Longitudinal outcomes of obeticholic acid therapy in ursodiol-nonresponsive primary biliary cholangitis: Stratifying the impact of add-on fibrates in real-world practice.

BACKGROUND: Suboptimal response to ursodeoxycholic acid occurs in 40% of primary biliary cholangitis (PBC) patients, affecting survival. Achieving a deep response (normalisation of alkaline phosphatase [ALP] and bilirubin ≤0.6 upper limit of normal) improves survival. Yet, the long-term effectiveness of second-line treatments remains uncertain. AIMS: To evaluate the long-term effectiveness of obeticholic acid (OCA) ± fibrates. Focusing on biochemical response (ALP ≤1.67 times the upper limit of normal, with a decrease of at least 15% from baseline and normal bilirubin levels), normalisation of ALP, deep response and biochemical remission (deep response plus aminotransferase normalisation). METHODS: We conducted a longitudinal, observational, multicentre study involving ursodeoxyccholic acid non-responsive PBC patients (Paris-II criteria) from Spain and Portugal who received OCA ± fibrates. RESULTS: Of 255 patients, median follow-up was 35.1 months (IQR: 20.2-53). The biochemical response in the whole cohort was 47.2%, 61.4% and 68.6% at 12, 24 and 36 months. GLOBE-PBC and 5-year UK-PBC scores improved (p < 0.001). Triple therapy (ursodeoxycholic acid plus OCA plus fibrates) had significantly higher response rates than dual therapy (p = 0.001), including ALP normalisation, deep response and biochemical remission (p < 0.001). In multivariate analysis, triple therapy remained independently associated with biochemical response (p = 0.024), alkaline phosphatase normalisation, deep response and biochemical remission (p < 0.001). Adverse effects occurred in 41.2% of cases, leading to 18.8% discontinuing OCA. Out of 55 patients with cirrhosis, 12 developed decompensation. All with baseline portal hypertension. CONCLUSION: Triple therapy was superior in achieving therapeutic goals in UDCA-nonresponsive PBC. Decompensation was linked to pre-existing portal hypertension.

Clinical performance of tooth root blocks for alveolar ridge reconstruction.

This systematic literature review set out to investigate the clinical outcomes of autogenous tooth root blocks used for ridge augmentation: survival rates, block resorption, implant survival, post-surgical complications, and histology findings. This review followed PRISMA guidelines. An automated search was made in four databases, supplemented by a manual search for relevant articles published before December 2020. The quality of evidence provided was assessed with the Newcastle-Ottawa Quality Assessment Scale and the Joanna Briggs Institute Critical Appraisal tool. Seven articles fulfilled the inclusion criteria and underwent analysis. The articles included a total of 136 patients, who received 118 autogenous tooth root blocks and 26 autogenous bone blocks showing block survival rates of 99.15% and 100%, respectively. Tooth root blocks presented a mean bone gain that was similar to autologous bone blocks but showed less resorption. The implant survival rate was 98.32% for autogenous tooth root blocks. Reconstruction of alveolar crests by means of autogenous tooth root blocks appears to be a satisfactory option for single-tooth gaps and low grades of bone atrophy in terms of the survival of the bone block and the implants placed subsequently. More research providing long-term data is needed to confirm these findings.

Dental implant placement through impacted teeth or residual roots as an alternative to invasive extraction surgeries: a systematic literature review.

This work systematically reviews dental implant placement through impacted teeth or residual roots, as an alternative to invasive extraction surgeries, evaluated in terms of survival rates, marginal bone loss, surgical, and prosthetic complications. The authors conducted an electronic search of four databases up to September 2020; also a complementary handsearch was carried out. The quality of the included studies was assessed using a protocol for assessment of risk of bias in exposure studies. Ten studies fulfilled the inclusion criteria and were analysed. A total of 44 patients received 62 dental implants and were monitored for a minimum of 12-months follow-up. An overall mean implant survival rate was 90.32%, reporting 97.56 % for dental implants through impacted teeth and 76.19% through residual roots. No surgical or prosthetic complications were reported. Placing dental implants through impacted teeth may offer a valid therapeutic option for implant-supported restorations in patients for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery. Moreover, additional caution is recommended when placing implants through retained root fragments, as this may involve long-term risk. Further research generating long-term data are needed to confirm these findings.

Interfacial water morphology in hydrated melanin.

The importance of electrically functional biomaterials is increasing as researchers explore ways to utilise them in novel sensing capacities. It has been recognised that for many of these materials the state of hydration is a key parameter that can heavily affect the conductivity, particularly those that rely upon ionic or proton transport as a key mechanism. However, thus far little attention has been paid to the nature of the water morphology in the hydrated state and the concomitant ionic conductivity. Presented here is an inelastic neutron scattering (INS) experiment on hydrated eumelanin, a model bioelectronic material, in order to investigate its 'water morphology'. We develop a rigorous new methodology for performing hydration dependent INS experiments. We also model the eumelanin dry spectra with a minimalist approach whereas for higher hydration levels we are able to obtain difference spectra to extract out the water scattering signal. A key result is that the physi-sorbed water structure within eumelanin is dominated by interfacial water with the number of water layers between 3-5, and no bulk water. We also detect for the first time, the potential signatures for proton cations, most likely the Zundel ion, within a biopolymer/water system. These new signatures may be general for soft proton ionomer systems, if the systems are comprised of only interfacial water within their structure. The nature of the water morphology opens up new questions about the potential ionic charge transport mechanisms within hydrated bioelectronics materials.

Correction: Feasibility of attenuated total reflection-fourier transform infrared (ATR-FTIR) chemical imaging and partial least squares regression (PLSR) to predict protein adhesion on polymeric surfaces.

Correction for 'Feasibility of attenuated total reflection-fourier transform infrared (ATR-FTIR) chemical imaging and partial least squares regression (PLSR) to predict protein adhesion on polymeric surfaces' by S. Mukherjee et al., Analyst, 2019, 144, 1535-1545. DOI.

Metabolic Syndrome, a Real Barrier for Living Kidney Donor Transplant.

INTRODUCTION: Renal transplantation is the optimal renal replacement therapy. In Mexico, most of the kidney transplants are from living donors. It is essential to identify conditions that increase the risk of developing chronic kidney disease (CKD) in donors, such as metabolic syndrome (MS). MATERIALS AND METHODS: In retrospect from January 2008 to December 2018, the donation protocols for renal transplantation of the Hospital Central Sur Alta Especialidad "Picacho" were reviewed, classifying all the cases of donors by nephrectomy or no nephrectomy and describing the demographic characteristics, prevalence of metabolic diseases, and cause of rejection of the protocol. RESULTS: A total of 178 donors were studied: 82 women (46%), 96 men (54%), mean age of 42 years, average body mass index (BMI) 27.9 kg/m2, glomerular filtration rate (GFR) by Chronic Kidney Disease Epidemiology Collaboration 99 mL/min, 59 patients with grade I and II obesity (BMI ≥ 30 kg/m2), and 1 patient with morbid obesity (BMI ≥ 40 kg/m2). A total of 39 patients (22%) underwent nephrectomy and 139 (78%) did not. The following characteristics and alterations were found: Of the 139 patients who did not undergo nephrectomy, 91 had metabolic disorders, 20 had low GFR, 21 had albuminuria, and 4 recipients received cadaveric transplants, 3 due to critical conditions of the recipient. The metabolic alterations in the rejected donors were as follows: MS 54 (59%), prediabetes 55 (39%), newly diagnosed hypertension 70 (76%), diabetes mellitus 20 (14%), obesity 47 (51.6%), dyslipidemia 76 (83%), hyperuricemia 17 (12%). DISCUSSION: The prevalence of MS in apparently healthy donors is similar to that of other studies in Mexico. Both MS and its components are independently associated with an increased risk of cardiovascular disease and CKD. It has been shown that these donors have a greater degree of glomerular and interstitial fibrosis; therefore, diagnosis, prevention, and timely treatment in this group are important.

Complications associated with inferior alveolar nerve reposition technique for simultaneous implant-based rehabilitation of atrophic mandibles. A systematic literature review.

INTRODUCTION: Surgical inferior alveolar nerve (IAN) reposition techniques offer an alternative approach to implant-based rehabilitation in patients with severe mandibular atrophy The aim of this systematic review, was to determine the complications associated with the technique and to determine which of two variants (lateralization or transposition) is less invasive. MATERIALS AND METHODS: An electronic search was conducted in databases complimented by a manual search to identify clinical studies investigating complications derived from these surgical techniques. Only studies of adult humans, published in English during the last seven years were included. The initial search located 78 articles, of which seven were included in analysis on the basis of the following characteristics: four investigated inferior alveolar nerve lateralization (IANL), one inferior alveolar nerve transposition (IANT), and two investigated both reposition techniques. RESULTS: This review included data from 289 patients who were recruited for lateralization (N=319) or transposition surgery (N=33) making a total of 352 reposition procedures. Five patients (1.73%) suffered persistent damage to the IAN at the end of the follow-up periods. The overall implant survival rate was 99.26% of a total of 817 implants. The most common complications were neurosensory problems, mandibular fracture, infection, implant loss, and insufficient anatomical reconstruction of the atrophic mandible; neurosensory complications (hypoesthesia, paraesthesia, and hyperesthesia caused by traumatic damage to the nerve) were the most prevalent. CONCLUSIONS: Lateralization of the inferior alveolar nerve would appear to be less invasive as it produces lower percentages of persistent neurosensory disorders (1.56%) than transposition (12.12%). Nevertheless, both techniques offer a viable approach to implant placement in edentulous atrophic mandibles, obtaining predictable clinical and radiological results after 5 years implant loading.

Genetic variances and covariances of live weight traits in Charolais cattle by multi-trait analysis.

Live weight traits are economically important for beef cattle production systems. Genetic analysis of live weight traits frequently presents a problem due to animal records, in that matter, not all the animals have complete records as many young animals leave the herd because of sale, transfer to another herd, or culling reasons. Therefore, the use of multi-trait genetic analysis might be of assistance to help overcome any possible loss of information for those animals with incomplete records. In this study, genetic variances and covariances were obtained to estimate genetic parameters for birth (BW), weaning (WW), and yearling (YW) live weights in a registered Charolais beef cattle population using a multivariate model, where a considerable reduction of data from birth weight to year weight was observed. Direct and maternal heritabilities for BW, WW, and YW were 0.50, 0.30, and 0.28, and 0.31, 0.25, and 0.14, respectively. Direct and maternal genetic correlations were negative in all live weight traits. Genetic correlations among direct BW with direct WW and YW were low, while genetic correlations among maternal traits were medium or high (r>0.39). Comparison between univariate and multi-trait models with substantial reduction of information revealed important differences, implying that multi-trait analysis is better for the structure of data allowing a better fitting of genetic effects by covariance among evaluated traits. Results support multi-trait analysis implementation for genetic evaluations for live weight traits of Charolais cattle.

Clinical repercussions and epidemiological considerations of supernumerary canines: A 26 case series.

BACKGROUND: To establish the prevalence of supernumerary canines (SNC) in a sector of the population of Madrid (Spain), as well possible complications associated with this unusual developmental variation. STUDY DESIGN: This observational study was performed between 2005 and 2017, among 21,615 patients seeking dental treatment at the Faculty of Dentistry, Complutense University of Madrid (Spain), and at the Virgen de la Paloma Hospital, Madrid (Spain); 22 patients with 26 SNCs were diagnosed. These 22 patients underwent clinical and radiological exploration, registering patient data. RESULTS: SNCs presented a prevalence of 0.10% of the study population. The supernumerary teeth (SNT) were located in the upper maxilla more frequently (61.54%) than the mandible (38.46%). 69.23% were found to be impacted, also causing the impaction of the permanent canine in 53.85% of these cases. In 15.38%, follicular expansion > 3mm was observed. SNCs were associated with other SNT in only four patients. CONCLUSIONS: Despite of the fact that the SNCs are usually diagnosed casually in the course of radiological exploration, in the present study over half of them (53.85%) caused impaction of the permanent canine. Early diagnosis allows optimal patient management and treatment planning, with intervention at an appropriate time to prevent complications in development and so reduce later treatment need.

Feasibility of attenuated total reflection-fourier transform infrared (ATR-FTIR) chemical imaging and partial least squares regression (PLSR) to predict protein adhesion on polymeric surfaces.

Predicting the degree to which proteins adhere to a polymeric surface is an ongoing challenge in the scientific community to prevent non-specific protein adhesion and drive favourable protein - surface interactions. This work explores the potential of multivariate PLSR modelling in conjunction with Attenuated Total Reflection - Fourier Transform Infrared (ATR-FTIR) chemical imaging to investigate whether experimentally characterised surface chemistry can be used to predict surface protein adhesion. ATR-FTIR spectra were collected on dry and wetted polymeric surfaces, followed by evaluation of adhered fibrinogen on surfaces using the micro bicinchoninic (BCA) protein assay as a reference method. Partial Least Squares Regression (PLSR) models were built using IR spectra as the predictor variable. Overall the models built with 'wetted polymer' IR spectra performed better as compared to the models built using 'dry polymer' IR spectra (average coefficient of determination, R2P 0.998, 0.996 respectively), with the lowest error in prediction (4 ± 0.6 µg) for ultra-high molecular weight polyethylene (UHMPE) as a test surface. This indicates the potential of this method to predict the degree to which protein adhesion occurs on polymeric surfaces using experimentally determined surface chemistry.

Use of autologous tooth-derived graft material in the post-extraction dental socket. Pilot study.

BACKGROUND: The objectives of the present pilot study are to compare via CBCT the alveolar contraction suffered both vertically and horizontally between the control group and the group using autologous dental material (ADM), as well as to study the densitometric differences between both post-extraction sockets. MATERIAL AND METHODS: A split-mouth study was performed in n = 9 patients who required two extraction of single-rooted teeth deemed suitable for deferred rehabilitation with osseointegrated implants. Two groups were formed - a control group, in which the post-extraction socket was not filled, and an ADM group, in which the alveolar defect was filled with freshly processed autogenous dental material. Both dimensional and densitometric analyses of the alveoli were performed in both groups immediately after surgery (baseline), as well as 8 weeks and 16 weeks later. RESULTS: The mean height of alveolar bone loss was: VL (Control 1.77 mm, loss of 16.87% of initial alveolar height; ADM 0.42 mm, loss of 4.2% of initial alveolar height), HL-BCB (Control 2.22 mm, ADM 0.16 mm, p= 0.067 at 16 weeks). The mean bone loss of the vestibular width (VL-BCB) was much higher in the control group (1.91 mm at 1 mm, 1.3 mm at 3 mm, and 0.89 mm at 5 mm) than in the ADM group (0.46 mm at 1 mm, 0.21 mm at 3 mm, 0.01 at 5 mm, p=0.098 at 16 weeks). At 16 weeks, densitometric analysis of the coronal alveolar area revealed a bone density of 564.35 ± 288.73 HU in the control group and 922.68 ± 250.82 HU in the ADM group (p=0.045 ). CONCLUSIONS: In light of these preliminary results, autologous dentine may be considered a promising material for use in socket preservation techniques.

Predictive modelling of the water contact angle of surfaces using attenuated total reflection - Fourier transform infrared (ATR-FTIR) chemical imaging and partial least squares regression (PLSR).

The static water contact angle (CA) quantifies the degree of wetting that occurs when a surface encounters a liquid, e.g. water. This property is a result of factors such as surface chemistry and local roughness and is an important analytical parameter linked to the suitability of a surface for a given bioanalytical process. Monitoring the spatial variation in wettability over surfaces is increasingly critical to analysts and manufacturers for improved quality control. However, CA acquisition is often time-consuming because it involves measurements over multiple spatial locations, independent sampling and the need for a single instrument operator. Furthermore, surfaces exposed to local environments specific to an intended application may affect the surface chemistry thereby modifying the surface properties. In this study, Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) chemical imaging data acquired from wet and dry polymer surfaces were used to develop multivariate predictive models for CA prediction. Partial Least Squares Regression (PLSR) models were built using IR spectra from surfaces presenting differences in the experimentally measured CA in the range 16°-141°. The best performing PLSR models were locally developed and combined to make a global model utilising wet IR spectra which performed well (R2p = 0.98, RMSECV ∼ 5°) when tested on an independent experimental set. This model was subsequently applied to IR spectra acquired from a surface exhibiting spatial differences in surface chemistry and the CA with a reasonable confidence and precision (prediction error within 10°), demonstrating the potential of this method for prediction of the spatially varying CA as a non-destructive in-line process monitoring technique.

Implant stability using piezoelectric bone surgery compared with conventional drilling: a systematic review and meta-analysis.

The aim of this systematic review was to assess the primary and secondary stability of dental implants placed at sites prepared with piezoelectric bone surgery (PBS) and conventional drilling (CD). The PubMed/MEDLINE and Cochrane Library databases were searched without date or language restriction up to June 2017. Controlled clinical trials in which each patient received implants placed at sites prepared with both PBS and CD were selected. Implant stability had to be measured on day 0 and during the osseointegration period. Methodological quality was assessed using the Cochrane Collaboration tool. A meta-analysis was performed to compare primary stability (on day 0) and secondary stability (after 2 and 3months) between the two groups. The studies included were determined to have a high risk of bias. There was no significant difference between the two groups for primary stability (on day 0) (P=0.51). After 2 and 3months, secondary stability was statistically higher in implants placed with PBS preparation (P=0.04 and P=0.01, respectively). The implant survival rate was 97.5% in the CD group and 100% in the PBS group. PBS preparation improves secondary stability after 2 and 3months in comparison to CD, with similar implant survival rates. Further studies are needed to determine whether implant osseointegration periods could be shortened with PBS preparation.

Masseter and temporalis muscle electromyography findings after lower third molar extraction.

BACKGROUND: The main clinical application of electromyography is to detect abnormalities in muscle function, to assess muscle activity for purposes of recruitment, and in the biomechanics of movement. OBJECTIVES: To analyze electromyography (EMG) findings for masticatory muscles during chewing following surgical extraction of lower third molars, and to determine any correlation between pain, inflammation, trismus, and the EMG data registered. MATERIAL AND METHODS: This prospective study included 31 patients. Surface EMG was used to study masseter and temporalis muscle function before lower third molar extraction and 72 hours and seven days after surgery. Clinical variables, pain, inflammation, and trismus were registered before and after surgery. RESULTS: Studying the area and size of the masticatory muscles, higher values were found for temporalis than masseter muscles, regardless of the surgical side, which points to the greater involvement of the temporalis muscle in mastication. Comparing the side where surgery had been performed with the non-surgical side, a sharp and statistically significant reduction in amplitude and area were noted on the surgical side reflecting major functional affectation. One week after surgery, amplitude and area had almost returned to base-line values, indicating almost complete recovery. While pain decreased progressively after surgery, inflammation peaked at 72 hours, while mouth opening reached a minimum at this time, returning to normality within the week. CONCLUSIONS: Surgical extraction of lower third molars produces changes to electromyography activity that are more evident during the first hours after surgery and closely related to the intensity of pain suffered and the patient's inflammatory responses, although they are not related to mouth opening capacity.

Circulating CCL20 as a New Biomarker of Abdominal Aortic Aneurysm.

Autoimmunity appears to play a role in abdominal aortic aneurysm (AAA) pathology. Although the chemokine CCL20 has been involved in autoimmune diseases, its relationship with the pathogenesis of AAA is unclear. We investigated CCL20 expression in AAA and evaluated it as a potential biomarker for AAA. CCL20 was measured in plasma of AAA patients (n = 96), atherosclerotic disease (AD) patients (n = 28) and controls (n = 45). AAA presence was associated with higher plasma levels of CCL20 after adjustments for confounders in the linear regression analysis. Diagnostic performance of plasma CCL20 was assessed by ROC curve analysis, AUC 0.768 (CI:0.678-0.858; p<0.001). Classification and regression tree analysis classified patients into two CCL20 plasma level groups. The high-CCL20 group had a higher number of AAA than the low-CCL20 group (91% vs 54.3%, p< 0.001). mRNA of CCL20 and its receptor CCR6 were higher in AAA (n = 89) than in control aortas (n = 17, p<0.001). A positive correlation was found between both mRNA in controls (R = 0674; p = 0.003), but not in AAA. Immunohistochemistry showed that CCR6 and CCL20 colocalized in the media and endothelial cells. Infiltrating leukocytes immunostained for both proteins but only colocalized in some of them. Our data shows that CCL20 is increased in AAA and circulating CCL20 is a high sensitive biomarker of AAA.

Unicystic Ameloblastoma: Rehabilitation with Chin Graft Harvested and Implant-Supported Fixed Prosthesis.

OBJECTIVE: The objective is to present a clinical case of a 38-year-old male with a maxillary unicystic ameloblastoma treated by means of tumor block resection followed by chin-harvested graft placement in order to place two dental implants for esthetic and functional rehabilitation. METHODS: Ameloblastoma is a benign odontogenic tumor characterized by local aggression and a high rate of recurrence; the latter partly depends on how it is treated. Complete resection of the tumor, which usually prevents recurrence, produces bone defects of varying size that must be reconstructed later on. In most cases this is done using bone grafts and implant-supported prostheses. Grafts harvested from the chin are relatively easy to obtain and enjoy a fairly uneventful post-operative with few complications; they are suitable for cases in which the defect generated by resection is of small size. RESULTS: Functional and esthetic rehabilitation and the tumor has not relapsed during a 7-year follow-up. CONCLUSION: Tumor block resection followed by chin-harvested graft placement and dental implants is a safe treatment for patients with unicystic ameloblastoma.

Genomewide association analysis of growth traits in Charolais beef cattle.

The objective of this study was to perform a genomewide association study (GWAS) for growth traits in Charolais beef cattle and to identify SNP markers and genes associated with these traits. Our study included 855 animals genotyped using 76,883 SNP from the GeneSeek Genomic Profiler Bovine HD panel. The examined phenotypic data included birth, weaning, and yearling weights as well as pre- and postweaning ADG. After quality control, 68,337 SNP and 823 animals were retained in the analysis. The association analysis was performed using the principal components method via the egscore function of the GenABEL version 1.8-0 package in the R environment. Eighteen SNP located in 13 BTA were associated with growth traits ( < 5 × 10). The most important genes in these genomic regions were (), (), (), (), and ( [angiotensinase C]), due to their relationships with perinatal and postnatal survival, bone growth, cell adhesion, regulation of adipogenesis, and appetite. In conclusion, this study is the first to describe a GWAS conducted in beef cattle in Mexico and represents a basis for further and future research. This study detected new QTL associated with growth traits and identified 5 positional and functional candidate genes that are potentially involved in variations of the analyzed traits. Future analyses of these regions could help to identify useful markers for marker-assisted selection and will contribute to the knowledge of the genetic basis of growth in cattle and be a foundation for genomic predictions in Mexican Charolais cattle.