Outcome stability of orthopaedic treatment of skeletal Class III malocclusion: A study of prognostic agreement between three models

Introduction: Long-term stability of the treatment outcome of skeletal Class III malocclusion is always not achievable, thereforeseveral prediction models of stability of orthopaedic treatment of the Class III malocclusion have been proposed. Aim: This cross-sectional study was aimed at the evaluation of the prognostic agreement and association between three differentprediction models based on skeletal parameters recorded on lateral cephalograms. Materials and methods: A total of 75 subjects (34 females and 41 males, age range 7-11, mean age 9.1±1.2years) having skeletal ClassIII malocclusion were included in the study. Prediction models reported by Baccetti et al. 2004 (prediction model 1), Moon et al.2005 (prediction model 2) and Yoshida et al. 2006 (prediction model 3), were considered. Percentage agreement and unweighted kappa coefficient evaluated the agreement between the prediction models in terms of stable or unstable cases. Multiple regressions were run to evaluate the association between the absolute scores obtained from each of the prediction model (prediction scores). Results: Percentage agreement ranged from 77.3% (models 2 and 3) to 89.3%, (models 1 and 2) and corresponding unweighted kappa coefficients ranged from 0.099 (models 1 and 3) to 0.205 (models 2 and 3). The prediction score from model 3 was significantly associated with those from both the other models; on the contrary, prediction scores from models 1 and 2 were not significantly associated. Conclusions: Agreement in terms of stability or instability outcome derived from these models is only partial and not satisfactory,even though significant association between the prediction scores denotes a common biological meaning of the models

ETHANOL PRODUCTION FROM A MEMBRANE PURIFIED HEMICELLULOSIC HYDROLYSATE DERIVED FROM SUGAR MAPLE BY PICHIA STIPITIS NRRL Y-7124

In an effort to devise inexpensive and sustainable production of ethanol fuel, experiments were conducted to establish conditions for Pichia stipitis NRRL Y-7124 to ferment a membrane treated wood hydrolysate derived from sugar maple to produce ethanol. The degree of aeration required to effectively utilize xylose, produce ethanol, and minimize xylitol formation as well as the optimal hydrolysate concentration were the conditions examined. P. stipitis produced the highest concentrations of ethanol in shake flasks at 150 rpm (14.3 g/L in 71 h), and 50% hydrolysate maximized ethanol yield (12.4 g/L in 51.5 h). In the 50% hydrolysate cultures, P. stipitis produced ethanol at a rate of 0.24 g/Lh with a yield of 0.41 g ethanol/g wood-derived carbohydrate

Socioeconomic condition and dietary habits in relation to oral health in 12-year-old children from Sarajevo, Bosnia-Hercegovina

Introduction: Living conditions and socioeconomic status are the significant determinants of oral health. The research goal was to analyze the dietary habits of 12-year-old children in Sarajevo, Bosnia-Hercegovina. Another goal was to investigate the differences in food cariogenicity of children living under different socioeconomic conditions and to determine their relationship with the oral health. Materials and methods: The sample included 109 children, classified in groups of high, average and low socioeconomic status. Based on the survey and examination, data on nutrition and caries experience (DMFT index) were obtained. Results: There was a difference in dietary habits between children living under different conditions. Children of high socioeconomic status (SES) had a more favorable number of daily meals comparing to children of low socioeconomic status. The average DMFT index, as a measure of caries experience of 12-year-old children amounted 4.8(±3.2). Children of high socioeconomic status had significantly lower caries experience than those from average and low statuses (high SES DMFT 3,60±2,84SD vs. middle SES DMFT 5,28±3,83SD and low SES DMFT 5,47±2,53SD; p<0.05)

Cameriere’s European formula for age estimation: A study on the children in Bosnia and Herzegovina

Introduction: A method for age estimation, based on measurements of projections of open apices and heights of developing permanentteeth on orthopantomograms (OPTs), was presented by Cameriere in 2006 and adopted European formula was presented in 2007. Aim: This cross-sectional study tested the accuracy of Cameriere’s European formula on a sample from the City of Sarajevo, Bosniaand Herzegovina. Materials and methods: A final sample of 560 OPTs of 305 girls and 255 boys aged 8 to 14 years was obtained. The sample was collected at the Department of Orthodontics, School of Dental Medicine at the University of Sarajevo (SFUNSA). Dental age was compared to chronological age and mean absolute error (MAE) was calculated. Intra-rater and inter-rater agreement of the evaluated variables were calculated. Results: The dental age was underestimated when compared to chronological age, precisely, mean underestimation was -0.14 years ingirls and -0.17 years in boys. The values of MAE were 0.62 years in girls and 0.56 years in boys. The greatest error was found for the 14-year old group; DA was -1.04 years and -0.70 years in girls and boys respectively. Conclusion: Our results showed that Cameriere’s European formula might be a useful tool for age estimation in children from Bosnia and Herzegovina under the age of 14 years

Bayesian Bootstrap Inference for the ROC Surface

Accurate diagnosis of disease is of great importance in clinical practice and medical research. The receiver operating characteristic (ROC) surface is a popular tool for evaluating the discriminatory ability of continuous diagnostic test outcomes when there exist three ordered disease classes (e.g., no disease, mild disease, advanced disease). We propose the Bayesian bootstrap, a fully nonparametric method, for conducting inference about the ROC surface and its functionals, such as the volume under the surface. The proposed method is based on a simple, yet interesting, representation of the ROC surface in terms of placement variables. Results from a simulation study demonstrate the ability of our method to successfully recover the true ROC surface and to produce valid inferences in a variety of complex scenarios. An application to data from the Trail Making Test to assess cognitive impairment in Parkinson's disease patients is provided

Long-Fiber Carbon Nanotubes Replicate Asbestos-Induced Mesothelioma with Disruption of the Tumor Suppressor Gene Cdkn2a (Ink4a/Arf).

Mesothelioma is a fatal tumor of the pleura and is strongly associated with asbestos exposure. The molecular mechanisms underlying the long latency period of mesothelioma and driving carcinogenesis are unknown. Moreover, late diagnosis means that mesothelioma research is commonly focused on end-stage disease. Although disruption of the CDKN2A (INK4A/ARF) locus has been reported in end-stage disease, information is lacking on the status of this key tumor suppressor gene in pleural lesions preceding mesothelioma. Manufactured carbon nanotubes (CNTs) are similar to asbestos in terms of their fibrous shape and biopersistent properties and thus may pose an asbestos-like inhalation hazard. Here we show that instillation of either long CNTs or long asbestos fibers into the pleural cavity of mice induces mesothelioma that exhibits common key pro-oncogenic molecular events throughout the latency period of disease progression. Sustained activation of pro-oncogenic signaling pathways, increased proliferation, and oxidative DNA damage form a common molecular signature of long-CNT- and long-asbestos-fiber-induced pathology. We show that hypermethylation of p16/Ink4a and p19/Arf in CNT- and asbestos-induced inflammatory lesions precedes mesothelioma; this results in silencing of Cdkn2a (Ink4a/Arf) and loss of p16 and p19 protein, consistent with epigenetic alterations playing a gatekeeper role in cancer. In end-stage mesothelioma, silencing of p16/Ink4a is sustained and deletion of p19/Arf is detected, recapitulating human disease. This study addresses the long-standing question of which early molecular changes drive carcinogenesis during the long latency period of mesothelioma development and shows that CNT and asbestos pose a similar health hazard

The evolution of lung cancer and impact of subclonal selection in TRACERx

Lung cancer is the leading cause of cancer-associated mortality worldwide1. Here we analysed 1,644 tumour regions sampled at surgery or during follow-up from the first 421 patients with non-small cell lung cancer prospectively enrolled into the TRACERx study. This project aims to decipher lung cancer evolution and address the primary study endpoint: determining the relationship between intratumour heterogeneity and clinical outcome. In lung adenocarcinoma, mutations in 22 out of 40 common cancer genes were under significant subclonal selection, including classical tumour initiators such as TP53 and KRAS. We defined evolutionary dependencies between drivers, mutational processes and whole genome doubling (WGD) events. Despite patients having a history of smoking, 8% of lung adenocarcinomas lacked evidence of tobacco-induced mutagenesis. These tumours also had similar detection rates for EGFR mutations and for RET, ROS1, ALK and MET oncogenic isoforms compared with tumours in never-smokers, which suggests that they have a similar aetiology and pathogenesis. Large subclonal expansions were associated with positive subclonal selection. Patients with tumours harbouring recent subclonal expansions, on the terminus of a phylogenetic branch, had significantly shorter disease-free survival. Subclonal WGD was detected in 19% of tumours, and 10% of tumours harboured multiple subclonal WGDs in parallel. Subclonal, but not truncal, WGD was associated with shorter disease-free survival. Copy number heterogeneity was associated with extrathoracic relapse within 1 year after surgery. These data demonstrate the importance of clonal expansion, WGD and copy number instability in determining the timing and patterns of relapse in non-small cell lung cancer and provide a comprehensive clinical cancer evolutionary data resource

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p&lt;00001), age 70 years or older versus younger than 70 years (230 [165-322], p&lt;00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p&lt;00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks