Purpose The immune checkpoint inhibitors (ICIs) have resulted in subgroups of patients with metastatic melanoma achieving high-quality durable responses. Metastatic melanoma survivors are a new population in the era of cancer survivorship. The aim of this study was to evaluate metastatic melanoma survivors in terms of health-related quality of life (HRQoL), immune-related adverse events (irAEs) and exposure to immunosuppressive agents in a large single centre in the UK. Methods We defined the survivor population as patients with a diagnosis of metastatic melanoma who achieved a durable response to an ICI and had been followed-up for a minimum of 12 months from initiation of ICI without disease progression. HRQoL was assessed using SF-36. Electronic health records were accessed to collect data on demographics, treatments, irAEs and survival. HRQoL data was compared with two norm-based datasets. Results Eighty-four metastatic melanoma survivors were eligible and 87% ( N  = 73) completed the SF-36. ICI-related toxicity of any grade occurred in 92% of patients and 43% had experienced a grade 3 or 4 toxicity. Almost half (49%) of the patients required steroids for the treatment of ICI-related toxicity, whilst 14% required treatment with an immunosuppressive agent beyond steroids. Melanoma survivors had statistically significant lower HRQoL scores with regard to physical, social and physical role functioning and general health compared with the normative population. There was a trend towards inferior scores in patients with previous exposure to ipilimumab compared with those never exposed to ipilimumab. Conclusions Our results show that metastatic melanoma survivors have potentially experienced significant ICI-related toxicity and experience significant impairments in specific HRQoL domains. Future service planning is required to meet this population’s unique survivorship needs.

Introduction: Many factors affect the growth and development of the mandible. The most common one is micrognathia; this can pose and neonatal emergency. Early recognition of mandibular and other face anomalies could provide immediate care for these infants, and presence of neonatologist or other doctors in the delivery room. The aim: Aim of this study was to develop normal ranges of the facial markers: mandibular length, jaw index and the facial angle in the fetus using 3D ultrasound. Material and methods: The research was conducted as a cross-sectional study in the second trimester of pregnancy. Fetuses (female n=23 and male n=27) from singleton pregnancy between 29-37 week of gestation were examined by ultrasound. All images were acquired transabdominally, using Voluson E16. Ultrasound was performed by an experienced operator (SM) and measured the values of head circumference, abdominal circumference, biparietal diameter, femur length, body mass. For mandibular length, inferior facial angle, and the jaw index was calculated (Jaw Index =AP mandibular diameter / BPD * 100), the profile images were used (only images in the exact midsagittal plane were used). The characteristics of the fetal profiles were determined by the Schwartz and Ricketts profile analysis using soft tissue landmarks and analysis of the profile photographs. Results: The results show that the jaw index ranged from 25.33 and 34.06 with an average of 26.00 for all examined fetuses. Conclusion: The physiological position of the mandible is retrognathic and that the average physiological length of the mandible in the third trimester is 2.31cm. There is no difference in mandibular length between genders. Corresponding Author: Samra Salga-Nefic Rosenweg 2a, 3125 Toffen, Switzerland, e-mail: samrasalaga@gmail.com A determination of the standards of morphometrics variables of the stomatognathic system of a fetus INTRODUCTION Many factors affect the growth and development of the mandible: genes, irregular cell migration, low growth potential, feeding habits, and other habits acquired by newborns.1 The most common anomalies are microgenia (weak mandible growth) and retrogenia (small mandible growth in the sagittal plane).1 Deviation of physiological mandibular growth and development may incapacitate the essential functions of the stomatognathic system. Fetuses with mandible anomalies are at risk of airway obstruction through retro-positioning of the tongue-base into posterior pharyngeal airway.2 Micrognathia is frequently seen in Pierre Robin sequence, however it can be found in many genetic syndromes.3 Antenatal diagnosis of anomalies by ultrasound is widely used nowadays. The aim of this study was to develop normal ranges of the facial marker: mandibular length, jaw index and the facial angle in the fetus using 3D ultrasound. MATERIAL AND METHODS The research was conducted as a cross-sectional study in the second trimester of pregnancy. Fetuses (female n=23 and male n=27) from singleton pregnancy between 29-37 week of gestation were examined by ultrasound. All images were acquired transabdominally, using ultrasound Voluson E16, GE Healthcare, Austria GmbH & Co OG. Salaga-Nefic S., Mehmedbasic S., Kozadra J., Zukanovic A., Tiro, A., Dzemidzic, V., Nakas E. A determination of the standards of morphometrics variables of the stomatognathic system of a fetus. South Eur J Orthod Dentofac Res. 2019;6(1):6-11. Submitted: July 30, 2018; Revised: March 7, 2019; Published: April 30, 2019 6 South Eur J Orthod Dentofac Res Salaga-Nefic S. et al. Morphometrics variables of the fetus

Ultra-high performance concrete (UHPC) is a durable material that allows the construction of innovative structural elements and conforms with accelerated bridge construction (ABC) goals. The main idea of this research is to utilize UHPC to prefabricate a shell that acts as a stay-in-place form for bridge columns. The prefabricated shell eliminates the conventional formwork while reducing the on-site construction time and acting as a durable protective layer for the normal concrete inside the shell against environmental attacks. In addition, the UHPC shell provides additional confinement to the column concrete, which improves the column’s structural performance. During construction and after completing the column reinforcement work onsite, based on the conventional construction methods, the prefabricated UHPC shell is placed around the column reinforcement, followed by casting a portion of UHPC for a column-to-footing connection, which improves the capacity of the connection and shifts the plastic hinge zone above the connection. Once the UHPC portion hardens, normal concrete is placed inside the shell, forming a permanent concrete-filled UHPC shell. The construction process is finalized by placing and connecting a prefabricated cap beam to the column through the same developed connection as that in this research. This technical note presents the development of two test specimens using an UHPC shell in lieu of a conventional formwork with the advantage of improving the column performance and durability.

Background A decade ago, the advancements in the microbiome data sequencing techniques initiated the development of research of the microbiome and its relationship with the host organism. The development of sophisticated bioinformatics and data science tools for the analysis of large amounts of data followed. Since then, the analyzed gut microbiome data, where microbiome is defined as a network of microorganisms inhabiting the human intestinal system, has been associated with several conditions such as irritable bowel syndrome - IBS, colorectal cancer, diabetes, obesity, and metabolic syndrome, and lately in the study of Parkinson’s and Alzheimer’s diseases as well. This paper aims to provide an understanding of differences between microbial data of individuals who have been diagnosed with multiple sclerosis and those who were not by exploiting data science techniques on publicly available data. Methods This study examines the relationship between multiple sclerosis (MS), an autoimmune central nervous system disease, and gut microbial community composition, using the samples acquired by 16s rRNA sequencing technique. We have used three different sets of MS samples sequenced during three independent studies (Jangi et al, Nat Commun 7:1–11, 2016), (Miyake et al, PLoS ONE 10:0137429, 2015), (McDonald et al, Msystems 3:00031–18, 2018) and this approach strengthens our results. Analyzed sequences were from healthy control and MS groups of sequences. The extracted set of statistically significant bacteria from the (Jangi et al, Nat Commun 7:1–11, 2016) dataset samples and their statistically significant predictive functions were used to develop a Random Forest classifier. In total, 8 models based on two criteria: bacteria abundance (at six taxonomic levels) and predictive functions (at two levels), were constructed and evaluated. These include using taxa abundances at different taxonomy levels as well as predictive function analysis at different hierarchical levels of KEGG pathways. Results The highest accuracy of the classification model was obtained at the genus level of taxonomy (76.82 % ) and the third hierarchical level of KEGG pathways (70.95 % ). The second dataset’s 18 MS samples (Miyake et al, PLoS ONE 10:0137429, 2015) and 18 self-reported healthy samples from the (McDonald et al, Msystems 3:00031–18, 2018) dataset were used to validate the developed classification model. The significance of this step is to show that the model is not overtrained for a specific dataset but can also be used on other independent datasets. Again, the highest classification model accuracy for both validating datasets combined was obtained at the genus level of taxonomy (70.98 % ) and third hierarchical level of KEGG pathways (67.24 % ). The accuracy of the independent set remained very relevant. Conclusions Our results demonstrate that the developed classification model provides a good tool that can be used to suggest the presence or absence of MS condition by collecting and analyzing gut microbiome samples. The accuracy of the model can be further increased by using sequencing methods that allow higher taxa resolution (i.e. shotgun metagenomic sequencing).

Purpose: Ventilator associated pneumonia (VAP) is one of the most common hospital-acquired infection in patients hospitalized in intensive care unit (ICU). Aim of this study was to evaluate predictive values of quantitative and qualitative culture of broncholaveolar lavage (BAL) in the diagnosis of VAP comparing with clinical pulmonary infection score (CPIS), and to determine positive and negative predictive values of the tests in patients on mechanical ventilation. Methodology: 209 samples were prospectively taken from the patients hospitalized in ICU on mechanical ventilation; along with the clinical pulmonary infection score (CPIS). After sampling, quantitative and qualitative culture of BAL was done. As the cut off value of quantitative culture 104 CFU/mL was taken, according CDC recommendations. Results: In our study, sensitivity of the quantitative culture of BAL was 91%, specificity 70%, positive predictive value 80% and negative predictive value was 85%. Sensitivity of the qualitative culture of BAL was 93%, specificity 36%, positive predictive value 70,2% and negative predictive value was 76%. Conclusion: Quantitative culture of BAL has better predictive values in VAP diagnosis in patients on mechanical ventilation, helping in the discrimination between colonization and the infection. Qualitative culture of BAL has higher sensitivity, but lower specificity than quantitative culture.