Successful Reconstruction Research Articles

Demystifying the pink enigma: A succinct overview on the interdental papilla

Abstract Nowadays, the scope of dentistry has extended beyond the realm of functionality to include the elusive domain of esthetics as well. Gingival black triangle (GBT) is a cosmetic aberration caused by the absence of the papilla, resulting in black gaps or exposed embrasures. Loss of interdental papilla is significantly linked to advancing age, periodontal diseases, and orthodontic therapy. The lack of an interdental papilla raises the concerns about phonetics, food accumulation, and plaque deposition, all of which exacerbate the current situation and cause esthetic issues. In dental procedures, replacing the missing interdental papilla is a difficult and unpredictable process. Because of its complicated anatomy and numerous contributing elements, attaining a successful reconstruction is not always assured. This review article discusses the anatomy of interdental papilla, different classifications of interdental papillary loss, the etiology of the GBT, and the currently available nonsurgical and surgical treatment modalities recommended for preservation of interdental papilla and management of interdental papilla loss.

Combined Double-breasted Full-thickness Abdominal Flap Plication and Acellular Dermal Matrix in Prune-belly Syndrome Reconstruction.

Reconstruction of the abdominal wall in patients with prune-belly syndrome (PBS) following previous intra-abdominal procedures is a challenging problem with a high incidence of revision due to persistent bulging or herniation. The abdominal wall flaccidity not only produces a severe psychological and aesthetic discomfort for the patient but often determines functional disabilities, including inability to cough properly, impaired bowel and bladder function, and delay in posture and balance. The authors describe three cases of reconstruction of abdominal wall using a modified double-breasted abdominoplasty fascial plication with additional acellular dermal matrix interposition and review the literature for innovations in the use of abdominal repair for reconstruction of these difficult cases. Three children with PBS at a mean age of 7.3 years achieved successful reconstruction of the abdominal wall, using the modified double-breasted abdominoplasty fascial plication with acellular dermal matrix interposition. Patients underwent previous procedures, including orchiopexy in two patients and bilateral nephrectomy in one patient. No postoperative complications have been found, apart from superficial skin dehiscence along the abdominal incision treated conservatively in one child. At mean follow-up of 42 months (range 28-56 months), no patient presented incisional hernia, persistent or recurrent fascial laxity with abdominal bulging. All patients achieved significant aesthetic and functional improvements, including children's ability to cough, spontaneous gain of abdominal tonus, balance, and ambulation. Modification of the original vertical, two-layer plications of the deficient abdominal interposing biological mesh has the purpose of improving strength, aesthetics, and function of the abdominal wall in pediatric patients with PBS.

Long-term stability of jaw reconstruction with microvascular bone flaps: A prospective longitudinal study

ObjectivesMicrovascular bone flap jaw reconstruction has achieved satisfactory clinical outcomes. However, little is known about the long-term stability of the reconstructed jaw. This prospective longitudinal study aimed to investigate the long-term stability of jaw reconstruction and factors that were associated with it. MethodsPatients with successful computer-assisted osseous free-flap jaw reconstruction in the Department of Oral and Maxillofacial Surgery, Queen Mary Hospital, Hong Kong were recruited for this prospective longitudinal study. The three-dimensional jaw models at the pre-operative plan, post-operative 1-month, and 2 years were aligned and compared. ResultsA total of 69 patients were recruited, among which 48 patients were available for the long-term analysis. Compared to 1-month after surgery, further deviation from the pre-operative plan was observed at post-operative 2 years. Lack of accuracy in surgery, segmental mandible resection especially with the involvement of mandible angles, and post-operative radiation therapy were identified as the significant factors affecting the positional stability of the reconstructed jaw (p < 0.05). Stable reconstruction was observed in the subgroup analysis of patients without post-operative radiation therapy. ConclusionUp to the best of our knowledge, this is the first prospective longitudinal study reporting the long-term stability of jaw reconstruction and its affecting factors. Our data demonstrated that the reconstructed jaw position lacked stability over the postoperative period. How to improve long-term stability of reconstructed jaw thus optimize the functional outcomes warrants further studies.

Realities of developing the research competence of teachers-philologists in wartime

The relevance of the research topic is determined by the urgent need to adapt the educational process and professional development of teachers-philologists to wartime conditions. The education sector should swiftly adjust to new realities in light of the challenges posed by the war and global changes, including making use of digital technology to provide access to high-quality education. Martial law makes adjustments not only to teaching methods but also to approaches to teachers’ professional development, emphasizing the need to integrate innovative methods and approaches. In the course of the research, it has been revealed that digital technologies play a crucial role in supporting language education in wartime by offering tools for distance learning and self-education. Innovative teaching methods, such as interactive exercises and online discussions, have been found to be effective in engaging students and motivating them to actively master the language. The reconstruction of the educational system provides an opportunity to revise and improve approaches to language teaching, with an emphasis on integrating the experience gained during the war. This emphasizes the importance of developing targeted support programs for teachers-philologists in order to enable them to use these technologies and methodologies effectively in their practice. The research findings emphasize the need for a comprehensive approach to the renovation and development of language education, with an emphasis on the role of teachers-philologists as agents of change. Ensuring their professional development, adaptation to new challenges, and engagement in intercultural communication are key elements of successful post-war reconstruction. Further studies should focus on the effectiveness of specific innovative methods in language teaching and the development of integrated professional development programs for teachers-philologists, including comprehensive support and development of the relevant competencies in the post-war period.

Multimodality therapy and innovative surgical techniques for successful resection and reconstruction of a rare and aggressive pleomorphic liposarcoma

Managing rare thoracic liposarcomas, accounting for < 1% of soft tissue sarcomas, demands tailored strategies. We explore effective approaches, considering tumor attributes and innovative techniques, and compare NCCN-guided therapies and surgeries. Using PubMed, Embase, and Cochrane Library, we identified studies on thoracic liposarcomas. Data synthesis summarized findings, acknowledging rarity's evidence limitations. This study reports a successful resection of a rare thoracic soft tissue sarcoma. Overcoming challenges through innovative techniques like hyperthermic pleural lavage and Gore-Tex® reconstruction, it underscores neoadjuvant therapies and surgical precision. Thoracic liposarcoma management demands tailored multidisciplinary approaches. Neoadjuvant chemotherapy, surgery, and adjuvant therapies are fundamental. Surgical ingenuity, like extrapleural pneumonectomy and novel reconstructions, ensures thorough tumor removal with minimal complications. Hyperthermic pleural lavage and Gore-Tex® offer promising refinements. Successful outcomes highlight potential for improved prognoses. Further research will optimize strategies for this rare, aggressive cancer.

High-resolution X-Ray imaging of small animal samples based on Commercial-Off-The-Shelf CMOS image sensors.

An automated system for acquiring microscopic-resolution radiographic images of biological samples was developed. Mass-produced, low-cost, and easily automated components were used, such as Commercial-Off-The-Self CMOS image sensors (CIS), stepper motors, and control boards based on Arduino and RaspberryPi. System configuration, imaging protocols, and Image processing (filtering and stitching) were defined to obtain high-resolution images and for successful computational image reconstruction. Radiographic images were obtained for animal samples including the widely used animal models zebrafish (Danio rerio) and the fruit-fly (Drosophila melanogaster), as well as other small animal samples. The use of phosphotungstic acid (PTA) as a contrast agent was also studied. Radiographic images with resolutions of up to (7±0.6)μm were obtained, making this system comparable to commercial ones. This work constitutes a starting point for the development of more complex systems such as X-ray attenuation micro-tomography systems based on low-cost off-the-shelf technology. It will also bring the possibility to expand the studies that can be carried out with small animal models at many institutions (mostly those working on tight budgets), particularly those on the effects of ionizing radiation and absorption of heavy metal contaminants in animal tissues.

A prospective and consecutive study assessing short-term clinical and radiographic outcomes of Chinese domestically manufactured 3D printing trabecular titanium acetabular cup for primary total hip arthroplasty: evaluation of 236 cases.

We prospectively evaluate the short-term clinical and radiographic outcomes of the only Chinese domestically produced trabecular titanium acetabular cup(3D ACT™ cup) in primary total hip arthroplasty (THA), aiming to provide evidence-based support for its clinical application. A total of 236 patients, who underwent primary THA using 3D ACT™ cup in the Department of Joint Surgery at our hospital between January 2017 and June 2019, were included in this study. General patient data, imaging information, functional scores, and complications were collected to evaluate the early clinical efficacy. All patients were followed up for 33-52 months, with an average of (42.2 ± 9.2) months. At the last follow-up, the preoperative HHS score increased significantly from 43.7 ± 6.8 to 85.6 ± 9.3 points (P < 0.01). Similarly, the preoperative WOMAC scores showed significant improvement from 59.2 ± 5.8 to 13.1 ± 3.5 points (P < 0.01). 92.3% of the patients expressed satisfaction or high satisfaction with the clinical outcome. Furthermore, 87.7% of the acetabular cups were positioned within the Lewinnek safe zone, achieving successful reconstruction of the acetabular rotation center. The cup survival rate at the last follow-up was 100%. The utilization of the only Chinese domestically manufactured 3D printing trabecular titanium acetabular cup in primary THA demonstrated favorable short-term clinical and radiographic outcomes. The acetabular cup exhibits excellent initial stability, high survival rate, and favorable osseointegration, leading to a significant enhancement in pain relief and functional improvement. In the future, larger sample sizes and multicenter prospective randomized controlled trials will be required to validate the long-term safety and effectiveness of this 3D ACT™ cup.

Enhancing the spatial resolution of time-of-flight based non-line-of-sight imaging via instrument response function deconvolution.

Non-line-of-sight (NLOS) imaging retrieves the hidden scenes by utilizing the signals indirectly reflected by the relay wall. Benefiting from the picosecond-level timing accuracy, time-correlated single photon counting (TCSPC) based NLOS imaging can achieve theoretical spatial resolutions up to millimeter level. However, in practical applications, the total temporal resolution (also known as total time jitter, TTJ) of most current TCSPC systems exceeds hundreds of picoseconds due to the combined effects of multiple electronic devices, which restricts the underlying spatial resolution of NLOS imaging. In this paper, an instrument response function deconvolution (IRF-DC) method is proposed to overcome the constraints of a TCSPC system's TTJ on the spatial resolution of NLOS imaging. Specifically, we model the transient measurements as Poisson convolution process with the normalized IRF as convolution kernel, and solve the inverse problem with iterative deconvolution algorithm, which significantly improves the spatial resolution of NLOS imaging after reconstruction. Numerical simulations show that the IRF-DC facilitates light-cone transform and frequency-wavenumber migration solver to achieve successful reconstruction even when the system's TTJ reaches 1200 ps, which is equivalent to what was previously possible when TTJ was about 200ps. In addition, the IRF-DC produces satisfactory reconstruction outcomes when the signal-to-noise ratio (SNR) is low. Furthermore, the effectiveness of the proposed method has also been experimentally verified. The proposed IRF-DC method is highly applicable and efficient, which may promote the development of high-resolution NLOS imaging.

Nunchaku-like Free Fibula Osteocutaneous Flap in Through-and-through Composite Oromandibular Defect Reconstruction.

The free fibula osteocutaneous flap (FFOCF) has been used for oromandibular reconstruction over several decades. However, when facing through-and-through composite oromandibular defects (COMDs), significant challenges still arise. The complexity of COMD necessitates the reconstruction of bone, intraoral mucosa, and extraoral skin. Additional flaps are often needed, which extend surgical durations and heighten associated risks. This report presents a 62-year-old man with squamous cell carcinoma of the left lower gingiva. After ablative surgery, successful reconstruction of a through-and-through COMD was achieved with a single FFOCF through innovative design. The flap was osteotomized into 2 segments with attached skin islands while preserving the vascular pedicle. Rotation of 1 segment created 2 skin islands on opposing sides, simultaneously repairing intraoral and extraoral defects. Postoperative outcomes at the 1-month follow-up were encouraging. Although technically challenging, the "Nunchaku-like FFOCF" offers a safe and effective approach for the comprehensive reconstruction of through-and-through COMD.

Two-stage microsurgical soft tissue reconstruction of a complex sacral wound using an arteriovenous loop

The surgical reconstruction of sacral soft tissue defects is challenging, and complications are frequent. We report a successful two-stage three-dimensional microsurgical soft tissue reconstruction of a wide and deep sacral defect anastomosing a free combined ALT/TFL/rectus femoris flap to an ipsilateral vena saphena magna arteriovenous loop which was applied primarily. This case shows that complex microsurgical procedures can be promising in this demanding patient population if the indication is correct and the operative/perioperative strategy is clear.

Evaluating the Point Cloud of Individual Trees Generated from Images Based on Neural Radiance Fields (NeRF) Method

Three-dimensional (3D) reconstruction of trees has always been a key task in precision forestry management and research. Due to the complex branch morphological structure of trees themselves and the occlusions from tree stems, branches and foliage, it is difficult to recreate a complete three-dimensional tree model from a two-dimensional image by conventional photogrammetric methods. In this study, based on tree images collected by various cameras in different ways, the Neural Radiance Fields (NeRF) method was used for individual tree dense reconstruction and the exported point cloud models are compared with point clouds derived from photogrammetric reconstruction and laser scanning methods. The results show that the NeRF method performs well in individual tree 3D reconstruction, as it has a higher successful reconstruction rate, better reconstruction in the canopy area and requires less images as input. Compared with the photogrammetric dense reconstruction method, NeRF has significant advantages in reconstruction efficiency and is adaptable to complex scenes, but the generated point cloud tend to be noisy and of low resolution. The accuracy of tree structural parameters (tree height and diameter at breast height) extracted from the photogrammetric point cloud is still higher than those derived from the NeRF point cloud. The results of this study illustrate the great potential of the NeRF method for individual tree reconstruction, and it provides new ideas and research directions for 3D reconstruction and visualization of complex forest scenes.

Economic Depression and Recovering from the Trauma of the World War: The Social Reconstruction of Britain after World War II

The passage focuses on the reconstruction of Britain after World War II. The background of the research was the time period after WWII. In order to analyze the situation more precisely, the background information of the research had a time span from the 1920s to approximately the 1950s, starting from the Roaring Twenties to the publication of the Green Belt Policy. The passage focuses on the reorganization of cities and the reconstruction of the welfare system. The two examples listed in the following passage are the Green Belt Policy and the NHS, which represents the reconstruction of cities in England and the reconstruction of the welfare system of England. Other examples include data recorded in 1931 and several government documents by the British government. By answering the question of the advantages of Britain in the reconstruction of World War II, the passage hopes to provide some characteristics of the successful reconstruction of Britain to help reconstruction in other countries like Palestine.

Successful soft tissue reconstruction using acellular fish skin grafts in a secondary blast war injury.

Successful soft tissue reconstruction using acellular fish skin grafts in a secondary blast war injury.

Roles of pore architecture of artificial bone grafts in invasion competition between bone and fibrous tissue and orientation of regenerated bone

&amp;nbsp;In the reconstruction of bone defects close to soft tissue, preventing the invasion of fibrous tissue into the bone defect is key to successful bone reconstruction. In this study, we clarified the effects of the pore architecture of artificial bone grafts on the penetration of bone and fibrous tissue, and the orientation of regenerated bone. Carbonate apatite grafts with uniaxial pores along the long- (L-graft) or short-axis (S-graft) direction of the graft and biaxial pores along the long- and short-axes (LS-graft) were used. These grafts were implanted in bone defects created by rabbit ulnae amputation. The pores of the L-, S-, and LS-grafts opened into the bone stumps, muscles, and bone stumps and muscles together, respectively. In the L-graft, the graft pores developed bone from the bone stump to the graft center, while preventing excessive invasion of fibrous tissue. In S- and LS-grafts, the graft pores along the short axis allowed the invasion of fibrous tissue into the grafts. Consequently, although the bone grew to the edge regions in these grafts, further bone ingrowth was inhibited by the fibrous tissue. Furthermore, the pore architecture of the grafts affected the orientation of the regenerated bone. The degree of orientation of the bone formed in the L- and S-grafts was 1.6-fold higher than that formed in the LS-grafts. Thus, controlling the pore architecture allowed the growth of bone to predominate over that of fibrous tissue and induced the formation of bone with an ordered orientation

Successful microvascular surgery in patients with thrombophilia in head and neck surgery: a case series

BackgroundIn this case series, a perioperative anticoagulation protocol for microvascular head and neck surgery in patients with thrombophilia is presented. Microvascular free-flap surgery is a standard procedure in head and neck surgery with high success rates. Nevertheless, flap loss—which is most often caused by thrombosis—can occur and has far-reaching consequences, such as functional impairment, prolonged hospitalization, and increased costs. The risk of flap loss owing to thrombosis is significantly increased in patients with thrombophilia. Therefore, perioperative anticoagulation is mandatory. To date, no perioperative anticoagulation protocol exists for these high-risk patients.Case presentationWe present three exemplary male Caucasian patients aged 53–57 years with free flap loss owing to an underlying, hidden thrombophilia.ConclusionWe present a modified anticoagulation protocol for microvascular surgery in these high-risk patients, enabling successful microsurgical reconstruction.

Survival analysis of PLWHA undergoing combined antiretroviral therapy: exploring long-term prognosis and influencing factors.

The survival time of human immunodeficiency virus (HIV)-infected individuals or patients with acquired immunodeficiency syndrome (AIDS) is influenced by multiple factors. Studying survival and influential factors after antiretroviral therapy (ART) contributes to improving treatment protocols, management strategies, and prognosis for people living with HIV/AIDS (PLWHA). This retrospective cohort study collected case data and follow-up records of PLWHA who received ART in Dazu District, Chongqing City, between 2007 and 2022. Cumulative survival rates were calculated using life tables. Survival curves were plotted using the Kaplan-Meier method. Uni-variable and multivariable Cox proportional hazards models analyzed factors influencing survival. The study included 5,237 PLWHA receiving ART. Within the first year of ART initiation, 146 AIDS-related deaths occurred, accounting for 29.49% (146/495) of total deaths. Cumulative survival rates at 1, 5, 10, and 15 years were 0.97, 0.90, 0.85, and 0.79, respectively. During the observation period, male patients who received ART had a 1.89 times higher risk of death compared to females (aHR, 1.89; 95%; CI, 1.50-2.37). Patients aged ≥60 years had a 3.44-fold higher risk of death than those aged <30 years (aHR, 3.44; 95% CI, 1.22-9.67). Injection drug users (aHR, 4.95; 95% CI, 2.00-12.24) had a higher risk of death than those with heterosexual (aHR, 1.60; 95% CI, 0.69-3.72) and homosexual transmission. Patients with a baseline CD4+ T lymphocyte count <200 cells/μL (aHR, 8.02; 95% CI, 4.74-13.57) and between 200 and 349 cells/μL (aHR, 2.14; 95% CI, 1.26-3.64) had a higher risk of death than those with ≥350 cells/μL. Patients with ART initiation at WHO clinical stage IV had a 2.48-fold higher risk of death than those at stage I (aHR, 2.48; 95% CI, 1.17-5.23). The first year following ART initiation is critical in HIV/AIDS treatment, emphasizing the need for intensified follow-up and monitoring to facilitate successful immune system reconstruction. Older age, male sex, injection drug use, baseline CD4+ T lymphocyte count <200 cells/μL, and WHO clinical stage IV are associated with an increased risk of death. Tailored treatment and management strategies should be implemented for patient populations at higher risk of mortality and with a poorer prognosis.

Marginal Tension Release Method of Nasoseptal Flap During Reconstruction of Skull Base Defect

The successful reconstruction of anterior skull base defects following transcribriform or transsphenoidal surgery is pivotal in mitigating the communication between the external environment and the cranial cavity. This intervention is crucial to prevent potential complications, including cerebrospinal fluid leakage and meningitis. The ideal reconstructive flap should possess sufficient vascularity and be of ample size to adequately cover vital nerves and vessels. Predominantly, the nasoseptal flap is employed for the repair of skull base defects. This flap is vascularized by the posterior division of the sphenopalatine artery, ensuring sufficient coverage of the defects. A significant advantage of the nasoseptal flap is its rotational capability, allowing for mobilization and repositioning to effectively cover the defect. Nonetheless, the rotational tension on the nasoseptal flap running from the nasal cavity to the skull base may affect the distal margin of the flap. Alleviation of this tension can be achieved through the insertion of multiple minuscule incisions in the vertical axis of the flap’s border. This report introduces and elaborates on this technique.

Evaluation on improved sparse signal reconstruction algorithm for trusted AI and DCS technology

The improved Sparse Signal Reconstruction (SR) algorithm for Trusted Artificial Intelligence (AI) and Distributed Compressed Sensing (DCS) technology was thoroughly investigated. The study verified its effectiveness and advantages in trusted AI and DCS systems, which have significant implications for enhancing the credibility, security, and performance of signal processing and AI algorithms. The reconstruction performance was evaluated using Orthogonal Matching Pursuit (OMP), Basis Pursuit (BP), and Least Absolute Shrinkage and Selection Operator (LASSO). The analysis primarily focused on runtime, refactoring errors, and the number of successful reconstruction attempts. When K = 4, K = 6, K = 8, and K = 10, OMP outperformed BP and LASSO in terms of successful reconstructions, demonstrating better performance and higher reconstruction precision.

Reconstruction of the elbow with distal humerus endoprosthetic replacement after tumor resection: a systematic review of the literature and institutional case series

Distal humerus replacement (DHR) is a modular endoprosthesis mainly used for bone reconstruction after resection of primary or metastatic bone lesions. Studies on DHR failure rates and postoperative functional outcomes are scarce. We sought to assess implant survival, modes of failure, and functional outcomes in patients undergoing DHR for oncologic indications. A systematic review of the PubMed and Embase databases was performed. PRISMA guidelines were followed for this manuscript. Our study was registered on PROSPERO (457,260). Quality appraisal of included studies was conducted using the STROBE checklist. Prosthetic failure was assessed using the Henderson classification for megaprosthetic failures. We additionally performed a retrospective review of patients treated with a DHR for oncologic indications at a large tertiary care academic center. Weighted means were calculated to pool data. Eleven studies with a total of 162 patients met the inclusion criteria. Mean follow-up was 3.7years (range, 1.66-8years). Henderson type 2 failures (aseptic loosening) were the most common mode of failure, occurring in 12% of cases (range, 0%-33%). Five-year implant survival was 72% (range, 49%-93.7%). Mean postoperative Musculoskeletal Tumor Society (MSTS) score was 81.1 (range, 74-84.3). In our institutional case series, 2 out of 5 patients had DHR revision for periprosthetic fracture and aseptic loosening at 16 and 27months after surgery, respectively. Distal humerus replacement is a successful reconstruction strategy for tumors of the distal humerus, with high implant survival and good to excellent functional outcomes.

Advanced Time-Stepping Interpretation of Fly-Scan Continuous Rotation Synchrotron Tomography of Dental Enamel Demineralization.

High-resolution spatial and temporal analysis and 3D visualization of time-dependent processes, such as human dental enamel acid demineralization, often present a challenging task. Overcoming this challenge often requires the development of special methods. Dental caries remains one of the most important oral diseases that involves the demineralization of hard dental tissues as a consequence of acid production by oral bacteria. Enamel has a hierarchically organized architecture that extends down to the nanostructural level and requires high resolution to study its evolution in detail. Enamel demineralization is a dynamic process that is best investigated with the help of in situ experiments. In previous studies, synchrotron tomography was applied to study the 3D enamel structure at certain time points (time-lapse tomography). Here, another distinct approach to time-evolving tomography studies is presented, whereby the sample image is reconstructed as it undergoes continuous rotation over a virtually unlimited angular range. The resulting (single) data set contains the data for multiple (potentially overlapping) intermediate tomograms that can be extracted and analyzed as desired using time-stepping selection of data subsets from the continuous fly-scan recording. One of the advantages of this approach is that it reduces the amount of time required to collect an equivalent number of single tomograms. Another advantage is that the nominal time step between successive reconstructions can be significantly reduced. We applied this approach to the study of acidic enamel demineralization and observed the progression of demineralization over time steps significantly smaller than the total acquisition time of a single tomogram, with a voxel size smaller than 0.5 μm. It is expected that the approach presented in this paper can be useful for high-resolution studies of other dynamic processes and for assessing small structural modifications in evolving hierarchical materials.