A New Full Digital Workflow for Fixed Prosthetic Rehabilitation of Full-Arch Edentulism Using the All-on-4 Concept.

(1) Background: Recent digital workflows are being developed for full-arch rehabilitations supported by implants with immediate function. The purpose of this case series is to describe a new digital workflow for the All-on-4 concept. (2) Methods: The patients were rehabilitated using the All-on-4 concept with a digital workflow including computerized tomography scanning, intra-oral scanning, and CAD-CAM production of the temporary prosthesis, with the 3D printing of stackable guides (base guide, implant guide, and prosthetic guide). The passive fit of the prostheses and the time to perform the rehabilitations were evaluated. (3) Results: The digital workflow allowed for predictable bone reduction, the insertion of implants with immediate function, and the connection of an implant-supported prosthesis with immediate loading. The time registered to perform the full-arch rehabilitations (implant insertion, abutment connection, prosthesis connection) was below 2 hours and 30 min. No passive fit issues were noted. (4) Conclusions: within the limitation of this case series, the digital workflow applied to the All-on-4 concept using stackable base-, implant-, and prosthetic guides constitutes a potential alternative with decreased time for the procedure without prejudice of the outcome.

Nanocelluloses and Their Applications in Conservation and Restoration of Historical Documents.

Nanocelluloses have gained significant attention in recent years due to their singular properties (good biocompatibility, high optical transparency and mechanical strength, large specific surface area, and good film-forming ability) and wide-ranging applications (paper, food packaging, textiles, electronics, and biomedical). This article is a comprehensive review of the applications of nanocelluloses (cellulose nanocrystals, cellulose nanofibrils, and bacterial nanocellulose) in the conservation and restoration of historical paper documents, including their preparation methods and main properties. The novelty lies in the information collected about nanocelluloses as renewable, environmentally friendly, and sustainable materials in the field of cultural heritage preservation as an alternative to conventional methods. Several studies have demonstrated that nanocelluloses, with or without other particles, may impart to the paper documents excellent optical and mechanical properties, very good stability against temperature and humidity aging, higher antibacterial and antifungal activity, high protection from UV light, and may be applied without requiring additional adhesive.

Morphometric Comparison of Two Implants with Different Macroscopy Placed Immediate in the Anterior Region of the Maxilla - A Randomized Clinical Trial with 6-Month of Follow Up.

Purpose - Compare the morphometric results of immediate implants (Type 1C) with a cylindrical (conventional) or triangular neck, in the anterior region of the maxilla, during 6 months of osseointegration. Materials and Methods - Prospective randomized clinical trial with a sample of 20 individuals randomly assigned to each group (10 triangular neck implants and 10 cylindrical neck implants). Consecutively direct measurements were performed: before (T-1) and after tooth extraction (T0), after implant placement (T1), after 1 month of the submerged implant healing (T2), when placing the healing abutment (T3), after placing the definitive crown (T3), and after 6 months of osseointegration (T4). Results - A significant difference between T1 and T3 in the buccal cortical thickness was identified (0.49Å}0.86mm). Although there was a significant increase in the buccal cortical thickness in both implants, this increase was greater for the triangular neck implants (cylindrical shape: 0.08Å}0.59 vs. triangular neck 0.90Å}0.91mm). It was also observed that implants placed below the buccal bone crest (í-1mm) promote less vertical buccal bone loss than implants placed Ñ-1mm at crest level (-0.65Å}0.52mm vs. -1.42Å}0.86mm). This observation needs to be further investigated in additional studies. Conclusions - The triangular neck implants present an increase in the cortical buccal thickness compared to the cylindrical implants. However, this increase does not fully compensate the remodulation after tooth loss.

Mucoepidermoid microcarcinoma in the context of parotid gland cyst.

Mucoepidermoid carcinoma is a type of salivary gland cancer that can develop in the context of a parotid gland cyst. This type of tumor is composed of mucous, epidermoid, and intercalated cells, and usually presents as a slow-growing and painless mass. A parotid gland cyst is a condition in which a fluid-filled sac forms in the parotid gland. The tumor can be masked as it develops within the parotid cyst. A 45-year-old female patient presented with a suspect of benign neoplasm of the major salivary gland. She underwent partial right parotidectomy, which upon pathological analysis confirmed the diagnosis of mucoepidermoid microcarcinoma associated with parotid gland cysts. The patient did well and continues under regular follow-up with no further treatment.

Body fat predicts urinary tract infection in kidney transplant recipients: a prospective cohort study.

BACKGROUND: The association between obesity and infectious diseases is increasingly reported in the literature. There are scarce studies on the association between obesity and urinary tract infection after kidney transplantation (KTx). These studies defined obesity based on body mass index, and their results were conflicting. The present study aimed to evaluate this association using bioelectrical impedance analysis for body composition evaluation, and obesity definition. METHODS: A single-center cohort study was conducted. Demographic, clinical, anthropometric, and laboratory data were collected at KTx admission, and bioelectrical impedance analysis was performed to measure the visceral fat area, waist circumference, and total fat mass. The occurrence of urinary tract infection (symptomatic bacteriuria and/or histological evidence of pyelonephritis) was evaluated within three months after KTx. RESULTS: Seventy-seven patients were included in the cohort, and 67 were included in the final analysis. Urinary tract infection was diagnosed in 23.9% of the transplanted patients. Waist circumference (HR: 1.053; 95% CI 1.005-1.104; p = 0.032), visceral fat area (HR: 1.015; 95% CI 1.003-1.027; p = 0.014), and total fat mass (HR: 1.075; 95% CI 1.008-1.146; p = 0.028) were associated with urinary tract infection occurrence after KTx, using Cox regression models. Patients with high waist circumference (above 102 cm for men and above 88 cm for women) had a 4.7 times higher risk of a urinary tract infection than those with normal waist circumference (HR: 4.726; 95% CI 1.267-17.630; p = 0.021). Kaplan-Meier curves showed that patients with high waist circumference, high visceral fat area, and high total fat mass had more urinary tract infections (Log-rank test p = 0.014, p = 0.020, and p = 0.018, respectively). Body mass index was not able to predict urinary tract infection in the study sample. CONCLUSIONS: Waist circumference, visceral fat area, and total fat mass, assessed by bioelectrical impedance analysis, were predictors of urinary tract infection risk within the first three months after KTx.

Differential diagnosis between multiple sclerosis and leukodystrophies - A scoping review.

Multiple Sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system (CNS) characterized by damage to the myelin sheaths of oligodendrocytes. Currently, there is no specific biomarker to identify the disease; however, a diagnostic criterion has been established based on patient's clinical, laboratory, and imaging characteristics, which assists in identifying this condition. The primary method for diagnosing MS is the McDonald criteria, first described in 2001 and revised in the years 2005, 2012, and 2017. These criteria have been continuously reviewed to enhance specificity and sensitivity in the diagnosis of MS, thereby reducing errors in its differential diagnosis. An important differential diagnosis that shares overlapping features with MS, mainly the progressive forms, are leukodystrophies with demyelination as underlying pathology. Leukodystrophies comprise a rare group of genetically determined disorders that lead to either demyelination or hypomyelination of the central nervous system that can result neuroimaging changes as well as clinical findings similar to those observed in MS. Thus, systematic evaluation encompassing clinical presentation, neuroimaging findings, and laboratory metrics proves indispensable for a differential diagnosis. As such, this study aimed to establish, clearly and objectively, the similarities and differences between MS and the main demyelinating leukodystrophies. The study analyzed the parameters of the McDonald criteria, including clinical, laboratory, and magnetic resonance imaging aspects, as found in patients with leukodystrophies through scoping literature review. The data were compared with the determinations of the revised 2017 McDonald criteria to facilitate the differential diagnosis of these diseases in clinical practice.

Evaluation of brushing efficiency in reducing oral microbiota in mechanically ventilated patients admitted to an intensive care unit.

Background: Patients admitted to the Intensive Care Unit (ICU) are at greater risk of developing nosocomial infections due to their investigations, treatment and changes in the immune system. One of the most prevalent nosocomial infections is respiratory tract infection, such as hospital acquired pneumonia and ventilator-associated pneumonia (VAP). The bacteria commonly found in the oral cavity in the hospital environment are Streptococcus viridians, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus spp., and Klebsiella pneumoniae. There is a need to test and define appropriate standard protocols for oral hygiene in patients undergoing mechanical ventilation in ICUs through the intervention of a dental specialist, preventing the proliferation of microorganisms into the respiratory tract, thus reducing hospitalization time, the use of antibiotics, and increased morbidity/mortality. Objective: This study aimed to evaluate the effectiveness of dental brushing in the reduction of the pathogenic buccal microbiota associated with mechanical ventilation in patients admitted to the Evangelical Hospital from Londrina, Paraná, Brazil. Methodology: The sample consisted of 90 patients (of both sexes), mean age of 65 years, under mechanical ventilation by orotracheal tube and tracheostomized patients, without suspected or confirmed diagnosis of pneumonia. Patients were randomized ∗∗∗. Results: Results showed that oral hygiene using a toothbrush by suction, with chlorhexidine gel 0.12% (Group B), was more effective than conventional hygiene using gauze soaked with chlorhexidine 0.12% (Group A) in reducing pathogenic buccal microbiota. Conclusions: There was a reduction of the pathogenic buccal microbiota in mechanically ventilated patients receiving oral hygiene using a toothbrush by suction with chlorhexidine gel 0.12% (Group B).

Maxillary Sinus Augmentation with Xenogenic Collagen-Retained Heterologous Cortico-Cancellous Bone: A 3-Year Follow-Up Randomized Controlled Trial.

Sinus augmentation procedures have become a valuable solution for patients with posterior maxillary edentulism. The objective of this study was to explore the efficacy and safety of porcine xenograft with collagen supplementation as a potential alternative to autologous bone grafts in lateral sinus augmentation over a three-year follow-up period. Twelve patients, each with bilateral posterior maxillary edentulism, were enrolled and randomly allocated to receive either a porcine xenograft or an autologous graft. Comprehensive assessments, including clinical and radiographic evaluations, were conducted at specific intervals, including implant stability, marginal bone loss, prosthetic and biological complications, and patient preferences. The results demonstrated no significant differences between the two graft materials in terms of implant survival, marginal bone loss, and patient preferences after three years of follow-up. Only one implant was affected by peri-implantitis, and prosthesis-related complications were present in one patient possibly due to bruxism. In conclusion, these findings suggest that a porcine xenograft with collagen supplementation may be a viable alternative to an autograft in lateral sinus augmentation procedures. The high implant survival rate, minimal complications, and patient satisfaction indicate the potential clinical relevance of this graft material and should be further investigated to confirm these promising results.

Sleep and memory complaints in long COVID: an insight into clustered psychological phenotypes.

This study evaluated clinical features of individuals with long COVID (5-8 months after diagnosis) who reported sleep and memory problems (62 cases) compared to those without (52 controls). Both groups had a similar mean age (41 vs. 39 years). Around 86% of the participants were non-hospitalized at the time of infection, and none of them were vaccinated at that point. Subsequently, both cases and controls received the vaccine; however, the vaccination rates differed significantly between the groups (30.7% vs. 51.0%). Cases and controls had similar rates of symptoms at acute COVID phase. However, cases were more likely to experience coryza, dyspnea, headache, and nausea/vomiting during long COVID. Regarding new-onset symptoms in long COVID, 12.9% of cases had dyspnea, and 14.5% experienced nausea/vomiting, whereas in the control group there were only 1.9% and 0.0%, respectively. Cases also had a significantly higher prevalence of persistent headache (22.6% vs. 7.7%), and dyspnea (12.9% vs. 0.0). In addition, cases also showed an increased rate of mental health complaints: disability in daily activities (45.2% vs. 9.6%; P < 0.001); concentration/sustained attention difficulties (74.2% vs. 9.6%; P < 0.001); anxiety-Generalized Anxiety Disorder 2-item scale (GAD-2) ≥ 3 (66.1% vs. 34.6%; P = 0.0013); and "post-COVID sadness" (82.3% vs. 40.4%; P < 0.001). We observed a significant correlation between sadness and anxiety in cases, which was not observed in controls (P=0.0212; Spearman correlation test). Furthermore, the frequency of concomitant sadness and anxiety was markedly higher in cases compared to controls (59.7% vs. 19.2%) (P < 0.0001; Mann-Whitney test). These findings highlight a noteworthy association between sadness and anxiety specifically in cases. In conclusion, our data identified concurrent psychological phenotypes in individuals experiencing sleep and memory disturbances during long COVID. This strengthens the existing evidence that SARS-CoV-2 causes widespread brain pathology with interconnected phenotypic clusters. This finding highlights the need for comprehensive medical attention to address these complex issues, as well as major investments in testing strategies capable of preventing the development of long COVID sequelae, such as vaccination.

Solar neighborhoods: the impact of urban layout on a large-scale solar strategies application.

The article addresses the challenges of evaluating energy performance in different neighborhood settings under various energy efficiency measures and proposes a methodology for selecting appropriate solar strategies on a neighborhood scale. The study selects five representative neighborhoods from various climatic zones with different building and street layouts. The proposed methodology involves a systematic three-step multi-domain workflow for implementing energy efficiency measures and solar strategies in the existing neighborhoods. The first step involves typical energy performance simulation, the second step involves energy simulation using high performance building envelope, and the third step involves the addition of solar strategies in combination with retrofitting materials to achieve net-zero status. The results of the study show that modifying the building envelope leads to a significant reduction in energy consumption, with up to 60% reduction observed. The study also finds that the optimal mix of solar strategies depends strongly on the type of neighborhood, its street layouts, and the type of buildings. The article highlights the importance of considering these factors when implementing solar strategies on a neighborhood scale to achieve energy efficiency and net-zero status. It provides urban planners with a systematic decision-making approach to evaluate and optimize neighborhoods to achieve net-zero energy status.

The All-on-4 Concept Using Polyetheretherketone (PEEK)-Acrylic Resin Prostheses: Follow-Up Results of the Development Group at 5 Years and the Routine Group at One Year.

BACKGROUND: It is necessary to investigate the application of polymer materials in implant dentistry. The aim of this study was to examine the outcome of full-arch polyetheretherketone (PEEK)-acrylic resin implant-supported prostheses. METHODS: Seventy-six patients were rehabilitated consecutively with 100 full-arch implant-supported prostheses of PEEK-acrylic resin (a development group (DG): 37 patients with 5 years of follow-up; a routine group (RG): 39 patients with 1 year of follow-up). The primary outcome measure was prosthetic survival. Secondary outcome measures were implant survival, marginal bone loss, biological complications, prosthetic complications, veneer adhesion, plaque levels, bleeding levels, and a patient subjective evaluation (including the Oral Health Impact Profile for the RG). RESULTS: In both groups, prosthetic (DG: 93.6%; RG: 100%) and implant survival (DG: 98.9%; RG: 99.5%) were high, and marginal bone loss was low (DG: 0.54 mm; RG: 0.28 mm). The veneer adhesion rate was 28.6% of prostheses in DG (RG = 0%). Mechanical complications occurred in 49% and 11.8% of prostheses in DG and RG, respectively. Biological complications, plaque, and bleeding levels were low in both groups. The subjective patient evaluation was excellent in both groups (8.6 < DG < 8.8; 9.3 < RG < 9.5; OHIP = 1.38). CONCLUSIONS: Within the limitations of this study, PEEK can be considered a viable prosthetic alternative.

Sampling frequency optimization of the water quality monitoring network in São Paulo State (Brazil) towards adaptive monitoring in a developing country.

Water quality monitoring networks (WQMNs) that capture both the temporal and spatial dimensions are essential to provide reliable data for assessing water quality trends in surface waters, as well as for supporting initiatives to control anthropogenic activities. Meeting these monitoring goals as efficiently as possible is crucial, especially in developing countries where the financial resources are limited and the water quality degradation is accelerating. Here, we asked if sampling frequency could be reduced while maintaining the same degree of information as with bimonthly sampling in the São Paulo State (Brazil) WQMN. For this purpose, we considered data from 2004 to 2018 for 56 monitoring sites distributed into four out of 22 of the state's water resources management units (UGRHIs, "Unidades de Gerenciamento de Recursos Hídricos"). We ran statistical tests for identifying data redundancy among two-month periods in the dry and wet seasons, followed by objective criteria to develop a sampling frequency recommendation. Our results showed that the reduction would be feasible in three UGRHIs, with the number of annual samplings ranging from two to four (instead of the original six). In both seasons, dissolved oxygen and Escherichia coli required more frequent sampling than the other analyzed parameters to adequately capture variability. The recommendation was compatible with flexible monitoring strategies observed in well-structured WQMNs worldwide, since the suggested sampling frequencies were not the same for all UGRHIs. Our approach can contribute to establishing a methodology to reevaluate WQMNs, potentially resulting in less costly and more adaptive strategies in São Paulo State and other developing areas with similar challenges.

Progress in circRNA-Targeted Therapy in Experimental Parkinson's Disease.

Circular RNAs (circRNAs) are single-stranded RNA molecules often circularized by backsplicing. Growing evidence implicates circRNAs in the underlying mechanisms of various diseases, such as Alzheimer's and Parkinson's disease (PD)-the first and second most prevalent neurodegenerative disorders. In this sense, circSNCA, circHIPK2, circHIPK3, and circSLC8A1 are circRNAs that have been related to the neurodegenerative process of PD. Gain-of-function and loss-of-function studies on circRNAs have shed light on their roles in the pathobiology of various diseases. Gain-of-function approaches typically employ viral or non-viral vectors that hyperexpress RNA sequences capable of circularizing to form the specific circRNA under investigation. In contrast, loss-of-function studies utilize CRISPR/Cas systems, antisense oligonucleotides (ASOs), or RNAi techniques to knock down the target circRNA. The role of aberrantly expressed circRNAs in brain pathology has raised a critical question: could circRNAs serve as viable targets for neuroprotective treatments? Translating any oligonucleotide-based therapy, including those targeting circRNAs, involves developing adequate brain delivery systems, minimizing off-target effects, and addressing the high costs of treatment. Nonetheless, RNAi-based FDA-approved drugs have entered the market, and circRNAs have attracted significant attention and investment from major pharmaceutical companies. Spanning from bench to bedside, circRNAs present a vast opportunity in biotechnology for oligonucleotide-based therapies designed to slow or even halt the progression of neurodegenerative diseases.

Maxilla Reconstruction with Xenograft Blocks to Allow Implant Rehabilitation: A Case Report.

Reducing patient morbidity is one of the challenging goals of proper surgical techniques. The rehabilitation success begins with a good surgical plan. Scientifically proven biomaterials are excellent options to overcome the lack of autologous bone for maxillary reconstructions. This case report presents a clinical case of maxillary reconstruction combining guided bone regeneration with xenograft blocks and maxillary sinus elevation. This technique achieved maxillary rehabilitation with a fixed implant-supported prosthesis of a challenging case. The clinical case has an 18-month follow-up with no major complications and excellent clinical and radiographic results.

Production of IgY against iron permease Ftr1 from Candida albicans and evaluation of its antifungal activity using Galleria mellonella as a model of systemic infection.

Candida albicans is one of the leading pathological agents of mucosal and deep tissue infections. Considering that the variety of antifungals is restricted and that toxicity limits their use, immunotherapies against pathogenic fungi have been viewed as alternatives with reduced adverse effects. In this context, C. albicans has a protein used to capture iron from the environment and the host, known as the high-affinity iron permease Ftr1. This protein may be a new target of action for novel antifungal therapies, as it influences the virulence of this yeast. Thus, the aim of the present study was to produce and conduct the biological characterization of IgY antibodies against C. albicans Ftr1. Immunization of laying hens with an Ftr1-derived peptide resulted in IgY antibodies extracted from egg yolks capable of binding to the antigen with high affinity (avidity index = 66.6 ± 0.3%). These antibodies reduced the growth and even eliminated C. albicans under iron restriction, a favorable condition for the expression of Ftr1. This also occurred with a mutant strain that does not produce Ftr1 in the presence of iron, a circumstance in which the protein analog of iron permease, Ftr2, is expressed. Furthermore, the survival of G. mellonella larvae infected with C. albicans and treated with the antibodies was 90% higher than the control group, which did not receive treatment (p < 0.0001). Therefore, our data suggest that IgY antibodies against Ftr1 from C. albicans can inhibit yeast propagation by blocking iron uptake.

Altered phagocytosis and morphogenesis of phenotypic switching-derived strains of the pathogenic Candida tropicalis co-cultured with phagocytic cells.

BACKGROUND AND OBJECTIVE: Candida tropicalis is among the most prevalent human pathogenic yeast species. Switch states of C. tropicalis differ in virulence traits. Here, we evaluate the effect of phenotypic switching on phagocytosis and yeast-hyphae transition in C. tropicalis. METHODS: C. tropicalis morphotypes included a clinical strain and two switch strains (rough variant and rough revertant). In vitro, phagocytosis assay was performed using peritoneal macrophages and hemocytes. The proportion of hyphal cells was ascertained by scoring morphology using optical microscopy. Expression of the WOR1 (White-opaque regulator 1) and EFG1 (Enhanced filamentous growth protein 1) was determined by quantitative PCR. RESULTS: The rough variant was more resistant to in vitro phagocytosis by peritoneal macrophages than that observed for the clinical strain, while hemocytes phagocytosed clinical and rough variant to the same extent. The rough revertant was more phagocytosed than the clinical strain by both phagocytes. During co-incubation with phagocytic cells, the clinical strain of C. tropicalis exists mainly as blastoconidia. The co-culture of the rough variant with macrophages resulted in a higher percentage of hyphae than blastoconidia cells, while in co-culture with hemocytes, no differences were observed between the percentage of hyphae and blastoconidia. The expression levels of WOR1 in the rough variant co-cultured with phagocytes were significantly higher than they were in the clinical strain. CONCLUSIONS: Differences on phagocytosis and hyphal growth between switch states cells of C. tropicalis co-cultured with phagocytic cells were observed. The pronounced hyphal growth may affect the complex host-pathogen relationship and favor the pathogen to escape phagocytosis. The pleiotropic effects of phenotypic switching suggest that this event may contribute to the success of infection associated with C. tropicalis.

Pleomorphic adenoma in tonsil.

Salivary tumors that involve the tonsil are rare, representing 0.5% of salivary neoplasms. Most tumors arise from the parotid glands. Rare studies have been reported in the literature regarding pleomorphic adenomas affecting the tonsil. Patients are usually asymptomatic and present with a slow-growing, mobile and painless mass. Radiological examinations are usually unable to differentiate benign from malignant tumors in most cases. There is low recurrence with complete excision of the tumor. The prognosis is excellent except in the rare cases of malignant transformation. This report describes the management of a case of pleomorphic adenoma affecting the palatine tonsils and the difficulty regarding the histopathological diagnosis.

Immediate placement of one-piece zirconia implants with or without xenograft into the buccal gap. Soft tissues as secondary outcomes of an experimental in vivo study.

OBJECTIVE: To histologically evaluate soft tissue healing following immediately placed one-piece zirconia implant and grafting a xenograft into the buccal gap. MATERIALS AND METHODS: The third and fourth premolars (PM3 and PM4) in both quadrants of the mandible of nine dogs were used for this experiment. Those teeth were removed flapless and implants were placed into the distal sockets in a lingual position. In one side of the jaw, the gap between the implant and the socket walls was grafted (test) while no grafting was performed in the contralateral side (control), randomly selected. After 6 months of healing, biopsies were obtained and prepared for histological analysis. Soft tissue measures like supracrestal soft tissue height (STH), length of barrier epithelium (BE), and connective tissue (CTC) were measured at buccal and lingual surfaces. RESULTS: The marginal mucosa was in a coronal position on the test side compared with the control side. At the buccal surface, the BE was longer in the test side than in the control side, while the CTC was longer in the control side than in the test side. For the STH (BE + CTC), the difference between the groups was not statistically significant. CONCLUSION: The placement of a xenograft into the gap between a 1-piece zirconia implant and the buccal wall in dogs modified the process of soft tissue healing, providing less soft tissue recession. The gap size seems to have a modifying effect on the application of this protocol.