课程文献中心 更多>>

关键词： finite element analysis   fatigue failure   implant abutments   implantology   material selection  

摘要： Objectives Due to the dynamic character of the stomatognathic system, fatigue life experiments simulating the cyclic loading experienced by implant-supported restorations are critical consideration. The aim of this study was to examine the effect of different crown and abutment materials on fatigue failure of single implant-supported *** Models were created for 10 different designs of implant-supported single crowns including two zirconia-reinforced lithium silicates (crystallized and precrystallized), monolithic lithium disilicate, polymer-infiltrated ceramic networks, and polyetheretherketone supported by zirconia and titanium abutments. A cyclic load of 179 N with a frequency of 1 Hz was applied on palatal cusp of a maxillary first premolar at a 30 degrees angle in a buccolingual *** In the models with titanium abutments, the polymer-infiltrated ceramic network model had a lower number of cycles to fatigue failure values in the implant (5.07), abutment (2.30), and screw (1.07) compared to others. In the models with zirconia abutments, the crystallized zirconia-reinforced lithium silicate model had a higher number of cycles to fatigue failure values in the abutment (8.52) compared to others. Depending on the fatigue criteria, polyetheretherketone implant crown could fail in less than five year while the other implant crowns exhibits an infinite life on all *** The type of abutment material had an effect on the number of cycles to fatigue failure values for implants, abutments, and screws, but had no effect on crown materials. The zirconia abutment proved longer fatigue lifetime, and should thus be considered for implant-supported single crowns.

摘要： Acute liver failure (ALF) is a hepatology emergency with rapid hepatic destruction, multiple organ failures, and high mortality. Despite decades of research, established ALF has minimal therapeutic options. Here, we report that the small bioactive compound SCM-198 increases the survival of male ALF mice to 100%, even administered 24 hours after ALF establishment. We identify adiponectin receptor 2 (AdipoR2) as a selective target of SCM-198, with the AdipoR2 R335 residue being critical for the binding and signaling of SCM-198-AdipoR2 and AdipoR2 Y274 residue serving as a molecular switch for Ca2+ influx. SCM-198-AdipoR2 binding causes Ca2+ influx and elevates the phosphorylation levels of CaMKII and NOS3 in the AdipoR2-CaM-CaMKII-NOS3 complex identified in this study, rapidly inducing nitric oxide production for liver protection in murine ALF. SCM-198 also protects human ESC-derived liver organoids from APAP/TAA injuries. Thus, selectively targeting the AdipoR2-CaM-CaMKII-NOS3 axis by SCM-198 is a rapid-acting therapeutic strategy for advanced ALF.

关键词： Plasma soluble suppression of tumorigenicity 2   Speckle-tracking echocardiography   Coronary artery disease   Chronic coronary syndrome   Gensini score  

摘要： Background Previous studies on the relation of sST2 with atherosclerotic disease mostly focused on the predictive value of sST2 for heart failure. However, there is no definite conclusion about the correlation between sST2 level and a complex coronary lesion morphology detected with coronary angiography (CAG). The purpose of this work was to know sST2 level and 3D speckle-tracking echocardiography as predictor of coronary artery disease (CAD) severity in chronic coronary syndrome (CCS) individuals using Gensini score. This prospective cohort work was performed on 90 participants aging from 18 to 80 years old, both sexes, with stable angina pectoris. Participants had been categorized into three groups: Group I (n = 30): control group scheduled by normal coronary angiography and group II (n = 60): case group which subdivided according to Gensini score into two equal subgroups: IIa: simple lesion (Gensini score < 20) and group IIb: complex lesion (Gensini score of >= 20). Plasma sST2 levels were measured in all participants using ELISA technique. Results GLS, GAS, GCS and ST2 can significantly predict severity of CAD in CCS, respectively (P < 0.001 and AUC (95% CI) = 0.949(0.881-0.984), 0.980(0.925 to 0.998), 0.908(0.828 to 0.959) and 0.702(0.597 to 0.794)) at cutoff >= - 10, - 21, - 12 and >= 10 with 96.67% (82.8% to 99.9%), 96.67% (82.8 to 99.9), 86.67% (69.3 to 96.2) and 63.33% (43.9 to 80.1) sensitivity (95% CI), 76.67% (64.0% to 86.6%), 85.0% (73.4 to 92.9), 73.33% (60.3 to 83.9) and 65.0% (51.6 to 76.9) specificity (95% CI), 67.44%, 76.32%, 61.90% and 47.50% PPV and 97.87%, 98.08%, 91.67% and 78.00%, NPV with accuracy of 83.33%, 88.89%, 77.78% and 64.44%. Conclusions sST2 level, GLS, GAS and GCS can significantly predict severity of CAD in CCS.

关键词： CAM-IMC   CAM-ICU   POD   Delirium   Non-intubated   Disorientation  

摘要： Background Disorientation is an early indicator of developing postoperative delirium (POD), which is associated with increased mortality and cognitive decline. The well-established "Confusion-Assessment-Method-for-Intensive-Care-Unit" (CAM-ICU) for diagnosing POD in intubated patients cannot make use of the feature 'disorientation', as this requires verbal communication. Other tools such as the 4AT test for disorientation but are not established in ICU settings. We therefore combined test-variables of the CAM-ICU (level of consciousness, fluctuating mental status and inattention) with verbal testing for disorientation to develop and enhance diagnostic accuracy of the "Confusion Assessment Method for Intermediate Care Unit" (CAM-IMC). In the present study we describe the development and the evaluation of the diagnostic accuracy of the CAM-IMC. Methods We conducted a prospective cohort-study to develop and evaluate the diagnostic accuracy of the CAM-IMC and disorientation for diagnosing POD in non-intubated patients undergoing elective cardiac surgery. All patients were eligible during data collection period. Exclusion criteria were preexisting brain-organic disease, age < 50 years, preoperative intubation, and insufficient language skills. Patients were assessed for POD using the CAM-IMC as the index-test by two independent examiners over three postoperative days. Reference-testing was conducted by experienced reference-raters. The primary outcome was the diagnostic test-performance. Results Among 178 eligible patients, 624 paired observations were completed with 155 patients. Of these, 9% experienced POD. Sensitivity and specificity were 0.96 (CI-95%: 0.87-1.00) and 0.94 (CI-95%: 0.92-0.96), respectively. Area-Under-the-Receiver-Operating-Characteristic-Curve (AUROC;equivalent to c-statistic) for CAM-IMC with a cut-off at three points was 0.95 (CI-95%: 0.93-0.98). The interrater reliability was 0.80 (CI-95%: 0.69-0.91). Conclusion The CAM-IMC demonstrates excellent

关键词： CRISPR   adenosine deaminase   cyclic oligoadenylate   CARF   bacteriophage   cryo-EM   X-ray crystallography   anti-phage defense   deamination   abortive infection  

摘要： Type III CRISPR systems provide immunity against genetic invaders through the production of cyclic oligo-adenylate (cA_n) molecules that activate effector proteins that contain CRISPR-associated Rossman fold (CARF) domains. Here, we characterized the function and structure of an effector in which the CARF domain is fused to an adenosine deaminase domain, CRISPR-associated adenosine deaminase 1 (Cad1). We show that upon binding of cA₄ or cA₆ to its CARF domain, Cad1 converts ATP to ITP, both in vivo and in vitro. Cryoelectron microscopy (cryo-EM) structural studies on full-length Cad1 reveal an hexameric assembly composed of a trimer of dimers, with bound ATP at inter-domain sites required for activity and ATP/ITP within deaminase active sites. Upon synthesis of cA_n during phage infection, Cad1 activation leads to a growth arrest of the host that prevents viral propagation. Our findings reveal that CRISPR-Cas systems employ a wide range of molecular mechanisms beyond nucleic acid degradation to provide adaptive immunity in prokaryotes.

关键词： Denture base   Denture tooth   TCML   Aging   3D printing   Milling   CAD/CAM   Denture   Bonding  

摘要： Objectives To investigate the survival rates and fracture resistance of dentures made from different teeth (milled, 3D-printed, fabricated), bases (milled, 3D-printed, pressed) and bonding combinations. Materials and methods Specimens (11 groups, n = 8 per group) were fabricated from combinations with a denture tooth (anterior tooth 21) and a denture base material. The groups consisted of combinations of teeth (6x), denture base materials (5x) and adhesive bonding options (4x). The teeth were printed, milled or prefabricated. The denture base was produced conventionally or was milled or 3D-printed. Two dentures were milled from one industrially produced block. The dentures were subjected to thermal and mechanical loading (TCML) and subsequent fracture test. Statistics: ANOVA, Bonferroni-test, Kaplan-Meier survival, Pearson correlation;alpha = 0.05. Results Mean loading cycles varied between 221,869 (8), 367,610 (11), 513,616 (6) 875,371 (3) and 9,000,030 (4). ANOVA revealed significant (p <= 0.001) different surviving cycles. Log Rank test showed significantly (p < 0.001) different loading cycles. Fracture force after TCML varied between 129.8 +/- 97.1 N (3) and 780.8 +/- 62.5 N (9). ANOVA comparison revealed significant (p < 0.001) different fracture loadings between the individual systems. Correlation was found between fracture force and loading cycles (0.587, p < 0.001). Conclusions Different survival rates and fracture forces were found for dentures made of different teeth (milled, 3D-printed, prefabricated), bases (milled, 3D-printed, pressed) and bonding combinations. Milled, pressed and prefabricated systems provided longer survival and fracture force than the other tested systems. Clinical relevance Optimal tooth-base combinations can help to produce a denture that is stable and resistant during clinical application.

关键词： HDL-C   hypoalphalipoproteinemia   premature CAD   Tangier disease   ABCA1   adenosine triphosphate binding cassette transporter A1   CAD   coronary artery disease   FFR   fractional flow reserve   high-density-lipoprotein cholesterol   LDL-C   low-density-lipoprotein cholesterol   RCA   right coronary artery  

摘要： Primary hypoalphalipoproteinemia is typically caused by genetic disorders and is characterized by low high-density-lipoprotein cholesterol (HDL-C). Low HDL-C has been proposed to confer an increased risk of atherosclerotic cardiovascular disease; however, a causal relationship has not been determined. We describe the case of an otherwise healthy and asymptomatic 37-year-old woman with severely low HDL-C who was found to have significant coronary artery disease in whom genetic testing supported a diagnosis of Tangier disease. Current lipid management guidelines focus on optimization of total cholesterol and low-density-lipoprotein cholesterol (LDL-C), although the lipid profile of patients with primary hypoalphalipoproteinemia typically portrays favorable non-HDL levels. Clinical trials investigating medications that target low HDL-C have failed to show a clear benefit in cardiovascular outcomes. Based on current evidence, patients with genetic disorders that manifest through low HDL-C and optimal LDL-C should be managed with lifestyle modification and statin therapy.

关键词： body composition   cardiorespiratory fitness   coronary artery disease   high-intensity interval training   CAD   CR   cardiac rehabilitation   GAHT   gender-affirming hormone therapy   HIIT   RPE   rating of perceived exertion   TW   transgender woman   VO2peak   peak oxygen uptake  

摘要： The presented case report examines the effects of cardiac rehabilitation (CR) on a 69-year-old transgender woman with coronary artery disease (CAD). The patient engaged in 19 CR sessions without experiencing any adverse effects. Pre- to post-CR assessments revealed a worsening of body composition, characterized by an approximate 3% increase in fat mass and a 4% reduction in lean mass. In contrast, peak oxygen uptake and exercise time increased by 6% and 9%, respectively. This case report highlights the need for additional targeted strategies to improve both body composition and cardiorespiratory fitness in transgender woman undergoing CR for coronary artery disease management.

关键词： acute coronary syndrome   hypocalcemia   pseudoinfarction   ST-segment elevation   Takotsubo syndrome   CAD   coronary artery disease   ECG   electrocardiogram   hs-TnI   high sensitive troponin I   LV   left ventricular   STE   TTS  

摘要： A wide range of etiologies, both ischemic and nonischemic, can produce an electrocardiographic pattern of ST-segment elevation (STE), including Takotsubo syndrome (TTS) and electrolyte imbalances. Instances of hypocalcemia-induced TTS and STE are exceedingly rare in medical literature. This paper presents the case of a 75-year-old woman with advanced ovarian cancer and no prior heart issues, who exhibited diffuse STE on electrocardiogram, resembling acute coronary syndrome. Additionally, echocardiography suggested left ventricle apical ballooning, as per TTS, in the context of severe hypocalcemia and elevated troponin I level. After confirming no coronary artery disease via angiography, we administered calcium supplementation. Subsequently, the electrocardiogram displayed widespread giant T-wave inversions, and the patient’s cardiac function fully recovered on normalization of calcium levels within few days. This case serves to highlight the importance of recognizing rare causes of STE (eg, hypocalcemia-induced cardiomyopathy), particularly in patients with neoplastic condition. However, the precise mechanism underlying a potential hypocalcemia-induced TTS remains to be elucidated, and there are only a limited number of case reports in the literature. In light of the aforementioned considerations, we propose a comprehensive examination of cases associated with hypocalcemia and STE and left ventricular systolic impairment.