Implant-Abutment Connections and Their Effect on Implant Survival Rates and Changes in Marginal Bone Levels (Δ): A Systematic Review and Meta-Analysis of 45,347 Oral Implants.

Purpose: To quantify the cumulative oral implant survival rates and changes in radiographic bone levels based on the configuration of the implant-abutment connection type over time. Materials and Methods: An electronic literature search was conducted in four databases (PubMed/MEDLINE, Cochrane Library, Web of Science, and Embase), and records were refereed by two independent reviewers based on the inclusion criteria. Data from included articles were grouped by implant-abutment connection type into four categories ([1] external hex; [2] bone level, internal, narrow cone < 45 degrees; [3] bone level, internal wide cone ≥ 45 degrees or flat; and [4] tissue level) and duration of follow-up (short-term 1 to 2 years, mid-term 2 to 5 years, and long-term > 5 years). Meta-analyses were performed for cumulative survival rate (CSR) and changes in marginal bone level (ΔMBL) from baseline (loading) to last reported follow-up. Studies were split or merged as appropriate based on the implants and follow-up duration in the study and trial design. The study was compiled under PRISMA 2020 guidelines and registered in the PROSPERO database. Results: A total of 3,082 articles were screened. Full-text review of 465 articles resulted in a total of 270 articles (representing 16,448 subjects with 45,347 implants) included for quantitative synthesis and analysis. Mean ΔMBL (95% CI) was as follows: short-term external hex = 0.68 mm (0.57, 0.79); short-term bone level, internal, narrow cone < 45 degrees = 0.34 mm (0.25, 0.43); short-term bone level, internal wide cone ≥ 45 degrees = 0.63 mm (0.52, 0.74); short-term tissue level = 0.42 mm (0.27, 0.56); mid-term external hex = 1.03 mm (0.72, 1.34); mid-term bone level, internal, narrow cone < 45 degrees = 0.45 mm (0.34, 0.56); mid-term bone level, internal wide cone ≥ 45 degrees = 0.73 mm (0.58, 0.88); mid-term tissue level = 0.4 mm (0.21, 0.61); long-term external hex = 0.98 mm, 0.70, 1.25); long-term bone level, internal, narrow cone < 45 degrees = 0.44 mm (0.31, 0.57); long-term bone level, internal wide cone ≥ 45 degrees = 0.95 mm (0.68, 1.22); and long-term tissue level = 0.43 mm (0.24, 0.61). CSRs (95% CI) were: short-term external hex = 97% (96%, 98%); short-term bone level, internal, narrow cone < 45 degrees = 99% (99%, 99%); short-term bone level, internal wide cone ≥ 45 degrees = 98% (98%, 99%); short-term tissue level = 99% (98%, 100%); mid-term external hex = 97% (96%, 98%); mid-term bone level, internal, narrow cone < 45 degrees = 98% (98%, 99%); mid-term bone level, internal wide cone ≥ 45 degrees = 99% (98%, 99%); mid-term tissue level = 98% (97%, 99%); long-term external hex = 96% (95%, 98%); long-term bone level, internal, narrow cone < 45 degrees = 98% (98%, 99%); long-term bone level, internal wide cone ≥ 45 degrees = 99% (98%, 100%); and long-term tissue level = 99% (98%, 100%). Conclusion: The configuration of the implant-abutment interface has a measurable effect on the ΔMBL over time. These changes can be observed over a period of at least 3 to 5 years. At all measured time intervals, similar ΔMBL was noted for external hex and internal wide cone ≥ 45-degree connections, as were internal, narrow cone < 45-degree and tissue-level connections.

Integration of visual context in early and late bilingual language processing: evidence from eye-tracking.

Previous research on the processing of language embedded in a rich visual context has revealed the strong effect that a recently viewed action event has on language comprehension. It has been shown that listeners are more likely to view the target object of a recently performed event than look at the target object of a plausible future event during sentence utterance, regardless of the tense cue. In the current visual-world eye-tracking experiments, we tested the strength of the recently observed visual context with a group of English monolingual and two groups of English-French early and late bilingual speakers. By comparing these different groups, we examined whether bilingual speakers, as a consequence of greater cognitive flexibility when integrating visual context and language information, show early anticipatory eye-movements toward the target object. We further asked whether early and late bilinguals show differences in their processing. The findings of the three eye-tracking experiments revealed an overall preference for the recently seen event. However, as a result of the early provision of tense cue, this preference was quickly diminished in all three groups. Moreover, the bilingual groups showed an earlier decrease in reliance on the recently seen event compared to monolingual speakers and the early bilinguals showed anticipatory eye-movements toward the plausible future event target. Furthermore, a post-experimental memory test revealed that the bilingual groups recalled the future events marginally better than the recent events, whereas the reverse was found in the monolingual groups.

Promise, Provision, and Potential: A Hopeful Trajectory for Spiritual Care in Long-Term Care.

This Canadian study aimed to better understand the provision of spiritual care in long-term care homes, its purpose/importance, the role of a spiritual care provider (SCP)/chaplain, effective practices, and challenges. Online survey responses revealed the need for spiritual care and the robust role of SCPs. Recommendations are made for more consistent employ and integration of SCPs, supported by sector-specific training and a system to connect LTC homes with skilled SCPs.

Spiritual Care in Ontario Long-Term Care: Current Staffing Realities and Recommendations.

How are spiritual needs addressed in long-term care? This quantitative study explored the level of spiritual care offered and qualifications of spiritual care providers in 177 LTC homes in Ontario. Data showed 49% of homes employ Spiritual Care Providers (SCPs), with more positions in urban and not-for-profit homes. Findings revealed SCPs bring a substantial skill set, attending to needs of residents, families and team members. More consistent staffing for spiritual care provision across the sector is recommended.

Outcome trends post discharge from inpatient rehabilitation to the community.

PURPOSE: This study provides evidence of the outcome trends following inpatient rehabilitation services. METHODS: The methodology of this study design uses descriptive statistical analysis, paired t-tests, and analysis of variance (ANOVA) to examine multiple variables. This quantitative, non-experimental study describes the research population and the data collection instrument, the inpatient rehabilitation facility patient assessment instrument (IRF PAI), including the Functional Independence Measure (FIM). FINDINGS: Identified trends provide evidence that functional gains of the disabled population were maintained post discharge from an inpatient rehabilitation facility. Demographics, medical information, and discharge information were studied to describe relationships between the discharge information (discharge living setting, discharge with home health services, discharge to the person living with) and maintained functional performance. CONCLUSIONS: This evidence provides essential information for healthcare providers, including nurses, policy makers, and governments regarding functional gains following inpatient rehabilitation, and community discharge trends of people receiving inpatient rehabilitation services. CLINICAL RELEVANCE: The evidence in this study supports that inpatient rehabilitation services should be provided to all persons with disabilities to increase functioning to the greatest level of independence possible. Further evidence-based knowledge regarding the proposed 75% Rule of the Prospective Payment System (PPS) is needed and required, affecting the access and delivery of rehabilitation services. All patients have a right to quality, cost-effective care without restrictions to certain populations to encourage return to community dwelling.

Survey of oral health-related quality of life among skeletal malocclusion patients following orthodontic treatment and orthognathic surgery.

OBJECTIVES: The goal of this work was to conduct a survey of oral health-related quality of life (OHRQoL) among skeletal malocclusion patients who had undergone orthodontic treatment combined with orthognathic surgery. PATIENTS AND METHODS: The study included 28 patients who had undergone orthodontic therapy combined with orthognathic surgery (surgical repositioning osteotomy) to treat skeletal malocclusion. OHRQoL was assessed based on a 14-item German version of the Oral Health Impact Profile (OHIP-G14) and an additional questionnaire developed by the authors to evaluate aspects of quality of life specific to skeletal malocclusion patients. RESULTS: The mean OHIP-G14 score demonstrates that the malocclusion patients have a lower OHRQoL than the general population. The information collected via our skeletal malocclusion questionnaire correlates with the patients' perceived esthetic and functional outcomes of treatment as well as their psychological state and social interactions. Satisfaction with treatment outcomes and improved social interactions correlated with high OHRQoL scores. High OHRQoL scores significantly correlated with enhanced well-being and the intensification of social contacts. CONCLUSION: Our skeletal malocclusion questionnaire provides useful additional information on specific aspects of skeletal malocclusion patients, mapping in a detailed fashion aspects of function, esthetics, psychological condition, and social interactions. OHIP-G14 scores correlated negatively with OHRQoL.

New immortalized cell lines of patients with small supernumerary marker chromosome: towards the establishment of a cell bank.

Sixteen newly established cell lines with small supernumerary marker chromosomes (sSMC) derived from chromosomes 1, 2, 4, 6, 7, 8, 14, 15, 16, 18, 19, 21, and 22 are reported. Two sSMC are neocentric and derived from 15q24.1-qter and 2q35-q36, respectively. Two further cases each present with two sSMC of different chromosomal origin. sSMC were characterized by multicolor fluorescence in situ hybridization for their chromosomal origin and genetic content. Moreover, uniparental disomy of the sister chromosomes of the sSMC was excluded in all nine cases studied for that reason. The 16 cases provide information to establish a refined genotype-phenotype correlation of sSMC and are available for future studies.

Age- and stage-dependent glyoxalase I expression and its activity in normal and Alzheimer's disease brains.

The reaction of lysine and arginine residues of proteins with 1,2-dicarbonyl compounds result in the formation of advanced glycation end products (AGEs). Accumulation of AGEs is a characteristic feature of the aging brain and contributes to the development of neurodegenerative diseases such as Alzheimer's disease (AD). Therefore, it is of particular interest to study the cellular defense mechanisms against AGE formation and particularly the detoxification of their precursors. AGE precursor compounds such as methylglyoxal and glyoxal were cellulary detoxified by the glyoxalase system, consisting of glyoxalases I and II. Glyoxalase I levels are diminished in old aged brains but elevated in AD brains. However, it is still unknown how glyoxalase I level of AD brains changes in a disease and in an age-dependent manner. Therefore, we investigated the AD stage- and the age-dependent levels of glyoxalase I in the Brodmann area 22 of AD brains (n=25) and healthy controls (n=10). Our results obtained from RT-PCR reveal reducing glyoxalase I RNA levels with advancing stage of AD and with increasing age. Western Blot analysis indicates that in comparison to healthy controls, glyoxalase I protein amounts are 1.5-fold increased in early AD subjects and continuously decrease in middle and late stages of AD. The glyoxalase I protein amounts of AD patients also decrease with age. Results obtained from glyoxalase I activity measurement show 1.05-1.2-fold diminished levels in AD brains compared to healthy controls and no significant decrease neither with the stage of AD nor with age. The immunohistochemical investigations demonstrate an elevated number of glyoxalase I stained neurons in brains of early and middle but not in late AD subjects compared to age-matched healthy controls. In addition, the stage-dependent immunohistochemical investigation demonstrates that with reduced glyoxalase I staining AGE deposits prevail, specifically in late stage of AD. In conclusion, the decrease of glyoxalase I expression with increasing AD stage might be one reason for methylglyoxal-induced neuronal impairment, apoptosis, and AGE formation in plaques and tangles.

The centromeric 11p15 imprinting centre is also involved in Silver-Russell syndrome.

Silver-Russell syndrome (SRS) is a heterogeneous disorder characterised by severe intrauterine and postnatal growth retardation, limb and body asymmetry, a typical facial appearance and less common dysmorphisms. Recently, epimutations and maternal duplications affecting the short arm of chromosome 11 have been shown to have a crucial role in the aetiology of the disease. Disturbances in the same genomic region cause the overgrowth disorder Beckwith-Wiedemann syndrome (BWS). In BWS, mutations in the telomeric as well as in the centromeric imprinting centres (ICR1 and ICR2) in 11p15 can be observed. In SRS, methylation defects in the imprinted region in 11p15 were considered to be restricted to the telomeric ICR1. They can be detected in about 30% of patients. This article reports on the first patient with SRS with a cryptic duplication restricted to the centromeric ICR2 domain in 11p15. The maternally inherited duplication in this patient included a region of 0.76-1 Mbp and affected the genes regulated by the ICR2, among them CDKN1C and LIT1. This study provides evidence for a role for this imprinting centre in the aetiology of SRS and shows that SRS presents a picture genetically opposite to that of BWS.

Age-dependent changes of glyoxalase I expression in human brain.

Increased modification and crosslinking of proteins by advanced glycation end products (AGEs) is a characteristic feature of aging, and contributes to the formation of many of the lesions of neurodegenerative diseases including neurofibrillary tangles and amyloid plaques in Alzheimer's disease. Therefore, defense mechanisms against AGE formation or detoxification of their precursors such as the glyoxalase system are of particular interest in aging research. Thus, we investigated the age-dependent protein expression, the activity as well as the RNA level of glyoxalase I in Brodmann area 22 (auditory association area of superior temporal gyrus) of the human cerebral cortex. Our immunohistochemical results demonstrate the localization of glyoxalase I in neurons, predominantly pyramidal cells, as well as in astroglia, located predominantly in the subpial region. The number of glyoxalase I expressing neurons and astroglia increases with age, with a peak at approximately 55 years, and progressively decreases thereafter. These results were confirmed by biochemical investigations in total brain tissue, where the RNA, the protein level as well as the activity of glyoxalase I enzyme were analyzed in different age groups. In conclusion, the increase in glyoxalase I expression up to the age of 55 may be a compensatory mechanism against high oxoaldyde levels and the accumulation of AGEs. However, the decline of glyoxalase expression and activity in old age, possibly caused by impairment in transcription or/and translation, may subsequently lead to increased levels of reactive carbonyl compounds, followed by protein crosslinking, inflammation, oxidative stress and neuronal degeneration.

Cardiovascular parameters in anaesthetized guinea pigs: a safety pharmacology screening model.

INTRODUCTION: Assessment of cardiovascular functions in vivo is part of the core battery of guideline ICH S7A and is thereby required by regulatory authorities. The haemodynamic effects of repeated intravenous administrations of reference compounds were analyzed in order to validate the guinea pig model for safety pharmacology studies under GLP conditions. METHODS: Male guinea pigs (n=54, weighing 565-762 g) were anaesthetized using 1.5 g/kg, i.p., urethane. Systolic arterial blood pressure (SAP), diastolic arterial blood pressure (DAP), heart rate (HR), left ventricular pressure (LVP), cardiac contractility (dp/dt(max)), and ECG (RR, QT, and QTc intervals) were recorded continuously. Animals received vehicle i.v. followed by cumulative doses of reference compounds. RESULTS: Vehicle did not produce any relevant changes, either in cardiovascular or ECG parameters. Isoproterenol caused a rapid and significant increase in HR, LVP, and dp/dt(max), in contrast to a dose-dependent decrease in SAP and DAP. Epinephrine led to a potent increase in all cardiovascular parameters. Nifedipine produced a slight decrease in HR and LVP, and a potent decrease in blood pressure and dp/dt(max). Verapamil caused a dose-dependent decrease in all cardiovascular parameters. Ouabain resulted in a significant increase in SAP, DAP, LVP, and dp/dt(max); ECG showed an atrioventricular block and arrhythmia. Terfenadine, cisapride, and sotalol prolonged QT and QTc intervals, whereas vehicle and the other tested compounds did not produce any prolongation of the QTc interval. DISCUSSION: Our results on HR, blood pressure, and ECG obtained after i.v. administration of reference compounds show the usefulness of the guinea pig in assessing cardiovascular safety. The anaesthetized guinea pig allows the measurement of cardiac contractility and the use of doses higher than in conscious animals. Using this animal model, several cardiovascular parameters can be recorded simultaneously at a modest cost in terms of test compound and the number of animals required.

[Utilization and effectiveness of short-term counseling in child guidance]. / Inanspruchnahme und Wirksamkeit von Kurzberatung in der Erziehungsberatung.

UNLABELLED: This study investigates the utilization and effectiveness of short-term counseling in child guidance. For this purpose a comparison was made between short-term and long-term counseling (each N = 89) and a catamnestic telephone interview of the parents who had had short-term counseling was conducted (N = 70). RESULTS: 1. The rate of short-term counseling amounts to 39%. 2. The individuals seeking short-term counseling are significantly less burdened with problems. 3. In stating the reason for a short-term counseling, 58% of the individuals concerned claim that the number of counseling sessions held had been sufficient, that there had been an improvement with regard to the problems, or that according to the counselor there had been no need for further activity; 24% were dissatisfied with the counseling and for this reason broke it off; 10% were directed to other institutions. 4. On the whole the persons seeking advice evaluated the short-term counseling mainly positively. The evaluation of satisfaction and success corresponds with the evaluation commonly gained in educational guidance: 70% of the individuals seeking counseling were satisfied with the results, 44% reported positive changes due to the advice they received, and 66% seem to have gained a better understanding for their children. 5. The good relationship between the counselor and the person seeking advice appeared to be particularly important.

Small supernumerary marker chromosomes (SMCs): genotype-phenotype correlation and classification.

Small supernumerary marker chromosomes (SMCs) are present in about 0.05% of the human population. In approximately 30% of SMC carriers (excluding the approximately 60% SMC derived from one of the acrocentric chromosomes), an abnormal phenotype is observed. The clinical outcome of an SMC is difficult to predict as they can have different phenotypic consequences because of (1). differences in euchromatic DNA-content, (2). different degrees of mosaicism, and/or (3). uniparental disomy (UPD) of the chromosomes homologous to the SMC. Here, we present 35 SMCs, which are derived from all human chromosomes, apart from chromosome 6, as demonstrated by the appropriate molecular cytogenetic approaches, such as centromere-specific multicolor fluoresence in situ hybridization (cenM-FISH), multicolor banding (MCB), and subcentromere-specific multicolor FISH (subcenM-FISH). In nine cases without an aberrant phenotype, neither partial proximal trisomies nor UPD could be detected. Abnormal clinical findings, such as psychomotoric retardation and/or craniofacial dysmorphisms, were associated with seven of the cases in which subcentromeric single-copy probes were proven to be present in three copies. Conversely, in eight cases with a normal phenotype, proximal euchromatic material was detected as partial trisomy. UPD was studied in 12 cases and subsequently detected in two of the cases with SMC (partial UPD 4p and maternal UPD 22 in a der(22)-syndrome patient), indicating that SMC carriers have an enhanced risk for UPD. At present, small proximal trisomies of 1p, 1q, 2p, 6p, 6q, 7q, 9p, and 12q seem to lead to clinical manifestations, whereas partial proximal trisomies of 2q, 3p, 3q, 5q, 7p, 8p, 17p, and 18p may not be associated with significant clinical symptoms. With respect to clinical outcome, a classification of SMCs is proposed that considers molecular genetic and molecular cytogenetic characteristics as demonstrated by presently available methods.

Situaçao de saúde da criança em área da regiao sul do Brasil, 1980-1992: tendências temporais e distribuiçao espacial / The health situation of children in area of southern Brazil, 1980-1992: tendencies over time and geographical distribution

Embora as estatísticas vitais sejam de fundamental importância para o planejamento e avaliaçäo das açöes de saúde, säo poucos os Estados brasileiros que dispöem de sistema de registro com cobertura e agilidade suficiente para atingir estas metas. Objetivou, portanto, analisar os dados gerados no Rio Grande do Sul, Brasil, para descrever tendências temporais e distribuiçäo espacial de indicadores de saude infantil, incluindo os coeficientes de mortalidade infantil e de mortalidade proporcional de menores de um ano, prevalência de baixo peso ao nascer, e cobertura vacinal. Entre 1980 e 1992, observaram-se reduçöes marcantes na mortalidade infantil (de 39,0 para 19,3 por mil) e na mortalidade proporcional de menores de um ano (13,9 por cento para 5,9 por cento). A prevalência de baixo peso ao nascer mostrou-se estável entre 8 e 10 por cento, tendo mesmo sido observado discreto aumento até 1991. A cobertura de vacina tríplice oscilou marcadamente de ano a ano, entre 79 por cento e 99 por cento. Houve forte correlaçäo, ao nível de Delegacias Regionais de Saúde, entre mortalidade infantil e baixo peso ao nascer. Os 4 indicadores estudados foram combinados de forma a construir um escore para identificar as Delegacias de Saúde com maiores necessidades de intervençöes sanitárias. A regiäo sul do Estado, caracterizada pela presença de grandes latifúndios, mostrou os piores índices de saúde infantil