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Tuberculosis (TB) is a prevalent and severe infectious disease that poses a significant threat to human health. However, it is frequently disregarded as there are not enough quick and accurate ways to diagnose tuberculosis. Here, we develop a strategy for tuberculosis detection to address the challenges, including an experimental strategy, namely, Double Adapter Directional Capture sequencing (DADCSeq), an easily operated and low-cost whole transcriptome sequencing method, and a computational method to identify hub differentially expressed genes as well as the diagnosis of TB based on whole transcriptome data using DADCSeq on peripheral blood mononuclear cells (PBMCs) from active TB and latent TB or healthy control. Applying our approach to create a robust and stable TB multi-mRNA risk probability model (TBMMRP) that can accurately distinguish active and latent TB patients, including active TB and healthy controls in clinical cohorts, this diagnostic biomarker was successfully validated by several independent cross-platform cohorts with favorable performance in differentiating active TB from latent TB or active TB from healthy controls and further demonstrated superior or similar diagnostic accuracy compared to previous diagnostic markers. Overall, we develop a low-cost and effective strategy for tuberculosis diagnosis; as the clinical cohort increases, we can expand to different disease kinds and learn new features through our disease diagnosis strategy.
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Biomarcadores , Transcriptoma , Tuberculose , Humanos , Tuberculose/diagnóstico , Tuberculose/microbiologia , Biomarcadores/análise , Biomarcadores/sangue , Tuberculose Latente/diagnóstico , Análise Custo-Benefício , Leucócitos Mononucleares , Perfilação da Expressão Gênica/métodos , Feminino , Mycobacterium tuberculosis/genética , Masculino , AdultoRESUMO
OBJECTIVE: Reward anticipation is important for future decision-making, possibly due to re-evaluation of prior decisions. However, the exact relationship between reward anticipation and prior effort-expenditure decision-making, and its neural substrates are unknown. METHOD: Thirty-three healthy participants underwent fMRI scanning while performing the Effort-based Pleasure Experience Task (E-pet). Participants were required to make effort-expenditure decisions and anticipate the reward. RESULTS: We found that stronger anticipatory activation at the posterior cingulate cortex was correlated with slower reaction time while making decisions with a high-probability of reward. Moreover, the substantia nigra was significantly activated in the prior decision-making phase, and involved in reward-anticipation in view of its strengthened functional connectivity with the mammillary body and the putamen in trial conditions with a high probability of reward. CONCLUSIONS: These findings support the role of reward anticipation in re-evaluating decisions based on the brain-behaviour correlation. Moreover, the study revealed the neural interaction between reward anticipation and decision-making.
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Antecipação Psicológica , Tomada de Decisões , Imageamento por Ressonância Magnética , Tempo de Reação , Recompensa , Humanos , Masculino , Tomada de Decisões/fisiologia , Antecipação Psicológica/fisiologia , Feminino , Adulto Jovem , Adulto , Tempo de Reação/fisiologia , Giro do Cíngulo/fisiologia , Giro do Cíngulo/diagnóstico por imagem , Mapeamento Encefálico , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem , Substância Negra/fisiologia , Substância Negra/diagnóstico por imagemRESUMO
BACKGROUND Previous studies have shown that systemic inflammation and suboptimal nutritional status are associated with poor cancer prognosis. This study aims to investigate the prognostic value of preoperative Glasgow prognostic score (GPS) and fibrinogen-to-prealbumin ratio (FPR) in patients with CRC (colorectal cancer) after laparoscopic surgery. MATERIAL AND METHODS In this study, the clinical data of 112 patients with CRC who underwent laparoscopic surgery were retrospectively analyzed, and the 3-year and 5-year survival rates of these patients were evaluated. In addition, the prognostic role of preoperative FPR and GPS in CRC patients was assessed using X-tile software, Kaplan-Meier analysis, and Cox regression analysis. Receiver operating characteristic (ROC) curves were generated to assess the predictive value of FPR, GPS, and FPR-GPS for the survival of these patients. RESULTS The results revealed a significant negative correlation between high FPR, elevated GPS, and overall survival (OS) in patients with CRC. Univariate and multivariate Cox regression analyses identified GPS (HR=3.207, 95% CI: 1.746~6.126), FPR (HR=2.669, 95% CI: 1.052~6.772), and lymph node metastasis (HR=2.222, 95% CI: 1.199~4.115) as independent prognostic indicators for overall survival. The ROC analysis demonstrated that the prediction based on FPR and GPS outperformed a single indicator in accurately predicting the prognosis of CRC patients. CONCLUSIONS Combining the preoperative FPR with the GPS contributes to accurate prognosis assessment for CRC patients after laparoscopic surgery. Patients exhibiting high FPR and GPS values are associated with a worse prognosis.
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Neoplasias Colorretais , Hemostáticos , Laparoscopia , Humanos , Pré-Albumina , Prognóstico , Fibrinogênio/análise , Estudos Retrospectivos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/cirurgia , Neoplasias Colorretais/patologiaRESUMO
Phase transition and floral induction in citrus requires several years of juvenility after germination. Such a long period of juvenility has been a major hindrance to its genetic improvement program. Studies have shown that miR156 along with its downstream genes SQUAMOSA PROMOTER BINDING PROTEINS (SBP) and SBP-LIKE (SPL) mediate the phase transition and floral induction process in plants. Our current study has systematically analyzed SPLs in 15 different citrus-related species, systematically annotated them based on their close homology to their respective Arabidopsis orthologs, and confirmed the functional attributes of the selected members in floral precocity. The majority of the species harbored 15 SPLs. Their cis-element assessment suggested the involvement of the SPLs in diverse developmental and physiological processes in response to different biotic and abiotic cues. Among all, SPL5, SPL9, and SPL11 stood out as consistently differentially expressed SPLs in the adult and young tissues of different citrus-related species. Independent overexpression of their F. hindsii orthologs (FhSPL5, FhSPL9, and FhSPL11) brought an enhanced expression of endogenous FLOWERING LOCUS T leading to the significantly precocious flowering in transgenic Arabidopsis lines. Future study of the genes in the citrus plant itself is expected to conclude the assessments made in the current study.
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Green finance is an essential instrument for improving the environment and addressing climate change. This study investigates the dynamic spillovers among green finance markets using time-varying parameter vector autoregression (TVP-VAR) spillover indices, and further investigates the impact of climate policy uncertainty and investor sentiment on spillovers based on the generalised autoregressive conditional heteroscedasticity mixed data sampling (GARCH-MIDAS) model. The results indicate that: (i) environmental, social and governance (ESG), clean energy and water markets are information transmitters in the green finance system, whereas green building, green transportation, green bond and carbon markets are mainly information receivers; (ii) green stock markets including clean energy, non-energy and ESG markets transmit and receive greater information in the green finance system, while green bond and carbon markets do less; (iii) the green bond market is more interconnected with other green finance markets after the COVID-19 outbreak; (iv) investor sentiment contributes more to the net total directional spillovers of green resource markets (water and clean energy), while climate policy uncertainty contributes more to total spillovers and the net total directional spillovers of other green finance markets. These findings offer invaluable guidance for both policymakers and environmental investors.
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COVID-19 , Humanos , Incerteza , Carbono , Políticas , ÁguaRESUMO
OBJECTIVE: To analyze the report status of outcomes and measurement instruments of randomized controlled trials (RCTs) of acupuncture for post-stroke dysphagia, so as to provide a basis for designing clinical trials and developing the core outcome set in acupuncture for post-stroke dysphagia. METHODS: RCTs of acupuncture for post-stroke dysphagia were searched in databases i.e. CNKI, SinoMed, Wanfang, PubMed, EMbase, Web of Science and clinical trial registries i.e. ClinicalTrials.gov and Chinese Clinical Trial Registry (ChiCTR), from January 1st, 2012 to October 30th, 2021. By literature screening and data extraction, outcomes and measurement instruments were summarized and analyzed. RESULTS: A total of 172 trials (including 165 RCTs and 7 ongoing trials registrations) were included, involving 91 outcomes. The outcomes could be classified into 7 domains according to functional attributes, namely clinical manifestation, physical and chemical examination, quality of life, TCM symptoms/syndromes, long-term prognosis, safety assessment and economic evaluation. It was found that there were various measurements instruments with large differences, inconsistent measurement time point and without discriminatively reporting primary or secondary outcomes. CONCLUSION: The status quo of outcomes and measurement instruments of RCTs of acupuncture for post-stroke dysphagia is not conducive to the summary and comparison of each trial's results. Thus, it is suggested to develop a core outcome set for acupuncture for post-stroke dysphagia to improve the normative and research quality of their clinical trial design.
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Terapia por Acupuntura , Transtornos de Deglutição , Acidente Vascular Cerebral , Humanos , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Bases de Dados Factuais , Exame Físico , Acidente Vascular Cerebral/complicaçõesRESUMO
Due to the rapid economic development and urban construction and the high exploitation rate of groundwater and geothermal resource, Jimo district existed a potential threat of surface deformation. To clarify the characteristics and causations of surface deformation, this study firstly used SBAS-InSAR (Small Baseline Subset-Interferometric Synthetic Aperture Radar) technology to analyze the surface defor-mation distribution in the whole research area. Then, three areas with different surface cover conditions were selected to analyze the causations of surface deformation. Lastly, taking central urban area as the key research area, surface deformation causations were analyzed in detail based on PS-InSAR (Persistent Scatter-Interferometric Synthetic Aperture Radar) technology. The study found that, in coastal mollisol area, farmland area, and hot spring area, the maximum subsidence velocity reached up to 46.8 mm/a, 24 mm/a, and 19.1 mm/a, respectively. The factors, including surface loading, precipitation, and the groundwater level, were the causations of surface deformation in different research areas. The trend of the surface deformation curve was consistent with that of the groundwater level curve in the central urban area, but the response time of surface deformation lagged behind the change of groundwater level by approximately 4 months.
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Monitoramento Ambiental , Água Subterrânea , China , Água Subterrânea/análise , Radar , Desenvolvimento EconômicoRESUMO
BACKGROUND: The aging of the population has made the health problems of the elderly increasingly prominent, and their health needs are increasing. Existing studies on health resource integration approaches are mostly incomplete in assessing the health service capacity from the perspective of the health service provider. OBJECTIVE: The unmet health needs of the elderly were sampled and analyzed from the perspective of health service demanders. To explore how to build an integrated medical organization structure to better meet the health needs of the elderly. METHODS: A whole-group sampling method was used to conduct a questionnaire survey of 1527 older adults in N district of H city, Zhejiang province, China, to cross-sectionally analyze their current status of unmet health needs. RESULTS: The survey and analysis found that the needs of the elderly in this community to obtain disease-related knowledge, rational exercise, a healthy diet, and access to health information were not met. There were more patients with chronic diseases, and the top three chronic disease prevalence rates were hypertension (40.2%), dyslipidemia (8.4), and diabetes (7%). Chronic disease co-morbidities accounted for 13.3%. CONCLUSION: The relatively independently set up health service system at the present stage in China can no longer fully meet the health needs of the elderly, and the health service providers should provide integrated and continuous health services to meet the needs of whole-cycle health management. Therefore, we believe that effectively integrating various health service providers in the region and building an integrated health service organization with general practitioners as the core may be a solution to the current situation of unmet health needs of the elderly.
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Recursos em Saúde , Serviços de Saúde , Humanos , Idoso , Estudos Transversais , China/epidemiologia , Doença CrônicaRESUMO
Objectives: This study aimed to provide an assessment of chlorothalonil's possible carcinogenic risk posed to the public. In combination and comparison with the non-carcinogenic risk, the results hopefully could provide useful insights, early warning, and references for policy formulation. Methods: This study firstly investigated the occurrence of chlorothalonil on selected key vegetables for different scenarios, and then conducted an exposure assessment with officially published data. Lastly, both the non-carcinogenic and carcinogenic risk of chlorothalonil were calculated by using Monte-Carlo simulation. Results: Even though mean non-carcinogenic risks of chlorothalonil for all scenarios were below threshold value, the mean carcinogenic risks for maximum-risk scenario and most-likely risk scenario were mostly above threshold value. High probabilities of exceedance of threshold value existed for carcinogenic risk under all scenarios. Conclusion: Potential threat to public health existed for conventionally 'safe' pesticide if considering the possible carcinogenicity. Extra caution should be taken and the potential carcinogenic effects should be included into consideration for better protection of public health during the policy formulation process.
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Carcinógenos , Verduras , Humanos , Nitrilas , Probabilidade , Medição de RiscoRESUMO
Net primary production (NPP) is an essential component of the terrestrial carbon cycle and an essential factor of ecological processes. In global change research, it was the core content to study the driving forces of NPP change. In this paper, we focused on the Southwest Karst area of China and analyzed the response mechanisms of NPP to topography, land-use types, climatic change, and human activities. Our results showed that (1) changes in elevation and slope lead to significant differences in the spatial distribution of NPP. With the increase of elevation and slope, NPP first increased and then decreased, their critical values were 2000 m and 15°, respectively. (2) NPP varied significantly among different land-use types. The average NPP of the forest was the highest, and the average NPP of cultivated land increased fastest. (3) Temperature and precipitation had the most substantial influence on NPP, both of them promoted the increase of NPP, and the effect of temperature was more obvious in the Southwest Karst area. (4) Ecological engineering significantly promoted the change of NPP, while animal husbandry significantly inhibited the change of NPP. (5) There were significant spatial differences in the driving effects and corresponding contributions of climatic change and human activities; both of them promoted the increase of NPP in the Southwest Karst area of China. Under climatic change and human activities, NPP increased by 1.24 gC·m-2·year-1 and 2.29 gC·m-2·year-1, respectively. The contributions rates of climatic change and human activities separately accounted for 35% and 65%. The contribution of human activities on NPP was much higher than that of climatic change in the Southwest Karst area, and the results suggested that we should focus on the role of human activities on NPP change.
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Mudança Climática , Ecossistema , Humanos , Modelos Teóricos , Atividades Humanas , ChinaRESUMO
Biochar is a widely used antecedent for improving biohydrogen production. However, little is known about the impact of biochar-derived dissolved organic matter (DOM) on the performance of fermentative bio-H2 production. Herein, we evaluated the impact of biochar-derived DOM on the fermentation performance of hydrogen-producing microflora. The pyrolysis temperature of biochar affected the DOM composition, with lower pyrolysis temperatures showing more serious inhibition on H2 accumulation. When biochar was pyrolyzed at 500 °C, DOM prolonged the fermentation period and decreased H2 production from 1330.41 mL L-1 to 1177.05 mL L-1 compared to the control group. The xylose utilization in mixed substrate decreased from 29.72% to 26.41%, which is not favorable for practical applications where lignocellulosic biomass is used as a substrate. Otherwise, DOM caused a 6% reduction in microbial biomass accumulation and less soluble metabolites formation. The potential mechanism of DOM inhibiting biohydrogen production was verified by identifying an increase in reactive oxygen species (ROS) level (178.2%) and the microbial community shifted to containing fewer hydrogen-producing strains. The finding prompts a more precise design of biochar applications in fermentation systems to alleviate the potential hazards and maximum the fermentation performance, not limited to fermentative hydrogen production system.
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Matéria Orgânica Dissolvida , Carvão Vegetal/química , Fermentação , HidrogênioRESUMO
Background: Rotational manipulation of chains or clusters of magnetic nanoparticles (MNPs) offers a means for directed translation and payload delivery that should be explored for clinical use. Multiple MNP types are available, yet few studies have performed side-by-side comparisons to evaluate characteristics such as velocity, movement at a distance, and capacity for drug conveyance or dispersion. Purpose: Our goal was to design, build, and study an electric device allowing simultaneous, multichannel testing (e.g., racing) of MNPs in response to a rotating magnetic field. We would then select the "best" MNP and use it with optimized device settings, to transport an unbound therapeutic agent. Methods: A magnetomotive system was constructed, with a Helmholtz pair of coils on either side of a single perpendicular coil, on top of which was placed an acrylic tray having multiple parallel lanes. Five different MNPs were tested: graphene-coated cobalt MNPs (TurboBeads™), nickel nanorods, gold-iron alloy MNPs, gold-coated Fe3O4 MNPs, and uncoated Fe3O4 MNPs. Velocities were determined in response to varying magnetic field frequencies (5-200 Hz) and heights (0-18 cm). Velocities were normalized to account for minor lane differences. Doxorubicin was chosen as the therapeutic agent, assayed using a CLARIOstar Plus microplate reader. Results: The MMS generated a maximal MNP velocity of 0.9 cm/s. All MNPs encountered a "critical" frequency at 20-30 Hz. Nickel nanorods had the optimal response based on tray height and were then shown to enable unbound doxorubicin dispersion along 10.5 cm in <30 sec. Conclusion: A rotating magnetic field can be conveniently generated using a three-coil electromagnetic device, and used to induce rotational and translational movement of MNP aggregates over mesoscale distances. The responses of various MNPs can be compared side-by-side using multichannel acrylic trays to assess suitability for drug delivery, highlighting their potential for further in vivo applications.
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Social determinants of health are conditions that influence an individual's health. Investigators explored associations between social needs and type 2 diabetes (T2DM) diagnoses through retrospective chart review (October 2017-Septemeber 2018) and statistical analyses of an 11-domain social needs questionnaire routinely administered in a large health system in Kansas City, Kansas (n = 26,093, temporal relationship between diagnoses and screening undetermined). Except for childcare needs, all social needs were more commonly reported in patients with a T2DM diagnosis. Domains with the strongest associations were prescription cost, transportation, and health literacy. These findings may inform health system and social service provider partnerships to offer assistance in specific domains.
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Ahead of Print article withdrawn by publisher.
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Social and economic development processes require large amounts of natural resources and in some cases seriously deteriorate river water quality. Since the reform and expansion era began, China has vigorously pursued socioeconomic development but neglected environmental protection. However, in recent years, improvements in environmental awareness and the implementation of environmental protection measures have led to a balanced relationship between economic development and the environment. In this study, the Yangtze River Basin and the Yellow River Basin were selected as research areas. We used a combination of canonical correlation analysis (CCA) and a distance-based influence assessment method to quantitatively assess the influence of socioeconomic development on river water quality. The results revealed a strong correlation between socioeconomic development and river water quality. The degree of influence of socioeconomic development on water quality varied not only temporally but also spatially due to differences in socioeconomic development and hydrometeorology in the two basins in North and South China. The average degree of influence in the Yangtze River Basin was between 0.22 and 0.27, and that in the Yellow River Basin was between 0.2 and 0.36. Moreover, the degree of influence in the Yangtze River Basin in the wet season was greater than that in the dry season, whereas the opposite pattern was observed in the Yellow River Basin. The degree of influence in both basins gradually declined after 2011, indicating that the coupling and coordination between socioeconomic development and environmental protection have continuously improved and that the water quality has gradually improved. By analysing the influences of various socioeconomic indicators on water quality, we found that the main factors that influence water quality are per capita GDP and urbanization rate in the Yangtze River Basin and urbanization rate in the Yellow River Basin. The results provide a basis for future sustainable development in the Yangtze River Basin and the Yellow River Basin.
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Rios , Qualidade da Água , China , Conservação dos Recursos Naturais , Fatores Socioeconômicos , UrbanizaçãoRESUMO
To evaluate the effect of emergency emission reduction measures during the heavy air pollution episodes in Beijing, Tianjin, Hebei, and its surrounding areas, a scenario simulation method was used. The concentrations of PM2.5, PM10, SO2, NO2, CO, and O3-8h, air quality index (AQI), characteristics of heavy air pollution, and climate and meteorological factors were analyzed using the observation data available from October to December 2019. The 24 h, 72 h, and 144 h prediction results of NAQPMS model were analyzed. The uncertainties of the assessment and model prediction were discussed. The results showed that the average PM2.5 concentration in Beijing, Tianjin, and its surrounding 26 cities ("2+26" cities) from October to December 2019 was 64 µg ·m-3, indicating a decrease of 10 µg ·m-3 as compared with that during the same period in 2018. There were 4 occurrences of regional heavy air pollution episodes, with the average PM2.5 concentration of 156 µg ·m-3 of affected cities. The value of evaluation on meteorological condition index of PM2.5 pollution (EMI) of "2+26" cities ranged from -15.6%-16.8%. The meteorological conditions of 12 cities, including Beijing, Tianjin, and Shijiazhuang, deteriorated as compared with those during the same period in 2018, and the changes ranged from 3.2%-16.8%. However, the emergency emission reduction measures effectively reduced the occurrence of regional heavy air pollution episodes, the peak concentration of PM2.5 was decreased significantly, and no severe regional pollution episode occurred. The daily PM2.5 concentrations reduced by 2% to 9% in Beijing, Shijiazhuang, Baoding, Tangshan, and other cities during a typical heavy air pollution period. The quarterly average concentrations of PM2.5 in the "2+26" cities reduced by 1 to 3 µg ·m-3. The regional emergency emission reduction measures have played an active role in protecting the health of the people and improving the quality of ambient air.
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Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Pequim , China , Cidades , Monitoramento Ambiental , Humanos , Material Particulado/análiseRESUMO
This study discusses the concentration characteristics of PM2.5 and PM10, as well as pollution meteorology in large-scale and long-term heavy pollution in the Beijing-Tianjin-Hebei region and its surrounding areas from November 23 to December 4, 2018, where the primary pollutants are comprised of PM2.5 and PM10. The monitoring results obtained from ground-based and vehicle-mounted lidars, as well as the HYSPLIT-4 backward trajectory combined with meteorological factors analysis are discussed. The accuracy and uncertainty of the air quality forecast model of NAQPMS, CMAQ, and CAMx during heavy air pollution were analyzed retrospectively. The results show that PM2.5 and sand dust in most cities in the south-central region contribute to severe pollution levels. The hourly peak concentrations of PM10 in Zhangjiakou, Beijing, Shijiazhuang, Handan, and Zhengzhou were 1589, 864, 794, 738, and 766 µg·m-3, respectively. The respective hourly peak concentrations of PM2.5 were 239, 319, 387, 321, and 380 µg·m-3. Ground static pressure field, high humidity, inversion, and other static and stable conditions, as well as sand dust transmitted from the northwest, were important pollution meteorological and weather factors. The monitoring data of ground-based lidar and vehicle-mounted lidar combined with the HYSPLIT-4 backward trajectory analysis showed that the air pollutant transmitted from the Southwest and Southeast during the heavy pollution period was primarily PM2.5. The air pollutant transmitted from the Northwest during the two sand dust processes. Moreover, the model of NAQPMS, CMAQ, and CAMx performed well in forecasting the heavy pollution process in the Beijing-Tianjin-Hebei region and its surrounding areas. However there are slight deviations for some individual cities, related to uncertainty in the meteorological model prediction, atmospheric chemical reaction mechanism, and pollution source list. Furthermore, the reduction in pollution source emissions caused by pollution emergency measures was also one of the main reasons for the overestimation.
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Groundwater pollution early warning has been regarded as an effective tool for regional groundwater pollution prevention, especially in China. In this study, the systemic model was established to assess the groundwater pollution early warning by integrating the present situation of groundwater quality (Q), groundwater quality trend (T) and groundwater pollution risk (R). The model integrated spatial and temporal variation of groundwater quality, and combined the state and process of the groundwater pollution. Q, T and R were assessed by the methods of fuzzy comprehensive assessment, Spearman or nonparametric Mann-Kendall trend test, and overlay index, respectively. Taking the Luoyang City as an example, the groundwater pollution early warning mapping was generated, and verified by corresponding the groundwater quality classes and the early warning degrees. The results showed that the groundwater was dominated by the levels of no warning and light warning, which accounted for 77% of the study area. The serious and tremendous warning areas were affected by the worse trend and relatively bad/bad present situations of groundwater quality with the typical contaminants of total hardness, nitrate, Hg and COD. In summary, the present situation of groundwater quality was the most important factor of groundwater pollution early warning mapping in the study area. The worse trend of groundwater quality played equally a key role in the local regions, as well as the high pollution risk, which was mainly affected by the pollution source loading. Targeted measures for groundwater pollution prevention were proposed in the corresponding degrees of groundwater pollution early warning. The QTR model was proved to be effective for assessing the regional groundwater pollution early warning. The accuracy of the model could be improved if there is further data acquisition of groundwater quality in longer time series and in larger number, and further investigation of pollution sources. The QTR model is proposed and proved to be effective for assessing regional groundwater pollution early warning.
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Água Subterrânea , Modelos Teóricos , Gestão de Riscos , Poluentes Químicos da Água , China , Monitoramento Ambiental , Água Subterrânea/química , Gestão de Riscos/métodosRESUMO
The aim of this study was to analyze the newly formed bone volume (FV), 6 months after secondary alveoloplasty using iliac cancellous bone graft, with and without platelet-rich plasma (PRP). Forty patients with unilateral alveolar cleft were involved in this randomized, prospective, comparative study, with 20 patients each forming the control (group A) and PRP (group B) groups, respectively. The preoperative alveolar defect volume (DV) and the postoperative FV were automatically calculated by the computer-aided engineering software using the patients' pre and postsurgical computed tomography data. The volume of the actual bone graft (AV) was identical to the DV calculated before surgery. The bone formation ratio (BF%) was calculated as follows: BF%â=â(FV/AV)â×â100%. The mean BF% was 42.54â±â9.32% in group A and 46.97â±â18.49% in group B. There was no statistically significant difference between the 2 groups for BF% (Pâ>â0.05). The study presents a fast and accurate method for assessing the effect of PRP in alveolar grafting. However, the study found no conclusive evidence on the effect of PRP on bone growth.
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Enxerto de Osso Alveolar , Osteogênese , Plasma Rico em Plaquetas , Adolescente , Enxerto de Osso Alveolar/métodos , Alveoloplastia/métodos , Transplante Ósseo , Criança , Fissura Palatina/cirurgia , Feminino , Humanos , Imageamento Tridimensional , Masculino , Estudos Prospectivos , Tomografia Computadorizada por Raios XRESUMO
This study aimed to evaluate 2 advanced methods for presurgical calculation of bilateral alveolar cleft defect volume using 3-dimensional (3D) printing and computer-aided engineering (CAE) software. Twelve patients with bilateral alveolar cleft (4 females, 8 males, age range 8-11 years) were enrolled in the study. All patients underwent preoperative helical computed tomography scans, and the digital imaging and communications in medicine (DICOM) data of the computed tomography images were analyzed using 3D printing and CAE software. The 3D-printed model used a simulated graft, and graft volume was measured by water displacement. The CAE software used a subtractive method to calculate volume. Simulated graft volumes and CAE-software-derived volumes were compared using Pearson's correlation test and paired Student's t-test. The average volume of the simulated bone grafts obtained using 3D-printed models was 1.45âmL, which was lower than the CAE-software-derived mean volume of 1.52âmL. The mean calculation time using the 3D-printed model was 51.5âminutes, which was 32.1âminutes longer than the average 19.4âminutes when using CAE software. Paired Student's t-test revealed no statistically significant difference between the volumes derived from these methods. The results of this study further validated the use of 3D printing and CAE technique in bilateral alveolar defect repair. The CAE software is more cost-effective in presurgical volumetric assessment. Moreover, 3D models overcome limitations of 3D visualizations by providing tactile feedback and superior appreciation of visuospatial relationships among anatomical structures.