (20 s of hydrofluoric acid etching for glass ceramic followed by silane for 60 s); and through use of light-cured polymerization for thin veneers. Long-term color stability may be maintained using resin cements with UDMA-based resin, glass ceramic materials, and light-cure polymerization with thin veneers.

Tagging mortality in acoustic telemetry studies: Insights from a multispecies analysis.

The widespread adoption of acoustic telemetry has transformed our understanding of marine species' behavior and movement ecology. However, accurately interpreting telemetry data, especially concerning tagging mortality, is essential for drawing valid conclusions. In this study, we scrutinized tagging mortality in 223 individuals across 14 species and evaluated the impact of tagging methodologies, including capture method and size effects. Results reveal high tagging survival rates overall, attributable to the resiliency of the studied species and the rigorous animal welfare protocols followed during tagging procedures. Our results highlight the importance of tailoring array designs to the specific mobility patterns of the studied species for accurate survival assessments. This research contributes to generalizing mortality assessments and clearing the path for more precise and reliable telemetry studies in the future.