Search results for: mean survival time

Authors: I. Iroka, L. Mgidlana, J. Willoughby, S. Dhlamini, P. Nxumalo, S. Sefadi, A. Mthembu, E. Gerber, E. Brits

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Introduction: Nephroblastoma is a common paediatric tumor with good survival rates when diagnosed and treated early. Method: This retrospective study aimed to describe the patients with nephroblastoma seen at Universitas Academic Hospital Complex between the years 2000 and 2020. Results: In the study period, there were 207 patients identified. The patient profile had slightly more male than female patients; the median age was under four years of age. The study found a median delay of one month between symptom onset and diagnosis; a common cause was a delay in seeking care. Patients diagnosed and treated more than a month after symptoms started had poorer survival rates. There was a higher rate of Stage IV disease compared to similar studies in South Africa. Good preoperative histology and no relapse had good survival rates.. Patients from Lesotho had longer delays and presented with more severe diseases than the South African cohort. Conclusion: Early identification and treatment lead to better outcomes. Health-seeking behaviour, misdiagnosis, and referral delays might contribute to the long delays. A targeted study for patients from Lesotho is recommended.

Keywords: nephroblastoma, South Africa, Lesotho, developing country

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Authors: James V. Luisi

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Understanding consciousness requires a synthesis of ideas from multiple disciplines, including obvious ones like psychology, biology, evolution, neurology, and neuroscience, as well as less obvious ones like protozoology, botany, entomology, carcinology, herpetology, mammalogy, and computer sciences. Furthermore, to incorporate the necessary backdrop, it is best presented in a theme of Eastern philosophy, specifically leveraging the teachings of Buddhism for its relevance to early thought on consciousness. These ideas are presented as a multi-level framework that illustrates the various aspects of consciousness within a tapestry of foundational and dependent building blocks as to how living organisms evolved to understand elements of their reality sufficiently to survive, and in the case of Homo sapiens, eventually move beyond meeting the basic needs of survival, but to also achieve survival of the species beyond the eventual fate of our planet. This is not a complete system of thought, but just a framework of consciousness gathering some of the key elements regarding the evolution of consciousness and the advent of free will, and presenting them in a unique way that encourages readers to continue the dialog and thought process as an experience to enjoy long after reading the last page. Readers are encouraged to think for themselves about the issues raised herein and to question every facet presented, as much further exploration is needed. Needless to say, this subject will remain a rapidly evolving one for quite some time to come, and it is probably in the interests of everyone to at least consider attaining both an ability and willingness to participate in the dialog.

Keywords: consciousness, sentience, intelligence, artificial intelligence, Buddhism

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Authors: Himanshu Rohela

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BACKGROUND: Ewing sarcoma can arise in either bone or soft tissue. Extraskeletal Ewing sarcoma (EES) is an uncommon primary tumor of the soft tissues, accounting for 20 30% of all reported cases of ES. AIM: Was to investigate demographic distribution, survival analysis and factors affecting the survival and recurrence in patients of EES. METHODS: Retrospective study of 19 biopsy-proven EES was performed. Overall survival (OS) using log-rank test and factors affecting OS and local recurrence (LR) were evaluated for the entire cohort. RESULTS: Patients with EES had a mean age of 19.5 and it was more commonly seen in males (63%). Axial location (58%) and solitary presentation (84%) were more common. The average size was 11 cm, 3 of 19 were metastatic at presentation, with the lung beings the most common site for metastasis. 17 received NACT, 16 with VAC-IE regimen and 1 underwent a second line with GEM/DOCE regimen. Unplanned surgery was done in 2 of 19. 3 patients received definitive RT and 13 underwent surgical-wide local excision. 2 of 13 showed good response to NACT. 10 patients required readmission out of which 6 patients had chemotherapy-related complications, 2 had surgical site complications and one patient developed secondary AML post-completion of treatment. A total of 4 patients had a recurrence. One had local recurrence alone, one had distant recurrence alone and 2 patients had a distant and local recurrence both. Tumor size >10 cm, axial location, and previous unplanned surgery was associated with higher LR rate. The mean overall survival was 32 months (2.66 years), with higher rates seen in non-metastatic and non-recurrent settings. CONCLUSIONS: Early and accurate diagnosis is the key to the management of EES, with promising results seen via NACT and RO resection regimens. But further studies with larger study groups are needed to standardize the treatment protocol and evaluate its efficacy.

Keywords: Ewings, sarcoma, extraskeletal, chemotherapy

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Authors: Ramanen Sugunesegran, Michael L. Williams

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Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

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Authors: Ella Tyuryumina, Alexey Neznanov

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This study is an attempt to obtain reliable data on the natural history of breast cancer growth. We analyze the opportunities for using classical mathematical models (exponential and logistic tumor growth models, Gompertz and von Bertalanffy tumor growth models) to try to describe growth of the primary tumor and the secondary distant metastases of human breast cancer. The research aim is to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoMPaS and corresponding software. We are interested in: 1) modelling the whole natural history of the primary tumor and the secondary distant metastases; 2) developing adequate and precise CoMPaS which reflects relations between the primary tumor and the secondary distant metastases; 3) analyzing the CoMPaS scope of application; 4) implementing the model as a software tool. The foundation of the CoMPaS is the exponential tumor growth model, which is described by determinate nonlinear and linear equations. The CoMPaS corresponds to TNM classification. It allows to calculate different growth periods of the primary tumor and the secondary distant metastases: 1) ‘non-visible period’ for the primary tumor; 2) ‘non-visible period’ for the secondary distant metastases; 3) ‘visible period’ for the secondary distant metastases. The CoMPaS is validated on clinical data of 10-years and 15-years survival depending on the tumor stage and diameter of the primary tumor. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer growth models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. The CoMPaS model and predictive software: a) fit to clinical trials data; b) detect different growth periods of the primary tumor and the secondary distant metastases; c) make forecast of the period of the secondary distant metastases appearance; d) have higher average prediction accuracy than the other tools; e) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoMPaS: the number of doublings for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases. The CoMPaS enables, for the first time, to predict ‘whole natural history’ of the primary tumor and the secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on the primary tumor sizes. Summarizing: a) CoMPaS describes correctly the primary tumor growth of IA, IIA, IIB, IIIB (T1-4N0M0) stages without metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and inception of the secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, metastases in lymph nodes, primary tumor, survival

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Authors: Rehana Akhter, Sajad A. Rather, F. A. Masoodi, Adil Gani, S. M. Wani

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During recent years probiotic food products receive market interest as health-promoting, functional foods, which are believed to contribute health benefits. In order to deliver the health benefits by probiotic bacteria, it has been recommended that they must be present at a minimum level of 106 CFU/g to 107 CFU/g at point of delivery or be eaten in sufficient amounts to yield a daily intake of 108 CFU. However a major challenge in relation to the application of probiotic cultures in food matrix is the maintenance of viability during processing which might lead to important losses in viability as probiotic cultures are very often thermally labile and sensitive to acidity, oxygen or other food constituents for example, salts. In this study Lactobacillus plantarum and Lactobacillus casei were encapsulated in calcium alginate beads with the objective of enhancing their survivability and preventing exposure to the adverse conditions of the gastrointestinal tract and where then inoculated in mutton nuggets. Micro encapsulated Lactobacillus plantarum and Lactobacillus casei were resistant to simulated gastric conditions (pH 2, 2h) and bile solution (3%, 2 h) resulting in significantly (p ≤ 0.05) improved survivability when compared with free cell counterparts. A high encapsulation yield was found due to the encapsulation procedure. After incubation at low pH-values, micro encapsulation yielded higher survival rates compared to non-encapsulated probiotic cells. The viable cell numbers of encapsulated Lactobacillus plantarum and Lactobacillus casei were 107-108 CFU/g higher compared to free cells after 90 min incubation at pH 2.5. The viable encapsulated cells were inoculated into mutton nuggets at the rate of 108 to 1010 CFU/g. The micro encapsulated Lactobacillus plantarum and Lactobacillus casei achieved higher survival counts (105-107 CFU/g) than the free cell counterparts (102-104 CFU/g). Thus micro encapsulation offers an effective means of delivery of viable probiotic bacterial cells to the colon and maintaining their survival during simulated gastric, intestinal juice and processing conditions during nugget preparation.

Keywords: survival, Lactobacillus plantarum, Lactobacillus casei, micro-encapsulation, nugget

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Authors: Li Yin, Xiaoqin Wang

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Background and purpose: Cancer diagnosis is part of a complex stochastic process, in which patients' personal and social characteristics influence the choice of diagnosing methods, diagnosing methods, in turn, influence the initial assessment of cancer stage, the initial assessment, in turn, influences the choice of treating methods, and treating methods in turn influence cancer outcomes such as cancer survival. To evaluate diagnosing methods, one needs to estimate and test the causal effect of a regime of cancer diagnosis and treatments. Recently, Wang and Yin (Annals of statistics, 2020) derived a new general formula, which expresses these causal effects in terms of the point effects of treatments in single-point causal inference. As a result, it is possible to estimate and test these causal effects via point effects. The purpose of the work is to estimate and test causal effects under various regimes of cancer diagnosis and treatments via point effects. Challenges and solutions: The cancer stage has influences from earlier diagnosis as well as on subsequent treatments. As a consequence, it is highly difficult to estimate and test the causal effects via standard parameters, that is, the conditional survival given all stationary covariates, diagnosing methods, cancer stage and prognosis factors, treating methods. Instead of standard parameters, we use the point effects of cancer diagnosis and treatments to estimate and test causal effects under various regimes of cancer diagnosis and treatments. We are able to use familiar methods in the framework of single-point causal inference to accomplish the task. Achievements: we have applied this method to stomach cancer survival from a clinical study in Sweden. We have studied causal effects under various regimes, including the optimal regime of diagnosis and treatments and the effect moderation of the causal effect by age and gender.

Keywords: cancer diagnosis, causal effect, point effect, G-formula, sequential causal effect

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

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Background: The TP53 mutation is frequently detected in acute myeloid leukemia (AML) patients with complex karyotype (CK), but the stability of this mutation during the clinical course remains unclear. Material and Methods: In this study, TP53 mutations were identified in 7% of 500 patients with de novo AML and 58.8% of patients with CK in Tabriz, Iran. TP53 mutations were closely associated with older age, lower white blood cell (WBC) and platelet counts, FAB M6 subtype, unfavorable-risk cytogenetics, and CK, but negatively associated with NPM1 mutation, FLT3/ITD and DNMT3A mutation. Result: Multivariate analysis demonstrated that TP53 mutation was an independent poor prognostic factor for overall survival and disease-free survival among the total cohort and the subgroup of patients with CK. A scoring system incorporating TP53 mutation and nine other prognostic factors, including age, WBC counts, cytogenetics, and gene mutations, into survival analysis proved to be very useful to stratify AML patients. Sequential study of 420 samples showed that TP53 mutations were stable during AML evolution, whereas the mutation was acquired only in 1 of the 126 TP53 wild-type patients when therapy-related AML originated from different clone emerged. Conclusion: In conclusion, TP53 mutations are associated with distinct clinic-biological features and poor prognosis in de novo AML patients and are rather stable during disease progression.

Keywords: acute myloblastic leukemia, TP53, FLT3/ITD, Iran

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Authors: Yu-Chih Wang, Chia-Yu Lai, Hsiao-Tien Liu, Yi-Ju Chen, Shao-Bin Cheng

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Liver transplant has been one of the curative treatment options for hepatocellular carcinomaunder certain oncological conditions. Two of the most validated criteria are from Milan in1996 and USCF in 2001, suggesting number and size limits of tumor without vascularinvasion or distant metastasis. We performed a retrospective cohort study of hepatocellular carcinoma patients undergoing livertransplant between August 2003 and December 2020 in our institute. Clinical andpathological characteristic, survival outcome, and recurrent pattern were analysed.UCSF criteria was applied for living donor transplantation, and Milan criteria was applied for deceased donor transplantation. Of 180 total patients, 52 cases(28.8%) with diagnosis of hepatocellular carcinoma, including26 living donor(LD) and 26 deceased donor(DD) liver transplant. Complete pathologicalremission was significantly more in the DD group(p=0.009). Pathological reports showed that30.8% of DD group exceeded Milan criteria, and 19.2% of LD group exceeded UCSFcriteria.After a median follow-up of 52.2 months, the 1-year, 3-year and 5-year overall survival was 87.6%, 74.1%, and 71.8%, respectively.Meanwhile, progression-free survival was 93.1%, 85.7%, and 81.6% for 1, 3, and 5-year, respectively, similar to that in Mazzaferro et al, 1996. We concluded that Liver transplant could be applied cautiously in expanded criteria for patent withhepatocellular carcinoma.

Keywords: liver transplant, milan criteria, UCSF criteria, living donor transplantation, deceased donor transplantation

Procedia PDF Downloads 133

Authors: A. D. Zikiryahodjaev, L. V. Bolotina, A. S. Sukhotko

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Purpose. To evaluate the expediency and timeliness of performance of surgical treatment as a component of multi-therapy treatment of patients with stage IV breast cancers. Materials and Methods. This investigation comparatively analyzed the results of complex treatment with or without surgery in patients with metastatic breast cancer. We analyzed retrospectively treatment experience of 196 patients with generalized breast cancer in the department of oncology and breast reconstructive surgery of P.A. Herzen Moscow Cancer Research Institute from 2000 to 2012. The average age was (58±1,1) years. Invasive ductul carcinoma was verified in128 patients (65,3%), invasive lobular carcinoma-33 (16,8%), complex form - 19 (9,7%). Complex palliative care involving drug and radiation therapies was performed in two patient groups. The first group includes 124 patients who underwent surgical intervention as complex treatment, the second group includes 72 patients with only medical therapy. Standard systemic therapy was given to all patients. Results. Overall, 3-and 5-year survival in fist group was 43,8 and 21%, in second - 15,1 and 9,3% respectively [p=0,00002 log-rank]. Median survival in patients with surgical treatment composed 32 months, in patients with only systemic therapy-21. The factors having influencing an influence on the prognosis and the quality of life outcomes for of patients with generalized breast cancer were are also studied: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause existence). Conclusion.Removing primary breast tumor in patients with generalized breast cancer improve long-term outcomes. Three- and five-year survival increased by 28,7 and 16,3% respectively, and median survival–for 11 months. These patients may benefit from resection of the breast tumor. One explanation for the effect of this resection is that reducing the tumor load influences metastatic growth.

Keywords: breast cancer, combination therapy, factors of prognosis, primary tumor

Procedia PDF Downloads 394

Authors: Michela C. Batista Matos, Madelaine Venzon, Elem F. Martins, Erickson C. Freitas, Adenir V. Teodoro, Maira C. M. Fonseca, Angelo Pallini

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Aromatic plant species are capable of producing and releasing volatile organic compounds spontaneously, which can repel or attract beneficial insects such as generalist predators of herbivores. Attractive plants could be used as crop companion plants to promote biological control of pests. In order to select such plants for future use in horticulture fields, we assessed the attractiveness of the aromatic plants Ocimum basilicum L. (basil), Mentha piperita L. (peppermint), Melissa officinalis L. (lemon balm) and Cordia verbenacea DC (black sage) to adults of the generalist lacewing predator Ceraeochrysa cubana Hagen (Neuroptera: Chrysopidae). This predator is commonly found in agroecosystems in Brazil and it feeds on aphids, mites, small caterpillars, insect eggs and scales. We further tested the effect of these plant species on the survival, development and oviposition of C. cubana. Finally, we evaluated the survival of larvae and adults of C. cubana when only flowers of basil were offered. Females of C. cubana were attracted to basil but not to the remaining aromatic plants. Larvae survival was higher when individuals had access only to basil leaf than when they had access to peppermint, lemon balm, black sage or water. Adult survival on leaf treatments and on water was no longer than three days. Flowers of basil enhanced predator larvae survival, yet they did not reach adulthood. Adults fed on basil flowers lived longer compared with water, but they did not reproduce. Basil is a promising aromatic plant species to be considered for conservation biological control programs. Besides being attractive to adults of the generalist predator, it benefits larvae and adults by providing nutritional resources when prey or other resources are absent. Financial support: CNPq, FAPEMIG and CAPES (Brazil).

Keywords: basil, chrysopidae, conservation biological control, companion plants

Procedia PDF Downloads 239

Authors: Noora Al-Shanfari, M. Mazharul Islam

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The cumulative incidence function (CIF) is a fundamental approach for analyzing survival data in the presence of competing risks, which estimates the marginal probability for each competing event. Parametric modeling of CIF has the advantage of fitting various shapes of CIF and estimates the impact of covariates with maximum efficiency. To calculate the total CIF's covariate influence using a parametric model., it is essential to parametrize the baseline of the CIF. As the CIF is an improper function by nature, it is necessary to utilize an improper distribution when applying parametric models. The Gompertz distribution, which is an improper distribution, is limited in its applicability as it only accounts for monotone hazard shapes. The generalized Gompertz distribution, however, can adapt to a wider range of hazard shapes, including unimodal, bathtub, and monotonic increasing or decreasing hazard shapes. In this paper, the generalized Gompertz distribution is used to parametrize the baseline of the CIF, and the parameters of the proposed model are estimated using the maximum likelihood approach. The proposed model is compared with the existing Gompertz model using the Akaike information criterion. Appropriate statistical test procedures and model-fitting criteria will be used to test the adequacy of the model. Both models are applied to the ‘colon’ dataset, which is available in the “biostat3” package in R.

Keywords: competing risks, cumulative incidence function, improper distribution, parametric modeling, survival analysis

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Authors: Gürcan D. Baysal, Ali Tanış

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In this study, samples of plant types including rose hip (Rosa canina L.), jujube (Ziziphus jujube), sea buckthorn (Hippophae rhamnoides), elderberry (Sambucus nigra), apricot (Prunus armeniaca), scots pine (Pinus sylvestris), and cedar of Lebanon (Cedrus libani) were grown using plant supporting units called Ekobox and drip irrigation systems in the Karapınar, Konya region of Turkey to reveal the efficiency of Ekobox and drip irrigation compared against a control with no irrigation. The plant diameter, height, and survival rates were determined, compared with each other, and statistically analyzed. According to the statistical analysis of the results, Ekobox applications resulted in the highest values for survival rate, diameter, and height measurements whereas the lowest values were determined in the control groups. These results indicate that the cultivation of plants with Ekobox may help protect against the loss of fertile soils as an effective mechanism for combating erosion and desertification. These advantages may also lead to a lasting economic effect on the cultivation of plants by locals of the Karapınar, Konya province who suffer from an ever-decreasing underground water level as a result of agricultural consumption.

Keywords: drip irrigation, ekobox, plant diameter, plant height, plant survival rate

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Authors: Taleb L., Benarbia M., Brahmi M., Belmiloud H., Boukerche A.

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Introduction and purpose of the study: Cavum cancer in children and adolescents is rare and represents 8% of all nasopharyngeal cancers treated in our department. Our objective is to study its epidemiological, clinical, therapeutic, and evolutionary particularities. Material and methods: Retrospective study of 39 patients under 20 years old, treated for undifferentiated non-metastatic carcinoma of the nasopharynx at the Emir Abdelkader Cancer Center between 2014 and 2020. Results and statistical analysis: Median age was 14 years [7-19 years], with a sex ratio of 2.9. The median time to diagnosis was 5.6 months [1 to 14 months], the circumstances of the discovery of which were dominated by lymph node syndrome in 43.6% of cases (n=17) followed by a rhinological syndrome in 30.8% of cases (n=13). The tumor stage was T1 for two patients (5.1%), T2 for 8 (20.5%), T3 for 9 (23.1%), T4 for 20 (51.3%), N0 for 2 (5 .1%) N1 for 4 (10.3%), N2 for 28 (71.8%) and N3 for 5 (12.8%). All patients received induction chemotherapy followed by concomitant radiotherapy with cisplatin. The dose of irradiation delivered to the cavum and adenopathies was 66 Gy with fractionation of 2 Gy per session in 69.2% of cases (n=27) and 1.8 Gy in 30.8% of cases (n=12). With a median follow-up of 51 months (15 to 97 months), the locoregional, metastatic, specific, and overall relapse-free survival rates at five years were 91.1%, 73.5%, 66.1%, and 68.4, respectively. Conclusion: Chemotherapy and radiotherapy treatment of cavum cancer in children and adolescents has allowed excellent locoregional control despite the advanced stage of the disease. However, the frequency of metastatic relapses could justify the possible use of systemic maintenance treatment.

Keywords: cancer, nasopharynx, radiotherapy, chemotherapy, survival

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Authors: Sampriti Panda

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Earning one’s own livelihood is the most basic and inseparable activity for survival and existence of humankind. In any kind of situation and in every type of geographical terrain, human does adopt various strategies and ways of earning their own livelihood. Since time immemorial, anthropocentrism has been the saga of livelihood where environment is out casted and exploited to any limit so that mankind can survive. With the passage of time, humans regained their consciousness and realized that the time has arrived now to shift to sustainable livelihood and stop being self centered. This paper tries to focus on the very central issue and the hotpot of discussion in the present era which revolves around sustainable livelihood. The aim of the paper is to find out how the tribal communities which are primarily forest based are the best example of sustainable livelihood since their existence. The paper also tries to throw light on the burning issue of the so-called term ‘development’ affecting the traditional ways of livelihood opted by the forest based tribal communities. The data presented in the paper are primary and have been collected using various techniques and methodology like observation, interviews, life histories, case studies and other techniques used in a self conducted fieldwork among the Juangs, who are one of the PVTGs of Odisha.

Keywords: forest, livelihood, sustainability, tribe

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Authors: Najrullah Khan, Athar Ali Khan

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The Topp-Leone distribution was introduced by Topp- Leone in 1955. In this paper, an attempt has been made to fit Topp-Leone Generalized exponential (TPGE) distribution. A real survival data set is used for illustrations. Implementation is done using R and JAGS and appropriate illustrations are made. R and JAGS codes have been provided to implement censoring mechanism using both optimization and simulation tools. The main aim of this paper is to describe and illustrate the Bayesian modelling approach to the analysis of survival data. Emphasis is placed on the modeling of data and the interpretation of the results. Crucial to this is an understanding of the nature of the incomplete or 'censored' data encountered. Analytic approximation and simulation tools are covered here, but most of the emphasis is on Markov chain based Monte Carlo method including independent Metropolis algorithm, which is currently the most popular technique. For analytic approximation, among various optimization algorithms and trust region method is found to be the best. In this paper, TPGE model is also used to analyze the lifetime data in Bayesian paradigm. Results are evaluated from the above mentioned real survival data set. The analytic approximation and simulation methods are implemented using some software packages. It is clear from our findings that simulation tools provide better results as compared to those obtained by asymptotic approximation.

Keywords: Bayesian Inference, JAGS, Laplace Approximation, LaplacesDemon, posterior, R Software, simulation

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Authors: Danni Cheng

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Background: Preclinical and epidemiological studies have reported potential protective effects of low-density lipoprotein cholesterol (LDL-C) lowering drugs on head and neck squamous cell cancer (HNSCC) survival, but the causality was not consistent. Genetic variants associated with LDL-C lowering drug targets can predict the effects of their therapeutic inhibition on disease outcomes. Objective: We aimed to evaluate the causal association of genetically proxied cholesterol-lowering drug targets and circulating lipid traits with cancer survival in HNSCC patients stratified by human papillomavirus (HPV) status using two-sample Mendelian randomization (MR) analyses. Method: Single-nucleotide polymorphisms (SNPs) in gene region of LDL-C lowering drug targets (HMGCR, NPC1L1, CETP, PCSK9, and LDLR) associated with LDL-C levels in genome-wide association study (GWAS) from the Global Lipids Genetics Consortium (GLGC) were used to proxy LDL-C lowering drug action. SNPs proxy circulating lipids (LDL-C, HDL-C, total cholesterol, triglycerides, apoprotein A and apoprotein B) were also derived from the GLGC data. Genetic associations of these SNPs and cancer survivals were derived from 1,120 HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) and 2,570 non-HPV-driven HNSCC patients in VOYAGER program. We estimated the causal associations of LDL-C lowering drugs and circulating lipids with HNSCC survival using the inverse-variance weighted method. Results: Genetically proxied HMGCR inhibition was significantly associated with worse overall survival (OS) in non-HPV-drive HNSCC patients (inverse variance-weighted hazard ratio (HR IVW), 2.64[95%CI,1.28-5.43]; P = 0.01) but better OS in HPV-positive OPSCC patients (HR IVW,0.11[95%CI,0.02-0.56]; P = 0.01). Estimates for NPC1L1 were strongly associated with worse OS in both total HNSCC (HR IVW,4.17[95%CI,1.06-16.36]; P = 0.04) and non-HPV-driven HNSCC patients (HR IVW,7.33[95%CI,1.63-32.97]; P = 0.01). A similar result was found that genetically proxied PSCK9 inhibitors were significantly associated with poor OS in non-HPV-driven HNSCC (HR IVW,1.56[95%CI,1.02 to 2.39]). Conclusion: Genetically proxied long-term HMGCR inhibition was significantly associated with decreased OS in non-HPV-driven HNSCC and increased OS in HPV-positive OPSCC. While genetically proxied NPC1L1 and PCSK9 had associations with worse OS in total and non-HPV-driven HNSCC patients. Further research is needed to understand whether these drugs have consistent associations with head and neck tumor outcomes.

Keywords: Mendelian randomization analysis, head and neck cancer, cancer survival, cholesterol, statin

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Authors: Nnedum Obiajuru Anthony Ugochukwu, Ezechukwu Emmanuel Ntomchukwu

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The research investigated the importance of marketing and customer relationship management in post-consolidated banks in achieving success and survival in the face of intense competition and global economic meltdown. The problem lies in the fact that during the pre-consolidation era in the banking industry in Nigeria, banks were comfortable transacting their businesses from their armchairs. Little attention was paid to marketing by banks as a veritable means of achieving and consolidating their profit position. This situation, no doubt sustained because banks were more or less currency exchange centers where customers buy and sell foreign exchange which was highly demanded, but in very short supply. Today, deregulation and consolidation of banks in Nigeria have tremendously increased the tempo of activities in the banking industry, and competition has become very severe among banks. The weak link in the success of post-consolidated banks in Nigeria is the utter neglect, and light or unserious consideration of customer relationship marketing by banks. Armchair banking which banks have been practicing has no regard for marketing as a means to survival. However, in order to survive, post-consolidated banks must take relationship marketing and customer relationship management seriously especially in the face of the current global economic crisis. This paper aims at exploring the role of marketing in building and managing customer relationships as a means to survival in post-consolidation banking in Nigeria.

Keywords: marketing, customer relationships, banking sector, Nigeria

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Authors: Raheela Akhtar, Zafar Iqbal Chaudhary, Yongqun Oliver He, Muhammad Younus, Aftab Ahmad Anjum

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Brucella abortus is an intracellular pathogen affecting macrophages. Macrophages release some components such as lysozymes (LZ), reactive oxygen species (ROS) and reactive nitrite intermediates (RNI) which are important tools against intracellular survival of Brucella. The antibrucella activity of bovine and murine macrophages was compared following stimulation with Brucella abortus lipopolysaccharides. Our results revealed that murine macrophages were ten times more potent to produce antibrucella components than bovine macrophages. The differential production of these components explained the differential Brucella killing ability of these species that was measured in terms of intramacrophagic survival of Brucella in murine and bovine macrophages.

Keywords: bovine macrophages, Brucella abortus, cell stimulation, cytokines, Murine macrophages

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Authors: Nelly S. Aggangan, Julieta A. Anarna

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Indigenous tree species are priority planting materials for the National Greening Program of the Department of Environment and Natural Resources. Areas for reforestation are marginal grasslands where plant growth is stunted and seedling survival is low. This experiment was conducted to compare growth rates and seedling survival of seven indigenous reforestation species. Narra (Pterocarpus indicus), salago (Wikstroemia lanceolata), kisubeng (Sapindus saponaria), tuai (Biscofia javanica), batino (Alstonia macrophylla), bani (Pongamina pinnata) and ipil (Intsia bijuga) were inoculated with Mykovam® (mycorrhizal fungi) and Bio-N® (N2-fixing bacteria) during pricking. After five months in the nursery, the treated seedlings were planted in degraded upland acidic red soil in Cavinti, Laguna (Luzon). During outplanting, all mycorrhiza inoculated seedlings had 50-80% mycorrhizal roots while the control ones had 5-10% mycorrhizal roots. Mykovam increased height of narra, salago and kisubeng. Stem diameter was bigger in mycorrhizal salago than the control. After two years in the field, Mykovam®+Bio-N® inoculated narra, salago and bani gave 95% survival while non-mycorrhizal tuai gave the lowest survival (25%). Inoculated seedlings grew faster than the control. Highest height increase was in batino (103%), followed by bani (95%), ipil (59%), narra (58%), tuai (53%) and kisubeng was the lowest (10%). Stem diameter was increased by Mykovam® from 13-39% over the control. Highest stem diameter was obtained from narra (50%), followed by bani (40%), batino (36%), ipil (33%), salago (28%), kisubeng and tuai (12%) had the lowest. In conclusion, Mykovam® inoculated batino, bani, narra, salago and ipil can be selected to restore degraded upland acidic red soil in the Philippines.

Keywords: Azospirillum spp., Bio-N®, Mykovam®, nitrogen fixing bacteria, acidic red soil

Procedia PDF Downloads 274

Authors: Raymond Puijk, Rachid Rassir, Inger N. Sierevelt, Anneke Spekenbrink-Sporen, Bart G. C. W. Pijls, Rob G. H. H. Nelissen, Peter A. Nolte

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Background: Among uncemented total knee arthroplasty (TKA), a wide variety of metal surface structures (MSS) and coatings exist to enhance implants' biological properties (i.e., bone ingrowth). This study explores the variety of MSS-coating combinations and compares their mid-long-term survivorships with cemented TKAs, by using data from the Dutch Arthroplasty Register. Methods: A total of 235,500 cemented and 11,132 uncemented primary TKAs with a median follow-up of 5.1 years were included. MSS-coating combinations were (1) Porous-uncoated (n=8986), (2) Beaded-hydroxyapatite (HA)(n=1093), (3) Matte-uncoated (n=846), (4) Matte-Titanium-nitride (TiN) (n=207). Five- and 10-year revision-free survival for all-cause revisions, and aseptic loosening of the tibial component, were calculated and compared by using Kaplan-Meier, Log-rank tests, and multivariable Cox proportional hazard regression analyses. Results: Ten-year survival rates with all-cause revisions as an endpoint, were 94.2% for cement, and 94.7%, 96.3%, 92.1%, and 79.0% for porous-uncoated, beaded-HA, matte-uncoated, and Matte-TiN, respectively (p<0.01). Rates for aseptic loosening were 98.8% for cemented, and 98.7%, 99.8%, 97.2%, and 94.9% for the uncemented, respectively (p<0.01).The beaded-HA implants were half the risk for an all-cause revision compared to cemented implants (p<0.01). Matte-uncoated and matte-TiN implants were at more risk of an all-cause revision than cemented implants (p=0.01, p<0.01). Proportions of revisions for aseptic loosening were comparable among most groups. Conclusion: Based on Dutch registry data, four main MSS-coating combinations among uncemented TKAs were found. survivorships for all-cause revisions and aseptic release differed widely between groups. Beaded-HA and porous-uncoated implants had the best survival rates among the uncemented TKAs and were non-inferior to the cemented TKAs.

Keywords: total knee arthroplasty, cement, uncemented, cementless;, metal surface structure, coating

Procedia PDF Downloads 132

Authors: M. Youngsabanant-Areekijseree, C. Thepsithar, K. Sribuddhachart, J. Tananantayot

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Porcine oviductal fluid (pOF) from oviduct, an unused organ from the slaughterhouse, was effectively used for biotechnology studies. The fluid components consisted of micro- and macro-nutrients, amino acids, carbon source and proteins that played important roles in animal cell and embryo development. This was our knowledge on investigating pOF as growth promoting substance in culture medium of an orchid, Dendrobium mirbelianum. Two-leaf shoots were cultured in liquid Vacin and Went (VW) medium as a standard medium supplemented with 2 g/L peptone (Pe) or 100 g/ L boiled-potato water (Po) alone or in combinations, and added with 0, 1, 3 or 5 ml/L pOF. All explants were cultured in a stationary condition for 8 weeks. It was found that medium added with 100 g/L Po and 1 ml/L pOF provided the best results (1.02 g fresh weight, 4.2 shoots, 0.53 cm shoot height, 4.4 protocorms, 11.0 leaves and 5.7 roots with 100% survival) when compared to other medium, but not statistically significant difference from medium added with 100 g/L Po (0.86 g fresh weight, 4.3 shoots, 0.51 cm shoot height, 4.6 protocorms, 12.4 leaves and 6.6 roots with 100% survival). However, VW medium supplemented with 1 or 3 ml/L pOF alone showed the higher percentage of survival (100%) than VW medium (86.67%). It was shown the potential role of pOF as an organic supplement for promoting growth of plants. Acknowledgements—The project was funded by a grant from Silpakorn University Research & Development Institute (SURDI) and Faculty of Science, Silpakorn University, Thailand.

Keywords: Dendrobium mirbelianum, pig, oviductal fluid, in vitro growth

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Authors: Ebru Turgal, Beyza Doganay Erdogan

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Machine learning aims to model the relationship between the response and features. Medical decision-making researchers would like to make decisions about patients’ course and treatment, by examining the repeated measurements over time. Boosting approach is now being used in machine learning area for these aims as an influential tool. The aim of this study is to show the usage of multivariate tree boosting in this field. The main reason for utilizing this approach in the field of decision-making is the ease solutions of complex relationships. To show how multivariate tree boosting method can be used to identify important features and feature-time interaction, we used the data, which was collected retrospectively from Ankara University Chest Diseases Department records. Dataset includes repeated PF ratio measurements. The follow-up time is planned for 120 hours. A set of different models is tested. In conclusion, main idea of classification with weighed combination of classifiers is a reliable method which was shown with simulations several times. Furthermore, time varying variables will be taken into consideration within this concept and it could be possible to make accurate decisions about regression and survival problems.

Keywords: boosted multivariate trees, longitudinal data, multivariate regression tree, panel data

Procedia PDF Downloads 180

Authors: Wasiu Olaniyi, Ofelia Omitogun

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Hybridization has been of importance in both research and commercial aquaculture due to its benefits such as increased growth rate, sex ratio manipulation, production of sterile species and many other desirable economic traits. In this study, we successfully produced hybrids between crosses of Clariid catfish species of Clarias gariepinus and Heterobranchus bidorsalis for stock improvement. Milt and eggs from parent broodstock of C. gariepinus and H. bidorsalis were collected for both intrageneric and interspecific hybridization, viz: same parent species crosses (♀C. gariepinus ×♂C. gariepinus; ♀H. bidorsalis × ♂H. bidorsalis) and inter-specific crosses (♀H. bidorsalis × ♂C. gariepinus; ♀C. gariepinus × ♂H. bidorsalis). These crosses were made in triplicates whereby the data on latency period, fertility, hatchability, deformity, and survival were recorded. A phenotypic form of distinction was registered in the hybrid ♀C. gariepinus × ♂H. bidorsalis that was smooth-greyed while its reciprocal cross was marpatic. The parent species C. gariepinus had greyed-marpatic color while the H. bidorsalis was yellowish-brown. Fertility data revealed the significant difference (p < 0.05) between the hybrid cross ♀C. gariepinus × ♂H. bidorsalis (88.00 ± 1.00%) compared to its reciprocal ♀H. bidorsalis × ♂C. gariepinus (71.67 ± 10.41%) which further had carried over effects to hatchability. The reciprocal ♀H. bidorsalis × ♂C. gariepinus recorded the highest deformity (11.67 ± 3.06%) that was significantly different (p < 0.05) from the rest of the crosses. Also, an outcome of equal sex ratio in the hybrids compared with the two parent species was shown. Specific growth rate (SGR) data revealed highest significant difference (p < 0.05) in the hybrid ♀C. gariepinus × ♂H. bidorsalis (2.64 ± 0.09%), followed by the cross of ♀C. gariepinus × ♂ C. gariepinus (1.91 ± 0.02%) while there were no significant differences (p > 0.05) between the reciprocal hybrid ♀H. bidorsalis × ♂C. gariepinus (2.20 ± 0.57%) and ♀H. bidorsalis × ♂H. bidorsalis (2.19 ± 0.19%). The SGR analysis proved that the crosses ♀C. gariepinus × ♂C. gariepinus had slow growth performance compared to its hybrid ♀C. gariepinus × ♂H. bidorsalis. Critical evaluation based on survival and specific growth performance showed the superiority of the hybrid ♀C. gariepinus × ♂H. bidorsalis. The least survival in reciprocal hybrid ♀H. bidorsalis × ♂C. gariepinus (27.33%) can be explained by significant deformity (11.67%) recorded due to maternal effects. Hence, the survival of hybrid ♀C. gariepinus × ♂H. bidorsalis was better.

Keywords: aquaculture, hybridization, Clarias gariepinus, Heterobranchus bidorsalis

Procedia PDF Downloads 139

Authors: Chernet Mulugeta, Girma Seyoum, Yeshineh Demrew, Kehabtimer Shiferaw

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Background: Obstetric fistula (OF) is a serious medical condition that includes an abnormal opening between the vagina and bladder (vesico-vaginal fistula) or the vagina and rectum (recto-vaginal fistula). It is usually caused by prolonged obstructed labour. Despite its serious health and psychosocial consequences, there is a paucity of evidence regarding the time it takes to heal from OF. Objective: The aim of this study was to assess the time to cure from obstetric fistula and its predictors among women admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa, Ethiopia. Methodology: An institution-based retrospective cohort study was conducted from January 2015 to December 2020 among a randomly selected 434 women with OF in Addis Ababa Hamlin Fistula Hospital. Data was collected using a structured checklist adapted from a similar study. The open data kit (ODK) collected data was exported and analyzed by using STATA (14.2). Kaplan Meir was used to compare the recovery time from OF. To identify the predictors of OF, a Cox regression model was fitted, and an adjusted hazard ratio with a 95% confidence interval was used to estimate the strength of the associations. Results: The average time to recover from obstetric fistula was 3.95 (95% CI: 3.0-4.6) weeks. About ¾ of the women [72.8% (95% CI - 0.65-1.2)] were physically cured of obstetric fistula. Having secondary education and above [AHR=3.52; 95% CI (1.98, 6.25)] compared to no formal education, having a live birth [AHR=1.64; 95% CI (1.22, 2.21)], having an intact bladder [AHR=2.47; 95% CI (1.1, 5.54)] compared to totally destructed, and having a grade 1 fistula [AHR=1.98; 95% CI (1.19, 3.31)] compared to grade 3 were the significant predictors of shorter time to cure from an obstetric fistula. Conclusion and recommendation: Overall, the proportion of women with OF who were not being cured was unacceptably high. The time it takes for them to recover from the fistula was also extended. It connotes us to work on the identified predictors to improve the time to recovery from OF.

Keywords: time to recovery, obstetric fistula, predictors, Ethiopia

Procedia PDF Downloads 54

Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

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Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

Procedia PDF Downloads 127

Authors: Narendra Kumar

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This study uses data from the ‘National Family Health Survey (NFHS-3) 2005-06’ to investigate the predictors of infant and child mortality among low economic households in East and Northeast region. The cross tabulation, life table survival estimates and Cox proportional hazard model techniques have been used to estimate the predictors of infant and child mortality. The life table survival estimates for infant and child mortality shows that infant mortality in female child is lower in comparison to male child but with child mortality, the rates are higher for female in comparison to male child and the Cox proportional hazard model also give highly significant in female in comparison to male child. The infant and child mortality rates among poor households highest in the Central region followed by North and Northeast region and the lowest in South region in comparison to all regions of India. Education of respondent has been found a significant characteristics in both analyzes, further birth interval, respondent occupation, caste/tribe and place of delivery has substantial impact on infant and child mortality among low economic households in East and Northeast region. Finally these findings specified that an increase in parents’ education, improve health care services and improve socioeconomic conditions of low economic households which should in turn raise infant and child survival and should decrease child mortality among low economic households in India.

Keywords: infant, child, mortality, socio-economic, India

Procedia PDF Downloads 290

Authors: Haiyan Wang, Dongyun Wang, Yongyong Yan, Richard T. Jaspers, Gang Wu

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Mesenchymal stem cell and 3D printing-based bone tissue engineering present a promising technique to repair large-volume bone defects. Its success is highly dependent on cell attachment, spreading, osteogenic differentiation, and in vivo survival of stem cells on 3D-printed scaffolds. In this study, human salivary histatin-1 (Hst1) was utilized to enhance the interactions between human adipose-derived stem cells (hASCs) and 3D-printed β-tricalcium phosphate (β-TCP) bioceramic scaffolds. Fluorescent images showed that Hst1 significantly enhanced the adhesion of hASCs to both bioinert glass and 3D-printed β-TCP scaffold. In addition, Hst1 was associated with significantly higher proliferation and osteogenic differentiation of hASCs on 3D-printed β-TCP scaffolds. Moreover, coating 3D-printed β-TCP scaffolds with histatin significantly promotes the survival of hASCs in vivo. The ERK and p38 but not JNK signaling was found to be involved in the superior adhesion of hASCs to β-TCP scaffolds with the aid of Hst1. In conclusion, Hst1 could significantly promote the adhesion, spreading, osteogenic differentiation, and in vivo survival of hASCs on 3D-printed β-TCP scaffolds, bearing a promising application in stem cell/3D printing-based constructs for bone tissue engineering.

Keywords: 3d printing, adipose-derived stem cells, bone tissue engineering, histatin-1, osteogenesis

Procedia PDF Downloads 38

Authors: Yuchao Yao

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As two of the main characteristics of Chinese demographic trends, increasing divorce rates and decreasing fertility rates both shaped the population structure in the recent decade. Figuring out to what extent can be having a child make a difference in the divorce rate of a couple will not only draw a picture of Chinese families but also bring about a new perspective to evaluate the Chinese child-breeding policies. Based on China Family Panel Studies (CFPS) Data 2010-2018, this paper provides a systematic evaluation of how children influence a couple’s marital stability through a series of empirical models. Using survival analysis and propensity score matching (PSM) model, this paper finds that the number and age of children that a couple has mattered in consolidating marital relationship, and these effects vary little over time; during the last decade, newly having children can in fact decrease the possibility of divorce for Chinese couples; the such decreasing effect is largely due to the birth of a second child. As this is an inclusive attempt to study and compare not only the effects but also the causality of children on divorce risk in the last decade, the results of this research will do a good summary of the status quo of divorce in China. Furthermore, this paper provides implications for further reforming the current marriage and child-breeding policies.

Keywords: divorce risk, fertility, China, survival analysis, propensity score matching

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Authors: Naira Ghambaryan, Gagik Hakobyan

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Purpose:The study was to evaluate the survival rate of short implants (5-6 mm) functionalized with UV radiation placed in the posterior segments of the atrophied maxilla. Materials and Methods:The study included 47 patients with unilateral/bilateral missing teeth and vertical atrophy of the posterior maxillary area. A total of 64 short UV-functionalized implants and 62 standard implants over 10 mm in length were placed in patients. The clinical indices included the following parameters: ISQБ MBL, OHIP-G scale. Results: For short implants, the median ISQ at placement was 62.2 for primary stability, and the median ISQ at 5 months was 69.6 ISQ. For standart implant, the mean ISQ at placement was 64.3 ISQ, and ISQ after 5 months was 71.6 ISQ. Аfter 6 months mean MBL short implants 0.87 mm, after 1 year, 1.13 mm, after 5 year was 1.48 mm. Аfter 6 months, mean MBL standard implants 0.84 mm, after 1 year, 1.24 mm, after 5 year was 1.58 mm. Mean OHIP-G scores -patients satisfaction with the implant at 4.8 ± 0.3, satisfaction with the operation 4.6 ± 0.4; satisfaction with prosthetics 4.7 ± 0.5. Cumulative 5-year short implants rates was 96.7%, standard implants was 97.4%, and prosthesis cumulative survival rate was 97.2%. Conclusions: Short implants with ultraviolet functionalization for prosthetic rehabilitation of the posterior resorbed maxilla region is a reliable, reasonable alternative to sinus lift, demonstrating fewer complications, satisfactory survival of a 5-year follow-up period, and reducing the number of additional surgical interventions and postoperative complications.

Keywords: short implant, ultraviolet functionalization, atrophic posterior maxilla, prosthodontic rehabilitation

Procedia PDF Downloads 59