Long term survival of mature autotransplanted teeth: A retrospective single center analysis

Objective: The replacement of an irremediably compromised tooth requires an implant rehabilitation or a traditional fixed partial denture. In well-selected cases, a further therapeutic possibility is represented by tooth autotransplantation. Although dental transplants are poorly understood and practiced, the international literature agrees that it is considered the first choice when applicable. The advantages of this technique are numerous: use of an autologous element, maintenance of tissue trophism, aesthetic and functional restoration, costs reduction. Although autotransplantation is often performed with immature teeth, even mature teeth with fully formed apex can be used as donors. The aim of the present work was to analyze consecutive cases of completely formed donor teeth autotransplantations performed from 2005 to 2011 in 21 patients for evaluating the survival and success rate. Materials and methods: The medical records of patients who underwent transplantation in a specialized center in Rimini (Italy) from 2005 to 2011 were checked. Only transplants of mature donor molars were considered. Patients were called up to evaluate the survival rate and success rate. Results: The mean age at the time of the surgery was 33,6 \ub1 7,4; mean follow up was 11,9 years \ub11,9. Success rate at the time of latest recall visit was 80 % and survival 95 % of the analyzed cases. Conclusions: The survival and success rate are in complete agreement with the most recent literature and confirm that the technique of autotransplantation is reliable when indications and protocols are rigidly followed, also using mature teeth as donors

Going beyond the green : senesced vegetation material predicts basal area and biomass in remote sensing of tree cover conditions in an African tropical dry forest (miombo woodland) landscape

© The Author(s), 2017. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Environmental Research Letters 12 (2017): 085004, doi:10.1088/1748-9326/aa7242.In sub-Saharan Africa (SSA), tropical dry forests and savannas cover over 2.5 million km2 and support livelihoods for millions in fast-growing nations. Intensifying land use pressures have driven rapid changes in tree cover structure (basal area, biomass) that remain poorly characterized at regional scales. Here, we posed the hypothesis that tree cover structure related strongly to senesced and non-photosynthetic (NPV) vegetation features in a SSA tropical dry forest landscape, offering improved means for satellite remote sensing of tree cover structure compared to vegetation greenness-based methods. Across regrowth miombo woodland sites in Tanzania, we analyzed relationships among field data on tree structure, land cover, and satellite indices of green and NPV features based on spectral mixture analyses and normalized difference vegetation index calculated from Landsat 8 data. From satellite-field data relationships, we mapped regional basal area and biomass using NPV and greenness-based metrics, and compared map performances at landscape scales. Total canopy cover related significantly to stem basal area (r 2 = 0.815, p  60%) at all sites. From these two conditions emerged a key inverse relationship: skyward exposure of NPV ground cover was high at sites with low tree basal area and biomass, and decreased with increasing stem basal area and biomass. This pattern scaled to Landsat NPV metrics, which showed strong inverse correlations to basal area (Pearson r = −0.85, p < 0.01) and biomass (r = −0.86, p < 0.01). Biomass estimates from Landsat NPV-based maps matched field data, and significantly differentiated landscape gradients in woody biomass that greenness metrics failed to track. The results suggest senesced vegetation metrics at Landsat scales are a promising means for improved monitoring of tree structure across disturbance and ecological gradients in African and other tropical dry forests.The project was funded by the US National Science Foundation Partnerships for International Research and Education (PIRE) program, project title 'Ecosystems and Human Well-Being' (Award # 0968211) PI Chris Neill. Additional research and dissertation support was provided to Marc Mayes from Brown University

Pupillometry via smartphone for low-resource settings

The photopupillary reflex regulates the pupil reaction to changing light conditions. Being controlled by the autonomic nervous system, it is a proxy for brain trauma and for the conditions of patients in critical care. A prompt evaluation of brain traumas can save lives. With a simple penlight, skilled clinicians can do that, whereas less specialized ones have to resort to a digital pupilometer. However, many low-income countries lack both specialized clinicians and digital pupilometers. This paper presents the early results of our study aiming at designing, prototyping and validating an app for testing the photopupillary reflex via Android, following the European Medical Device Regulation and relevant standards. After a manual validation, the prototype underwent a technical validation against a commercial Infrared pupilometer. As a result, the proposed app performed as well as the manual measurements and better than the commercial solution, with lower errors, higher and significant correlations, and significantly better Bland-Altman plots for all the pupillometry-related measures. The design of this medical device was performed based on our expertise in low-resource settings. This kind of environments imposes more stringent design criteria due to contextual challenges, including the lack of specialized clinicians, funds, spare parts and consumables, poor maintenance, and harsh environmental conditions, which may hinder the safe operationalization of medical devices. This paper provides an overview of how these unique contextual characteristics are cascaded into the design of an app in order to contribute to the Sustainable Development Goal 3 of the World Health Organization: Good health and well-being

Correlation between choriocapillaris density and retinal sensitivity in age-related macular degeneration

Purpose: The purpose of this study was to investigate the relationship between perfusion of the choriocapillaris (CC) and retinal sensitivity in eyes with intermediate agerelated macular degeneration (iAMD). Methods: This prospective study included patients with iAMD and healthy controls. All enrolled subjects underwent optical coherence tomography angiography (OCT-A) in order to compute the percent perfused choriocapillaris area (PPCA). In patients with iAMD, microperimetry (MP) testing was performed in order to quantify: mean retinal sensitivity (MRS), over an area of 10 degrees; mean macular sensitivity (MMS), over the macular area scanned with OCT-A; and retinal sensitivity (RS) in each macular point. Results: Eighteen eyes of 13 patients were included in the analysis. In addition, 18 eyes of 12 healthy subjects were enrolled as controls. No statistically significant difference (P value &gt; 0.2) was observed in age between patients (73.9 ± 2.0 years) and controls (70.1 ± 2.8 years). We observed significantly lower values of PPCA between patients with iAMD and healthy controls (42.0% ± 3.8% vs. 66.4% ± 3.0%; -Β = 23.8%; P value &lt; 0.001). Among iAMD eyes, higher values of PPCA were significantly associated with higher values of MRS (P value=0.002) and MMS (P value=0.013). Finally, higher values of RS in eachmacular point analyzedwithMPwere significantly (P value&lt;0.001) associated with higher values of PPCA computed in circular regions of interest (ROIs) centered in each analyzed MP point with radii of 0.5 degrees and 1.0 degree. Conclusions: Using OCT-A, we demonstrated a significant association between CC impairment and macular dysfunction, quantified by MP, in iAMD eyes. Translational Relevance: OCT-A could be a useful tool for detecting CC alterations and to monitor disease progression

Oct analysis in patients with relapsing-remitting multiple sclerosis during fingolimod therapy: 2-year longitudinal retrospective study

Many studies have demonstrated the usefulness of some optical coherence tomography (OCT) parameters, like total macular volume (TMV) and retinal nerve fiber layer thickness (RNFL-T), for monitoring patients with multiple sclerosis (MS). However, there are no real-world, long-term studies on patients with relapsing-remitting MS (RR-MS) treated with fingolimod. Therefore, the purpose of this study was to describe retinal changes associated with fingolimod therapy during a two-year follow-up while considering previous episodes of optic neuritis (ON). Patients diagnosed with RR-MS and treated with fingolimod (46 in total) underwent a two-year follow-up. Based on previous ON history, we identified 16 ON+ and 30 ON− patients. The ophthalmological evaluations, including visual field (VF) examination and OCT, were performed at a baseline at 3–6, 12 and 24 months to evaluate the progression rate for each parameter. When analyzing the whole sample, OCT showed no cases of macular edema. Instead, we observed a significant reduction rate in the central retinal thickness (CRT) (p&lt;0.001), TMV (p &lt; 0.001) and RNFL (p &lt; 0.05). Moreover, we observed a significant difference in the progression rate between ON+ and ON− patients, relative to the VF and RNFL (p &lt; 0.05) examinations. OCT highlighted a significant progression rate of retinal damage in MS patients despite fingolimod therapy, especially in MS ON+ patients

Evaluation of Donor and Recipient Characteristics Involved in Descemet Stripping Automated Endothelial Keratoplasty Outcomes

Aims: To evaluate both donor and recipient features involved in visual acuity restoring and complication insurgence in eyes that have undergone Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: In this retrospective study, charts of 111 eyes of 96 patients (mean age 70.25 ± 8.58 years) that underwent DSAEK were evaluated. Only Fuch's Distrophy (FD) or Bullous Keratopathy (BK) due to cataract surgery eyes were included. A complete ophthalmic check with endothelial cell density (ECD) and central corneal thickness (CCT) measurement was performed before surgery and at 1, 3, 6, and 12 months follow-up. Each DSAEK was performed by the same well-trained surgeon; only pre-cut lenticules, provided by same Eye Bank, were implanted. Results: A total of 48 (43%) complications have been observed (most of them were 22 partial graft detachments and 17 IOP spikes). At the last follow-up (mean: 8.58 ± 4.09 months), a significant increase (p &lt; 0.05) of best corrected visual acuity (BCVA) was detected. Overall mean BCVA of the eyes evaluated was 0.40 ± 0.43 LogMAR with BK eyes showing a significantly higher improvement (p &lt; 0.05) compared to FD eyes. The only factor showing a significant correlation (p &lt; 0.05) with visual acuity enhancement was the implant of a lenticule thinner than 100 μm. Recipient features significantly (p &lt; 0.05) associated with complications observed after surgery were glaucoma and diabetes mellitus. Conclusion: The use of a graft thinner than 100 μm can provide better visual acuity recovery while recipients affected by glaucoma or diabetes mellitus are more prone to develop complications after surgery

The Amazon frontier of land-use change : croplands and consequences for greenhouse gas emissions

Author Posting. © American Meteorological Society, 2010. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Earth Interactions 14 (2010): 1–24, doi:10.1175/2010EI327.1.The Brazilian Amazon is one of the most rapidly developing agricultural frontiers in the world. The authors assess changes in cropland area and the intensification of cropping in the Brazilian agricultural frontier state of Mato Grosso using remote sensing and develop a greenhouse gas emissions budget. The most common type of intensification in this region is a shift from single- to double-cropping patterns and associated changes in management, including increased fertilization. Using the enhanced vegetation index (EVI) from the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor, the authors created a green-leaf phenology for 2001–06 that was temporally smoothed with a wavelet filter. The wavelet-smoothed green-leaf phenology was analyzed to detect cropland areas and their cropping patterns. The authors document cropland extensification and double-cropping intensification validated with field data with 85% accuracy for detecting croplands and 64% and 89% accuracy for detecting single- and double-cropping patterns, respectively. The results show that croplands more than doubled from 2001 to 2006 to cover about 100 000 km2 and that new double-cropping intensification occurred on over 20% of croplands. Variations are seen in the annual rates of extensification and double-cropping intensification. Greenhouse gas emissions are estimated for the period 2001–06 due to conversion of natural vegetation and pastures to row-crop agriculture in Mato Grosso averaged 179 Tg CO2-e yr−1, over half the typical fossil fuel emissions for the country in recent years.This work was supported by the NASA Earth and Space Science Fellowship (G. L. Galford) and Large-Scale Biosphere Atmosphere Experiment in Amazonia (Grant NNG06GE20A) and the Environmental Change Initiative at Brown University

Promoting occupational health through gamification and e-coaching: A 5-month user engagement study

Social gamification systems have shown potential for promoting healthy lifestyles, but applying them to occupational settings faces unique design challenges. While occupational settings offer natural communities for social interaction, fairness issues due to heterogeneous personal goals and privacy concerns increase the difficulty of designing engaging games. We explored a two-level game-design, where the first level related to achieving personal goals and the second level was a privacy-protected social competition to maximize goal compliance among colleagues. The solution was strengthened by employing occupational physicians who personalized users’ goals and coached them remotely. The design was evaluated in a 5-month study with 53 employees from a Dutch university. Results suggested that the application helped half of the participants to improve their lifestyles, and most appreciated the role of the physician in goal-setting. However, long-term user engagement was undermined by the scalability-motivated design choice of one-way communication between employees and their physician. Implications for social gamification design in occupational health are discussed

Sensitivity and specificity of vestibular bed-side examination in detecting VIII cranial nerve schwannoma with sensorineural sudden unilateral hearing loss as presenting symptom

Gli obiettivi dello studio sono stati: identificare segni di sofferenza vestibolare attraverso un protocollo di bed-side examination in caso di ipoacusia improvvisa monolaterale senza segni clinici di sofferenza vestibolare; proporre i risultati della bed side examination vestibolare come criterio per lesecuzione mirata della RMN per i canali acustici interni in caso di sospetto di neurinoma dell VIII nervo cranico. Sono stati valutati 96 pazienti, 52 uomini e 44 donne, con ipoacusia improvvisa neurosensoriale monolaterale che non presentavano né vertigine né nistagmo spontaneo. Sono stati eseguiti: esame audiometrico tonale, esame impedenzometrico con test di Anderson per la ricerca di adattamento, Head Shaking Test, Test Vibratorio, Head Impulse Test, Test di iperventilazione, ricerca del nistagmo posizionale in posizione supina e nei decubiti laterali; lABR è stato eseguito nei pazienti con segni di sofferenza vestibolare se con soglia tonale ai toni acuti migliore di 70 dB nHL; tutti i pazienti con ipoacusia improvvisa hanno eseguito RMN con gadolinio per i canali acustici interni. Segni di sofferenza vestibolare sono stati identificati in 22/96 pazienti (22.9%) e la RMN ha evidenziato la presenza di schwannoma dell VIII nervo cranico in 5/96 casi (5.2%), tutti con segni di sofferenza vestibolare evidenziati alla vestibular bed-side examination. I nostri dati hanno evidenziato che gli schwannomi dell VIII nervo cranico sono stati individuati solo nei casi di ipoacusia improvvisa monolaterale con segni di deficit vestibolare omolaterale. Lindicazione alla RMN con gadolinio può quindi essere limitata solo a questi casi, con evidente beneficio organizzativo ed economico