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The Polity of Idalion: A Constitutional Government of King and Polis or a Monarchy with Institutions?
No full textHow are large-scale extractive industries affecting progress toward the sustainable development goals in Madagascar? Perceived social-ecological impacts of mining investments
Get PDFThe rapid worldwide increase in resource extraction is evident in Madagascar—a global biodiversity hotspot. This study examines the localized effects of operational and planned large-scale extractive investments on social-ecological systems in Madagascar and links them to the Sustainable Development Goals. The focus is on sites owned or explored by foreign investors, specifically Ambatovy Moramanga, Ambatovy Tamatave, QIT Madagascar Minerals/Rio Tinto, Ranobe, and Tantalum Rare Earth Malagasy. Employing a counterfactual approach, we gathered survey responses from 459 small-scale farming, agro-pastoral, and artisanal-fisheries-based households. The survey provided information on general household characteristics, land use, land management, livelihoods, well-being, and any perceived changes to these variables, as well as any perceived mining impacts related to the changes. Overall, respondents reported predominantly negative effects on land (and sea) use, livelihoods, well-being, and security. Mining pollution, primarily from operational sites, had reduced access to water and fisheries resources, and natural forest areas had diminished. Reduced productivity due to pollution of soils, water, and air had a negative impact on various land uses and affected people's health, particularly in the surroundings of QIT Madagascar Minerals/Rio Tinto. Although some projects, such as Ambatovy, had eventually improved healthcare and infrastructure, most negative mining impacts had occurred during both the exploratory and the operational phases of the projects. Overall, this study offers a comprehensive view of how large-scale extractive investments affect land (and sea) use and human well-being. In addition, we highlight policy implications that must be considered if large-scale extractive investments are to support progress on the 2030 Agenda
Impact of peri-implant keratinized mucosa width on the long-term reconstructive outcomes of peri-implantitis: A retrospective analysis with a follow-up up to 10 years.
Get PDFPURPOSE
To investigate the effect of mid-buccal peri-implant keratinized mucosa width (KMW) ≥2 mm or peri-implant KMW >0 mm and <2 mm on the long-term outcomes of peri-implantitis reconstructive treatment.
MATERIALS AND METHODS
Twenty-nine patients (40 implants; mean follow-up: 9.2 ± 1.4 years) with at least one implant affected by peri-implantitis and surgically treated through a reconstructive procedure followed by a submerged healing were included. Patients were categorized according to their initial KMW: Group 1 (KMW ≥2 mm) and Group 2 (KMW >0 mm and <2 mm). Peri-implant clinical and radiographic parameters and a dedicated composite outcome were assessed at different follow-up visits during supportive peri-implant therapy for up to 10 years. Regression analyses were utilized to identify possible risk/predictive indicators for probing pocket depth (PPD) change and treatment success at the latest follow-up.
RESULTS
The mean PPD did not exhibit any statistical difference from the baseline to the latest follow-up between the groups at both patient and implant levels. Long-term treatment success was 46.6% (Group 1) and 42.6% (Group 2) at patient level, it was 42.8% (Group 1) and 33.3% (Group 2), respectively, at implant level (p > 0.05). Group 1 demonstrated significantly higher vertical defect depth reduction than Group 2 (p = 0.018). Presence of buccal bony wall and mean PPD at the baseline were found to be associated with mean PPD change, while KMW at 6 months following surgery was identified as the only significant indicator for treatment success (p < 0.05).
CONCLUSION
Implants with KMW ≥2 mm did not present significantly better long-term clinical outcomes following reconstructive therapy than those exhibiting KMW >0 mm and <2 mm. However, KMW values at the end of healing phase following a submerged approach had a significant impact on long-term treatment success
Diagnostic methods/parameters to monitor peri-implant conditions.
Get PDFThe diagnostic accuracy of clinical parameters, including visual inspection and probing to monitor peri-implant conditions, has been regarded with skepticism. Scientific evidence pointed out that primary diagnostic tools (chairside) seem to be highly specific, while their sensitivity is lower compared with their use in monitoring periodontal stability. Nonetheless, given the association between pocket depth at teeth and implant sites and the aerobic/anaerobic nature of the microbiome, it seems plausible for pocket probing depth to be indicative of disease progression or tissue stability. In addition, understanding the inflammatory nature of peri-implant diseases, it seems reasonable to advocate that bleeding, erythema, ulceration, and suppuration might be reliable indicators of pathology. Nevertheless, single spots of bleeding on probing may not reflect peri-implant disease, since implants are prone to exhibit bleeding related to probing force. On the other side, bleeding in smokers lacks sensitivity owing to the decreased angiogenic activity. Hence, the use of dichotomous scales on bleeding in the general population, in contrast to indices that feature profuseness and time after probing, might lead to false positive diagnoses. The definitive distinction between peri-implant mucositis and peri-implantitis, though, relies upon the radiographic evidence of progressive bone loss that can be assessed by means of two- and three-dimensional methods. Accordingly, the objective of this review is to evaluate the existing clinical and radiographic parameters/methods to monitor peri-implant conditions
Medication and Outcome in Older Heart Failure Patients: Results from a Prospective Cohort Study.
Get PDFPurpose: Acute heart failure (AHF) is associated with high morbidity and mortality, and the prognosis is particularly poor in older patients. Although the application of guideline-directed medical therapy (GDMT) has shown a positive impact on prognosis, the effects are less clear in older age groups. The aim of this study was to analyze real-world data regarding GDMT and outcomes in older HF patients. Methods: This is a prospective cohort study from a secondary care hospital in central Switzerland. A total of 97 consecutive patients aged ≥60 years were enrolled between January 2019 and 2022. The main outcome parameters were prescribed GDMT at discharge, and in case of rehospitalization, GDMT at readmission, and survival in terms of all-cause mortality and HF-related hospitalizations during a 3-year follow-up period. Results: Follow-up data were available for 93/97 patients. The mean age was 77.8 ± 9.8 years, 46% being female. The mean left ventricular ejection fraction (LVEF) was 35.3 ± 13.9%, with a mean BNP level of 2204.3 ± 239 ng/L. Upon discharge, 86% received beta-blockers and 76.3% received renin-angiotensin system (RAS) inhibitors. At rehospitalization for AHF, beta-blockers use was significantly lower and decreased to 52.8% (p = 0.003), whereas RAS inhibitor use increased slightly to 88.9% (p = 0.07), and SGLT-2 inhibitors showed a significant increase from 5.4% vs. 47.2% (p = 0.04). GDMT prescription was not dependent on LVEF. Overall, 73.1% of patients received two-stage or three-stage GDMT at discharge, whereas this percentage decreased to 61% at rehospitalization (p = 0.01). Kaplan-Meier analysis for the combined outcome rehospitalization and death stratified by LV function showed significant differences between LVEF groups (aHR: 0.6 [95% CI: 0.44 to 0.8]; p = 0.0023). Conclusions: Our results indicate that first, the majority of older AHF patients from a secondary care hospital in Switzerland were not on optimal GDMT at discharge and even fewer at readmission, and second, that prognosis of the population is still poor, with almost half of the patients having been rehospitalized or died during a 3-year follow-up period under real-world conditions, without significant difference between women and men. Our findings underline the need for further improvements in the medical treatment of AHF, in particular in older patients, to improve prognosis and to reduce the burden of disease
Platelet-Rich Fibrin Increases CXCL8 Expression in Gingival Fibroblasts.
Get PDFPlatelet-rich fibrin (PRF), the coagulated plasma of fractionated blood, is widely used to support tissue regeneration in dentistry, and the underlying cellular and molecular mechanisms are increasingly being understood. Periodontal connective tissues steadily express CXCL8, a chemokine that attracts granulocytes and lymphocytes, supporting homeostatic immunity. Even though PRF is considered to dampen inflammation, it should not be ruled out that PRF increases the expression of CXCL8 in gingival fibroblasts. To test this hypothesis, we conducted a bioassay where gingival fibroblasts were exposed to PRF lysates and the respective serum. We show here that PRF lysates and, to a lesser extent, PRF serum increased the expression of CXCL8 by the gingival fibroblasts, as confirmed by immunoassay. SB203580, the inhibitor of p38 mitogen-activated protein kinase, reduced CXCL8 expression. Consistently, PRF lysates and, to a weaker range, the PRF serum also caused phosphorylation of p38 in gingival fibroblasts. Assuming that PRF is a rich source of growth factors, the TGF-β receptor type I kinase inhibitor SB431542 decreased the PRF-induced expression and translation of CXCL8. The findings suggest that PRF lysates and the respective serum drive CXCL8 expression by activating TGF-β and p38 signaling in gingival fibroblasts
In-vitro effects of different hyaluronic acids on periodontal biofilm-immune cell interaction.
Get PDFINTRODUCTION
Recent studies have demonstrated a positive role of hyaluronic acid (HA) on periodontal clinical outcomes. This in-vitro study aimed to investigate the impact of four different HAs on interactions between periodontal biofilm and immune cells.
METHODS
The four HAs included: high-molecular-weight HA (HHA, non-cross-linked), low-molecular-weight HA (LHA), oligomers HA (OHA), and cross-linked high-molecular-weight HA (CHA). Serial experiments were conducted to verify the influence of HAs on: (i) 12-species periodontal biofilm (formation and pre-existing); (ii) expression of inflammatory cytokines and HA receptors in monocytic (MONO-MAC-6) cells and periodontal ligament fibroblasts (PDLF) with or without exposure to periodontal biofilms; (iii) generation of reactive oxygen species (ROS) in MONO-MAC-6 cells and PDLF with presence of biofilm and HA.
RESULTS
The results indicated that HHA and CHA reduced the bacterial counts in a newly formed (4-h) biofilm and in a pre-existing five-day-old biofilm. Without biofilm challenge, OHA triggered inflammatory reaction by increasing IL-1β and IL-10 levels in MONO-MAC cells and IL-8 in PDLF in a time-dependent manner, whereas CHA suppressed this response by inhibiting the expression of IL-10 in MONO-MAC cells and IL-8 in PDLF. Under biofilm challenge, HA decreased the expression of IL-1β (most decreasing HHA) and increased IL-10 levels in MONO-MAC-6 cells in a molecular weight dependent manner (most increasing CHA). The interaction between HA and both cells may occur via ICAM-1 receptor. Biofilm stimulus increased ROS levels in MONO-MAC-6 cells and PDLF, but only HHA slightly suppressed the high generation of ROS induced by biofilm stimulation in both cells.
CONCLUSION
Overall, these results indicate that OHA induces inflammation, while HHA and CHA exhibit anti-biofilm, primarily anti-inflammatory, and antioxidant properties in the periodontal environment
Open- vs. closed-chest pig models of donation after circulatory death.
Get PDFBACKGROUND
During donation after circulatory death (DCD), cardiac grafts are exposed to potentially damaging conditions that can impact their quality and post-transplantation outcomes. In a clinical DCD setting, patients have closed chests in most cases, while many experimental models have used open-chest conditions. We therefore aimed to investigate and characterize differences in open- vs. closed-chest porcine models.
METHODS
Withdrawal of life-sustaining therapy (WLST) was simulated in anesthetized juvenile male pigs by stopping mechanical ventilation following the administration of a neuromuscular block. Functional warm ischemic time (fWIT) was defined to start when systolic arterial pressure was <50 mmHg. Hemodynamic changes and blood chemistry were analyzed. Two experimental groups were compared: (i) an open-chest group with sternotomy prior to WLST and (ii) a closed-chest group with sternotomy after fWIT.
RESULTS
Hemodynamic changes during the progression from WLST to fWIT were initiated by a rapid decline in blood oxygen saturation and a subsequent cardiovascular hyperdynamic (HD) period characterized by temporary elevations in heart rates and arterial pressures in both groups. Subsequently, heart rate and systolic arterial pressure decreased until fWIT was reached. Pigs in the open-chest group displayed a more rapid transition to the HD phase after WLST, with peak heart rate and peak rate-pressure product occurring significantly earlier. Furthermore, the HD phase duration tended to be shorter and less intense (lower peak rate-pressure product) in the open-chest group than in the closed-chest group.
DISCUSSION
Progression from WLST to fWIT was more rapid, and the hemodynamic changes tended to be less pronounced in the open-chest group than in the closed-chest group. Our findings support clear differences between open- and closed-chest models of DCD. Therefore, recommendations for clinical DCD protocols based on findings in open-chest models must be interpreted with care
Ungarische Studenten im Repertorium Academicum Germanicum (RAG) 1372-1526. Projekt, Datenbestand und Auswertungsperspektiven.
Get PDFThe Repertorium Academicum Germanicum (RAG) is a long-term digital project that has been researching the students and scholars of the Holy Roman Empire (HRE) between 1250 and 1550. In 2020, the RAG was integrated into the larger project Repertorium Academicum (REPAC), which now also includes the Repertorium Academicum Helveticum (RAH) and the Repertorium Bernense (RB). The three sub-projects analyse different European regions: the HRE in the RAG, the Swiss Confederation in the RAH and the territory of the city of Bern in the RB. REPAC is based at the Historical Institute of the University of Bern. The common goal of the projects is to create prosopographical foundations for the history of the impact of scholars and their knowledge in order to clarify the origins and developments of the modern knowledge society.
Methodologically, the projects combine approaches from social, university and knowledge history with digital prosopography. At the centre is a research database in which the biographical events of students and scholars are recorded. This data is localised geographically and temporally to enable dynamic visualisations on maps, in networks and time series. The analyses focus on the geographical and social mobility of individuals and on the dissemination and application of academic knowledge by individuals and institutions such as universities, schools, churches, monasteries, ecclesiastical and secular courts and tribunals. In addition, this digital methodology enables together with the tools for data visualisation the reconstruction of specific knowledge spaces analysing their determining factors.
This article explains this methodologies using the Hungarian scholars documented in the RAG. This group is a vivid example of the study of academic knowledge circulation and spaces in European networks, with the University of Vienna playing a central role as a mediator of knowledge. The Hungarian scholars demonstrate fundamental research perspectives that are particularly relevant for collaborative approaches: Since biographical data collection requires in-depth knowledge of the historical background of the respective region, an in-depth study of the Hungarian scholars in the RAG would be particularly insightful if their biographies could be digitally supplemented with information from regional or local librariesand archives.A Repertorium Academicum Germanicum (RAG) egy hosszú távú digitális projekt, amely a Német-római Szent Birodalom diákjainak és tudósainak adatbázisát kívánja létrehozni az 1250 és 1550 közötti időszak vonatkozásában. A RAG 2020-ban integrálódott a nagyobb Repertorium Academicum (REPAC) projektbe, amely utóbbi m már a Repertorium Academicum Helveticumot (RAH) és a Repertorium Bernense-t (RB) is magában foglalja. A három alprojekt különböző európai régiókat elemez: a RAG-ban a Német-római Szent Birodalomra, a RAH-ban a svájci államszövetségre, az RB-ben pedig Bern városára vonatkozó adatokat vizsgálja.A REPAC székhelye a Berni Egyetem Történeti Intézetében található. A projektek közös célja, hogy a tudósok és tudásuk hatásának történetéhez prozopográfiai alapokat teremtsenek, hogy tisztázzák a modern tudásalapú társadalom eredetét és fejlődését.
Nevezett projektek módszertanilag a társadalom-, egyetem- és tudástörténeti megközelítéseket ötvözik a digitális prozopográfiával. A középpontban egy kutatási adatbázis áll, amelyben a hallgatók és tudósok életrajzi eseményeit rögzítik. Ezeket az adatokat földrajzilag és időben lokalizálják, hogy lehetővé tegyék a dinamikus megjelenítést térképeken, hálózatokban és idősorokban. Az elemzések az egyének földrajzi és társadalmi mobilitására, valamint a tudományos ismeretek egyének és intézmények − egyetemek, iskolák, egyházak, kolostorok, egyházi és világi bíróságok − általi terjesztésére és alkalmazására összpontosítanak. Ez a digitális módszertan az adatok vizualizálására szolgáló eszközökkel ezenkívül együtt lehetővé teszi a konkrét tudásterek rekonstruálását, elemezve azok meghatározó tényezőit.
A tanulmány ezt a módszertant a RAG-ban dokumentált magyarországi hallgatók és tudósok segítségével kívánja bemutatni. A magyarországiak csoportja szemléletes példája az európai hálózatokban zajló akadémiai tudáscirkuláció és -terek tanulmányozásának, amelyben a Bécsi Egyetem központi szerepet játszik a tudás közvetítőjeként. A magyarországi tudósok adatainak elemzése olyan alapvető kutatási perspektívákat mutat be, amelyek különösen fontosak az együttműködésen alapuló megközelítések szempontjából: mivel az életrajzi adatok gyűjtése az adott régió történelmi hátterének alapos ismeretét igényli, a RAG magyarországi tudósainak mélyreható tanulmányozása különösen tanulságos lenne, ha életrajzaikat digitálisan ki lehetne egészíteni a regionális vagy helyi könyvtárakból és levéltárakból származó információkkal
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