Orthopedic Treatment of Skeletal Class III Malocclusions With Maxillary Deficiency

Objective:The purpose of this study was to compare the treatment effects of a double-plate appliance (DPA) and a double-plate appliance and facemask combination (DPA-FM) in correcting Class III malocclusions.Materials and Methods:The material consisted of lateral cephalometric radiographs of 40 children with skeletal and dental Class III malocclusion. In the first treatment group, 13 patients (mean age: 10 years 3 months) were treated with DPA. In the second treatment group, 15 patients (mean age: 10 years 9 months) were treated with DPA-FM. In the third group, 12 patients (mean age: 10 years 6 months) were observed without treatment for 9 months. Statistical evaluation was made by ANOVA, Duncan, and paired t tests.Results:The increases in SNA and ANB angles were significantly greater in the DPA-FM group than in the DPA group. The proclination of upper incisors (U1/NA) and retroclination of lower incisors (L1/NB) were significantly greater in the DPA group than in the DPA-FM group. The retroclination of lower incisors (L1/NB) in the DPA group showed a significant difference compared with the control group. The increase in ANS-Me length was significantly greater in the DPA-FM group than in the control group.Conclusion:The DPA-FM treatment was more effective in sagittal correction of the maxilla than the DPA treatment. The dental contribution to Class III treatment seemed to be greater in the DPA group, but in this group vertical skeletal changes were more satisfying

Expression of Transketolase like gene 1 (TKTL1) predicts disease-free survival in patients with locally advanced rectal cancer receiving neoadjuvant chemoradiotherapy

<p>Abstract</p> <p>Background</p> <p>For patients with locally advanced rectal cancer (LARC) neoadjuvant chemoradiotherapy is recommended as standard therapy. So far, no predictive or prognostic molecular factors for patients undergoing multimodal treatment are established. Increased angiogenesis and altered tumour metabolism as adaption to hypoxic conditions in cancers play an important role in tumour progression and metastasis. Enhanced expression of Vascular-endothelial-growth-factor-receptor <it>(VEGF-R</it>) and Transketolase-like-1 (<it>TKTL1</it>) are related to hypoxic conditions in tumours. In search for potential prognostic molecular markers we investigated the expression of <it>VEGFR-1</it>, <it>VEGFR-2 </it>and <it>TKTL1 </it>in patients with LARC treated with neoadjuvant chemoradiotherapy and cetuximab.</p> <p>Methods</p> <p>Tumour and corresponding normal tissue from pre-therapeutic biopsies of 33 patients (m: 23, f: 10; median age: 61 years) with LARC treated in phase-I and II trials with neoadjuvant chemoradiotherapy (cetuximab, irinotecan, capecitabine in combination with radiotherapy) were analysed by quantitative PCR.</p> <p>Results</p> <p>Significantly higher expression of <it>VEGFR-1/2 </it>was found in tumour tissue in pre-treatment biopsies as well as in resected specimen after neoadjuvant chemoradiotherapy compared to corresponding normal tissue. High <it>TKTL1 </it>expression significantly correlated with disease free survival. None of the markers had influence on early response parameters such as tumour regression grading. There was no correlation of gene expression between the investigated markers.</p> <p>Conclusion</p> <p>High <it>TKTL-1 </it>expression correlates with poor prognosis in terms of 3 year disease-free survival in patients with LARC treated with intensified neoadjuvant chemoradiotherapy and may therefore serve as a molecular prognostic marker which should be further evaluated in randomised clinical trials.</p

Spatial and temporal heterogeneity in human mobility patterns in Holocene Southwest Asia and the East Mediterranean

We present a spatiotemporal picture of human genetic diversity in Anatolia, Iran, Levant, South Caucasus, and the Aegean, a broad region that experienced the earliest Neolithic transition and the emergence of complex hierarchical societies. Combining 35 new ancient shotgun genomes with 382 ancient and 23 present-day published genomes, we found that genetic diversity within each region steadily increased through the Holocene. We further observed that the inferred sources of gene flow shifted in time. In the first half of the Holocene, Southwest Asian and the East Mediterranean populations homogenized among themselves. Starting with the Bronze Age, however, regional populations diverged from each other, most likely driven by gene flow from external sources, which we term “the expanding mobility model.” Interestingly, this increase in inter-regional divergence can be captured by outgroup-f$_3$-based genetic distances, but not by the commonly used F$_{ST}$ statistic, due to the sensitivity of F$_{ST}$, but not outgroup-f$_3$, to within-population diversity. Finally, we report a temporal trend of increasing male bias in admixture events through the Holocene

Evaluatıon of the dentoalveolar and skeletal effects of molar dıstalızatıon wıth frog applıance

Bu çalışmanın amacı, Sınıf II maloklüzyonların tedavisinde üst birinci molar dişin distalizasyonu amacıyla kullanılan Frog Apareyinin iskeletsel, dişsel ve yumuşak dokularda meydana getirdiği değişimleri incelemektir. Araştırmaya, dişsel Sınıf II maloklüzyona sahip olan, üst çenede orta şiddetli çapraşıklık, alt çenede ise minimal düzeyde veya çapraşıklığı olmayan, SN/GoGN açısı 38º den yüksek olmayan ve ikinci molar dişleri oklüzyonda olan vakalar dahil edildi. Ayrıca, üst üçüncü molarların varlığı tedavi öncesi değerlendirilerek, ikinci molar trifurkasyon hattının altında olduğu vakalarda, bu dişlerin çekimi tedavi öncesinde yapıldı. Uygulama grubu kronolojik yaş ortalaması 14 yıl 8 ay olan 15 kız, 5 erkek toplam 20 bireyden oluşturuldu Araştırma kapsamına alınan kronolojik yaşları ortalama 14 yıl olan 15 birey (10 kız, 5 erkek) ise kontrol grubunu oluşturdu. Kontrol grubu altı ay süre ile takip edildi. Uygulama grubunda, ortalama tedavi süresi 6,6 ± 0,44 aydır. Araştırma kapsamına alınan tüm bireylerden uygulama başlangıcı ve sonunda lateral sefalometrik film, panaromik film ve ortodontik model alındı. Bu araştırmada her bir parametre bakımından gözlemler faktöriyel düzende tekrarlanan ölçümlü varyans analiz tekniği (Repeated Measurements Factorial ANOVA) ile analiz edildi. Farkların hesaplanmasında Duncan testi uygulandı. Her bir özellik bakımından farkların farkı Student-t testi ile karşılaştırıldı. Frog apareyi ile üst birinci ve ikinci molarlarda belirgin bir distalizasyon sağlanırken, her iki dişte de distale devrilme izlenmektedir. Ankraj kaybı, birinci ve ikinci premolar dişlerdeki meziyal hareket ve keser dişlerde protrüzyon ile ortaya çıkmaktadır. İskeletsel vertikal ölçümler değerlendirildiğinde alt ön yüz yüksekliğinde ve arka yüz yüksekliğinde artış uygulama grubunda istatistiksel olarak önemli bulundu.The purpose of this study was to evaluate the dentoalveoler, skeletal and soft tissue effects of the Frog appliance which was used for upper molar distalization in the treatment of Class II malocclusions. Patients which had Class II molar relationship, moderate space defiency in the maxillary arch, none or minimum space defiency in the mandibular arch, SN/GoGN angle within normal limits and all second molar in occlusion were included in this study. Cases with third molars were evaluate at the beginning of the treatment and extraction of third molars was done if the crowns were under the level of second molar trifurcation. The average chronological age of the treatment group of 20 patients (15 female, 5 male) were 14 years 8 months. The control group of 15 patients (10 female, 5 male) had an avarage age of 14 years. Control group was observed for six months without treatment. The mean time for the correction of the Class II molar relationship was 6,6 ± 0,44 months. Lateral cephalograms, panoromic films and study models were taken before and after treatment. In this study for each parameter statistical analysis were made by Repeated measurement factorial designed Anova technique . Duncan test was used to evaluate the differences between the groups. Student-t test was used to evaluate the differences between the groups during the treatment. First and second maxillary molars were distalized with Frog appliance. Both second and first molars were tipped distally during treatment. The anchroge teeth, maxillary first and second premolars were moved and tipped mesially. Maxillary incisors demostrated protrusion and tiping. Evaluation of the skeletal vertical changes showed significant increase in lower face height and posterior face height in the treatment group

A Method Based on SMAA-Topsis for Stochastic Multi-Criteria Decision Making and a Real-World Application

Stochastic multi-criteria acceptability analysis (SMAA-2) and the technique for order preference by similarity to ideal solution (TOPSIS) are methods for evaluating alternatives with multiple criteria. SMAA is a method that is used for solving multi-criteria decision-making problems with uncertain, inaccurate information, and does not require preference information from the decision makers. The TOPSIS method is based on the principle of determining a solution with the shortest distance to the ideal solution and the greatest distance from the negative-ideal solution. This paper proposes a new method, SMAA-TOPSIS, by combining the SMAA and TOPSIS methods. The SMAA-TOPSIS method was executed for two problems: drug benefit-risk analysis and machine gun selection. This paper found that TOPSIS could be used with uncertain and arbitrarily distributed values for weights and criteria measurements by using a combination of SMAA and TOPSIS. Also, we obtained clearer and consistent SMAA outputs

Comparison of double-plate appliance/facemask combination and facemask therapy in treating Class III malocclusions

Objective: To compare the treatment effects of double-plate appliance/facemask (DPA-FM) combined therapy and facemask (FM) therapy in treating Class III malocclusions. Materials and Methods: The material consisted of lateral cephalometric radiographs of 45 children with skeletal and dental Class III malocclusion. The first treatment group comprised 15 patients (mean age = 11 years) treated with FM. The second treatment group comprised 15 patients (mean age = 10 years 9 months) treated with DPA-FM. The third group comprised 15 patients (mean age = 10 years 5 months) used as controls. The paired t-test was used to evaluate the treatment effects and changes during the treatment and observation period in each group. Differences between the groups were determined by variance analysis and the Duncan test. Results: With the DPA-FM and FM appliances, the SNA and ANB angles increased significantly. These changes were statistically different compared with the control group. Lower facial height showed a greater increase in both treatment groups than in the control group. Molar relation showed a greater increase in the DPA-FM group than in the FM group. The increase in U6/ANS-PNS angle in the FM group was significantly different from the DPA-FM and control groups. The L1/NB angle and Pg-T increased significantly only in the FM group, but no significant difference was found between the treatment groups. Conclusions: In the treatment of Class III malocclusion, both appliances were effective. The significant sagittal changes in the lower incisors and pogonion in the FM group compared with the nonsignificant changes in the DPA-FM group might be due to the restriction effect of acrylic blocks in the DPA-FM group

Analysis of end-of-life treatment and physician perceptions at a university hospital in Germany

Purpose!#!Providing state-of-the-art palliative care is crucial in all areas of in- and outpatient settings. Studies on the implementation of palliative care standards for dying patients are rare.!##!Methods!#!N = 141 physicians from all internal departments were polled anonymously about the treatment of dying patients using a self-designed questionnaire. Furthermore, we evaluated the terminal care of n = 278 patients who died in internal medicine departments at University Hospital Mannheim between January and June, 2019 based on clinical data of the last 48 h of life. We defined mandatory criteria for good palliative practice both regarding treatment according to patients' records and answers in physicians' survey.!##!Results!#!Fifty-six physicians (40%) reported uncertainties in the treatment of dying patients (p &amp;lt; 0.05). Physicians caring for dying patients regularly stated to use sedatives more frequently and to administer less infusions (p &amp;lt; 0.05, respectively). In multivariate analysis, medical specialization was identified as an independent factor for good palliative practice (p &amp;lt; 0.05). Physicians working with cancer patients regularly were seven times more likely to use good palliative practice (p &amp;lt; 0.05) than physicians who did not. Cancer patients received good palliative practice more often than patients dying from non-malignant diseases (p &amp;lt; 0.05).!##!Conclusion!#!Guideline-based palliative care for dying patients was found to be implemented more likely and consistent within the oncology department. These results point to a potential lack of training of fellows in non-oncological departments in terms of good end-of-life care