Comparison of Skeletal and Dentoalveolar Changes between Two Bone-Borne Maxillary Expanders

Introduction: Bone-borne maxillary expander (BBME) are designed to provide additional anchorage to widen the maxillary arch for patients who exhibit maxillary transverse deficiency. One form of BBME is the hybrid BBME which uses mini-implants (bone-borne) and posterior teeth (tooth-borne) as anchorage for maxillary expansion. The other form of BBME is absolute BBME which only uses mini-implants as anchorage. It is not clear in the literature if there is a difference in skeletal and dental changes with these two types of expanders. The objective of this study was to compare the skeletal, dentoalveolar, and periodontal changes between the hybrid and the absolute BBME using cone-beam computed tomography (CBCT). Materials and Methods: Thirty four adolescent patients with transverse maxillary deficiency were divided into two groups; the first group (16 patients) was treated with the hybrid BBME, and the second group (18 patients) was treated with absolute BBME. CBCT scans were taken pre-treatment (T1); and immediately post-expansion (T2) to measure the changes in midpalatal suture opening, total expansion (TE), alveolar bone bending (ABB), dental tipping (DT), and buccal bone thickness (BBT) at the first molar (M1) and first premolar (PM1) levels. Data were analyzed using paired t-test and sample t-test. Results: Midpalatal suture separation was found in 100% of the patients and the pattern of midpalatal suture opening was parallel in both groups. The total expansion at M1 level was 5.9 mm in the hybrid, and 4.7 mm in the absolute BBME group. The skeletal contributions were 56% and 83% of the TE in hybrid and absolute BBME groups at the M1 level, respectively. Subjects in the absolute BBME group experienced significantly less dental buccal tipping (0.5◦ for M1, and -1◦ for PM1), and BBT loss (0.2 mm for M1, and 0.4 mm for PM1) than the hybrid BBME group, (

Mechanical Thrombectomy for Large Ischemic Stroke: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVES There is growing evidence for endovascular thrombectomy (EVT) in patients with large ischemic core infarct and large vessel occlusion. The objective of this study was to compare the efficacy and safety of EVT versus medical management (MM) via a systematic review and meta-analysis of observational studies and randomized controlled trials (RCTs). METHODS We searched the PubMed, Embase, Cochrane Library, and Web of Science databases to obtain articles related to mechanical thrombectomy for large ischemic core from inception until February 10, 2023. The primary outcome was independent ambulation (modified Rankin Scale [mRS] 0-3). Effect sizes were computed as risk ratio (RR) with random-effect or fixed-effect models. The quality of articles was evaluated through the Cochrane risk assessment tool and Newcastle-Ottawa scale. This study was registered in PROSPERO (CRD42023396232). RESULTS A total of 5395 articles were obtained through the search and articles that did not meet the inclusion criteria were excluded by review of the title, abstract, and full text. Finally, 3 RCTs and 10 cohort studies met the inclusion criteria. The RCT analysis showed that EVT improved the 90-day functional outcomes of patients with large ischemic core with high-quality evidence, including independent ambulation (mRS 0-3: RR 1.78, 95% CI 1.28-2.48, P < 0.001) and functional independence (mRS 0-2: RR 2.59, 95% CI 1.89-3.57, P < 0.001), but without significantly increasing the risk of symptomatic intracranial hemorrhage (sICH: RR 1.83, 95% CI: 0.95-3.55, P = 0.07) or early mortality (RR 0.95, 95% CI 0.78-1.16, P = 0.61). Analysis of the cohort studies showed that EVT improved functional outcomes of patients without an increase in the incidence in sICH. CONCLUSION This systematic review and meta-analysis indicates that in patients with large vessel occlusion stroke with a large ischemic core, EVT was associated with improved functional outcomes over medical management without increasing sICH risk. Results of ongoing RCTs may provide further insight in this patient population

Thousands of Qatari genomes inform human migration history and improve imputation of Arab haplotypes

Arab populations are largely understudied, notably their genetic structure and history. Here we present an in-depth analysis of 6,218 whole genomes from Qatar, revealing extensive diversity as well as genetic ancestries representing the main founding Arab genealogical lineages of Qahtanite (Peninsular Arabs) and Adnanite (General Arabs and West Eurasian Arabs). We find that Peninsular Arabs are the closest relatives of ancient hunter-gatherers and Neolithic farmers from the Levant, and that founder Arab populations experienced multiple splitting events 12–20 kya, consistent with the aridification of Arabia and farming in the Levant, giving rise to settler and nomadic communities. In terms of recent genetic flow, we show that these ancestries contributed significantly to European, South Asian as well as South American populations, likely as a result of Islamic expansion over the past 1400 years. Notably, we characterize a large cohort of men with the ChrY J1a2b haplogroup (n = 1,491), identifying 29 unique sub-haplogroups. Finally, we leverage genotype novelty to build a reference panel of 12,432 haplotypes, demonstrating improved genotype imputation for both rare and common alleles in Arabs and the wider Middle East

Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients

International audienceThe aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed