The Therapy of Peri-implantitis: A Systematic Review

Purpose: To evaluate the success of treatments aimed at the resolution of peri-implantitis in patients with osseointegrated implants. Materials and Methods: The potentially relevant literature was assessed independently by two reviewers to identify case series and comparative studies describing the treatment of peri-implantitis with a follow-up of at least 3 months. Medline, Embase, and The Cochrane Library were searched. For the purposes of this review, a composite criterion for successful treatment outcome was used which comprised implant survival with mean probing depth < 5 mm and no further bone loss. Results: A total of 43 publications were included: 4 papers describing 3 nonsurgical case series, 13 papers describing 10 comparative studies of nonsurgical interventions, 15 papers describing 14 surgical case series, and 11 papers describing 6 comparative studies of surgical interventions. No trials comparing nonsurgical with surgical interventions were found. The length of follow-up varied from 3 months to 7.5 years. Due to the heterogeneity of study designs, peri-implantitis case definitions, outcome variables, and reporting, no meta- analysis was performed. Eleven studies could be evaluated according to a composite success criterion. Successful treatment outcomes at 12 months were reported in 0% to 100% of patients treated in 9 studies and in 75% to 93% of implants treated in 2 studies. Commonalities in treatment approaches between studies included (1) a pretreatment phase, (2) cause-related therapy, and (3) a maintenance care phase. Conclusions: While the available evidence does not allow any specific recommendations for the therapy of peri-implantitis, successful treatment outcomes at 12 months were reported in a majority of patients in 7 studies. Although favorable short-term outcomes were reported in many studies, lack of disease resolution as well as progression or recurrence of disease and implant loss despite treatment were also reported. The reported outcomes must be viewed in the context of the varied peri-implantitis case definitions and severity of disease included as well as the heterogeneity in study design, length of follow-up, and exclusion/inclusion criteria. Int J Oral MaxIllOfac IMplants 2014;29(suppl):325–345. doi: 10.11607/jomi.2014suppl.g5.

The Role of Resilience in Rebuilding Lives of Injured Veterans

The aim of this commentary is to discuss potential clinical implications of introducing resilience building interventions into care for veterans who are living with a war wound. Some war veterans are expected to live with a wound upon discharge from an active military role and also to fit into civilian life. These lifestyle adjustments can tax the person’s coping abilities and in that context may hinder successful adaptation. The experience of living with a wound or wounds, either acute or chronic, is connected to losses, including loss of mobility, loss of financial capacity (unable to work during some of the wound healing period) and losses attached to changed social roles. Psychological stress is also a common experience for veterans returning to civilian life. Psychological stress is associated with impaired healing or dysregulation of a biomarker associated with wound healing. Modern health practice is centred on symptom reduction and working with pathology however, working with people’s adaptive behaviours such as resilience has not been a consideration. Using the resilience model as a conceptual framework healthcare professionals can engage with veterans towards resilience within the context of their personal experience of ill health. Using this contemporary framework for considering these aspects of care has the potential to facilitate resistance to stressors associated with being injured potentially averting quality of life impairments

Late Quaternary chironomid community structure shaped by rate and magnitude of climate change

Much is known about how climate change impacts ecosystem richness and turnover, but we have less understanding of its influence on ecosystem structures. Here, we use ecological metrics (beta diversity, compositional disorder and network skewness) to quantify the community structural responses of temperature-sensitive chironomids (Diptera: Chironomidae) during the Late Glacial (14 700–11 700 cal a bp) and Holocene (11 700 cal a bp to present). Analyses demonstrate high turnover (beta diversity) of chironomid composition across both epochs; however, structural metrics stayed relatively intact. Compositional disorder and skewness show greatest structural change in the Younger Dryas, following the rapid, high-magnitude climate change at the Bølling–Allerød to Younger Dryas transition. There were fewer climate-related structural changes across the early to mid–late Holocene, where climate change was more gradual and lower in magnitude. The reduced impact on structural metrics could be due to greater functional resilience provided by the wider chironomid community, or to the replacement of same functional-type taxa in the network structure. These results provide insight into how future rapid climate change may alter chironomid communities and could suggest that while turnover may remain high under a rapidly warming climate, community structural dynamics retain some resilience

Plant functional and taxonomic diversity in European grasslands along climatic gradients

Aim: European grassland communities are highly diverse, but patterns and drivers of their continental-scale diversity remain elusive. This study analyses taxonomic and functional richness in European grasslands along continental-scale temperature and precipitation gradients. Location: Europe. Methods: We quantified functional and taxonomic richness of 55,748 vegetation plots. Six plant traits, related to resource acquisition and conservation, were analysed to describe plant community functional composition. Using a null-model approach we derived functional richness effect sizes that indicate higher or lower diversity than expected given the taxonomic richness. We assessed the variation in absolute functional and taxonomic richness and in functional richness effect sizes along gradients of minimum temperature, temperature range, annual precipitation, and precipitation seasonality using a multiple general additive modelling approach. Results: Functional and taxonomic richness was high at intermediate minimum temperatures and wide temperature ranges. Functional and taxonomic richness was low in correspondence with low minimum temperatures or narrow temperature ranges. Functional richness increased and taxonomic richness decreased at higher minimum temperatures and wide annual temperature ranges. Both functional and taxonomic richness decreased with increasing precipitation seasonality and showed a small increase at intermediate annual precipitation. Overall, effect sizes of functional richness were small. However, effect sizes indicated trait divergence at extremely low minimum temperatures and at low annual precipitation with extreme precipitation seasonality. Conclusions: Functional and taxonomic richness of European grassland communities vary considerably over temperature and precipitation gradients. Overall, they follow similar patterns over the climate gradients, except at high minimum temperatures and wide temperature ranges, where functional richness increases and taxonomic richness decreases. This contrasting pattern may trigger new ideas for studies that target specific hypotheses focused on community assembly processes. And though effect sizes were small, they indicate that it may be important to consider climate seasonality in plant diversity studies

Metrics of structural change as indicators of chironomid community stability in high latitude lakes

© 2020 Elsevier Ltd Understanding the effects of climate change on ecosystem structure and stability is challenging, especially in high latitude regions that are predicted to experience the largest increases in ambient temperature. Global warming is likely to be a key driver of ecosystem change in freshwater lakes. Increased temperature can positively or negatively affect lake community composition through the loss of cold-adapted taxa and the arrival of temperate or eurytopic taxa. Here, we analyse the likely effects of temperature-induced changes in taxonomic richness and compositional turnover of environmentally-sensitive chironomids (Diptera: Chironomidae) across three regions - northern North America, Norway, and Russia - using existing datasets. Structural parameters (beta diversity, compositional disorder, and network skewness) were applied to model-simulated and empirical chironomid datasets across a large spatial temperature gradient. The analyses of empirical datasets showed changes in community structure across temperature gradients, suggesting varying states of ecosystem stability or instability. The comparison with null models enabled assessment as to whether these stresses agreed with expected patterns due to covarying summer temperature conditions or whether they deviated from expectations suggesting additional stress on the ecosystems. For all three regions, lakes in the mid-temperature range showed most evidence of relative ecosystem stability, with greater beta diversity, compositional disorder, and skewness, unanticipated by the modelled simulations. This is most likely due to more diverse habitats across the ecotone boundaries and additional factors that can influence ecosystem structures. Thus, we show that structural changes typical for ecosystem stability can be detected through changes in community structure across temperature gradients. This is important for understanding how lakes may change under current and future climate change