Assessment of failure rate of dental implants in medically compromised patients

Background and Aims:

The present study was conducted to assess failure rate of dental implant in medically compromised patients.

Methods:

This study comprised of 68 medically compromised patients of both genders who underwent dental implants 5 years ago (Group I). Equal number of healthy subjects was taken as control (Group II). Amount of bone loss around the implant over 1mm of bone loss in the first year and over 0.3 mm bone loss every subsequent year were considered as failures.

Results:

The age group of 30-40 comprised of 25 patients in group I and 35 in group II, 40-50 years had 27 in group I and 23 in group II and 50-60 years had 16 in group I and 10 in group II. Medically compromised patients were diabetes (25) with 30 dental implants followed by osteoporosis (16) with 17 dental implants, hypothyroidism (12) with 14 dental implants, organ transplant (10) with 12 dental implants and CVD (5) with 7 dental implants. Chi- square test was applied which revealed significant difference in patients (P < 0.05). In group I, there were 18 (22.5%) and in group II, there were 4 (5.56%) dental implant failures. The difference with chi- square test found to be significant P < 0.05).

Conclusion:

Among medically compromised conditions, higher failure rate was found in diabetes.

P89 Role of inflammation as a risk factor for atrial fibrillation in rheumatic mitral stenosis and its correlation with atrial late gadolinium enhancement (LGE) on cardiac MRI

Funding Acknowledgements

ICMR

Aims

Association of atrial fibrillation (AF) is a common cause of morbidity and mortality in patients with rheumatic heart disease (RHD). Association of Atrial Fibrillation with inflammation is well delineated in nonvalvular AF as compared to Rheumatic AF. This study evaluated the presence of atrial inflammation, in patients with AF and rheumatic mitral stenosis (MS), using cardiac MRI and its correlation with inflammatory markers.

Methods and Results

Twenty RHD patients with predominant mitral stenosis were recruited for the study. Ten patients had persistent AF, three had paroxysmal AF and seven were in sinus rhythm. Patients with AF had lower mitral valve areas. Cardiac MRI showed evidence of late gadolinium enhancement (LGE) in the atrial wall in 61.54% (8/13) of patients with AF as compared with only 20% (1/5; p &lt; 0.05) of patients in sinus rhythm. Mean levels of IL-6 were also significantly higher in patients with AF (10.62 ± 5.92 pg/mL versus 4.37 ± 2.68 pg/mL; P= 0.017). IL6 with a cutoff of ≥ 6.5 pg/mL was associated with a sensitivity of 76.92 % and specificity of 71.43 % for prediction of AF. There was also significant association between high IL-6 levels and LGE on MRI (13.13 ± 5.75 pg/mL vs 5.29 ± 3.23pg/mL; P &lt; 0.05)

Conclusion

Patients with MS who developed AF show evidence of atrial inflammatory sequelae in the form of fibrosis as suggested by LGE on cardiac MRI. Systemic inflammation in the form of elevated IL-6 levels correlated significantly with atrial fibrosis and AF.

Table 1: MS patients with or without AF Clinical Features Rhythm P-Value NSR (n = 7) AF (n = 13) Mean Valve Area (cm2) 1.28 ± 0.35 0.83 ± 0.26 &lt; 0.01 Mean Diastolic Gradient (mmHg) 6.29 ± 2.2 11.92 ± 5.65 &lt;0.01 Wilkin Score 7 ± 0.816 8.46 ± 1.66 0.04 LVEF % (non indexed) 59.57 ± 1.13 58.77 ± 2.89 0.49 LA Volume with MRI (ml) 127.50 ± 51.32 284.33 ± 133.12 &lt;0.01 Inflammatory Markers hs-CRP (mg/L) 5.59 ± 3.89 3.94 ± 3.47 0.34 IL6 (pg/mL) 4.37 ± 2.68 10.62 ± 5.92 0.017 sCD-40L (ng/mL) 3.72 ± 3.73 4.77 ± 2.80 0.48 Atrial LGE 0 (0%) 8 (61.5%) 0.04

Abstract P89 Figure. Image 1: Cardiac MRI showing LGE

Abstract B051: Antitumor activity of dual PD-1 and LAG-3 blockade reversed by adoptive transfer of tumor-draining lymph node cells

Immune checkpoint inhibitors (ICIs) emerged as promising therapies for various cancer types. Yet, therapeutics that target single immune checkpoint protein (ICP) have met with obstacles including low response rates and acquired tumor resistance. To overcome these obstacles, combination therapies that simultaneously target multiple ICPs are being actively pursued in the field. In this study, we utilized the B16F10 tumors, a syngeneic mouse melanoma model that showed limited responses to numerous ICIs against single ICP, and assessed the efficacy of dual blockade of PD-1 and LAG-3 (an ICP expressed on the surface of T and NK cells) through i.p. injection of neutralizing antibodies [anti-PD-1 (clone: RMP1-14) and anti-LAG-3 (clone: C9B7W), 10 mg/kg each, twice weekly]. Moreover, to interrogate the effects of altered immune landscape in the tumor microenvironment (TME) on tumor responses to ICIs, we performed a single-time adoptive transfer of tumor-draining lymph node (TDLN) cells harvested from B16F10 tumor-bearing donor mice (5 M TDLN cells per recipient mouse, i.v.), 2 days before the first antibody treatments, and assessed its impact on tumor responses in recipient mice. TDLN cells were either used immediately after isolation or cultured in vitro with anti-CD3/IL-2 for 5 days that resulted in rapid proliferation and overpopulation (&gt;98%) of T cells. Our results showed that combination treatment with anti-PD-1 and anti-LAG-3, compared to isotype controls, significantly inhibited B16F10 tumor growth (&gt;60%) in mice that did not received donor TDLN cells. FACS analyses of blood and tumor samples indicated that anti-PD-1/anti-LAG-3 significantly enhanced the percentages of CD8+ T cells and CD49b+ NK cells as well as the ratio between CD8+ T cells and CD4+CD25+CD127-/low regulatory T cells, in B16F10 tumors but not in the peripheral blood. Interestingly, adoptive transfer of freshly-isolated TDLN cells completely abrogated the antitumor activity, whereas infusion with anti-CD3/IL-2-treated TDLN cells only partially alleviated the antitumor activity of anti-PD-1/anti-LAG-3. FACS analyses indicated that, in mice receiving donor TDLN cells, anti-PD-1/anti-LAG-3 was not able to stimulate intratumoral infiltration of CD8+ T cells or NK cells or increase the ratio between CD8+ T cells and regulatory T cells. In conclusion, combined treatment of anti-PD-1 and anti-LAG-3 significantly inhibits B16F10 tumor growth associated with activation of immune responses in the TME, which is at least partially reversed by adoptive transfer of TDLN cells. Our results support the usage of the B16F10 mouse melanoma model for testing the efficacy of combination therapies or bi-specific antibodies against both PD-1 and LAG-3. The reason behind tumor resistance induced by adoptive transfer of TDLN cells remains unclear. It is important to identify this mechanism of resistance, as the knowledge can benefit patient selection or provide a rationale for future combination therapies that concomitantly target PD-1/LAG-3 and this resistance machinery.

Citation Format: Wei Liang, Lilibet Valdovinos, Kaitlyn Yapjoco, Kaede Hinata, Geeta Sharma, Thomas B Broudy. Antitumor activity of dual PD-1 and LAG-3 blockade reversed by adoptive transfer of tumor-draining lymph node cells [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2019 Oct 26-30; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2019;18(12 Suppl):Abstract nr B051. doi:10.1158/1535-7163.TARG-19-B051

Plant and fungi diversity of Devi Pindiyan Valley in Trikuta Hills of northwestern Himalaya, India

The Devi Pindiyan Valley, an abode of Goddess Vaishno Devi, in Trikuta Hills (western Himalaya) is a unique hill-top land ecosystem with a diverse regional mixed subtropical and temperate flora. Because of its suitable geographic location, specific and unique habitat conditions, this mountainous belt of Shivalik Himalaya has a large number of endemic and threatened plant species.  This study presents information on the plant diversity of Devi Pindiyan Valley of Trikuta Hills. Several line-transect (100m N-S and 100 E-W) surveys were conducted in which nested quadrats of 10m × 10m were laid for trees, within which interspersed two 5m × 5m sub-quadrats for shrubs and five 1m × 1m sub-quadrants for herbs at different places for determination of floristic composition. In the diverse habitats of this valley, we recorded 213 vascular plant species belonging to 164 genera under 71 families. This study area also harbors rich diversity of fungi, where the most visible 7 species of macrofungi belongs to 7 genera and 4 families were documented.  Out of the documented species, 35 species have been categorized as threatened based on the latest IUCN Red list criteria, while 178 species are included in the catalogue of world life. Engelhardtia spicata Lechen ex Blume var. integra (Kurz) Manning ex Steenis has been categorized as Least Concerned (LC) by IUCN Red List site. The species diversity indicates the high conservation value of this area and documenting such an ecologically rich ecosystem becomes a prerequisite for developing and formulating conservation-cum-management strategies. Therefore, we recommend there is need for ecological research in terms of biodiversity conservation on Devi Pindiyan Valley and similar ecosystems. 

Volatile organic compound measurements point to fog-induced biomass burning feedback to air quality in the megacity of Delhi

We report the first ambient measurements of thirteen VOCs for investigations of emissions and air quality during fog and non-fog wintertime conditions at a tower site (28.57° N, 77.11° E, 220 m amsl) in the megacity of Delhi. Measurements of acetonitrile (biomass burning (BB) tracer), isoprene (biogenic emission tracer in daytime), toluene (a traffic exhaust tracer) and benzene (emitted from BB and traffic), together with soluble and reactive oxygenated VOCs such as methanol, acetone and acetaldehyde were performed during the winters of 2015-16 and 2016-17, using proton transfer reaction mass spectrometry. Remarkably, ambient VOC composition changes during fog were not governed by solubility. Acetaldehyde, toluene, sum of C8-aromatics (e.g. xylenes), sum of C9-aromatics (e.g. trimethyl benzenes) decreased by ≥30% (>95% confidence interval), whereas acetonitrile and benzene showed significant increases by 20% (>70% confidence interval), even after accounting for boundary layer dilution. During fog, the lower temperatures appeared to induce an emissions feedback from enhanced open BB within Delhi for warming, releasing both gaseous and aerosol pollutants with consequences for fog chemistry, sustenance and intensity. The potential feedback is important to consider for improving current emission parametrizations in models used for predicting air quality and fog in such atmospheric environments.

Frequency and variability of five non metric dental crown traits in the permanent maxillary dentitions of a racially mixed population from Bengaluru, Karnataka

INTRODUCTION

Evaluation of Tooth Crown non metric traits benefits to assess the biological distance between populations. It is well known that these traits are characterised by a high inter-population differentiation, low sexual dimorphism, and their recording is loaded by relatively small intra and inter observer error. The dental morphological traits are successfully used in the description and explanation of the microevolutionary and ethnogenetic processes. This paper presents the results of the permanent maxillary dentition tooth crown traits differentiation of human populations from Bengaluru.

MATERIALS AND METHODS

The comparative analysis was carried out on the basis of 4 groups for 5 Tooth Crown non metric traits in maxillary permanent dentition using Arizona State University Dental Anthropology System for morphological scoring system of each trait and each score was charted on Osteoware Dental Morphology software.

RESULTS

Study analysed 400 dental casts from 4 different ethnic groups. Traits Winging, shovelling, lingual tubercle showed highest expression in Iranians while Cusp of Carabelli's trait expression showed 87% of prevalence in the surveyed group but the Hypocone trait showed the highest expression in Muslims.

CONCLUSION

Traits of the human dentition can be a valuable diagnostic tool for anthropological studies in classifying and characterizing different ethnic groups. According to the results obtained from this study, it can be said that the groups Hindus, Muslims and Christians (Indians) belong to Sundonts, while Iranians fall under sinodonts population group.

Magnetocaloric effects from an interplay of magnetic sublattices in Nd2NiMnO6

We present a combined experimental and theoretical study to understand the magnetism and magnetocaloric behavior of the double perovskite Nd₂NiMnO₆. The magnetic susceptibility data confirms a ferromagnetic transition with [Formula: see text] K. An additional feature at T  =  25 K, indicative of antiferromagnetic correlations, is present. A positive magnetocaloric effect (MCE) near [Formula: see text] and a negative MCE around T  =  25 K is inferred from the temperature dependence of the change in magnetic entropy at low magnetic fields. The negative MCE peak is suppressed on the application of a magnetic field and can be made to switch to a conventional positive MCE upon increasing magnetic field. We understand and reproduce these features in Monte Carlo simulations of a phenomenological Heisenberg model for Nd₂NiMnO₆. The validity of the model is tested using density functional theory calculations. We argue that this simple understanding of the experimental observations in terms of two antiferromagnetically coupled sublattices allows these results to be useful across a broader class of magnetocaloric materials.

Thermoelectric and vibrational properties of Be2C, BeMgC and Mg2C using first-principles method

Transport coefficients are calculated combining first-principles calculations with the Boltzmann transport theory. Electronic states obtained in terms of the k-space eigen-energies from the crystalline orbital program, based on density functional theory, are Fourier transformed and interfaced with the transport equations modeled in the BoltzTraP. The calculations are performed for Be₂C, Mg₂C, and the BeMgC mixed crystal. The Seebeck coefficient, electronic thermal conductivity and the power factor are calculated. Further, the transport coefficients are linked to find the electronic fitness function to compare the performance with other thermoelectric materials. The procedure can also be applied to study the thermoelectric properties of other materials. The vibrational frequencies at the Brillouin zone centre are calculated generating a Hessian matrix from the analytical gradients of the energy with respect to atomic coordinates in the three antifluorite crystals. Moreover, the static, high frequency dielectric constants and Born effective charges are calculated to find splitting in the longitudinal optic and transverse optic modes. Results are compared with the data wherever available in the literature and a very good agreement is found in most cases.

The EFF of Mg₂C. A very good thermoelectric has the EFF above the horizontal lines marked at 300 and 800 K.

A loop-mediated isothermal amplification assay for the diagnosis of pulmonary tuberculosis

Quantitated Mycobacterium tuberculosis (M.tb) H37Rv DNA was used to analyse the sensitivity and the specificity was assessed using DNA isolated from the reference strain H37Rv, 12 nontuberculous mycobacterium (NTM) species and five nonmycobacterium species. Furthermore, performance of the assay was evaluated on the sputum samples and compared with smear microscopy, culture and PCR. mpt64 (also called mpb64 or Rv1980c) loop-mediated isothermal amplification (LAMP) successfully detected 1 pg DNA within 40 min and successfully rejected NTMs and other bacterial species tested. It specifically detected all the 119 confirmed TB cases and 100 of the 104 control cases. The resulting sensitivity and specificity of LAMP assay was found to be 100% (95% CI: 96·79-100%) and 96·15% (95% CI; 90·44-98·94%) respectively. SIGNIFICANCE AND IMPACT OF THE STUDY: Loop-mediated isothermal amplification (LAMP) is a technique for isothermal DNA amplification suitable for cost-limited settings as it prevents the use of sophisticated instruments. Using mpt64 antigenic protein gene, we developed a LAMP assay especially for organisms of the M. tuberculosis complex. mpt64 LAMP assay showed 100% sensitivity and detected all the bacteriologically and clinically positive TB cases not detected by smear, culture or PCR methods.

TSR-033, a Novel Therapeutic Antibody Targeting LAG-3, Enhances T-Cell Function and the Activity of PD-1 Blockade In Vitro and In Vivo

Progressive upregulation of checkpoints on tumor-infiltrating lymphocytes promotes an immunosuppressive tumor microenvironment, severely compromising tumor immunity. Lymphocyte activation gene-3 (LAG-3) is a coinhibitory receptor associated with impaired T-cell function and is frequently coexpressed with programmed cell death protein-1 (PD-1) in the context of human cancers. Targeting LAG-3 in conjunction with PD-1 thus represents a strategy to amplify and broaden the therapeutic impact of PD-1 blockade alone. We have generated a high affinity and selective humanized monoclonal IgG4 antibody, TSR-033, which binds human LAG-3 and serves as a functional antagonist, enhancing in vitro T-cell activation both in mixed lymphocyte reactions and staphylococcal enterotoxin B-driven stimulation assays. In a humanized mouse non-small cell lung carcinoma model, TSR-033 boosted the antitumor efficacy of PD-1 monotherapy, with a concomitant increase in immune activation. Analogous studies in a murine syngeneic tumor model using surrogate antibodies demonstrated significant synergy between LAG-3 and PD-1 blockade-combination treatment led to a marked improvement in therapeutic efficacy, increased T-cell proliferation, IFNγ production, and elicited durable immunologic memory upon tumor rechallenge. Taken together, the pharmacologic activity of TSR-033 demonstrates that it is a potent anti-LAG-3 therapeutic antibody and supports its clinical investigation in cancer patients.

Development of strategy for simultaneous enhanced production of alkaline xylanase-pectinase enzymes by a bacterial isolate in short submerged fermentation cycle

The aim of this study is to enhance the production of industrially valuable xylanase and pectinase enzymes in short duration, using agrowaste extracted substrates. Conventional cum statistical multifactor analysis approaches were used in order to evaluate the effect of crude extracted substrates, supplemented for the production of xylanase-pectinase enzymes. Incorporation of crude extracted xylan (1.2 mg/ml of inoculum) and pectin (4.8 mg/ml of inoculum) substrates in inoculum resulted in maximal xylanase (320 ± 15) and pectinase titre (90 ± 8) after 48 h, using 2% wheat bran and 2% citrus peel in production medium with 48 h of fermentation time, with one variable factor at a time approach. The best condition obtained after performing statistical multifactor interaction analysis includes 5.50 mg/ml of pectin in inoculum,1.50 mg/ml of xylan in inoculum, wheat bran 3%, temperature 37.5 °C, time 48 h, 7 mg/ml of pectin in production medium, peptone 1.05%, inoculum size 2% and inoculum age of 20 h, with alkaline xylanase activity of 415.22 ± 18.50 IU/ml and alkaline pectinase activity of 109.10 ± 8.80 IU/ml. Activity of different pectinolytic enzymes per ml was also calculated, with 18.98 IU of exo-polymethylgalacturonase, 0.14 IU of endo-polymethylgalacturonase, 80 IU of exo-polygalacturonase, 0.28 IU of endo-polygalacturonase, 1.42 IU of polymethylgalacturonate lyase, 1.47 IU of polygalacturonate lyase, 0.15 IU of pectin esterase. This is the first report mentioning the utilization of crude extracted xylan and extracted pectin in inoculum to get the increment in the activity of both alkaline xylanase-pectinase enzymes simultaneously under short submerged fermentation cycle.

Abstract 5690: Characterization of tumor growth and immune microenvironment in humanized NOG-EXL mice implanted with A549, MDA-MB-436 and A375 cells

Syngeneic mouse models are the most extensively explored mouse models for evaluation of immune-oncology therapeutic modalities in preclinical settings. One of the major limitations with syngeneic models is that both the tumor and the immune system is murine and thus do not express any human targets. Also, this precludes the evaluation of human clinical product (antibody or protein) mandating the synthesis and use of murine surrogates. Therefore, development of models of human tumors in mice with competent human immunity became an urgent need. Tumor-bearing, humanized NOG-EXL mice are a new and valuable preclinical testing platform for immuno-oncology, to simulate trials, evaluate multiple drugs alone or in combination, and produce predictive data both in cell line derived (CDX) and patient derived (PDX) models. With the objective of understanding the tumor growth and basal immune microenvironment in Hu-NOG-EXL mice (NOG mice humanized using CD34+ cells isolated from cord blood), we implanted three different human tumor cell lines (A549: Human Lung Carcinoma; MDA-MB-436: Triple Negative Breast Cancer; A375: Human Melanoma) in Hu-NOG EXL mice procured from Taconic, NY. The tumors were collected at a tumor volume of 1000-1500mm3, and profiled for the lymphoid and myeloid compartments using flow cytometry. The corresponding splenic compartment was also profiled to monitor the correlation or lack thereof between the tumor and splenic compartments. Finally the tumors were compared and categorized based on their basal infiltrates. The results demonstrated that Hu-NOG-EXL mice could be an useful tool to dissect the immune response in human tumors. It was possible to identify and quantitate the myeloid cells which are absent in a model that has been implanted with human PBMNC's (Peripheral Blood Mono Nuclear Cells) instead of human CD34 stem cells.

Citation Format: Srimoyee Ghosh, Anne Fiore, Christoph Eberle, Sarah Wang, Keith Mikule, Kristen McEachern, Sujatha Kumar, David Jenkins, Geeta Sharma. Characterization of tumor growth and immune microenvironment in humanized NOG-EXL mice implanted with A549, MDA-MB-436 and A375 cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5690.

Regulated intratumoral expression of IL-12 using a RheoSwitch Therapeutic System® (RTS®) gene switch as gene therapy for the treatment of glioma

The purpose of this study was to determine if localized delivery of IL-12 encoded by a replication-incompetent adenoviral vector engineered to express IL-12 via a RheoSwitch Therapeutic System^® (RTS^®) gene switch (Ad-RTS-IL-12) administered intratumorally which is inducibly controlled by the oral activator veledimex is an effective approach for glioma therapy. Mice bearing 5–10-day-old intracranial GL-261 gliomas were intratumorally administered Ad-RTS-mIL-12 in which IL-12 protein expression is tightly controlled by the activator ligand, veledimex. Local tumor viral vector levels concomitant with veledimex levels, IL-12-mRNA expression, local and systemic cytokine expression, tumor and systemic flow cytometry and overall survival were studied. Ad-RTS-mIL-12+veledimex elicited a dose-related increase in tumor IL-12 mRNA and IL-12 protein and discontinuation of veledimex resulted in a return to baseline levels. These changes correlated with local immune and antitumor responses. Veledimex crossed the blood–brain barrier in both orthotopic GL-261 mice and cynomolgus monkeys. We have demonstrated that this therapy induced localized controlled production of IL-12 which correlates with an increase in tumor-infiltrating lymphocytes (TILs) leading to the desired biologic response of tumor growth inhibition and regression. At day 85 (study termination), 65% of the animals that received veledimex at 10 or 30 mg/m²/day were alive and tumor free. In contrast, the median survival for the other groups were: vehicle 23 days, bevacizumab 20 days, temozolomide 33 days and anti-PD-1 37 days. These findings suggest that the controlled intratumoral production of IL-12 induces local immune cell infiltration and improved survival in glioma, thereby demonstrating that this novel regulated immunotherapeutic approach may be an effective form of therapy for glioma.