Does initial buccal crest thickness affect final buccal crest thickness after flapless immediate implant placement and provisionalization:A prospective cone beam computed tomogram cohort study

BACKGROUND: Flapless immediate implant placement and provisionalization (FIIPP) in the aesthetic zone is still controversial. Especially, an initial buccal crest thickness (BCT) of ≤1 mm is thought to be disruptive for the final buccal crest stability jeopardizing the aesthetic outcome. PURPOSE: To radiographically assess the BCT and buccal crest height (BCH) after 1 year and to calculate the correlation between initial and final achieved BCT. MATERIALS AND METHODS: The study was designed as a prospective study on FIIPP. Only patients were included in whom one maxillary incisor was considered as lost. In six centers, 100 consecutive patients received FIIPP. Implants were placed in a maximal palatal position of the socket, thereby creating a buccal space of at least 2 mm, which was subsequently filled with a bovine bone substitute. Files of preoperative (T0), peroperative (T1) and 1-year postoperative (T3) cone beam computed tomogram (CBCT) scans were imported into the Maxillim™ software to analyze the changes in BCT-BCH over time. RESULTS: Preoperatively, 85% of the cases showed a BCT ≤1 mm, in 25% of the patients also a small buccal defect (≤5 mm) was present. Mean BCT at the level of the implant-shoulder increased from 0.6 mm at baseline to 3.3 mm immediate postoperatively and compacted to 2.4 mm after 1 year. Mean BCH improved from 0.7 to 3.1 mm peroperatively, and resorbed to 1.7 mm after 1 year. The Pearson correlation of 0.38 between initial and final BCT was significant (p = 0.01) and therefore is valued as moderate. If only patients (75%) with an intact alveolus were included in the analysis, still a "moderate correlation" of 0.32 (p = 0.01) was calculated. CONCLUSIONS: A "moderate correlation" was shown for the hypothesis that "thinner preoperative BCT's deliver thinner BCT's" 1 year after performing FIIPP

Impact of sarcopenia on acute radiation-induced toxicity in head and neck cancer patients

Background and purpose: Sarcopenia is related to late radiation-induced toxicities and worse survival in head and neck cancer (HNC) patients. This study tested the hypothesis that sarcopenia improves the performance of current normal tissue complication probability (NTCP) models of radiation-induced acute toxicity in HNC patients. Material/methods: This was a retrospective analysis in a prospective cohort of HNC patients treated from January 2007 to December 2018 with (chemo)radiotherapy. Planning CT scans were used for evaluating skeletal muscle mass. Characteristics of sarcopenic and non-sarcopenic patients were compared. The impact of sarcopenia was analysed by adding sarcopenia to the linear predictors of current NTCP models predicting physician- and patient-rated acute toxicities. Results: The cut-off values of sarcopenia in the study population (n = 977) were established at skeletal muscle index = 2, p = 3 dysphagia (week 3-6 during RT, p 0.99). Conclusion: Sarcopenia in HNC patients was an independent prognostic factor for radiation-induced physician-rated acute grade >= 3 dysphagia, which might be explained by its impact on swallowing muscles. However, addition of sarcopenia did not improve the NTCP model performance. (c) 2022 The Author(s). Published by Elsevier B.V. Radiotherapy and Oncology 170 (2022) 122-128 This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Patient-Reported Toxicity and Quality-of-Life Profiles in Patients With Head and Neck Cancer Treated With Definitive Radiation Therapy or Chemoradiation

Purpose: Radiation therapy is an effective but burdensome treatment for head and neck cancer (HNC). We aimed to characterize the severity and time pattern of patient-reported symptoms and quality of life in a large cohort of patients with HNC treated with definitive radiation therapy, with or without systemic treatment. Methods and Materials: A total of 859 patients with HNC treated between 2007 and 2017 prospectively completed the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Head and Neck Cancer module (QLQ-HN35) and Core Quality of Life Questionnaire (QLQ-C30) at regular intervals during and after treatment for up to 5 years. Patients were classified into 3 subgroups: early larynx cancer, infrahyoideal cancer, and suprahyoideal cancer. Outcome scales of both questionnaires were quantified per subgroup and time point by means of average scores and the frequency distribution of categorized severity (none, mild, moderate, and severe). Time patterns and symptom severity were characterized. Toxicity profiles were compared using linear mixed model analysis. Additional toxicity profiles based on age, human papillomavirus status, treatment modality, smoking status, tumor site, and treatment period were characterized as well. Results: The study population consisted of 157 patients with early larynx cancer, 304 with infrahyoideal cancer, and 398 with suprahyoideal cancer. The overall questionnaire response rate was 83%. Generally, the EORTC QLQ-HN35 symptoms reported showed a clear time pattern, with increasing scores during treatment followed by a gradual recovery in the first 2 years. Distinct toxicity profiles were seen across subgroups (P < .001), with generally less severe symptom scores in the early larynx subgroup. The EORTC QLQ-C30 functioning, quality-of-life, and general symptoms reported showed a less evi- dent time pattern and less pronounced differences in mean scores between subgroups, although differences were still signifi- cant (P < .001). Differences in mean scores were most pronounced for role functioning, appetite loss, fatigue, and pain. Conclusions: We established patient-reported toxicity and quality-of-life profiles that showed different patterns for 3 sub-groups of patients with HNC. These profiles provide detailed information on the severity and persistence of various symptoms as experienced by patients during and after definitive radiation therapy. These profiles can be used to inform treatment of future patients and may serve as a benchmark for future studies. (C) 2021 The Authors. Published by Elsevier Inc

Restored intertidal eelgrass (Z. marina) supports benthic communities taxonomically and functionally similar to natural seagrasses in the Wadden Sea

Ecological restoration has become an important management-tool to counteract the widespread losses of seagrass meadows and their associated biodiversity. In the Dutch Wadden Sea, long-term restoration efforts have recently led to the successful restoration of annual eelgrass (Zostera marina) at high densities on a local scale. However, it is yet unknown if restored seagrass plants also lead to improved local biodiversity and ecosystem functioning in the intertidal zone. We therefore compared the macrozoobenthos communities of a small-scale restored meadow to 22 naturally occurring intertidal seagrass meadows. Using a taxonomic and trait-based approach we aimed to study 1) how intertidal seagrasses (Zostera marina and Zostera noltii) affect benthic communities and their functional trait distribution and 2) if a restored meadow facilitates benthic communities similar to natural meadows. We found that both natural and restored seagrasses increased abundances of benthic animals and the richness (both taxonomic and functional) of associated benthic communities compared to nearby unvegetated areas. Additionally, the presence of intertidal seagrass shifted benthic community composition both taxonomically and functionally, thus broadening the niche space for species inhabiting tidal flats. Seagrasses especially facilitated epifaunal species and traits associated with these animals. Surprisingly, our results indicate that the mere presence of seagrass aboveground structure is enough to facilitate benthic communities, as neither higher seagrass cover nor biomass increased benthic biodiversity in the intertidal zone. By studying the effect of seagrass restoration on benthic diversity, we found that the restored meadow functioned similarly to the natural meadows after only two years and that the success of our restoration efforts indeed led to local biodiversity enhancements. Our findings contribute to the understanding of the ecological functioning of intertidal seagrasses and can be used to define/refine conservation and restoration goals of these valuable ecosystems

A review of the dodo and its ecosystem: insights from a vertebrate concentration Lagerstätte in Mauritius

The dodo Raphus cucullatus Linnaeus, an extinct and flightless, giant pigeon endemic to Mauritius, has fascinated people since its discovery, yet has remained surprisingly poorly known. Until the mid-19th century, almost all that was known about the dodo was based on illustrations and written accounts by 17th century mariners, often of questionable accuracy. Furthermore, only a few fragmentary remains of dodos collected prior to the bird's extinction exist. Our understanding of the dodo's anatomy was substantially enhanced by the discovery in 1865 of subfossil bones in a marsh called the Mare aux Songes, situated in southeastern Mauritius. However, no contextual information was recorded during early excavation efforts, and the majority of excavated material comprised larger dodo bones, almost all of which were unassociated. Here we present a modern interdisciplinary analysis of the Mare aux Songes, a 4200-year-old multitaxic vertebrate concentration Lagerstätte. Our analysis of the deposits at this site provides the first detailed overview of the ecosystem inhabited by the dodo. The interplay of climatic and geological conditions led to the exceptional preservation of the animal and associated plant remains at the Mare aux Songes and provides a window into the past ecosystem of Mauritius. This interdisciplinary research approach provides an ecological framework for the dodo, complementing insights on its anatomy derived from the only associated dodo skeletons known, both of which were collected by Etienne Thirioux and are the primary subject of this memoir.publishedVersio

The OncoLifeS data-biobank for oncology:a comprehensive repository of clinical data, biological samples, and the patient's perspective

BACKGROUND: Understanding cancer heterogeneity, its temporal evolution over time, and the outcomes of guided treatment depend on accurate data collection in a context of routine clinical care. We have developed a hospital-based data-biobank for oncology, entitled OncoLifeS (Oncological Life Study: Living well as a cancer survivor), that links routine clinical data with preserved biological specimens and quality of life assessments. The aim of this study is to describe the organization and development of a data-biobank for cancer research. RESULTS: We have enrolled 3704 patients aged ≥ 18 years diagnosed with cancer, of which 45 with hereditary breast-ovarian cancer (70% participation rate) as of October 24th, 2019. The average age is 63.6 ± 14.2 years and 1892 (51.1%) are female. The following data are collected: clinical and treatment details, comorbidities, lifestyle, radiological and pathological findings, and long-term outcomes. We also collect and store various biomaterials of patients as well as information from quality of life assessments. CONCLUSION: Embedding a data-biobank in clinical care can ensure the collection of high-quality data. Moreover, the inclusion of longitudinal quality of life data allows us to incorporate patients' perspectives and inclusion of imaging data provides an opportunity for analyzing raw imaging data using artificial intelligence (AI) methods, thus adding new dimensions to the collected data

Bragatston study protocol: a multicentre cohort study on automated quantification of cardiovascular calcifications on radiotherapy planning CT scans for cardiovascular risk prediction in patients with breast cancer

Introduction Cardiovascular disease (CVD) is an important cause of death in breast cancer survivors. Some breast cancer treatments including anthracyclines, trastuzumab and radiotherapy can increase the risk of CVD, especially for patients with pre-existing CVD risk factors. Early identification of patients at increased CVD risk may allow switching to less cardiotoxic treatments, active surveillance or treatment of CVD risk factors. One of the strongest independent CVD risk factors is the presence and extent of coronary artery calcifications (CAC). In clinical practice, CAC are generally quantified on ECGtriggered cardiac CT scans. Patients with breast cancer treated with radiotherapy routinely undergo radiotherapy planning CT scans of the chest, and those scans could provide the opportunity to routinely assess CAC before a potentially cardiotoxic treatment. The Bragatston study aims to investigate the association between calcifications in the coronary arteries, aorta and heart valves (hereinafter called ‘cardiovascular calcifications’) measured automatically on planning CT scans of patients with breast cancer and CVD risk. Methods and analysis In a first step, we will optimise and validate a deep learning algorithm for automated quantification of cardiovascular calcifications on planning CT scans of patients with breast cancer. Then, in a multicentre cohort study (University Medical Center Utrecht, Utrecht, Erasmus MC Cancer Institute, Rotterdam and Radboudumc, Nijmegen, The Netherlands), the association between cardiovascular calcifications measured on planning CT scans of patients with breast cancer (n≈16 000) and incident (non-)fatal CVD events will be evaluated. To assess the added predictive value of these calcifications over traditional CVD risk factors and treatment characteristics, a case-cohort analysis will be performed among all cohort members diagnosed with a CVD event during follow-up (n≈200) and a random sample of the baseline cohort (n≈600). Ethics and dissemination The Institutional Review Boards of the participating hospitals decided that the Medical R