Multidisciplinary approach in the management of a complex case: Implant-prosthetic rehabilitation of a periodontal smoking patient with partial edentulism, malocclusion, and aesthetic diseases

Complex periprosthetic cases are considered as challenges by clinicians. Clinical and radiographic parameters should be considered separately to make the right choice between an endodontically or periodontally compromised treated tooth and implant. Therefore, in order to decide whether the tooth is safe or not, data that have to be collected are specific parameters of both the patient and the clinician. In addition, the presence of periodontal, prosthetic, and orthodontic diseases requires patients to be set in multidisciplinary approach. The aim of this case report is to describe how the multidisciplinary approach could be the best way to manage difficult cases of implant-prosthetic rehabilitation. How to rehabilitate with fixed prosthesis on natural teeth and dental implants a smoker patient who presents with active periodontitis, multiple edentulous areas, dental malocclusion, and severe aesthetic problems was also described

Urea-induced ROS generation causes insulin resistance in mice with chronic renal failure.

Although supraphysiological concentrations of urea are known to increase oxidative stress in cultured cells, it is generally thought that the elevated levels of urea in chronic renal failure patients have negligible toxicity. We previously demonstrated that ROS increase intracellular protein modification by O-linked β-N-acetylglucosamine (O-GlcNAc), and others showed that increased modification of insulin signaling molecules by O-GlcNAc reduces insulin signal transduction. Because both oxidative stress and insulin resistance have been observed in patients with end-stage renal disease, we sought to determine the role of urea in these phenotypes. Treatment of 3T3-L1 adipocytes with urea at disease-relevant concentrations induced ROS production, caused insulin resistance, increased expression of adipokines retinol binding protein 4 (RBP4) and resistin, and increased O-GlcNAc–modified insulin signaling molecules. Investigation of a mouse model of surgically induced renal failure (uremic mice) revealed increased ROS production, modification of insulin signaling molecules by O-GlcNAc, and increased expression of RBP4 and resistin in visceral adipose tissue. Uremic mice also displayed insulin resistance and glucose intolerance, and treatment with an antioxidant SOD/catalase mimetic normalized these defects. The SOD/catalase mimetic treatment also prevented the development of insulin resistance in normal mice after urea infusion. These data suggest that therapeutic targeting of urea-induced ROS may help reduce the high morbidity and mortality caused by end-stage renal disease

Fluid geochemistry of the Los Humeros geothermal field (LHGF - Puebla, Mexico): New constraints for the conceptual model

Geothermal power in Mexico is mainly produced in four geothermal fields operated by the Comision Federal de Electricidad (CFE): Cerro Prieto, Los Azufres, Los Humeros, and Las Tres Virgenes. The Los Humeros Geothermal Field (LHGF) is ranked third in terms of generated capacity, and in the last decade its installed capacity has doubled (up to 95.0 MW). Further increases in the geothermal power generation capacity in Mexico are planned, and thus the LHGF warrants further examination. The development and growth phases of any geothermal project must start from an awareness of the conceptual model of the natural system studied. The recharge mechanism, feeding zones, and fluid flow-path must be identified, along with the estimation of the temperature at the productive level and of phase separation (liquid - steam). To accomplish this, detailed fluid geochemical surveys were carried out in June 2017 and March 2018, in which 57 and 87 samples were collected, respectively, from cold and thermal springs, water wells and maar lakes located around and inside the LHGF. Samples from fumaroles inside the producing area were also collected for the first time, together with fluid from re-injection wells. The presence of a meteoric component, which plays an important role at the regional scale, is confirmed by the chemical and isotope data, and its contribution in terms of recharge may be higher than previously assumed. The Sierra Madre Oriental, on the west side of the LHGF, is characterized by widespread outcrops of limestone belonging to the same geological formation as those at the bottom of the LHGF. The isotope composition (delta D and delta O-18, respectively -77.3 parts per thousand and -10.50 parts per thousand for the hypothetical Infiltration Water IW) is similar to that observed in cold springs located in the Sierra Madre Oriental, and from this the evolution of isotopes in the liquid-rock-steam system during water-rock interaction and phase separation processes can be modelled. Thus, the experimental data obtained for natural gas emissions (fumarolic condensates) and for geothermal fluids can be reproduced. These findings suggest that geothermal fluids in the LHGF are likely to be derived from meteoric water infiltrating (IW) the limestone outcrops of the Sierra Madre Oriental. During their flow-path, the infiltrating waters exchange isotopes at a high temperature with the crustal rocks, which have a much higher O-18/O-16 ratio, resulting in a shift towards higher delta O-18 (-4.35 parts per thousand +/- 1) as the water O exchanges with rock O. The vapor phase can be separated from this deep water (DW) and it is discharged from the fumarolic effluents of Loma Blanca. Single Step Vapor Separation (SSVS) and Continuous Steam Separation processes (CSS) were modelled using stable isotopes of water. The results of geochemical modeling agree with available data for geothermal liquids discharged from several geothermal wells, suggesting that steam separation may be interpreted either as SSVS or CSS. Other processes can affect the chemistry and isotope composition of geothermal fluids (e.g. phase segregation, gas exchange, contributions from magmatic-volcanic deep fluids and re-injection fluids). The proposed conceptual model is consistent with both the geochemical data and the geological setting, and provides a useful point of reference for examining the fluid flow-path and geochemical processes active in the LHGF, at least at a general level. An involvement of magmatic-volcanic deep fluids in the feeding mechanism of the geothermal system cannot be excluded at priori, but the regional meteoric end-member is supported by the data and it seems the most important component

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Upgrading of a wastewater treatment plant with a hybrid moving bed biofilm reactor (MBBR)

The wastewater treatment plant of Porto Tolle (RO, Italy) was originally projected for 2200 person equivalent (p.e.) and it was made of a pumping station, an activated sludge oxidation tank (395 m3), a settler (315 m3), and two sludge drying beds. Other units were not yet in use in 2008: a fine screen, a sand and grit removal unit, a new settler (570 m3), a disinfection tank and a sludge thickener. Effective hydraulic load was 245% higher, organic load was 46% lower and nitrogen load was 39% higher than project values. Moreover, higher pollutant loads and more strict emission limits for nitrogen were expected. So the plant was upgraded: the old settler was divided into a sector of 180 m3 that was converted into a predenitrification tank, and a sector of 100 m3 that was converted into a hybrid MBBR tank filled with 50% AnoxKaldnesTM K3 carriers; the new settler was connected to the hybrid MBBR, and the other units were started. Biofilm growth was observed two months after plant restarting, its concentration reached 1.1 gTS/m2 (0.26 kgTS/m3), while activated sludge concentration was 2.0–2.8 kgTSS/m3 in all the period of study. The upgraded plant treats 1587 m3/d wastewater with 57 kgCOD/d, 23 kgBOD/d and 13.3 kgN/d, and has a significant residual capacity; the effluent respects all emission limits

Numerical simulation tests with light dynamical quarks

Two degenerate flavours of quarks are simulated with small masses down to about one fifth of the strange quark mass by using the two-step multi-boson (TSMB) algorithm. The lattice size is 8^3 x 16 with lattice spacing about 0.27fm which is not far from the N_t=4 thermodynamical cross-over line. Autocorrelations of different physical quantities are estimated as a function of the quark mass. The eigenvalue spectra of the Wilson-Dirac operator are investigated.Comment: 14 pages, 7 figures, uses svjour.cls; mistake in the autocorrelation of the pion mass corrected, version accepted for publication on Eur. Phys. J.

Zone Based Node Replica Detection in Wireless Sensor Network Using Trust

Abstract-A wireless sensor network is a group of sensor nodes. Sensor senses the environment, process data and communicates wirelessly over a short distance. Wireless sensor network has been used in various critical applications. Hence security is of prime concern. The node replication attack is one in which an adversary captures a sensor node and creates copies of the captured sensor node. These newly created copies called clone nodes will be placed at strategic locations in the network, from where they can provide many insider attacks. Replica node will act like an authenticated sensor node. Hence it will be very difficult to detect the clone nodes. In zone based node replica detection with trust, the entire network is divided into a number of zones and node replica detection is done based on the values of trust values calculated

Prospective validation of the CLIP score: a new prognostic system for patient with cirrhosis and hepatocellular carcinoma

Prognosis of patients with cirrhosis and hepatocellular carcinoma (HCC) depends on both residual liver function and tumor extension. The CLIP score includes Child-Pugh stage, tumor morphology and extension, serum alfa-fetoprotein (AFP) levels, and portal vein thrombosis. We externally validated the CLIP score and compared its discriminatory ability and predictive power with that of the Okuda staging system in 196 patients with cirrhosis and HCC prospectively enrolled in a randomized trial. No significant associations were found between the CLIP score and the age, sex, and pattern of viral infection. There was a strong correlation between the CLIP score and the Okuda stage, As of June 1999, 150 patients (76.5%) had died. Median survival time was 11 months, overall, and it was 36, 22, 9, 7, and 3 months for CLIP categories 0, 1, 2, 3, and 4 to 6, respectively. In multivariate analysis, the CLIP score had additional explanatory power above that of the Okuda stage. This was true for both patients treated with locoregional therapy or not. A quantitative estimation of 2-year survival predictive power showed that the CLIP score explained 37% of survival variability, compared with 21% explained by Okuda stage. In conclusion, the CLIP score, compared with the Okuda staging system, gives more accurate prognostic information, is statistically more efficient, and has a greater survival predictive power. It could be useful in treatment planning by improving baseline prognostic evaluation of patients with RCC, and could be used in prospective therapeutic trials as a stratification variable, reducing the variability of results owing to patient selection