CARD-like domains mediate anti-phage defense in bacterial gasdermin systems.

Caspase recruitment domains (CARDs) and pyrin domains are important facilitators of inflammasome activity and pyroptosis. Upon pathogen recognition by NLR proteins, CARDs recruit and activate caspases, which, in turn, activate gasdermin pore forming proteins to and induce pyroptotic cell death. Here we show that CARD-like domains are present in defense systems that protect bacteria against phage. The bacterial CARD is essential for protease-mediated activation of certain bacterial gasdermins, which promote cell death once phage infection is recognized. We further show that multiple anti-phage defense systems utilize CARD-like domains to activate a variety of cell death effectors. We find that these systems are triggered by a conserved immune evasion protein that phages use to overcome the bacterial defense system RexAB, demonstrating that phage proteins inhibiting one defense system can activate another. We also detect a phage protein with a predicted CARD-like structure that can inhibit the CARD-containing bacterial gasdermin system. Our results suggest that CARD domains represent an ancient component of innate immune systems conserved from bacteria to humans, and that CARD-dependent activation of gasdermins is conserved in organisms across the tree of life.

Nutrition in the Management of ADHD: A Review of Recent Research.

PURPOSE OF REVIEW: Various nutrients and diet quality have been suggested to be involved in the pathophysiology of ADHD. The purpose of this review was to examine data from recent cohort studies and dietary interventions to determine whether nutrition may play a role in the management of ADHD. RECENT FINDINGS: Preliminary evidence suggests that minerals might have beneficial effects on ADHD symptomatology. Probiotics might offer novel strategies to prevent or treat ADHD. Inverse associations between adherence to "healthy" diets and ADHD symptoms have been observed. Children with ADHD responding to the few-foods diet (or oligoantigenic diet) with an elimination of individually identified food items show substantially improved behavior and cognitive functioning. Evidence from recent research does not allow any recommendations regarding the use of micronutrients or probiotics in the management of ADHD. The few-foods diet may become an additional therapeutic option for children with ADHD.

Abundance, distribution, and composition of microplastics in the filter media of nine aged stormwater bioretention systems.

Bioretention systems are designed for quality treatment of stormwater. Particulate contaminants are commonly treated efficiently and accumulate mainly in the surface layer of the bioretention filter material. However, concerns exist that microplastic particles may not show equal accumulation behavior as other sediment particles. So far only two field and two laboratory studies are available on the fate of microplastics in few relatively newly built bioretention systems. Therefore, this study investigated the abundance and distribution of microplastics in nine 7-12 years old stormwater bioretention systems. It was found that microplastics generally accumulate on the surface of bioretention systems. Microplastic median particle concentrations decreased significantly from the surface layer (0-5 cm) of the filter material to the 10-15 cm depth layer from 448 to 136 particles/100 g, respectively. The distance to the inlet did not significantly affect the surface accumulation of microplastic particles, suggesting modest spatial variability in microplastics accumulation in older bioretention systems. Further, this study investigated the polymer composition in bioretention systems. It was shown that PP, EVA, PS and EPDM rubber are the most abundant polymer types in bioretention systems. Also, it was found that large percentages of microplastic particles are black particles (median percentage of black particles: 39%) which were found in 28 of the 33 investigated samples. This underlines the importance of including black particles in microplastic studies on stormwater, which has been overlooked in most previous studies.

Microplastics in urban catchments: Review of sources, pathways, and entry into stormwater.

Urban areas play a key role in the production of microplastics (MPs) and their entry into water bodies. This article reviews the literature on the sources, transport, and control of MPs in urban environments with the aim of clarifying the mechanisms underlying these processes. Major MP sources include atmospheric deposition, micro-litter, and tire and road wear particles (TRWPs). MPs deposited from the atmosphere are mostly fibers and may be particularly important in catchments without traffic. Littering and attrition of textiles and plastic products is another important MP source. However, the quantities of MPs originating from this source may be hard to estimate. TRWPs are a significant source of MPs in urban areas and are arguably the best quantified source. The mobilization of MPs in urban catchments is poorly understood but it appears that dry unconsolidated sediments and MP deposits are most readily mobilized. Sequestration of MPs occurs in green areas and is poorly understood. Consequently, some authors consider green/pervious parts of urban catchments to be MP sinks. Field studies have shown that appreciable MP removal occurs in stormwater quality control facilities. Street cleaning and snow removal also remove MPs (particularly TRWPs), but the efficacy of these measures is unknown. Among stormwater management facilities, biofiltration/retention units seem to remove MPs more effectively than facilities relying on stormwater settling. However, knowledge of MP removal in stormwater facilities remains incomplete. Finally, although 13 research papers reported MP concentrations in stormwater, the total number of field samples examined in these studies was only 189. Moreover, the results of these studies are not necessarily comparable because they are based on relatively small numbers of samples and differ widely in terms of their objectives, sites, analytical methods, size fractions, examined polymers, and even terminology. This area of research can thus be considered "data-poor" and offers great opportunities for further research in many areas.

Investigation of intra - event variations of total, dissolved and truly dissolved metal concentrations in highway runoff and a gross pollutant trap - bioretention stormwater treatment train.

Metals in stormwater can be toxic to organisms, particularly when occurring in truly dissolved form (fraction <3 kDa). Here, using 153 samples collected during six rains, we investigated intra-events variations of total, dissolved and truly dissolved metal concentrations in highway runoff, and how they were affected by a stormwater treatment train, comprising a gross pollutant trap (GPT) and a bioretention system. Although intra-event variations in metal concentrations were observed in the highway stormwater, the effluent of the GPT and the effluent from the bioretention system, generally no "first flush" was observed. While total Pb, Cu and Zn concentrations were, on average, significantly reduced by the bioretention system (>76%, 79% and 94%, respectively), removal of dissolved metals was lower and truly dissolved Cd and Cu were generally not effectively removed (average removal Cd -11%, Cu 7.7%). Only for truly dissolved Zn was removal 65%. However, as with Cu, effluent Zn concentrations exceeded environmental threshold values. While Cu, Pb and Zn occurred in the highway runoff in particulate form, with average percentages of 86%, >99% and 72%, respectively, the speciation of Cu and Zn in the bioretention effluent shifted towards greater fractions of colloidal and truly dissolved metals. The GPT had no significant effect on metal concentrations and speciation.

Occurrence and concentration of 20-100 µm sized microplastic in highway runoff and its removal in a gross pollutant trap - Bioretention and sand filter stormwater treatment train.

Microplastic pollution of stormwater can be a serious threat to the environment. Gross pollutant trap (GPT) - bioretention treatment trains have been shown previously to treat (inter alia) particulate stormwater pollutants including microplastic particles larger than 100 µm. This study was carried out to investigate whether such stormwater treatment trains also remove smaller 20 to 100 µm sized microplastic particles from highway runoff. Further, it investigates occurrence and concentration of 20 to 100 µm sized microplastic particles in highway runoff and which polymer types they can be assigned to. Volume proportional samples from nine rain events were taken from the incoming highway stormwater, from the gross pollutant trap effluent and the outflow from a bioretention system as well as a non-vegetated sand filter. The microplastic analyses were carried out using µFTIR and FTIR-ATR, which made it possible to detect particles where carbon black was present. It was found that 20 to 100 µm sized microplastic particles are abundant in highway runoff and that their concentrations are highly variable, with a median of 230 particles/L, a minimum of 42 particles/L and a maximum of 8577 particles/L. The dominant polymer types in highway stormwater were Polypropylene (PP), Ethylene Propylene Diene (EPDM) rubber and Ethylene-vinyl acetate (EVA). The treatment train with the bioretention system treated 20 to 200 µm sized microplastic particles significantly better than the treatment train with a non-vegetated sand filter, with median effluent concentrations of 26.5 particles/L and 121 particles/L, respectively. The GPT had no significant impact on the treatment of 20 to 100 µm sized microplastic particles.

Removal of rubber, bitumen and other microplastic particles from stormwater by a gross pollutant trap - bioretention treatment train.

Microplastic particles in stormwater pose significant threats to the environment. This study investigated how effective a stormwater treatment train was at removing rubber, bitumen and other microplastics (incl. fibers, fragments, and paint particles) in the 100-300 µm and >300 µm size fractions from highway runoff. The two treatment trains comprise a gross pollutant trap (GPT) followed by either a vegetated bioretention cell or non-vegetated sand filter. Flow-proportional composite samples were taken from the highway runoff, GPT outflow and the outflow from the two parallel filters during nine rain events to determine overall treatment performance, as well as the performance of individual system components. The identified rubber, bitumen and other microplastic particles mainly represented the 100-300 µm fraction and included high ratios of rubber (30%) and bitumen (60%). Overall, the treatment train efficiently removed rubber, bitumen and other microplastic particles in the 100-300 µm size fraction from the stormwater. The filter cells accounted for a major share of this removal, as the GPT did not reduce microplastic particle concentrations. This observation is likely explained by the fact that the rubber, bitumen and other microplastic particles have a density close to the density of water and thus removal by sedimentation is decreased. This identified an inherent weakness of the system; more specifically, the high microplastic concentrations in the surface water of the GPT means there can be a risk of microplastic release through overflow pits when inflows surpass the system capacity. Despite some differences, both the vegetated bioretention cell and the non-vegetated sand filter removed rubber, bitumen and other microplastic particles to similar extent.

The Swiss STAR trial - an evaluation of target groups for sexually transmitted infection screening in the sub-sample of women.

OBJECTIVES: In Switzerland, universal health insurance does not cover any routine testing for sexually transmitted infections (STIs), not even in individuals at high risk, and extra-genital swabbing is not standard of care. We compared STI prevalence in a multicentre prospective observational cohort of multi-partner women with/without sex work and evaluated associated risk factors. MATERIALS AND METHODS: Between January 2016 and June 2017, we offered free STI testing to women with multiple  sexual partners (three or more in the previous 12 months), with follow-up examinations every 6 months. We used multiplex polymerase chain-reaction testing (for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium) for pooled swabs (pharynx, urethra/vagina, anus), and antibody tests for human immunodeficiency virus (HIV) and Treponema pallidum at every visit, and for hepatitis B and C at baseline. RESULTS: We screened 490 female sex workers (FSWs), including 17 trans women, and 92 other multi-partner women. More than half reported a steady partner. Previously undiagnosed HIV was found in 0.2% vs 0.0%, respectively, and T. pallidum antibodies in 5.9% vs 0.0%. STIs requiring antibiotic treatment comprised: active syphilis 1.2% vs 0.0%; N. gonorrhoeae 4.9% vs 0.0%; C. trachomatis 6.3% vs 5.4%, T. vaginalis 10.4% vs 0.0%; M. genitalium 6.7% vs 6.5%. One in four FSWs vs one in nine other women had one or more of these STIs at baseline. 15.8% vs 3.8% had a history of hepatitis B, 45.5% vs 22.8% had no immunity (HBs-AB <10 IU/l). Two FSWs had hepatitis C virus antibodies (0.4%) without concurrent HIV infection. Non-condom-use (last three months) for anal/vaginal sex was not associated with STIs. Independent risk factors were group sex (adjusted odds ratio [aOR] 2.1, 95% confidence interval [CI] 1.1–4.0), age less than 25 (aOR 3.7, 95% CI 1.6–8.9), and being active in sex work for less than 1 year (aOR 2.7, 95% CI 1.3–5.3). CONCLUSION: HIV and HCV do not appear to pose a major public health problem among FSWs in Switzerland, whereas vaccination against HBV should be promoted. FSWs showed high rates of STIs requiring treatment to reduce transmission to clients and/or steady partners. FSWs should be offered low-cost or free STI screening as a public health priority.

The Swiss STAR trial - an evaluation of target groups for sexually transmitted infection screening in the sub-sample of men.

OBJECTIVES: In Switzerland, universal health insurance does not cover any routine testing for sexually transmitted infections (STIs), not even in individuals at high risk, and extra-genital swabbing is not standard of care. We determined the prevalence and incidence of human immunodeficiency virus (HIV), viral hepatitis and non-viral STIs in a multicentre prospective observational cohort of multi-partner men who have sex with men (MSM) and other men. MATERIALS AND METHODS: Between January 2016 and June 2017, we offered free STI testing to all men with multiple  sexual partners (three or more in the previous 12 months), with follow-up examinations every 6 months. We used multiplex polymerase chain-reaction testing (for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium) on pooled swabs (pharynx, urethra/vagina, anus), and antibody tests for HIV and Treponema pallidum at every visit, and for hepatitis B/C at baseline. RESULTS: We screened 779 multi-partner MSM and 92 other men. Previously undiagnosed HIV was found in 0.5% vs 0.0%, respectively and T. pallidum antibodies in 15.3% vs 1.1%. STIs requiring antibiotic treatment comprised: active syphilis 1.7% vs 0.0%; N. gonorrhoeae 10.3% vs 0.0%; C. trachomatis 8.7% vs 1.1%. One in four MSM versus 1 in 100 other multi-partner men had any of these three STIs at baseline. 10.4% vs 1.3% had a history of hepatitis B, 31.9% vs 47.3% had no immunity (HBs-AB <10 IU/l). Ten MSM had HCV antibodies (1.4%), with 8 out of the 10 being MSM with HIV; HCV seroprevalence was 0.3% among HIV-negative MSM. In MSM, incidence of the three bacterial STIs was 25.5 per year over 333 person years of follow-up, HIV incidence was 0.3%. Non-condom-use (in the last 3 months) for anal/vaginal sex was not associated with STIs. Independent risk factors were sex with men (adjusted odds ratio [aOR] 16.4) and the number of sexual partners (aOR 2.3 for >20). CONCLUSION: Among MSM, but not among other multi-partner men, STIs, mostly asymptomatic, are common. Given the high risk of onward transmission, low-cost or free routine screening of multi-partner MSM is a public health priority.

Effects of plant species and traits on metal treatment and phytoextraction in stormwater bioretention.

To study effects of plant species selection on total and dissolved metal treatment performance of bioretention systems (BRS), 12 sets of columns were prepared, each planted with one of 12 species that are either widely used in BRS or have potentially important traits for metal removal (ability to hyperaccumulate metals, C4 photosynthesis, or ability to form mycorrhiza). Artificial stormwater was applied to half of the columns during all of a 31-week test period, while treatment of the others included a 5-week long dry period to test interactive effects of drying and plant traits on BRS metal treatment in more realistic alternating wet and dry conditions. Concentrations of metals (dissolved and total) in the effluent significantly differed between most columns with different plants, and the differences in concentrations of dissolved metals after the dry period were particularly important. Mean dissolved Cd concentrations exceeded Swedish reference values in effluents from BRS with two of the plant species, while mean dissolved Zn concentrations exceeded them in effluents from BRS with three of the species (and non-vegetated controls). Dissolved Cu leaching was observed in effluents from BRS with five of the plant species after the dry period, and mean concentrations exceeded Swedish reference values in effluents from all the BRS (including the constantly watered systems). Some support in terms of metal concentrations in shoots and shoot/soil ratios was obtained for using hyperaccumulators in BRS to remove metals from filter material. For example, Armeria maritima (a hyperaccumulator with the lowest shoot biomass) and Miscanthus sinsenis (a C4 plant with the highest biomass production) took up similar amounts of metals despite large differences in biomass. However, no significant correlations between effluent metal concentrations and plants' metal uptake were found, possibly because of the short duration of the experiment. The results indicate that root biomass affected effluent metal concentrations more strongly. Root biomass was often positively correlated with total and (particularly) dissolved effluent metal concentrations. Further experiments with different soil metal concentrations, organic matter analyses and stronger focus on root characteristics are recommended, including additional tests of effects of hyperaccumulators and mycorrhiza on metal treatment and phytoextraction.

Metal speciation in stormwater bioretention: Removal of particulate, colloidal and truly dissolved metals.

For comprehensive estimation of the metal treatment efficiency of bioretention systems, information on metal speciation in the stormwater and the effluent is needed. However, so far, most bioretention studies only considered total metal concentrations. Despite their environmental importance, dissolved metals (defined as fractions < 0.45 µm) have only been evaluated in few studies. This study represents the first bioretention study to subdivide the <0.45 µm fraction further by filtration through a 3 kDa ultrafilter (corresponding to appr. 2-3 nm), thus enabling distinction between particulate, colloidal and truly dissolved metals. Higher bioavailability of the truly dissolved fraction has been indicated by previous research, underlining the importance of this study. Since vegetation and salt in stormwater both may be explanatory variables for metal fractionation, these have been added as factors in the utilized full factorial pilot-scale column experiment. While total metal removal was often >95%, detailed fractionation revealed that Cu and (when no salt was added) Zn removal in the <0.45 µm and <3 kDa fractions was significantly lower. Further, mean concentrations of Cu and (in one treatment) Cd in the <0.45 µm effluent fraction did not meet Swedish receiving water quality guidelines. By calculating the particulate, colloidal and truly dissolved fractions, it was shown that bioretention systems affect metal speciation of Cu and Zn. Colloidal and truly dissolved fractions were mostly prevalent in the effluent rather than the influent. Salt affected metal removal mostly negatively. Fractionation was affected by salt mainly in the influent where it increased the concentrations of Cd and Zn in the truly dissolved fraction (no effects on Cu and Pb fractions). In the effluent, Cu and Zn were only slightly affected by salt. Vegetation had mostly no significant effects on metal removal and fractionation. Further integration of detailed metal fractionation into sampling routines in bioretention research is recommended.

Towards a Unified Functional Trait Framework for Parasites.

Trait-based research holds high potential to unveil ecological and evolutionary processes. Functional traits are fitness-related characteristics of individuals, which are measured at individual level and defined without using information external to the individual. Despite the usefulness of the functional approach to understand the performance of individuals in ecosystems, and parasitism being the most common life-history strategy on Earth, studies based on functional traits of parasites are still scarce. Since the choice of functional traits is a critical step for any study, we propose a core list of seven functional traits of metazoan parasites, related to three universal challenges faced by organisms (dispersal, establishment, and persistence), and give guidelines to define appropriate functional traits in future parasite community studies.

The Role of Nutritional Supplements in the Treatment of ADHD: What the Evidence Says.

Attention-deficit hyperactivity disorder (ADHD) is a common behavioral disorder in children and adolescents and may persist into adulthood. Insufficient nutritional supply of long-chain polyunsaturated fatty acids (LC-PUFAs) and other components including various minerals has been suggested to play a role in the development of ADHD symptoms. This review presents the evidence regarding the role of nutritional PUFA, zinc, iron, and magnesium supplements in the treatment of ADHD with a focus on the critical evaluation of the relevant literature published from 2014 to April 2016. The evaluation of therapeutic nutritional LC-PUFA supplementation in ADHD has shown mixed and inconclusive results and at best marginal beneficial effects. The benefits of PUFAs are much smaller than the effect sizes observed for traditional pharmacological treatments of ADHD. The effectiveness of PUFA supplements in reducing medication dosage has been suggested but needs to be confirmed. Zinc, iron, and magnesium supplementation may reduce ADHD symptoms in children with or at high risk of deficiencies in these minerals. However, convincing evidence in this regard is lacking.

Antibiotic Resistance Genes in Freshwater Biofilms May Reflect Influences from High-Intensity Agriculture.

Antibiotic resistance is a major public health concern with growing evidence of environmental gene reservoirs, especially in freshwater. However, the presence of antibiotic resistance genes in freshwater, in addition to the wide spectrum of land use contaminants like nitrogen and phosphate, that waterways are subjected to is inconclusive. Using molecular analyses, freshwater benthic rock biofilms were screened for genes conferring resistance to antibiotics used in both humans and farmed animals (aacA-aphD to aminoglycosides; mecA to ß-lactams; ermA and ermB to macrolides; tetA, tetB, tetK, and tetM to tetracyclines; vanA and vanB to glycopeptides). We detected widespread low levels of antibiotic resistance genes from 20 waterways across southern New Zealand throughout the year (1.3 % overall detection rate; 480 samples from three rocks per site, 20 sites, eight occasions; July 2010-May 2011). Three of the ten genes, ermB, tetK, and tetM, were detected in 62 of the 4800 individual screens; representatives confirmed using Sanger sequencing. No distinction could be made between human and agricultural land use contamination sources based on gene presence distribution alone. However, land use pressures are suggested by moderate correlations between antibiotic resistance genes and high-intensity farming in winter. The detection of antibiotic resistance genes at several sites not subject to known agricultural pressures suggests human sources of resistance, like waterway contamination resulting from unsatisfactory toilet facilities at recreational sites.

A trait-based framework for stream algal communities.

The use of trait-based approaches to detect effects of land use and climate change on terrestrial plant and aquatic phytoplankton communities is increasing, but such a framework is still needed for benthic stream algae. Here we present a conceptual framework of morphological, physiological, behavioural and life-history traits relating to resource acquisition and resistance to disturbance. We tested this approach by assessing the relationships between multiple anthropogenic stressors and algal traits at 43 stream sites. Our "natural experiment" was conducted along gradients of agricultural land-use intensity (0-95% of the catchment in high-producing pasture) and hydrological alteration (0-92% streamflow reduction resulting from water abstraction for irrigation) as well as related physicochemical variables (total nitrogen concentration and deposited fine sediment). Strategic choice of study sites meant that agricultural intensity and hydrological alteration were uncorrelated. We studied the relationships of seven traits (with 23 trait categories) to our environmental predictor variables using general linear models and an information-theoretic model-selection approach. Life form, nitrogen fixation and spore formation were key traits that showed the strongest relationships with environmental stressors. Overall, FI (farming intensity) exerted stronger effects on algal communities than hydrological alteration. The large-bodied, non-attached, filamentous algae that dominated under high farming intensities have limited dispersal abilities but may cope with unfavourable conditions through the formation of spores. Antagonistic interactions between FI and flow reduction were observed for some trait variables, whereas no interactions occurred for nitrogen concentration and fine sediment. Our conceptual framework was well supported by tests of ten specific hypotheses predicting effects of resource supply and disturbance on algal traits. Our study also shows that investigating a fairly comprehensive set of traits can help shed light on the drivers of algal community composition in situations where multiple stressors are operating. Further, to understand non-linear and non-additive effects of such drivers, communities need to be studied along multiple gradients of natural variation or anthropogenic stressors.

Feasibility of proximal right coronary artery imaging by 2D and 3D echocardiography in comparison to coronary angiography.

The present study was carried out to test the feasibility of proximal right coronary artery (RCA) imaging and to detect proximal RCA narrowing and occlusion by 2D and 3D transthoracic echocardiography in comparison to coronary angiography (CA). Standardised 2D and 3D echocardiography were performed prior to CA in 97 patients with sinus rhythm. The following parameters were determined: the longest longitudinal detectable RCA segment, the minimum and maximum width of the RCA, the area and number of detectable narrowing >50% of the proximal RCA and the correlation between the echocardiographic and angiographic findings. The visualisation of the proximal RCA and the detection of coronary artery narrowing in the proximal RCA are generally possible. Differences in width and area were not statistically significant between 2D and 3D echocardiography, but showed significant differences between echocardiography and CA. For the detection of proximal RCA narrowing, higher sensitivity and specificity values were obtained by 2D than by 3D echocardiography. However, in patients with sufficient image quality 3D echocardiography permits a more detailed visualisation of the anatomical proportions and an en-face view into the RCA ostium. The visualisation of the proximal RCA is feasible and narrowing can be detected by 2D and 3D echocardiography if image quality is sufficient. CA is the gold standard for the detection of coronary artery stenoses. However, the potential of this new approach is clinically important because crucial findings of the proximal RCA can be presumably detected non-invasively prior to CA.

Risk factors for technical and biological complications with zirconia single crowns.

OBJECTIVES: This practice-based study evaluated the clinical performance and risk factors for biological and technical complications with conventionally luted zirconia crowns. MATERIALS AND METHODS: Sixty-eight patients (39 female) with a total of 323 restorations placed on 219 vital teeth, 69 endodontically treated teeth (ETT), and 41 implants (incisors, 96; premolars, 89; molars, 138; observational period, 79.7 ± 14.2 months) underwent a clinical follow-up examination and were included in the study. Time-dependent survival (in situ), success (event free), and veneering ceramic fracture (VCF) rates were calculated and analyzed relative to the following risk factors: smoking status, location of the crown, and type of abutment. RESULTS: Fifty-three complete failures were recorded. A significant influence of the abutment type on survival could be detected (p = 0.033): ETT demonstrated a significantly (p = 0.029) lower 7-year survival rate (73.8%, 95% confidence interval [95% CI] 0.600-0.876) than crowns placed on implants (90.0%, 95% CI 0.814-0.990). The success rate of the crowns was significantly influenced by the location of the restoration (p = 0.0058). A total of 75.6% (95% CI 0.648-0.864) of the anterior crowns remained event free, compared to 50.4% (95% CI 0.388-0.621) of the molar crowns. Furthermore, the location of the crowns affected the VCF rate (p = 0.018, event-free anterior teeth 95.2% (95% CI 0.880-1), event-free molars 80.9% (95% CI 0.706-0.913)). CONCLUSIONS: Survival and success rates were significantly influenced by the type of abutment and the location of the restoration. CLINICAL RELEVANCE: More complete failures should be expected for crowns placed on ETT, while crowns on molars demonstrated more biological and technical complications than anterior zirconia crowns.

Cerebrospinal fluid apolipoprotein E concentration and progression of Alzheimer's disease.

BACKGROUND/OBJECTIVE: Apolipoprotein E plays a role in the pathogenesis of Alzheimer's disease (AD). Cerebrospinal fluid (CSF) and plasma level alterations have been reported in AD patients. In search of a potential biomarker, which would be predictive of cognitive, functional, or motor decline, we analyzed CSF apolipoprotein E (ApoE) levels of AD patients in this regard. METHODS: Subjects with newly diagnosed AD enrolled into an observational study were followed up longitudinally. Neuropsychological testing and physical examination were performed annually. In a sub-cohort of patients, where baseline CSF ApoE concentration values were available, multiple regression analyses were used to determine possible associations of CSF ApoE concentration and speed of decline on different cognitive, functional, and motor scales (MMSE, iADL, bADL, GDS, UPDRSIII) adjusting for possible confounders. RESULTS: No association of CSF ApoE levels and speed of decline on the various scales could be established (p = 0.09 to 0.88). Nevertheless, the use of neuroleptic drugs could be linked to higher velocity of global and extrapyramidal deterioration (p = 0.04 and 0.05 for GDS and UPDRSIII, respectively), but not to other outcomes (MMSE, bADL, and iADL). CONCLUSION: Herein, CSF ApoE at time of AD diagnosis could not be shown to be a viable biomarker for future cognitive, functional, or motor decline. Expectedly, the use of neuroleptic drugs was associated with detrimental effects.

Technical and biological complications of single-molar implant restorations.

OBJECTIVES: Retrospective evaluation of the biological and technical complications in implant-supported single-tooth molar restorations performed in a private practice after functional periods of ≥4 years. MATERIAL AND METHODS: Sixty-five patients (34 females, age 51.7 ± 10.6 years) with 112 implants received annual follow-up examinations and participated in a maintenance program. The survival (in situ) and success (complication-free) rates of implants and superstructures were evaluated. Time-dependent peri-implantitis rates were calculated, and the influencing factors were identified using a multiple Cox regression. RESULTS: The implant survival rate was 100%. Three of 112 crowns required replacement (prosthetic survival rate = 98.1%). Thirty technical complications were observed: loss of retention (16), ceramic fracture (10), and screw loosening (4). The success rate of the superstructures was 79.0% after 7 years. Overall, 9.2% of the patients developed peri-implantitis (probing depth ≥5 mm, BOP, suppuration, bone loss ≥3.5 mm); (smokers: 41.6%, non-smokers: 1.8%). After 7 years, the time-dependent implant success rate (free of peri-implantitis) was 100% for non-smokers and 58.6% for smokers. Multiple analysis showed a significant effect of smoking (hazard ratio, 19.5; P = 0.008) on peri-implantitis. CONCLUSIONS: Implants with cemented single-tooth restorations in the molar region constitute a reliable treatment in private practice. Smokers have a significantly increased peri-implantitis rate.