Statement of problem Selective laser melting (SLM) additive manufacturing (AM) technology is a current option to fabricate cobalt-chromium (Co-Cr) metal frameworks for dental prostheses. However, the Co-Cr alloy composition, surface roughness, and ceramic bond strength values that SLM metals can obtain are not well-defined. Purpose The purpose of this in vitro study was to compare the chemical composition, surface roughness, and ceramic shear bond strength of the milled and SLM Co-Cr dental alloys. Material and methods A total of 50 disks of 5 mm in diameter and 1 mm in thickness were fabricated by using subtractive (control group) and AM with each of following SLM providers SLM-1 (EOS), SLM-2 (3D systems), and SLM-3 (Concept Laser). The milled disks were airborne-particle abraded with 100-μm aluminum oxide particles. All the specimens were cleaned before surface roughness (Ra), weight (Wt%), and atomic (At%) percentages were analyzed. Three-dimensional profilometry was used to analyze the topographical propeay ANOVA, followed by the post hoc Sidak test (α=.05). Results Significant differences were obtained in Wt%, At%, and Ra values among the Co-Cr alloys evaluated (P less then .05). Furthermore, the control group revealed significantly lower mean ±standard deviation Ra values (0.79 ±0.11 μm), followed by AM-3 (1.57 ±0.15 μm), AM-2 (1.80 ±0.43 μm), AM-1 (2.43 ±0.34 μm), and AM-4 (2.84 ±0.27 μm). However, no significant differences were obtained in the metal-ceramic shear bond strength among the different groups evaluated, ranging from mean ±standard deviation 75.77 ±11.92 MPa to 83.65 ±12.21 MPa. Conclusions Co-Cr dental alloys demonstrated a significant difference in their chemical compositions. Subtractive and additive manufacturing procedures demonstrated a significant influence on the surface roughness of the Co-Cr alloy specimens. However, the metal-ceramic shear bond strength of Co-Cr alloys was found to be independent of the manufacturing process.Background Few studies have assessed differences in the gut microbiota composition after bariatric surgery in the long term or whether differences are correlated with remission of type 2 diabetes. Objectives This observational study assessed differences in the gut microbiota between individuals at up to 13 years after surgery and a comparison group of individuals with severe obesity. The relationship between type 2 diabetes remission and the gut microbiota was also assessed. Setting University. Methods Stool samples were collected from individuals completing bariatric surgery (surgery group; n = 16) and individuals with severe obesity that did not receive surgery (nonsurgery group; n = 19) as part of the 12-year follow-up in the Utah Obesity Study. Metabolic health data were collected at baseline and the follow-up examination. The gut microbiota was quantified by sequencing the V4 region of the 16 S rRNA gene. H3B-6527 cost Significant differences in microbiota composition with surgery and other covariates were determined by Unifrac distance analysis and permutational multivariate analysis of variance. Significant differences in the relative abundance of individual bacterial taxa were assessed using analysis of composition of microbiomes software. Results The surgery group had higher relative abundances of Verrucomicrobiaceae (5.7 ± 1.3% versus 1.1 ± .3%) and Streptococcaceae (6.3 ± 1.0% versus 3.2 ± .8%), but lower relative abundances of Bacteroidaceae (8.8 ± 1.8% versus 18.6 ± 2.3%) 10.6 years after surgery. In a small subset of 8 individuals, a higher relative abundance of Akkermansia muciniphila was correlated with type 2 diabetes remission. Conclusions Differences in the gut microbiota are evident a decade after bariatric surgery compared with individuals with severe obesity that did not undergo surgery. The observed long-term differences are consistent with previous findings.Purpose The present study compared the efficacy of sunitinib and sorafenib as first-line treatment of metastatic clear cell renal cell carcinoma (mCC-RCC) with favorable or intermediate Memorial Sloan Kettering Cancer Center (MSKCC) risk. Patients and methods Treatment-naive patients with mCC-RCC were randomized to receive open-label sunitinib followed by sorafenib (SU/SO) or sorafenib followed by sunitinib (SO/SU). The primary endpoint was first-line progression-free survival (PFS). The secondary endpoints were total PFS and overall survival (OS). Results Of the 124 patients enrolled at 39 institutions from February 2010 to July 2012, 120 were evaluated. The median first-line PFS duration was 8.7 and 7.0 months in the SU/SO and SO/SU groups, respectively (hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.42-1.08). The total PFS and OS were not significantly different between the SU/SO and SO/SU groups (27.8 and 22.6 months; HR, 0.73; 95% CI, 0.428-1.246; and 38.4 and 30.9 months; HR, 0.934; 95% CI, 0.588-1.485, respectively). The subgroup analysis revealed that the total PFS with SU/SO was superior to the total PFS with SO/SU in the patients with favorable MSKCC risk and those with less then 5 metastatic sites). SO/SU was superior to SU/SO for patients without previous nephrectomy. Conclusions No statistically significant differences were found in first-line PFS, total PFS, or OS between the 2 treatment arms (ClinicalTrials.gov identifier, NCT01481870).Introduction Alkaptonuria (AKU) is a rare inherited disorder of tyrosine metabolism resulting in an accumulation of homogentisic acid oxidation products in the joints and cardiovascular system. Aortic distensibility may be a non-invasive indicator of cardiovascular complications. Descending thoracic aortic distensibility in alkaptonuria has not been studied. Methods Patients diagnosed with alkaptonuria underwent Magnetic Resonance Imaging (MRI) and gated non-contrast and contrast-enhanced cardiovascular computed tomography. Using MRI cine images, aortic distensibility of the descending thoracic aorta was determined. Results Seventy-six patients with alkaptonuria were imaged. When compared to literature normal values, aortic distensibility in AKU was impaired (5.2 vs 6.2 × 10-3, p less then .001). Aortic distensibility was inversely related to age (r = -0.6, p = .0001). Hypertensive patients with alkaptonuria had impaired distensibility compared to normotensive patients with alkaptonuria (4.6 vs 5.6 × 10-3, p = .