Digital methods such as intraoral scanners for recording the location of implants supporting complete arch prostheses have limitations. Photogrammetry devices should be able to digitize implant ...positions accurately, but standardized comparisons between different digital acquisition methods are lacking.
The purpose of this in vitro study was to compare the repeatability of different digital acquisition methods for complete arch prostheses supported by 6 and 4 implants.
A master cast was created with 6 and 4 dental implants with multiunit abutments to obtain the master digital casts. The evaluated devices were the industrial high-resolution 12-megapixel scanner (reference) Atos Compact Scan 12M (GOM), the laboratory scanners D2000 (3Shape A/S) and S900 Arti (Zirkonzahn), the photogrammetry devices iCam (iMetric4D) and PIC (PIC Dental), and the intraoral scanners TRIOS 3 (3Shape A/S) and iTero Element 5D (Align Technology). The resulting files were imported to a computer-aided design software program (exocad GmbH) to obtain the implant replicas as standard tessellation language (STL) files. These files were imported into a software program (Geomagic Control X) and superimposed per group through the best-fit algorithm to determine repeatability, defined as the closeness of agreement between each group’s scanned results as root mean square (RMS) values. The normality of distribution was tested by the Shapiro-Wilk normality test, and the Kruskal-Wallis test with adjustment with the Bonferroni correction method was used accordingly (α=.05).
The repeatability means and 95% confidence intervals for the 4 implant scans were: 1.07 µm (0.86; 1.29) for GOM, 2.05 µm (1.89; 2.21) for D2000, 3.61 µm (3.23; 3.99) for S900, 7.01 µm (6.11; 7.91) for iCam, 5.18 µm (4.6; 5.76) for PIC, 20.52 µm (18.33; 22.72) for TRIOS 3, and 20.5 µm (17.37; 23.63) for iTero. Statistically significant differences were found between devices, except for iCam versus PIC, GOM versus S900, iCam versus D2000, PIC versus D2000, and TRIOS 3 versus iTero. The repeatability means and 95% confidence intervals for the 6 implant groups were: 1.36 µm (1.08; 1.65) for GOM, 3.17 µm (3.01; 3.33) for D2000, 2.15 µm (2.04; 2.25) for S900, 8.67 µm (8.06; 9.28) for iCam, 13.88 µm (12.62; 15.14) for PIC, 40.32 µm (36.29; 44.36) for TRIOS 3, and 38.86 µm (34.01; 43.71) for iTero. Statistically significant differences were detected between devices, except for S900 versus GOM, PIC versus iCam, and iTero versus TRIOS 3.
The results suggest that photogrammetry could be a suitable alternative for recording implant locations of complete arch prostheses supported by 4 or 6 implants, with better repeatability than intraoral scanners. Increasing the number of implants decreased the repeatability of every device tested except the laboratory scanners.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Whether influenza vaccination can play a prognostic role in patients with cardiovascular (CV) disease (coronary artery disease (CAD), heart failure, stroke, peripheral artery disease (PAD)) is still ...not completely well-established. We conducted this overview of systematic reviews (SR) evaluating the effects of influenza vaccination in secondary prevention of CV disease.
An electronic search was performed in the MEDLINE (to November 2019). Eligibility criteria included SR evaluating the effect of influenza vaccination in patients with CV disease. The risk of bias of the included systematic reviews was evaluated using the ROBIS tool. All-cause mortality, CV mortality, major adverse cardiovascular events (MACE) and hospitalizations were evaluated. Whenever required, data were recalculated through a random-effects meta-analysis to obtain pooled data for the patients at secondary CV prevention.
The search process yielded four SR: two in CAD, one in heart failure and one in stroke. There were no SR evaluating the vaccine in PAD. The risk of bias was unclear (2 SR) and high (2 SR). Influenza vaccination in patients with CAD showed a risk reduction in all-cause mortality (data recalculated), cardiovascular mortality and MACE, particularly in patients with recent acute coronary syndrome. In patients with heart failure, vaccination was associated with a decreased risk of all-cause mortality. There was a non-significant trend in recurrent stroke risk reduction in patients with previous stroke.
The available evidence suggests that influenza vaccination was associated with a protective effect in CAD and HF patients. However, these results need to be clarified with higher quality evidence studies.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
Objective
To undertake a systematic review and meta-analysis to assess the satisfaction of patients receiving nonvitamin K anticoagulants (NOACs), compared with vitamin K antagonists ...(VKAs).
Methods
We searched CENTRAL, MEDLINE, Embase, and Clinicaltrials.gov for randomized controlled trials (RCTs) and observational studies. Two reviewers screened, extracted, and appraised data independently. We pooled data using a random-effects model. Outcome included treatment satisfaction, which was assessed by scores of Duke Anticoagulation Satisfaction Scale (DASS), Anticlot Treatment Scale (ACTS), Perception of Anticoagulant Treatment Questionnaire 2 (PACT-Q2), or Treatment Satisfaction Questionnaire for Medication version II (TSQM-VII) and their domains reported with 95% confidence intervals (95% CIs). We followed MOOSE and PRISMA guidelines.
Results
We included four RCTs and 16 observational studies, enrolling 18,684 participants overall. Compared with VKAs, treatment with NOACs improved the ACTS Burdens score by 4.21 points (95% CI: 2.99–5.43,
I
2
= 95%, combined
n
= 6,180), and ACTS Benefits by 0.49 points (95% CI: 0.18–0.81,
I
2
= 85%, combined
n
= 6,171). Switching from VKAs to NOACs improved the ACTS Burdens score by 5.33 points (95% CI: 3.53–7.14, combined
n
= 3,097). Compared with VKAs, treatment with NOACs improved the TSQM-VII Global Satisfaction score by 6.86 points (95% CI: 3.00–10.73, combined
n
= 5,535).
Conclusion
In patients with nonvalvular atrial fibrillation or venous thromboembolism, NOAC treatment is associated with greater satisfaction compared with VKAs. The switch from VKAs to NOACs was associated with improved patients' satisfaction. These effects were largely due to a lower degree of treatment burden with NOAC treatment.
Introduction: Sacubitril-valsartan is a recently approved drug. However, there are few data regarding safety issues. We aimed to summarize the available evidence regarding sacubitril-valsartan's ...safety and tolerability.
Methods: We conducted a systematic review with meta-analysis of randomized controlled trials (RCTs) enrolling patients receiving sacubitril-valsartan for any condition, compared with standard therapy or placebo. Database search was performed in October 2019. Outcomes were adverse events (AEs), serious AEs (SAEs), discontinuation due to AEs, and five AEs of special interest. Data were reported using risk ratio (RR) and 95% confidence interval (95%CI).
Results: We included 20 RCTs (22510 participants). When compared with active controls, there were no differences in SAEs (RR=0.93, 95%CI 0.86-1.01) and AEs (RR=1.00, 95%CI 0.97-1.03). However, sacubitril-valsartan resulted in an 8% risk reduction in discontinuation due to AEs (95%CI 0.85-0.99) and an increased risk of hypotension (RR=1.45, 95%CI 1.27-1.67). The risk of angioedema was higher with follow-ups greater than 12 months (RR=2.36, 95%CI 1.29-4.33). There were no further significant differences in the remaining AEs' risk.
Conclusions: Sacubitril-valsartan was at least as safe and tolerable as active control, with a similar need of administration cautiousness, except for a higher risk of hypotension. However, one should consider the study's limitations.
•It is known that telomere length shortening is associated with replicative senescence and can be counteracted by telomerase activity.•However, up regulation of the latter can also favour cell ...immortalization.•Current smokers without COPD, with a lifespan tobacco exposure had telomerase up regulation and attenuation of telomere shortening.•If causal, the positive effects of tobacco exposure might be mitigated by the chronic pulmonary inflammatory process.
Immunosenescence are alterations on immune system that occurs throughout an individual life. The main characteristic of this process is replicative senescence, evaluated by telomere shortening. Several factors implicate on telomere shortening, such as smoking. In this study, we evaluated the influence of smoking and Chronic Obstructive Pulmonary Disease (COPD) on cytokines, telomere length and telomerase activity.
Blood samples were collected from subjects aged over 60 years old: Healthy (never smokers), Smokers (smoking for over 30 years) and COPDs (ex-smokers for ≥15 years). A young group was included as control. PBMCs were cultured for assessment of telomerase activity using RT-PCR, and cytokines secretion flow cytometry. CD4+ and CD8+ purified lymphocytes were used to assess telomere length using FlowFISH.
We observed that COPD patients have accelerated telomere shortening. Paradoxically, smokers without lung damage showed preserved telomere length, suggesting that tobacco smoking may affect regulatory mechanisms, such as telomerase. Telomerase activity showed diminished activity in COPDs, while Smokers showed increased activity compared to COPDs and Healthy groups.
Extracellular environment reflected this unbalance, indicated by an anti-inflammatory profile in Smokers, while COPDs showed an inflammatory prone profile. Further studies focusing on telomeric maintenance may unveil mechanisms that are associated with cancer under long-term smoking.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Thirteen reference genes were investigated to determine their stability to be used as a housekeeping in gene expression studies in skeletal muscle of chickens. Five different algorithms were used for ...ranking of reference genes and results suggested that individual rankings of the genes differed among them. The stability of the expression of reference genes were validated using samples obtained from the Pectoralis major muscle in chicken. Samples were obtained from chickens in different development periods post hatch and under different nutritional diets. For gene expression calculation the ΔΔCt approach was applied to compare relative expression of pairs of genes within each of 52 samples when normalized to mitochondrially encoded cytochrome c oxidase II (MT-CO2) target gene. Our findings showed that hydroxymethylbilane synthase (HMBS) and hypoxanthine phosphoribosyl transferase 1 (HPRT1) are the most stable reference genes while transferrin receptor (TFRC) and beta-2-microglobulin (B2M) ranked as the least stable genes in the Pectoralis major muscle of chickens. Moreover, our results revealed that HMBS and HPRT1 gene expression did not change due to dietary variations and thus it is recommended for accurate normalization of RT-qPCR data in chicken Pectoralis major muscle.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Simulation of the dielectric charging-up effect in a GEM detector Alfonsi, M.; Croci, G.; Duarte Pinto, S. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
04/2012, Volume:
671
Journal Article
Peer reviewed
Open access
The charging up effect is well-known in detectors containing dielectric materials and it is due to electrons and ions liberated in an avalanche and collected on the dielectric surfaces. In particular ...in Gas Electron Multiplier (GEM) based detectors, charges can be captured by the Kapton that separates top and bottom electrodes. The collection of a substantial number of charges on the dielectric surfaces induces a modification of the field inside the GEM holes that implies important consequences on some fundamental parameters such as the electron transparency and the effective gain. The correct simulation of this effect opens new ways to the detailed study of the processes that happens in a GEM-based detector and gives the possibility to optimise the GEM geometry in order to avoid it. This paper compares results of the measurements and the simulations, with and without the introduction of the charging-up effect, of the GEM electron transparency in the case of a single GEM detector. The introduction of the charging up effect in the simulation resulted to be crucial in order to get the proper agreement with the measurements. The measurements and simulations of the GEM effective gain will be the subject of a future work.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The human-restricted bacterium Haemophilus influenzae is responsible for respiratory infections in both children and adults. While colonization begins in the upper airways, it can spread throughout ...the respiratory tract potentially leading to invasive infections. Although the spread of H. influenzae serotype b (Hib) has been prevented by vaccination, the emergence of infections by other serotypes as well as by non-typeable isolates (NTHi) have been observed, prompting the need for novel prevention strategies. Here, we aimed to study the population structure of H. influenzae and to get some insights into its pan-genome. We studied 305H. influenzae strains, enrolling 217 publicly available genomes, as well as 88 newly sequenced H. influenzae invasive strains isolated in Portugal, spanning a 24-year period. NTHi isolates presented a core-SNP-based genetic diversity about 10-fold higher than the one observed for Hib. The analysis of key factors involved in pathogenesis, such as lipooligosaccharides, hemagglutinating pili and High Molecular Weight-adhesins, suggests that NTHi shape its virulence repertoire, either by acquisition and loss of genes or by SNP-based diversification, likely towards host immune evasion and persistence. Discreet NTHi subpopulations structures are proposed based on core-genome supported with 17 candidate genetic markers identified in the accessory genome. Additionally, this study provides two bioinformatics tools for in silico rapid identification of H. influenzae serotypes and NTHi clades previously proposed, obviating laboratory-based demanding procedures. The present study constitutes an important genomic framework that could lay way for future studies on the genetic determinants underlying invasiveness and disease and population structure of H. influenzae.
•Large-scale pan-genomic study of Haemophilus influenzae•Non-typeable H. influenzae display high degree of genetic diversification.•Discreet NTHi subpopulations are supported by both core and accessory genome.•Introduction of two bioinformatics tools for WGS-based surveillance of H. influenzae
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
Aims
There are several guidelines that recommend pneumococcal vaccination (PPSV23 and/or PCV13) in adults with a history of cardiovascular disease (established heart failure, coronary ...disease, and cerebrovascular disease) or at a very high risk of cardiovascular disease. However, there is no randomized controlled trial (RCT) systematic review that evaluates the impact of vaccination on all-cause mortality compared to no vaccination in this particular population. Our objective is to conduct a systematic review and meta-analysis of the impact of pneumococcal vaccination in the referred population.
Methods and results
We searched CENTRAL and MEDLINE for relevant RCTs and observational studies. Data were screened, extracted, and appraised by two independent reviewers. We pooled results using a random effects model, and used hazard ratios (HRs) with 95% confidence intervals (CIs) to assess measure of effect. The primary outcome was all-cause mortality and we assessed the confidence in the evidence using the GRADE framework. No RCTs were found. Seven observational studies were included for analyses. Pooled results from five studies enrolling a total of 163 756 participants showed a significant decrease in all-cause mortality (HR 0.78, 95% CI 0.73–0.83, very low confidence), without statistically significant heterogeneity (χ2 test P = 0.21; I2 = 32%).
Conclusions
Pneumococcal vaccination was associated with a 22% decrease of all-cause mortality in patients with cardiovascular disease or at a very high cardiovascular risk. However, limitations due to study design and the serious risk of bias in three of the included studies leads to a decreased level of result confidence.
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