Josephmorris4850

he complete dentures had no significant influence on OHRQoL. However, digital dentures needed only 2 visits, 1 hour less chair time, and 5 hours less time for the dental laboratory technicians.

From the perspective of the participants, the fabrication method of the complete dentures had no significant influence on OHRQoL. However, digital dentures needed only 2 visits, 1 hour less chair time, and 5 hours less time for the dental laboratory technicians.

Medium- to long-term data for the performance of zirconia crowns with titanium (Ti) bases are sparse, particularly when the crown height space and occlusal loads are high.

The purpose of this invitro study was to assess the effect of the height of zirconia screw-retained implant crowns with a Ti base on the screw joint stability after cyclic loading. A secondary aim was to investigate the survival of zirconia crowns of different heights after cyclic loading.

Twenty-one internal connection implants were secured between fiberglass-reinforced epoxy resin sleeves. Mandibular first molar monolithic zirconia crowns with 3 different heights (6 mm, 10 mm, and 14 mm) were milled and bonded to the Ti bases (n=7). The screws were tightened to 30 Ncm, and a 30-degree 120-N cyclic load was applied to the crowns at 2 Hz for 5 million cycles. After 5 million cycles, the crowns were evaluated for stability, and the same protocol was repeated for 275-N and 435-N loads for 5 million cycles each. After loading, the detorq the tested internal connection implant was used, the crown height did not affect the detorque values, and 14-mm crowns performed similarly to the shorter crowns in terms of torque loss after cyclic loading. However, survival of the 14-mm crown-implant complex was lower, resulting in screw and implant fractures.

When the tested internal connection implant was used, the crown height did not affect the detorque values, and 14-mm crowns performed similarly to the shorter crowns in terms of torque loss after cyclic loading. However, survival of the 14-mm crown-implant complex was lower, resulting in screw and implant fractures.

Although the clinical use of self-adhesive flowable composite resins is convenient, the decision to use flowable or conventional composite resin remains controversial.

The purpose of this systematic review and meta-analysis was to assess the invitro bond strength of self-adhesive flowable composite resins to enamel or dentin compared with conventional composite resins using etch-and-rinse or self-etch adhesive systems.

Two independent reviewers performed searches in the PubMed (MEDLINE), Cochrane Wiley, Web of Science, Scopus, and Google Scholar databases for studies reporting on the bond strength of self-adhesive flowable and conventional composite resins to enamel and dentin published from January 2010 up to September 2020. A meta-analysis software program was used for the meta-analysis. Comparisons were conducted using standardized mean differences considering the random-effects model (α=.05).

Twenty-two studies were considered for the meta-analysis. Immediate and long-term bond strength to enamel was improved when a conventional composite resin was used in combination with an adhesive system (P<.001). Bond strength to dentin was improved by using an adhesive system in combination with a conventional composite resin (P<.001).

The bond strength of self-adhesive flowable composite resins is lower than that of conventional composite resins, indicating limited ability to bond to enamel and dentin.

The bond strength of self-adhesive flowable composite resins is lower than that of conventional composite resins, indicating limited ability to bond to enamel and dentin.Coastal systems are highly productive areas for primary productivity and ecosystem services and host a large number of human activities. Since industrialization, metal micronutrients in these regions have increased. Phytoplankton use metals as micronutrients in metabolic processes, but in excess, had deleterious effects. In coastal systems, picoeukaryotes represent a diverse and abundant group with widespread distribution and fundamental roles in biogeochemical cycling. We combined different approaches to explore picoeukaryotes seasonal variability in a chronically metal polluted coastal area at the south-eastern Pacific Ocean. Through remote and field measurements to monitor environmental conditions and 18S rRNA gene sequencing for taxonomic profiling, we determined metal chronic effect on picoeukaryote community's structure. Our results revealed a stable richness and a variable distribution of the relative abundance, despite the physicochemical seasonal variations. These results suggest that chronic metal contamination influences temporal heterogeneity of picoeukaryote communities, with a decoupling between abiotic and biotic patterns.

To report long-term outcomes after deep hypothermic circulatory arrest (DHCA) with or without perioperative blood or blood products.

All patients who underwent proximal aortic surgery with DHCA from 2011 to 2018 were propensity matched according to baseline characteristics. Primary outcomes included short- and long-term mortality. SBI0206965 Stratified Cox regression analysis was performed for significant associations with survival.

A total of 824 patients underwent aortic replacement requiring circulatory arrest. After matching, there were 224 patients in each arm (transfusion and no transfusion). All baseline characteristics were well matched, with a standardized mean difference (SMD)<0.1. Preoperative hematocrit (41.0 vs 40.6; SMD=0.05) and ejection fraction (57.5% vs 57.0%; SMD=0.08) were similar between the no transfusion and blood product transfusion cohorts. Rate of aortic dissection (42.9% vs 45.1%; SMD=0.05), hemiarch replacement (70.1% vs 70.1%; SMD=0.00), and total arch replacement (21.9% vs 23.2%; SMD=0.03) were not statistically different. Cardiopulmonary bypass and cross-clamp time were higher in the blood product transfusion cohort (P<.001). Operative mortality (9.4% vs 2.7%; P=.003), stroke (7.6% vs 1.3%; P=.001), reoperation rate, pneumonia, prolonged ventilation, and dialysis requirements were significantly higher in the transfusion cohort (P<.001). In stratified Cox regression, transfusion was an independent predictor of mortality (hazard ratio, 2.62 [confidence interval, 1.47-4.67]; P=.001). One- and 5-year survival were significantly reduced for the transfusion cohort (P<.001).

In patients who underwent aortic surgery with DHCA, perioperative transfusions were associated with poor outcomes despite matching for preoperative baseline characteristics.

In patients who underwent aortic surgery with DHCA, perioperative transfusions were associated with poor outcomes despite matching for preoperative baseline characteristics.

To determine whether the homeless population experiences disparities in care and communication during inpatient hospitalizations in a safety-net hospital.

We administered a modified Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to 112 age-sex- and education matched homeless and non-homeless adults at a university-affiliated-safety-net hospital from December 2017 through March 2018 and performed a retrospective review of medical records. Linear regression models were used to assess differences in responses to survey subscales, length of stay and other measures.

Homeless participants trended toward poorer ratings for all HCAHPS subscales, reaching significance for the Communication about Medications subscale, with a mean score 1.2 (95% CI 0.48-1.76) points lower compared to non-homeless sample. Length of stay was not significantly different between homeless and non-homeless participants.

In an urban safety-net hospital, disparities in communications regarding medications between hospital staff and patients were found based on housing status.

In an urban safety-net hospital, disparities in communications regarding medications between hospital staff and patients were found based on housing status.Mortality due to cardiovascular disease in pregnancy is a growing problem in developed countries, being nowadays the leading cause of maternal death. Within this group, the most common cause of death are congenital or acquired heart diseases, representing a challenge in the management of these patients, since the pregnancy-related physiological alterations can impair their basal condition and treatment. We present the case of a 34-year-old patient, without any relevant pathological antecedents, who developed a second-degree atrioventricular block, Mobitz type I, following the administration of methylergometrine during cesarean section due to failure to progress in labour. We emphasize the importance of considering the side effects of commonly used drugs in pregnant patients, despite rare possibility of some adverse reactions.

The purpose of this study was to assess variability in age at Kasai portoenterostomy (KP) in infants with biliary atresia (BA) across children's hospitals in the United States.

A multi-institutional retrospective study was performed examining infants with BA undergoing KP within 6 months of birth from 2016-2019, utilizing the Pediatric Health Information System (PHIS). Multivariable negative binomial mixed effects regression was performed for age at KP, and inter-hospital variability was examined.

Across 46 hospitals, 470 infants with BA underwent KP at a median age of 57 days (IQR 42-72), with 212 (45.1%) undergoing KP at ≥60 days of age. There was significant inter-hospital variability in age at KP ranging from 38 days (95% CI 31d, 47d) to 76 days (95% CI 63d, 91d) (p<0.0001). Factors associated with later KP were black or African-American race, urgent/emergent admission, and treatment at a hospital in the Pacific-West region. Predictors of earlier KP included later year, history of neonatal comorbidity, and admission to an intensive care service (all p<0.05).

There is significant variability in the age at KP in infants with BA across children's hospitals in the United States.

Retrospective study.

III.

III.

A retrospective chart review of liver histologies in Kasai biliary atresia BA patients operated 1/2017- 7/2019 at our institution was conducted to identify histologic prognostic factors for biliary outcome.

Patients with wedge liver biopsies and portal plate biopsies (n=85) were categorized into unfavorable and favorable outcome, based on a 3-month serum total bilirubin level of <34μM or mortality. Hepatocellular histologies, presence of ductal plate malformation (DPM) and of large bile duct of ≥ 150μm diameter size at the portal plate were evaluated.

Total Bilirubin levels> 34μM correlates with worse 1-year survival. Age at surgery, histologic fibrosis or inflammation does not predict outcome. Potential adverse predictors are severe hepatocellular swelling, severe cholestasis, presence of DPM (n=24), and portal plate bile duct size < 150µm (n=28). In multivariate analyses adjusting for age at Kasai and postop cholangitis, bile duct size and severe hepatocellular swelling remain independent histologic prognosticators (OR 3.25, p=0.039 and OR 3.26, p=0.006 respectively), but not DPM.

Advanced histologic findings of portal plate bile duct size of <150µm and severe hepatocellular damage predict poor post-Kasai jaundice clearance and short-term survival outcome, irrespective of Kasai timing.

Level III.

Level III.