Replacement and Immunomodulatory Activities of 20% Subcutaneous Immunoglobulin Treatment: A Single-Center Retrospective Study in Autoimmune Myositis and CVID Patients

BackgroundImmunoglobulin (Ig) replacement therapy represents a life-saving treatment in primary antibody deficiencies. The introduction of subcutaneous Ig (SCIg) administration brings a major improvement in quality of life for patients, compared to the traditional intravenous administration. In recent years, an additional role has been proposed for Ig therapy for various inflammatory and immune-mediated diseases. Consequently, the use of SCIg has expanded from immunodeficiencies to immune-mediated diseases, such as polymyositis (PM) and dermatomyositis (DM). Given the rarity of these conditions, it is still difficult to evaluate the real impact of SCIg treatment on PM and DM, and additional data are constantly required on this topic, particularly for long-term treatments in real-life settings.AimThis study aimed to increase the knowledge about the anti-inflammatory and immunomodulatory effects of SCIg treatment for myositis. To this aim, a long-term evaluation of the effectiveness of 20% human SCIg treatment (20% SCIg, Hizentra®, CSL Behring) was carried out in patients with PM/DM in care at our Center. In addition, an evaluation of the 20% SCIg therapy in CVID patients was provided. This analysis, beside adding knowledge about the use of SCIg therapy in this real-life setting, was intended as a term of comparison, regarding the safety profile.ResultsResults support the beneficial effect and tolerability of long-term 20% SCIg therapy in PM/DM patients, reporting a significant improvement in creatine kinase levels, muscle strength, skin conditions, dysphagia, disease activity (MITAX score) and disability (HAQ-DI score). None of the patients reported systemic reactions. The duration of the reported local reactions was a few hours in 80% of the patients, and all resolved spontaneously. CVID patients reported an improvement in all the considered effectiveness parameters at the end of 20% SCIg therapy. The frequency of the adverse events reported by PM/DM patients was not different from what reported in CVID patients, where the use of SCIg therapy is more consolidatedConclusionsThis study suggests that 20% SCIg treatment represents a viable and safe treatment for PM/DM patients and a valid therapeutic alternative to IVIg, with important advantages for patients’ quality of life.

Different Sweet Orange–Rootstock Combinations Infected by Candidatus Liberibacter asiaticus under Greenhouse Conditions: Effects on the Scion

The devastating citrus disease huanglongbing (HLB) associated with the phloem-limited bacteria Candidatus Liberibacter asiaticus (CLas) has caused a more than 70% reduction in citrus production since its discovery in Florida in 2005. Most citrus scion cultivars are sensitive to HLB, whereas some cultivars used as rootstocks are tolerant. Using such tolerant rootstocks can help trees to cope better with the disease’s impact. Evaluating rootstock effects on a grafted scion in the field takes many years, but shorter-term evaluation is imperative to aid in rootstock selection for an HLB-endemic production environment. In this study, we investigated grafted healthy and CLas-infected citrus trees under controlled greenhouse conditions. The objectives were to identify traits suitable for assessing grafted tree tolerance in advance of longer-term field studies and aiding in the selection of superior rootstock cultivars. We assessed 10 commercially important rootstocks grafted with ‘Valencia’ sweet orange scion and with known field performance. At 6, 9, 15, and 21 months after graft inoculation (mai), leaf CLas titers were determined and canopy health was evaluated. Plants were destructively sampled at 21 mai to assess plant biomasses and other physiological and horticultural variables. There was little influence of the rootstock cultivar on CLas titers. Surprisingly, few HLB foliar disease symptoms and no differences in soluble and nonsoluble carbohydrate concentrations were measured in infected compared with healthy plants, despite high CLas titers and significant reductions in plant biomasses. Most trees on rootstocks with trifoliate orange parentage were less damaged by HLB than other rootstocks, although results did not always agree with reported field performance. Among the different variables measured, leaf size appeared to be most predictive for grafted tree assessment of HLB sensitivity. The results of this study provide a better understanding of the strengths and weaknesses of assessing rootstock influence on grafted tree performance in a controlled greenhouse environment. Although such studies provide valuable information for cultivar tolerance to HLB, other rootstock traits will ultimately contribute to field survival and productivity in an HLB endemic production environment.

Re-Opening Dallas: A Short-Term Evaluation of COVID-19 Regulations and Crime

We investigated the relationship between COVID-19 stay-at-home regulations and property and violent crime indexes in Dallas, TX during the first 6 months of 2020. We tested for changes in property and violent crime trends using four key “intervention” dates: the stay-at-home order issued by Judge Clay Jenkins (March 24), the start of Governor Abbott’s phase one of re-opening (May 1), a second phase of more widespread re-openings (May 18), and a third phase of increased capacity limits for businesses (June 3). Our analyses point to two main findings: (1) the time between the initial stay-at-home policy and the phase one re-opening was associated with an increase in the trend of both violent and property crime (although at lower levels than pre-pandemic); and (2) the third phase of re-opening the City of Dallas was associated with higher daily counts of property and violent crime. Our findings suggest that policy makers need to consider policies not only related to police enforcement but also allocation of other social services, particularly when such a sudden policy (e.g., stay-at-home order) is implemented.

Short-Term Evaluation of Prosthetic Rehabilitation of Thin Wiry Ridge by Ridge Splitting and Simultaneous Implants Placement: Non-randomized Control Trial

Objective This article evaluates the success of prosthetic rehabilitation of thin wiry ridge and implants placed simultaneously in splitted ridge both clinically and radiographically. Materials and Methods Twenty-one participants were enrolled of which 13 patients (8 females and 5 males) were suffering from maxillary ridge atrophy and 8 patients (5 females and 3 males) had mandibular ridge atrophy; a total of 42 implants were performed using the ridge expansion technique. The expansion was performed using the conventional disk technique, piezoelectric corticotomy, and self-threading expanders. Implants were placed and loaded with fixed partial denture after 4 months for the mandible and 6 months for the maxilla. Implant stability quotient (ISQ) was measured at T0 (implant placement) and TL (loading). Crestal bone levels were measured at different times: T0, TL, and T12 (12 months). Evaluation of prosthetic and surgical complications was carried out. Data were analyzed and compared using analysis of variance and paired t-tests at a significance level of 5%. Results All implants met the criteria for success. All implants showed a higher mean bone loss from T0 to TL (1.259 ± 0.3020) than from TL to T12 (0.505 ± 0.163) with a statistically significant difference (p < 0.0001). ISQ values sharply increased at the time of loading (72.52 ± 2.734) than at implant insertion (44.5 ± 4.062) with a significant difference (p < 0.0001). Minor prosthetic and surgical complications were reported. Conclusion The results from this study support the efficacy of prosthetic rehabilitation of thin wiry ridge using split ridge technique and the success of implants placed simultaneously in splitted ridge.

Long-Term Evaluation of Poly(lactic acid) (PLA) Implants in a Horse: An Experimental Pilot Study

In horses, there is an increasing interest in developing long-lasting drug formulations, with biopolymers as viable carrier alternatives in addition to their use as scaffolds, suture threads, screws, pins, and plates for orthopedic surgeries. This communication focuses on the prolonged biocompatibility and biodegradation of PLA, prepared by hot pressing at 180 °C. Six samples were implanted subcutaneously on the lateral surface of the neck of one horse. The polymers remained implanted for 24 to 57 weeks. Physical examination, plasma fibrinogen, and the mechanical nociceptive threshold (MNT) were performed. After 24, 28, 34, 38, and 57 weeks, the materials were removed for histochemical analysis using hematoxylin-eosin and scanning electron microscopy (SEM). There were no essential clinical changes. MNT decreased after the implantation procedure, returning to normal after 48 h. A foreign body response was observed by histopathologic evaluation up to 38 weeks. At 57 weeks, no polymer or fibrotic capsules were identified. SEM showed surface roughness suggesting a biodegradation process, with an increase in the median pore diameter. As in the histopathological evaluation, it was not possible to detect the polymer 57 weeks after implantation. PLA showed biocompatible degradation and these findings may contribute to future research in the biomedical area.

Titanium Base Abutments in Implant Prosthodontics: A Literature Review

Implant abutments are essential components in restoring dental implants. Titanium base abutments were introduced to overcome issues related to existing abutments, such as the unesthetic appearance of titanium abutments and the low fracture strength of ceramic abutments. This study aimed to comprehensively review studies addressing the mechanical and clinical behaviors of titanium base abutments. A search was performed on PubMed/MEDLINE, Web of Science, Google Scholar, and Scopus databases to find articles that were published in English until December 2020 and that addressed the review purpose. A total of 33 articles fulfilled the inclusion criteria and were included for data extraction and review. In vitro studies showed that titanium base abutments had high fracture strength, adequate retention values, particularly with resin cement, and good marginal and internal fit. Although the clinical assessment of titanium base abutments was limited, they showed comparable performance with conventional abutments in short-term evaluation, especially in the anterior and premolar areas. Titanium base abutments can be considered a feasible treatment option for restoring dental implants, but long-term clinical studies are required for a better assessment.

Addressing Spatial Inequality in Broadband Use and Community-Level Outcomes

This chapter considers the significance of place for broadband policy evaluation and examines long-term data on Chicago neighborhoods as an example of quasi-experimental design. Interventions are often targeted to low-income urban neighborhoods or rural communities, with goals for increased local employment, economic development, or community health. Measuring outcomes by place provides a way to aggregate impacts for individual residents and to suggest potential spillover benefits for communities. Evaluating broadband use (i.e., subscriptions) over time in communities can address issues of causation as well as long-term outcomes of use. Chicago’s Smart Communities program illustrates the benefits of conducting long-term evaluation, taking advantage of new American Community Survey data that allows tracking of broadband subscriptions in smaller or less-populated geographies such as neighborhoods or rural communities. Finally, the chapter discusses strategies for expanding community-level research through other quasi-experimental designs and the creation and utilization of community-level data on broadband adoption and use.