Incidence and predictors of weaning failure from veno-arterial extracorporeal membrane oxygenation therapy in patients with cardiogenic shock.

Aims: This study aimed to investigate incidence and predictors of weaning failure and in-hospital death after successful weaning from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock (CS).

Methods And Results: Overall, 685 patients with CS treated with VA-ECMO from 23 tertiary care centres in 7 countries were analysed (median age 57 [interquartile range 49-66] years, 542 [79.1%] male, median lactate 7.

Bayesian Reanalyses of the Trials TOMAHAWK and COACT.

Background: The timing of coronary angiography in patients with successfully resuscitated out-of-hospital cardiac arrest and missing ST-segment elevations on the electrocardiogram has been investigated in 2 large randomized controlled trials, TOMAHAWK (Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation) and COACT (Coronary Angiography After Cardiac Arrest Trial). Both trials found neutral results for immediate vs delayed/selective coronary angiography on short-term all-cause mortality. The TOMAHAWK trial showed a tendency towards harm with immediate coronary angiography, though not statistically significant with traditional frequentist methods.

Systematic review of peri-implant conditions and aesthetic outcomes of customized versus conventional healing abutments.

Purpose: Customized healing abutments are utilized to enhance aesthetics and peri-implant soft and hard tissue health, and play a crucial role in the implant-prosthetic workflow. This systematic review was performed to assess and compare the clinical outcomes of customized healing abutments with conventional ones.

Methods: The review was registered with PROSPERO (ID: CRD42024532449) and followed the PRISMA-guidelines.

Higher frequency of interstate over international transmission chains of SARS-CoV-2 virus at the Rio Grande do Sul - Brazil state borders.

Brazil's COVID-19 response has faced challenges due to the continuous emergence of variants of concern (VOCs), emphasizing the need for ongoing genomic surveillance and retrospective analyses of past epidemic waves to reassess and fine tune containment protocols. Rio Grande do Sul (RS), Brazil's southernmost state, has international borders and trades with Argentina and Uruguay, along with significant domestic connections within Brazil. The identification of source and sink transmission chains at national and international scales can identify main hubs and pathways to target future interventions.

Bone regeneration and dental implant surgeries in florid cemento-osseous dysplasia: A case report.

Cemento-osseous dysplasia (COD) is a benign fibro-osseous pathology in which fibrous connective tissues, osteoid and cementum-like materials, replace bone. Concerning the hypovascularization and increased mineralization of bone that occurs in these patients, the clinician may face two types of problems: infectious complications such as osteomyelitis and increased implant failure. The present study aims to report the successful and innovative management of a COD patient complicated by mandibular osteomyelitis and the implant rehabilitation of this area.

Numerical determination of the substrate's zero-chirp geometry for the elimination of the period chirp in laser interference lithography.

The technique of deliberately bending the substrate during the exposure offers a promising solution to eliminate the period chirp in laser interference lithography. The exact geometry of the substrate to allow for this elimination is given by the solution of an ordinary differential equation (ODE) which has not been solved before. We therefore present a new contemplation of this particular ODE and its solution, the zero-chirp geometry.

Selenoprotein P as a prognostic biomarker of burn sepsis: A prospective cohort study.

Introduction: Severely burned patients exhibit increased nutritional requirements and are at high risk of developing sepsis. Selenium is an essential trace element supporting antioxidant and anti-inflammatory pathways, mediated by incorporation into selenoproteins. The selenium status may affect sepsis risk in burn injury.

Intra-lymph node crosslinking of antigen-bearing polymers enhances humoral immunity and dendritic cell activation.

Lymph node (LN)-resident dendritic cells (DCs) are a promising target for vaccination given their professional antigen-presenting capabilities and proximity to a high concentration of immune cells. Direct intra-LN injection has been shown to greatly enhance the immune response to vaccine antigens compared to traditional intramuscular injection, but it is infeasible to implement clinically in a vaccination campaign context. Employing the passive lymphatic flow of antigens to target LNs has been shown to increase total antigen uptake by DCs more than inflammatory adjuvants, which recruit peripheral DCs.

A TLR7 Agonist Conjugated to a Nanofibrous Peptide Hydrogel as a Potent Vaccine Adjuvant.

Toll-like receptors (TLRs) recognize pathogen- and damage-associated molecular patterns and, in turn, trigger the release of cytokines and other immunostimulatory molecules. As a result, TLR agonists are increasingly being investigated as vaccine adjuvants. Many of these agonists are small molecules that quickly diffuse away from the vaccination site, limiting their co-localization with antigens and, thus, their effect.

Timing of veno-arterial extracorporeal membrane oxygenation support in patients with cardiogenic shock.

Aims: The optimal timing for implementing mechanical circulatory support (MCS) in cardiogenic shock (CS) remains indeterminate. This study aims to evaluate patient characteristics and outcome associated with the time interval between CS onset and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) implementation.

Methods And Results: In this study, patients with CS treated with MCS at 15 tertiary care centres in three countries were enrolled.

Long-term safety and efficacy of endovascular ultrasound renal denervation in resistant hypertension: 8-year results from the ACHIEVE study.

Background: Ultrasound renal sympathetic denervation (uRDN) reduces blood pressure (BP) in the absence and presence of antihypertensive treatment at 2 months. Beyond 3 years, there is a lack of follow-up data. This study investigated the long-term safety and efficacy of uRDN.

Human outbreaks of a novel reassortant Oropouche virus in the Brazilian Amazon region.

The Brazilian western Amazon is experiencing its largest laboratory-confirmed Oropouche virus (OROV) outbreak, with more than 6,300 reported cases between 2022 and 2024. In this study, we sequenced and analyzed 382 OROV genomes from human samples collected in Amazonas, Acre, Rondônia and Roraima states, between August 2022 and February 2024, to uncover the origin and genetic evolution of OROV in the current outbreak. Genomic analyses revealed that the upsurge of OROV cases in the Brazilian Amazon coincides with spread of a novel reassortant lineage containing the M segment of viruses detected in the eastern Amazon region (2009-2018) and the L and S segments of viruses detected in Peru, Colombia and Ecuador (2008-2021).

New-onset autoantibodies to selenoprotein P following severe burn injury.

The liver-derived selenium (Se) transporter selenoprotein P (SELENOP) declines in critical illness as a negative acute phase reactant and has recently been identified as an autoantigen. Hepatic selenoprotein biosynthesis and cotranslational selenocysteine insertion are sensitive to inflammation, therapeutic drugs, Se deficiency, and other modifiers. As severe burn injury induces a heavy inflammatory burden with concomitant Se depletion, we hypothesized an impairment of selenoprotein biosynthesis in the acute post-burn phase, potentially triggering the development of autoantibodies to SELENOP (SELENOP-aAb).

Dimensional reliability in CAD/CAM production of complete denture bases: A comparative study of milling and various 3D printing technologies.

This study aims to assess the dimensional accuracy of complete denture bases fabricated from different CAD/CAM technologies and a conventional method, including milling (CNC), PolyJet (PJ), laser sintering (SLS), digital light processing (DLP), and injection molding (IM). It also examines the influence of the removal of technology-specific connectors or support structures when present. Denture base surfaces were digitized using a laboratory scanner, and virtual measurement points were calculated with tetrahedral reference geometries.

An activity-specificity trade-off encoded in human transcription factors.

Transcription factors (TFs) control specificity and activity of gene transcription, but whether a relationship between these two features exists is unclear. Here we provide evidence for an evolutionary trade-off between the activity and specificity in human TFs encoded as submaximal dispersion of aromatic residues in their intrinsically disordered protein regions. We identified approximately 500 human TFs that encode short periodic blocks of aromatic residues in their intrinsically disordered regions, resembling imperfect prion-like sequences.

Bending of Lloyd's mirror to eliminate the period chirp in the fabrication of diffraction gratings.

We present a new technique to prevent the detrimental period chirp that appears in optical gratings fabricated by laser interference lithography (LIL). The idea is to bend the Lloyd's mirror in the lithographic setup to eliminate the period chirp already at the step of the grating's exposure. A new mathematical model was developed to describe the required bending geometry of the mirror.

Expediting online liquid chromatography for real-time monitoring of product attributes to advance process analytical technology in downstream processing of biopharmaceuticals.

The application of Process Analytical Technology (PAT) principles for manufacturing of biotherapeutics proffers the prospect of ensuring consistent product quality along with increased productivity as well as substantial cost and time savings. Although this paradigm shift from a traditional, rather rigid manufacturing model to a more scientific, risk-based approach has been advocated by health authorities for almost two decades, the practical implementation of PAT in the biopharmaceutical industry is still limited by the lack of fit-for-purpose analytical methods. In this regard, most of the proposed spectroscopic techniques are sufficiently fast but exhibit deficiencies in terms of selectivity and sensitivity, while well-established offline methods, such as (ultra-)high-performance liquid chromatography, are generally considered as too slow for this task.

Spatiotemporal transmission of SARS-CoV-2 lineages during 2020-2021 in Pernambuco-Brazil.

SARS-CoV-2 virus emerged as a new threat to humans and spread around the world, leaving a large death toll. As of January 2023, Brazil is among the countries with the highest number of registered deaths. Nonpharmacological and pharmacological interventions have been heterogeneously implemented in the country, which, associated with large socioeconomic differences between the country regions, has led to distinct virus spread dynamics.

Clinical performance and risk factors of all-ceramic screw-retained implant crowns in the posterior region based on a retrospective investigation.

Objectives: Clinical data on all-ceramic screw-retained implant crowns (SICs) luted on titanium base abutments (TBAs) over more than 3 years are sparse. This study aimed to evaluate the clinical performance and potential risk factors for these restorations.

Materials And Methods: Analysis took place based on the medical patient-records of three dental offices.

A contemporary training concept in critical care cardiology.

Critical care cardiology (CCC) in the modern era is shaped by a multitude of innovative treatment options and an increasingly complex, ageing patient population. Generating high-quality evidence for novel interventions and devices in an intensive care setting is exceptionally challenging. As a result, formulating the best possible therapeutic approach continues to rely predominantly on expert opinion and local standard operating procedures.

Modelling the unexpected dynamics of COVID-19 in Manaus, Brazil.

In late March 2020, SARS-CoV-2 arrived in Manaus, Brazil, and rapidly developed into a large-scale epidemic that collapsed the local health system and resulted in extreme death rates. Several key studies reported that ∼76% of residents of Manaus were infected (attack rate AR≃76%) by October 2020, suggesting protective herd immunity had been reached. Despite this, an unexpected second wave of COVID-19 struck again in November and proved to be larger than the first, creating a catastrophe for the unprepared population.