This systematic review and meta-analysis considered the results of randomized controlled clinical trials(RCTs)to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis.Two independent author...This systematic review and meta-analysis considered the results of randomized controlled clinical trials(RCTs)to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis.Two independent authors screened publications from three electronic databases to include RCTs meeting all the inclusion and exclusion criteria.A meta-analysis was performed to evaluate the weighted mean differences in survival rate(SR)and changes in pocket probing depth(PPD),bone level(BL),and clinical attachment level(CAL).The study cohorts were defined as antibiotic and control groups with subgroups for analysis.Seven studies including 309 patients(390 implants)were considered.Within the limitations of this review,patients in the antibiotic groups exhibited significant improvements in PPD.Subgroup analysis indicated that the administration of systemic antibiotics or the use of antibiotics in non-surgical treatments did not result in a significant alteration in BL.It was established that the addition of antibiotics can ameliorate PPD and SR in the treatment of peri-implantitis,whether through surgical or non-surgical approaches,and also shows moderate performance regarding BL and CAL.Considering the lack of application of new technologies in the control group and the hardship of assessing the potential risks of antibiotics,careful clinical judgment is still necessary.展开更多
Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption,ultimately resulting in implant failure.Dental implants for clinical use barely have antibacterial pr...Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption,ultimately resulting in implant failure.Dental implants for clinical use barely have antibacterial properties,and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis.Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque.However,it is particularly important to prevent the occurrence of peri-implantitis rather than treatment.Therefore,the current research spot has focused on improving the antibacterial properties of dental implants,such as the construction of specific micro-nano surface texture,the introduction of diverse functional coatings,or the application of materials with intrinsic antibacterial properties.The aforementioned antibacterial surfaces can be incorporated with bioactive molecules,metallic nanoparticles,or other functional components to further enhance the osteogenic properties and accelerate the healing process.In this review,we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration.Furthermore,we summarized the obstacles existing in the process of laboratory research to reach the clinic products,and propose corresponding directions for future developments and research perspectives,so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy,biological safety,and osteogenic property.展开更多
Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants ...Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus(S.aureus),Escherichia coli(E.coli),Candida albicans(C.albicans)and clinical strains of S.aureus,Klebsiella pneumonia(K.pneumonia)and Candida parapsilosis(C.parapsilosis)by disk diffusion test.Minimum inhibitory concentrations(MIC)and minimum cidal concentrations(MCC)were determined using modified agar dilution millpore method.The extract was further combined with polyethylene glycol and propylene glycol,and was tested for antimicrobial effects.Results:Grape seed extract showed positive inhibitory effects with S.aureus at MIC of 0.625 mg/mL and MCC of1.25 mg/mL respectively.However the extracts showed minimal or no reactivity against strains of E.coli,K.pneumonia,C.parapsilosis and C.albicans.The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S.aureus.Conclusions:The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skinabutment interface of craniofacial implants.展开更多
Subperiosteal implants are generally used in the severely resorbed areas, and although dwindling in use, they have shown to be successful treatment options for the edentulous dental patients. We report a case of maxil...Subperiosteal implants are generally used in the severely resorbed areas, and although dwindling in use, they have shown to be successful treatment options for the edentulous dental patients. We report a case of maxillary subperiosteal implantitis that caused sinusitis. A 59-year-old man was referred to our clinic in March 2003 with a chief complaint of pain and swelling in the bilateral upper molar region. He received a surgical operation for maxillary subperiosteal implant at another dental clinic in April 2001. CT scans demonstrated that the radiopacity of the right maxillary sinus extended to the ethmoid and frontal sinuses. Extensive surgical debridement was performed. The radiopacity of the right maxillary sinus in CT almost disappeared in a month. Two months later, the occlusal function was recovered using a new maxillary complete denture. The patient has had no symptoms and no occlusal disturbance by the denture for more than nine years.展开更多
Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods:...Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.展开更多
Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability t...Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability to prevent and treat peri-implantitis is hampered by a paucity of knowledge of how these biomes are acquired and the factors that engender normobiosis.Therefore,we combined a 3-month interventional study of 15 systemically and periodontally healthy adults with whole genome sequencing,finescale enumeration and graph theoretics to interrogate colonization dynamics in the pristine peri-implant sulcus.We discovered that colonization trajectories of implants differ substantially from adjoining teeth in acquisition of new members and development of functional synergies.Source-tracking algorithms revealed that this niche is initially seeded by bacteria trapped within the coverscrew chamber during implant placement.These pioneer species stably colonize the microbiome and exert a sustained influence on the ecosystem by serving as anchors of influential hubs and by providing functions that enable cell replication and biofilm maturation.Unlike the periodontal microbiome,recruitment of new members to the peri-implant community occurs on nepotistic principles.Maturation is accompanied by a progressive increase in anaerobiosis,however,the predominant functionalities are oxygen-dependent over the 12-weeks.The peri-implant community is easily perturbed following crown placement,but demonstrates remarkable resilience;returning to pre-perturbation states within three weeks.This study highlights important differences in the development of the periodontal and peri-implant ecosystems,and signposts the importance of placing implants in periodontally healthy individuals or following the successful resolution of periodontal disease.展开更多
Flexible electronics are transforming our lives by making daily activities more convenient.Central to this innovation are field-effect transistors(FETs),valued for their efficient signal processing,nanoscale fabricati...Flexible electronics are transforming our lives by making daily activities more convenient.Central to this innovation are field-effect transistors(FETs),valued for their efficient signal processing,nanoscale fabrication,low-power consumption,fast response times,and versatility.Graphene,known for its exceptional mechanical properties,high electron mobility,and biocompatibility,is an ideal material for FET channels and sensors.The combination of graphene and FETs has given rise to flexible graphene field-effect transistors(FGFETs),driving significant advances in flexible electronics and sparked a strong interest in flexible biomedical sensors.Here,we first provide a brief overview of the basic structure,operating mechanism,and evaluation parameters of FGFETs,and delve into their material selection and patterning techniques.The ability of FGFETs to sense strains and biomolecular charges opens up diverse application possibilities.We specifically analyze the latest strategies for integrating FGFETs into wearable and implantable flexible biomedical sensors,focusing on the key aspects of constructing high-quality flexible biomedical sensors.Finally,we discuss the current challenges and prospects of FGFETs and their applications in biomedical sensors.This review will provide valuable insights and inspiration for ongoing research to improve the quality of FGFETs and broaden their application prospects in flexible biomedical sensing.展开更多
Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic ...Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.展开更多
To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elas...To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elastic modulus(EM),degradation rate and in vitro cell experiments of the modified WE43 alloys were systematically studied.A modified layer composed of Mg,MgO,the implanted elements and their oxides was formed on the modified alloys.Since high-speed metal ions caused severe surface lattice damage,the surface hardness of the substrate considerable increased.Electrochemical tests demonstrated a substantial enhancement in the corrosion resistance of the modified alloys via the implantation of Ti and Zr ions,resulting in a reduction of the corrosion current density to 88.1±9.9 and 15.6±11.4μA cm^(−2),respectively,compared with the implantation of Fe and Zn ions.Biocompatibility tests showed that the implantation of Fe,Ti,Zn and Zr ions enhanced the anticoagulant and hemolytic resistance of the WE43 alloy.All surface-modified samples showed negligible cytotoxicity(0-1)at 12.5%extract concentration.Moreover,the alloys implanted with Fe,Ti and Zn ions significantly promoted proliferation of human umbilical vein endothelial cells(HUVEC)compared with the unmodified alloy.The results demonstrate that Ti ion implantation is the best choice for WE43 alloy modification to achieve outstanding corrosion resistance and biocompatibility.展开更多
Background Increased backfat thickness of sows in early gestation is negative to reproductive performance.Endometrial receptivity is an important determinant of reproductive success,but it is unclear whether the effec...Background Increased backfat thickness of sows in early gestation is negative to reproductive performance.Endometrial receptivity is an important determinant of reproductive success,but it is unclear whether the effect of sow backfat thickness on litter size is associated with endometrial receptivity and whether melatonin treatment may have benefits.The present study seeks to answer these questions through in vitro and in vivo investigations.Results Excessive lipid deposition and lower melatonin levels in the uterus are detrimental to endometrial receptivity and embryo implantation in high backfat thickness sows.In cells treated with melatonin,the MT2/PI3K/LIF axis played a role in reducing lipid accumulation in porcine endometrial epithelium cells and improved endometrial receptivity.Furthermore,we found a reduction of lipids in the uterus after eight weeks of intraperitoneal administration of melatonin to HFD mice.Notably,melatonin treatment caused a significant reduction in the deposition of endometrial collagen,an increase in the number of glands,and repair of the pinopode structure,ultimately improving endometrial receptivity,promoting embryo implantation,and increasing the number of litter size of mice.Conclusions Collectively,the finding reveals the harmful effects of high backfat thickness sows on embryo implantation and highlight the role of melatonin and the MT2/PI3K/LIF axis in improving endometrial receptivity by enhancing metabolism and reducing the levels of uterine lipids in obese animals.展开更多
Infections associated with titanium(Ti)-based implants present significant challenges in clinical treatments,especially when biofilms already form on the implant surface.Many antimicrobial agents,including antibiotics...Infections associated with titanium(Ti)-based implants present significant challenges in clinical treatments,especially when biofilms already form on the implant surface.Many antimicrobial agents,including antibiotics,metallic nanoparticles and antimicrobial peptides,have been extensively used to deal with Ti implant infections.However,these chemical approaches suffer from potential toxicity,antibiotic resistance and poor long-term antibacterial performance.Hence,physical antibacterial surfaces on Ti-based implants have attracted increasing attention.The antibacterial behavior of different surfaces on Ti-based biomaterials against various bacteria only by physical properties of the implants themselves(e.g.,nanotopography)or exogenous physical stimulus(e.g.,photocatalysis)was reviewed,as well as parameters influencing the physical antibacterial processes,such as size,shape and density of the surface nanotextures,and bacterial growth phases.Besides,mechanisms of different fabrication techniques for the physical antibacterial surfaces on Ti-based biomaterials were also summarized.展开更多
Objective To compare the efficacy of toric implantable collamer lens(Toric-ICL)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK)for myopia correction in patients with moderate to high myopia complicated ...Objective To compare the efficacy of toric implantable collamer lens(Toric-ICL)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK)for myopia correction in patients with moderate to high myopia complicated with astigmatism.Methods We retrospectively collected data from 64 patients(aged 18-42 years)with moderate to high myopia complicated with astigmatism(128 eyes)undergoing either Toric-ICL(28 patients/56 eyes)or FS-LASIK(36 patients/72 eyes)at our department between January,2019 and December,2020.The changes of uncorrected distance visual acuity(UCVA),spherical equivalent(SE),mean astigmatism correction index(CI),corneal endothelial cell density(ECD)and intraocular pressure(IOP)following the procedures were compared between the two groups.Results In FS-LASIK group,all the eyes(72/72)achieved an UCVA≥1.0,similar to the rate in Toric-ICL group(55/56 eyes;P=0.2374).The postoperative SE was also comparable between FS-LASIK and Toric-ICL groups[0.43±0.06 D(range:-1.0 to 1.50 D)vs 0.38±0.05 D(range:-0.75 to 1.00 D);P=0.56].The mean astigmatism CI was significantly higher in FS-LASIK group than in Toric-ICL group(0.8561 vs 0.7176;P<0.0001),and 88.89%of the eyes in FS-LASIK group and 69.64%in Toric-ICL group had postoperative astigmatism≤0.50 D.No significant changes were observed in postoperative corneal ECD in FS-LASIK group,whereas ECD decreased significantly after the procedure in Toric-ICL group(P=0.0057).The patients undergoing Toric-ICL exhibited no significant changes of postoperative IOP,but the patients receiving FS-LASIK had significantly reduced IOP after the procedure(P<0.001).Conclusion Although the patients included in Toric-ICL group had higher myopia and astigmatism,Toric-ICL still showed better predictability and efficacy for astigmatic correction in Toric-ICL group.Toric-ICL is an effective and safe equivalent of FS-LASIK for correcting moderate myopia but can be more advantageous for correcting high myopia with astigmatism.展开更多
Diabetic patients often suffer higher orthopedic implant failure rates due to high blood sugar causing inflammation and oxidative stress.While molecular hydrogen(H_(2))shows anti-inflammatory and antioxidant promise,c...Diabetic patients often suffer higher orthopedic implant failure rates due to high blood sugar causing inflammation and oxidative stress.While molecular hydrogen(H_(2))shows anti-inflammatory and antioxidant promise,current delivery methods lack precision for sustained implantsite treatment.A collaborative team led by Prof.展开更多
Background Transcatheter Aortic Valve Implantation(TAVI)has changed the treatment paradigm of the aortic stenosis(AS).It has become the treatment of choice in patients with symptomatic AS and surgical high risk,and a ...Background Transcatheter Aortic Valve Implantation(TAVI)has changed the treatment paradigm of the aortic stenosis(AS).It has become the treatment of choice in patients with symptomatic AS and surgical high risk,and a valid alternative to surgical aortic valve replacement in patients with low and medium surgical risk.Despite numerous evidence on clinical results,indications and benefits,only a few studies analyse it from patient's perspective and the impact of TAVI on them.The objective of this study is to evaluate the experience of patients undergoing TAVI.Methods Cross-sectional,descriptive observational study in two Spanish hospitals,with a establish Nurse TAVI program,with100 patients undergoing TAVI.A specific questionnaire was designed(VALVEX questionnaire)and a pilot study was conducted by a multidisciplinary team of doctors,nurses and patients.The questionnaire was given to patients at 30 days after TAVI procedure during the follow up at the TAVI nurse clinic.Results The study demonstrated a mean satisfaction of 9 for the TAVI program,with 96%of patients that would recommend TAVI to other patients.Patients scored a high satisfaction on the information received prior to the procedure.During the procedure and admission,the satisfaction was high in relation to the care received.During the follow up,satisfaction was high in relation to the role of the TAVI nurse,for the information and continuation of care during the procedure,in reducing anxiety,organising their admission and understanding the process.However,questions with less scores were related to hospital catering,delay between diagnosed and treatment,and patient decision-making process.Conclusion The evaluation of patient experience allows us to improve the information given to the patient during their TAVI process and it can also allow patients to be more relax,aware and prepared for the procedure.Continuous follow up enables monitoring of patient recovery and helps to discuss any doubts improving patient's satisfaction.The use of PREMs and PROMs associated to TAVI pathway combined with an active participation of the patient on the design of the questionnaire is essential for keeping the patient in the centre of the TAVI pathway.展开更多
Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow ...Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.展开更多
The incidence of new-onset cardiac conduction disturbances following transcatheter aortic valve implantation(TAVI)has not decreased compared to other complications,and nowadays is by far the most frequent drawback fol...The incidence of new-onset cardiac conduction disturbances following transcatheter aortic valve implantation(TAVI)has not decreased compared to other complications,and nowadays is by far the most frequent drawback following the procedure.Meanwhile,the global management of TAVI recipients has led to a minimalist approach with short postprocedural length of stay,which may be limited by the occurrence of late arrhythmic events in patients at high-risk.This review focuses on those strategies to overcome the conundrum between early discharge and new-onset conduction disturbances in elderly TAVI candidates and provides a perspective on future improvements in this field.展开更多
Background The number of transcatheter aortic valve implantation(TAVI)procedures in patients with severe aortic stenosis(AS)is increasing worldwide.We aimed to assess the impact of a TAVI program on clinical profile,m...Background The number of transcatheter aortic valve implantation(TAVI)procedures in patients with severe aortic stenosis(AS)is increasing worldwide.We aimed to assess the impact of a TAVI program on clinical profile,management and outcomes of these patients and to describe predictors of length of hospital stay(LoS)in this context.Methods Retrospective single center study enrolling consecutive AS patients undergoing TAVI and surviving to discharge(January 2018-December 2022).A TAVI program was implemented in may 2021.Baseline clinical characteristics,management and in-hospital complications were registered.Predictors of long hospital stay(>7 day)were assessed by binary logistic regression.Results We included 614 patients,with mean age 80.5 years.Most patients(438/614,71.2%)presented conditions that precluded an early discharge.Mean hospital stay was 7.6 days.Patients admitted after the implementation of the program had a significantly lower burden of comorbidities.The rate of conduction disturbances after TAVI remained stable around 60%.However,permanent pacemaker requirement declined from 30.3%to 22.5%(P=0.028).LoS was reduced after the implementation of the program both in patients suitable for an early discharge(from 6.5 day to 4 day,P<0.001)and unsuitable patients(from 9.4 day to 7.7 day,P=0.014).The final predictive model for LoS included prior pacemaker and availability of TAVI program as protectors and other valvular diseases,day of the week,emergent procedures,and conduction disturbances and other complications as independent predictors of long stay after TAVI.Conclusions Most patients undergoing TAVI present conditions that preclude an early hospital discharge.The implementation of a TAVI program improved selection of patients,with a lower burden of comorbidities,a lower rate of complications and a marked reduction of hospital stay.展开更多
Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAV...Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAVI).Their efforts underscore the growing importance of frailty assessment in cardiovascular risk stratification.We would like to respectfully highlight several areas that,if addressed in future studies(Figure 1),could further enhance the utility and inclusivity of these assessments.展开更多
Introduction: Family planning is one of the pillars of the Safe Motherhood Initiative which is aimed at reducing unwanted pregnancy and maternal death. Objective: To evaluate the uptake, efficacy, and safety profile o...Introduction: Family planning is one of the pillars of the Safe Motherhood Initiative which is aimed at reducing unwanted pregnancy and maternal death. Objective: To evaluate the uptake, efficacy, and safety profile of 68 mg etonogestrel subdermal implant in Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Ebonyi State. Materials and Methods: A 5-year retrospective descriptive analysis was carried out on 68 mg etonogestrel subdermal implant uptake among family planning attendees in AEFUTHA. The medical records of the clients that had 68 mg etonogestrel subdermal implant insertion were studied. Socio-demographic characteristics, side effects, discontinuation, and reasons for discontinuation were extracted and analyzed. Analysis was done with SPSS version 20. Data obtained were represented using frequency tables and pie chart. Results: During the study period, 2538 women accepted various methods of contraception, 14.3% (364) of the women used Implanon. The mean age of 68 mg etonogestrel subdermal implant users was 30.7 ± 13.4 years with a range of 20 - 44. Multiparous clients constituted 54.5%. The majority (55.2%) had secondary education as their highest level of education. Less than 20% of the acceptors had side effects, the commonest 24 (42.9%) being prolonged menstrual flow and followed by irregular menstrual flow 18 (32.1%). Discontinuation rate was 17.9%;desire to conceive. 40 (61.5%) was the commonest reason for discontinuation. Only one (0.3%) acceptor reported serious itching at the site of insertion. None of the women reported pregnancy during the period of use (Pearl Index = 0). Conclusion: The acceptance rate of 68 mg etonogestrel subdermal implant among the women is low, however, it is found be effective with good continuation rate in the center. Efforts should be made to increase its uptake so as to prevent unwanted pregnancy and associated sequelae.展开更多
Background Exogenous gonadotropin-controlled ovarian stimulation is the critical step in animal reproductive management,such as pig,sheep,bovine and other species.It helps synchronize ovulation or stimulate multiple o...Background Exogenous gonadotropin-controlled ovarian stimulation is the critical step in animal reproductive management,such as pig,sheep,bovine and other species.It helps synchronize ovulation or stimulate multiple ovu-lations.However,a number of evidence indicated an unexpected decrease in pregnancy outcomes following ovarian stimulation.This study aimed to explore the underlying mechanism of the pregnancy defect and develop a practical rescue strategy.Results Compared with those in the control group,gilts that underwent ovarian stimulation showed a decrease in pregnancy rate,farrowing rate,and total number of piglets born.Stimulated gilts also showed an increase in estra-diol(E_(2))levels.The supraphysiologicalE_(2) level was correlated with the decrease in the number of piglets born.Furthermore,we found that high levels ofE_(2) impair uterine receptivity,as shown by the overproliferation of endo-metrial epithelial cells.In vitro mechanistic studies demonstrated that high levels ofE_(2) hyperactivate FGF-FGFR-ERK signaling cascade in the uterine endometrium,and in turn induces overproliferation of endometrial epithelial cells.Of note,N-acetyl-L-cysteine(NAC)supplementation effectively inhibits ERK hyperphosphorylation and ameliorates endometrial epithelial overproliferation.Importantly,in vivo experiments indicated that dietary NAC supplementa-tion,compared with ovarian stimulation group,improves the uterine receptivity in gilts,and significantly increases the pregnancy rate and total number of piglets born.Conclusions Ovarian stimulation-induced supraphysiological levels ofE_(2) impairs uterine receptivity by hyperactivat-ing FGF-FGFR-ERK signaling cascade,thereby reducing pregnancy rate and litter size.Supplementing NAC to a con-ventional diet for gilts ameliorates hyperactivated ERK signaling and improves uterine receptivity,thus rescuing adverse pregnancy outcomes following ovarian stimulation.展开更多
基金supported by the Fundamental Research Funds for the Central Universities(No.2023QZJH59/226-2023-00155)the National Natural Science Foundation of China(Nos.82370990 and 82201051)+1 种基金the Medical Health Science and Technology Project of Zhejiang Provincial Health Commis-sion(No.WKJ-ZJ-2335)the Innovative Talent of Zhejiang Provincial Health Commission,the Zhejiang“Xinmiao”Tal-ents Program(No.2023R401211),China.
文摘This systematic review and meta-analysis considered the results of randomized controlled clinical trials(RCTs)to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis.Two independent authors screened publications from three electronic databases to include RCTs meeting all the inclusion and exclusion criteria.A meta-analysis was performed to evaluate the weighted mean differences in survival rate(SR)and changes in pocket probing depth(PPD),bone level(BL),and clinical attachment level(CAL).The study cohorts were defined as antibiotic and control groups with subgroups for analysis.Seven studies including 309 patients(390 implants)were considered.Within the limitations of this review,patients in the antibiotic groups exhibited significant improvements in PPD.Subgroup analysis indicated that the administration of systemic antibiotics or the use of antibiotics in non-surgical treatments did not result in a significant alteration in BL.It was established that the addition of antibiotics can ameliorate PPD and SR in the treatment of peri-implantitis,whether through surgical or non-surgical approaches,and also shows moderate performance regarding BL and CAL.Considering the lack of application of new technologies in the control group and the hardship of assessing the potential risks of antibiotics,careful clinical judgment is still necessary.
基金supported by the National Key Research and Development Program of China(2023YFC2412600)the National Natural Science Foundation of China(52271243,52171233,82370924,82170929)+3 种基金the Beijing Natural Science Foundation(L212014)the Beijing Nova Program(20230484459)the National Clinical Key Discipline Construction Project(PKUSSNKP-T202103)the Research Foundation of Peking University School and Hospital of Stomatology(PKSS20230104).
文摘Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption,ultimately resulting in implant failure.Dental implants for clinical use barely have antibacterial properties,and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis.Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque.However,it is particularly important to prevent the occurrence of peri-implantitis rather than treatment.Therefore,the current research spot has focused on improving the antibacterial properties of dental implants,such as the construction of specific micro-nano surface texture,the introduction of diverse functional coatings,or the application of materials with intrinsic antibacterial properties.The aforementioned antibacterial surfaces can be incorporated with bioactive molecules,metallic nanoparticles,or other functional components to further enhance the osteogenic properties and accelerate the healing process.In this review,we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration.Furthermore,we summarized the obstacles existing in the process of laboratory research to reach the clinic products,and propose corresponding directions for future developments and research perspectives,so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy,biological safety,and osteogenic property.
文摘Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus(S.aureus),Escherichia coli(E.coli),Candida albicans(C.albicans)and clinical strains of S.aureus,Klebsiella pneumonia(K.pneumonia)and Candida parapsilosis(C.parapsilosis)by disk diffusion test.Minimum inhibitory concentrations(MIC)and minimum cidal concentrations(MCC)were determined using modified agar dilution millpore method.The extract was further combined with polyethylene glycol and propylene glycol,and was tested for antimicrobial effects.Results:Grape seed extract showed positive inhibitory effects with S.aureus at MIC of 0.625 mg/mL and MCC of1.25 mg/mL respectively.However the extracts showed minimal or no reactivity against strains of E.coli,K.pneumonia,C.parapsilosis and C.albicans.The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S.aureus.Conclusions:The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skinabutment interface of craniofacial implants.
文摘Subperiosteal implants are generally used in the severely resorbed areas, and although dwindling in use, they have shown to be successful treatment options for the edentulous dental patients. We report a case of maxillary subperiosteal implantitis that caused sinusitis. A 59-year-old man was referred to our clinic in March 2003 with a chief complaint of pain and swelling in the bilateral upper molar region. He received a surgical operation for maxillary subperiosteal implant at another dental clinic in April 2001. CT scans demonstrated that the radiopacity of the right maxillary sinus extended to the ethmoid and frontal sinuses. Extensive surgical debridement was performed. The radiopacity of the right maxillary sinus in CT almost disappeared in a month. Two months later, the occlusal function was recovered using a new maxillary complete denture. The patient has had no symptoms and no occlusal disturbance by the denture for more than nine years.
文摘Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.
基金supported by National Institutes of Health R03DE027492 to Shareef Dabdoubsupported by National Institutes of Health,project number 7R01DE027857-06supported by National Institutes of Health R56DE033913 awarded to Purnima Kumar.
文摘Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability to prevent and treat peri-implantitis is hampered by a paucity of knowledge of how these biomes are acquired and the factors that engender normobiosis.Therefore,we combined a 3-month interventional study of 15 systemically and periodontally healthy adults with whole genome sequencing,finescale enumeration and graph theoretics to interrogate colonization dynamics in the pristine peri-implant sulcus.We discovered that colonization trajectories of implants differ substantially from adjoining teeth in acquisition of new members and development of functional synergies.Source-tracking algorithms revealed that this niche is initially seeded by bacteria trapped within the coverscrew chamber during implant placement.These pioneer species stably colonize the microbiome and exert a sustained influence on the ecosystem by serving as anchors of influential hubs and by providing functions that enable cell replication and biofilm maturation.Unlike the periodontal microbiome,recruitment of new members to the peri-implant community occurs on nepotistic principles.Maturation is accompanied by a progressive increase in anaerobiosis,however,the predominant functionalities are oxygen-dependent over the 12-weeks.The peri-implant community is easily perturbed following crown placement,but demonstrates remarkable resilience;returning to pre-perturbation states within three weeks.This study highlights important differences in the development of the periodontal and peri-implant ecosystems,and signposts the importance of placing implants in periodontally healthy individuals or following the successful resolution of periodontal disease.
基金supported by the National Key R&D Plan of China(Grant No.2023YFB3210400)the National Natural Science Foundation of China(No.62174101)+2 种基金the Major Scientific and Technological Innovation Project of Shandong Province(2021CXGC010603)the Fundamental Research Funds of Shandong University(2020QNQT001)Collaborative Innovation Center of Technology and Equipment for Biological Diagnosis and Therapy in Universities of Shandong,Collaborative Innovation Center of Technology and Equipment for Biological Diagnosis and Therapy in Universities of Shandong,the Natural Science Foundation of Qingdao-Original exploration project(No.24-4-4-zrjj-139-jch).
文摘Flexible electronics are transforming our lives by making daily activities more convenient.Central to this innovation are field-effect transistors(FETs),valued for their efficient signal processing,nanoscale fabrication,low-power consumption,fast response times,and versatility.Graphene,known for its exceptional mechanical properties,high electron mobility,and biocompatibility,is an ideal material for FET channels and sensors.The combination of graphene and FETs has given rise to flexible graphene field-effect transistors(FGFETs),driving significant advances in flexible electronics and sparked a strong interest in flexible biomedical sensors.Here,we first provide a brief overview of the basic structure,operating mechanism,and evaluation parameters of FGFETs,and delve into their material selection and patterning techniques.The ability of FGFETs to sense strains and biomolecular charges opens up diverse application possibilities.We specifically analyze the latest strategies for integrating FGFETs into wearable and implantable flexible biomedical sensors,focusing on the key aspects of constructing high-quality flexible biomedical sensors.Finally,we discuss the current challenges and prospects of FGFETs and their applications in biomedical sensors.This review will provide valuable insights and inspiration for ongoing research to improve the quality of FGFETs and broaden their application prospects in flexible biomedical sensing.
文摘Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.
基金supported by National Natural Science Foundation of China(52271117)Educational Commission of Hunan Province of China(23A0107)High Technology Research and Development Program of Hunan Province of China(2022GK4038).
文摘To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elastic modulus(EM),degradation rate and in vitro cell experiments of the modified WE43 alloys were systematically studied.A modified layer composed of Mg,MgO,the implanted elements and their oxides was formed on the modified alloys.Since high-speed metal ions caused severe surface lattice damage,the surface hardness of the substrate considerable increased.Electrochemical tests demonstrated a substantial enhancement in the corrosion resistance of the modified alloys via the implantation of Ti and Zr ions,resulting in a reduction of the corrosion current density to 88.1±9.9 and 15.6±11.4μA cm^(−2),respectively,compared with the implantation of Fe and Zn ions.Biocompatibility tests showed that the implantation of Fe,Ti,Zn and Zr ions enhanced the anticoagulant and hemolytic resistance of the WE43 alloy.All surface-modified samples showed negligible cytotoxicity(0-1)at 12.5%extract concentration.Moreover,the alloys implanted with Fe,Ti and Zn ions significantly promoted proliferation of human umbilical vein endothelial cells(HUVEC)compared with the unmodified alloy.The results demonstrate that Ti ion implantation is the best choice for WE43 alloy modification to achieve outstanding corrosion resistance and biocompatibility.
基金supported by the China Agriculture Research System(CARS-35-PIG)the National Natural Science Foundation of China(32272847,U22A20516)+1 种基金the National Key Research and Development Program of China(No.2021YFF1000602)the Key Research and Development Program of Shaanxi Province(No.2022ZDLNY01–04)。
文摘Background Increased backfat thickness of sows in early gestation is negative to reproductive performance.Endometrial receptivity is an important determinant of reproductive success,but it is unclear whether the effect of sow backfat thickness on litter size is associated with endometrial receptivity and whether melatonin treatment may have benefits.The present study seeks to answer these questions through in vitro and in vivo investigations.Results Excessive lipid deposition and lower melatonin levels in the uterus are detrimental to endometrial receptivity and embryo implantation in high backfat thickness sows.In cells treated with melatonin,the MT2/PI3K/LIF axis played a role in reducing lipid accumulation in porcine endometrial epithelium cells and improved endometrial receptivity.Furthermore,we found a reduction of lipids in the uterus after eight weeks of intraperitoneal administration of melatonin to HFD mice.Notably,melatonin treatment caused a significant reduction in the deposition of endometrial collagen,an increase in the number of glands,and repair of the pinopode structure,ultimately improving endometrial receptivity,promoting embryo implantation,and increasing the number of litter size of mice.Conclusions Collectively,the finding reveals the harmful effects of high backfat thickness sows on embryo implantation and highlight the role of melatonin and the MT2/PI3K/LIF axis in improving endometrial receptivity by enhancing metabolism and reducing the levels of uterine lipids in obese animals.
基金National Natural Science Foundation of China(52171114)。
文摘Infections associated with titanium(Ti)-based implants present significant challenges in clinical treatments,especially when biofilms already form on the implant surface.Many antimicrobial agents,including antibiotics,metallic nanoparticles and antimicrobial peptides,have been extensively used to deal with Ti implant infections.However,these chemical approaches suffer from potential toxicity,antibiotic resistance and poor long-term antibacterial performance.Hence,physical antibacterial surfaces on Ti-based implants have attracted increasing attention.The antibacterial behavior of different surfaces on Ti-based biomaterials against various bacteria only by physical properties of the implants themselves(e.g.,nanotopography)or exogenous physical stimulus(e.g.,photocatalysis)was reviewed,as well as parameters influencing the physical antibacterial processes,such as size,shape and density of the surface nanotextures,and bacterial growth phases.Besides,mechanisms of different fabrication techniques for the physical antibacterial surfaces on Ti-based biomaterials were also summarized.
文摘Objective To compare the efficacy of toric implantable collamer lens(Toric-ICL)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK)for myopia correction in patients with moderate to high myopia complicated with astigmatism.Methods We retrospectively collected data from 64 patients(aged 18-42 years)with moderate to high myopia complicated with astigmatism(128 eyes)undergoing either Toric-ICL(28 patients/56 eyes)or FS-LASIK(36 patients/72 eyes)at our department between January,2019 and December,2020.The changes of uncorrected distance visual acuity(UCVA),spherical equivalent(SE),mean astigmatism correction index(CI),corneal endothelial cell density(ECD)and intraocular pressure(IOP)following the procedures were compared between the two groups.Results In FS-LASIK group,all the eyes(72/72)achieved an UCVA≥1.0,similar to the rate in Toric-ICL group(55/56 eyes;P=0.2374).The postoperative SE was also comparable between FS-LASIK and Toric-ICL groups[0.43±0.06 D(range:-1.0 to 1.50 D)vs 0.38±0.05 D(range:-0.75 to 1.00 D);P=0.56].The mean astigmatism CI was significantly higher in FS-LASIK group than in Toric-ICL group(0.8561 vs 0.7176;P<0.0001),and 88.89%of the eyes in FS-LASIK group and 69.64%in Toric-ICL group had postoperative astigmatism≤0.50 D.No significant changes were observed in postoperative corneal ECD in FS-LASIK group,whereas ECD decreased significantly after the procedure in Toric-ICL group(P=0.0057).The patients undergoing Toric-ICL exhibited no significant changes of postoperative IOP,but the patients receiving FS-LASIK had significantly reduced IOP after the procedure(P<0.001).Conclusion Although the patients included in Toric-ICL group had higher myopia and astigmatism,Toric-ICL still showed better predictability and efficacy for astigmatic correction in Toric-ICL group.Toric-ICL is an effective and safe equivalent of FS-LASIK for correcting moderate myopia but can be more advantageous for correcting high myopia with astigmatism.
文摘Diabetic patients often suffer higher orthopedic implant failure rates due to high blood sugar causing inflammation and oxidative stress.While molecular hydrogen(H_(2))shows anti-inflammatory and antioxidant promise,current delivery methods lack precision for sustained implantsite treatment.A collaborative team led by Prof.
基金funded by a IBYE23_0002 grant supported by Instituto de investigación biom-édica de Salamanca IBSAL,Castilla y León (Spain) and by a GRS 2860/A1/2023 by Gerencia Regional de Salud o f Castilla y León (Spain)。
文摘Background Transcatheter Aortic Valve Implantation(TAVI)has changed the treatment paradigm of the aortic stenosis(AS).It has become the treatment of choice in patients with symptomatic AS and surgical high risk,and a valid alternative to surgical aortic valve replacement in patients with low and medium surgical risk.Despite numerous evidence on clinical results,indications and benefits,only a few studies analyse it from patient's perspective and the impact of TAVI on them.The objective of this study is to evaluate the experience of patients undergoing TAVI.Methods Cross-sectional,descriptive observational study in two Spanish hospitals,with a establish Nurse TAVI program,with100 patients undergoing TAVI.A specific questionnaire was designed(VALVEX questionnaire)and a pilot study was conducted by a multidisciplinary team of doctors,nurses and patients.The questionnaire was given to patients at 30 days after TAVI procedure during the follow up at the TAVI nurse clinic.Results The study demonstrated a mean satisfaction of 9 for the TAVI program,with 96%of patients that would recommend TAVI to other patients.Patients scored a high satisfaction on the information received prior to the procedure.During the procedure and admission,the satisfaction was high in relation to the care received.During the follow up,satisfaction was high in relation to the role of the TAVI nurse,for the information and continuation of care during the procedure,in reducing anxiety,organising their admission and understanding the process.However,questions with less scores were related to hospital catering,delay between diagnosed and treatment,and patient decision-making process.Conclusion The evaluation of patient experience allows us to improve the information given to the patient during their TAVI process and it can also allow patients to be more relax,aware and prepared for the procedure.Continuous follow up enables monitoring of patient recovery and helps to discuss any doubts improving patient's satisfaction.The use of PREMs and PROMs associated to TAVI pathway combined with an active participation of the patient on the design of the questionnaire is essential for keeping the patient in the centre of the TAVI pathway.
基金Supported by the National Key Research and Development Program(No.2019YFC1710200)the Shandong Province Pharmaceutical Technology Development Project(No.202107020970).
文摘Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.
文摘The incidence of new-onset cardiac conduction disturbances following transcatheter aortic valve implantation(TAVI)has not decreased compared to other complications,and nowadays is by far the most frequent drawback following the procedure.Meanwhile,the global management of TAVI recipients has led to a minimalist approach with short postprocedural length of stay,which may be limited by the occurrence of late arrhythmic events in patients at high-risk.This review focuses on those strategies to overcome the conundrum between early discharge and new-onset conduction disturbances in elderly TAVI candidates and provides a perspective on future improvements in this field.
文摘Background The number of transcatheter aortic valve implantation(TAVI)procedures in patients with severe aortic stenosis(AS)is increasing worldwide.We aimed to assess the impact of a TAVI program on clinical profile,management and outcomes of these patients and to describe predictors of length of hospital stay(LoS)in this context.Methods Retrospective single center study enrolling consecutive AS patients undergoing TAVI and surviving to discharge(January 2018-December 2022).A TAVI program was implemented in may 2021.Baseline clinical characteristics,management and in-hospital complications were registered.Predictors of long hospital stay(>7 day)were assessed by binary logistic regression.Results We included 614 patients,with mean age 80.5 years.Most patients(438/614,71.2%)presented conditions that precluded an early discharge.Mean hospital stay was 7.6 days.Patients admitted after the implementation of the program had a significantly lower burden of comorbidities.The rate of conduction disturbances after TAVI remained stable around 60%.However,permanent pacemaker requirement declined from 30.3%to 22.5%(P=0.028).LoS was reduced after the implementation of the program both in patients suitable for an early discharge(from 6.5 day to 4 day,P<0.001)and unsuitable patients(from 9.4 day to 7.7 day,P=0.014).The final predictive model for LoS included prior pacemaker and availability of TAVI program as protectors and other valvular diseases,day of the week,emergent procedures,and conduction disturbances and other complications as independent predictors of long stay after TAVI.Conclusions Most patients undergoing TAVI present conditions that preclude an early hospital discharge.The implementation of a TAVI program improved selection of patients,with a lower burden of comorbidities,a lower rate of complications and a marked reduction of hospital stay.
文摘Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAVI).Their efforts underscore the growing importance of frailty assessment in cardiovascular risk stratification.We would like to respectfully highlight several areas that,if addressed in future studies(Figure 1),could further enhance the utility and inclusivity of these assessments.
文摘Introduction: Family planning is one of the pillars of the Safe Motherhood Initiative which is aimed at reducing unwanted pregnancy and maternal death. Objective: To evaluate the uptake, efficacy, and safety profile of 68 mg etonogestrel subdermal implant in Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Ebonyi State. Materials and Methods: A 5-year retrospective descriptive analysis was carried out on 68 mg etonogestrel subdermal implant uptake among family planning attendees in AEFUTHA. The medical records of the clients that had 68 mg etonogestrel subdermal implant insertion were studied. Socio-demographic characteristics, side effects, discontinuation, and reasons for discontinuation were extracted and analyzed. Analysis was done with SPSS version 20. Data obtained were represented using frequency tables and pie chart. Results: During the study period, 2538 women accepted various methods of contraception, 14.3% (364) of the women used Implanon. The mean age of 68 mg etonogestrel subdermal implant users was 30.7 ± 13.4 years with a range of 20 - 44. Multiparous clients constituted 54.5%. The majority (55.2%) had secondary education as their highest level of education. Less than 20% of the acceptors had side effects, the commonest 24 (42.9%) being prolonged menstrual flow and followed by irregular menstrual flow 18 (32.1%). Discontinuation rate was 17.9%;desire to conceive. 40 (61.5%) was the commonest reason for discontinuation. Only one (0.3%) acceptor reported serious itching at the site of insertion. None of the women reported pregnancy during the period of use (Pearl Index = 0). Conclusion: The acceptance rate of 68 mg etonogestrel subdermal implant among the women is low, however, it is found be effective with good continuation rate in the center. Efforts should be made to increase its uptake so as to prevent unwanted pregnancy and associated sequelae.
基金National Natural Science Foundation of China(31930103)National Center of Technology Innovation for Pigs(NCTIP-XD/B03)+2 种基金Ningbo Major Science and Technology Project(2021Z112)National Key R&D Program(2022YFD1300303)Beijing Innovation Consortium of Livestock Research System BAIC05-2024.
文摘Background Exogenous gonadotropin-controlled ovarian stimulation is the critical step in animal reproductive management,such as pig,sheep,bovine and other species.It helps synchronize ovulation or stimulate multiple ovu-lations.However,a number of evidence indicated an unexpected decrease in pregnancy outcomes following ovarian stimulation.This study aimed to explore the underlying mechanism of the pregnancy defect and develop a practical rescue strategy.Results Compared with those in the control group,gilts that underwent ovarian stimulation showed a decrease in pregnancy rate,farrowing rate,and total number of piglets born.Stimulated gilts also showed an increase in estra-diol(E_(2))levels.The supraphysiologicalE_(2) level was correlated with the decrease in the number of piglets born.Furthermore,we found that high levels ofE_(2) impair uterine receptivity,as shown by the overproliferation of endo-metrial epithelial cells.In vitro mechanistic studies demonstrated that high levels ofE_(2) hyperactivate FGF-FGFR-ERK signaling cascade in the uterine endometrium,and in turn induces overproliferation of endometrial epithelial cells.Of note,N-acetyl-L-cysteine(NAC)supplementation effectively inhibits ERK hyperphosphorylation and ameliorates endometrial epithelial overproliferation.Importantly,in vivo experiments indicated that dietary NAC supplementa-tion,compared with ovarian stimulation group,improves the uterine receptivity in gilts,and significantly increases the pregnancy rate and total number of piglets born.Conclusions Ovarian stimulation-induced supraphysiological levels ofE_(2) impairs uterine receptivity by hyperactivat-ing FGF-FGFR-ERK signaling cascade,thereby reducing pregnancy rate and litter size.Supplementing NAC to a con-ventional diet for gilts ameliorates hyperactivated ERK signaling and improves uterine receptivity,thus rescuing adverse pregnancy outcomes following ovarian stimulation.
