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There is a paucity of in vivo studies that investigate the safety and efficacy of temporomandibular joint (TMJ) tissue regeneration approaches, in part due to the lack of established animal models. Review of disease models for study of TMJ is presented herein with an attempt to identify relevant preclinical animal models for TMJ tissue engineering, with emphasis on the disc and condyle. Although degenerative joint disease models have been mainly performed on mice, rats, and rabbits, preclinical regeneration approaches must employ larger animal species. There remains controversy regarding the preferred choice of larger animal models between the farm pig, minipig, goat, sheep, and dog. The advantages of the pig and minipig include their well characterized anatomy, physiology, and tissue properties. The advantages of the sheep and goat are their easier surgical access, low cost per animal, and its high tissue availability. The advantage of the dog is that the joint space is confined, so migration of interpositional devices should be less likely. However, each species has limitations as well. For example, the farm pig has continuous growth until about 18 months of age, and difficult surgical access due to the zygomatic arch covering the lateral aspect of joint. The minipig is not widely available and somewhat costly. The sheep and the goat are herbivores, and their TMJs mainly function in translation. The dog is a carnivore, and the TMJ is a hinge joint that can only rotate. Although no species provides the gold standard for all preclinical TMJ tissue engineering approaches, the goat and sheep have emerged as the leading options, with the minipig as the choice when cost is less of a limitation; and with the dog and farm pig serving as acceptable alternatives. Finally, naturally occurring TMJ disorders in domestic species may be harnessed on a preclinical trial basis as a clinically relevant platform for translation.

Simplicial decomposition (SD) of variational inequalities experiences the long-tail convergence property. That is, the equilibrium solution rapidly progresses at first but then tails off, making only a tiny amount of progress per column generation iteration, which is a drawback of SDVI. In the context of Dantzig-Wolfe of LP, it is reported that the more proposals are used to initialize the algorithm, the faster the solution can be found by reducing the number of decomposition steps. Therefore, I proposed to solve multiple nonlinear column generation (mNCG) subproblems in each SD-VI iteration (SD-VI-mNCG) instead of solving only one subproblem as in SD-VI. Generating multiple column generation subproblem solutions in each SD-VI iteration enabled the corresponding convex hull to be rapidly enlarged. Consequently, the number of SD-VI iterations could be greatly reduced. A transportation network equilibrium problem was used to study the performance of the SDVI-mNCG. [ABSTRACT FROM AUTHOR]

Background: Thumb carpometacarpal joint (CMC) osteoarthritis is the most symptomatic hand arthritis but the long-term healthcare burden for managing this condition is unknown. We sought to compare total healthcare cost and utilisation for operative and nonoperative treatments of thumb CMC arthritis. Methods: We conducted a retrospective longitudinal analysis using a large nationwide insurance claims database. A total of 18,705 patients underwent CMC arthroplasty (trapeziectomy with or without ligament reconstruction tendon interposition) or steroid injections between 1 October 2015 and 31 December 2018. Primary outcomes, healthcare utilisation and costs were measured from 1 year pre-intervention to 3 years post-intervention. Generalised linear mixed effect models adjusted for potentially confounding factors such as the Elixhauser comorbidity score with propensity score matching were applied to evaluate the association between the primary outcomes and treatment type. Results: A total of 13,646 patients underwent treatment through steroid injections, and 5,059 patients underwent CMC arthroplasty. At 1 year preoperatively, the surgery group required $635 more healthcare costs (95% CI [594.28, 675.27]; p < 0.001) and consumed 42% more healthcare utilisation (95% CI [1.38, 1.46]; p < 0.0001) than the steroid injection group. At 3 years postoperatively, the surgery group required $846 less healthcare costs (95% CI [−883.07, −808.51], p < 0.0001) and had 51% less utilisation (95% CI [0.49, 0.53]; p < 0.0001) annually. Cumulatively over 3 years, the surgical group on average was $4,204 costlier than its counterpart secondary to surgical costs. Conclusions: CMC arthritis treatment incurs high healthcare cost and utilisation independent of other medical comorbidities. At 3 years postoperatively, the annual healthcare cost and utilisation for surgical patients were less than those for patients who underwent conservative management, but this difference was insufficient to offset the initial surgical cost. Level of Evidence: Level III (Therapeutic) [ABSTRACT FROM AUTHOR]

Viral persistence is one of the main hypotheses explaining the presence of post-COVID symptoms. This systematic review investigated the presence of SARS-CoV-2 RNA in plasma, stool, urine, and nasal/oral swab samples in individuals with post-COVID symptomatology. MEDLINE, CINAHL, PubMed, EMBASE, Web of Science databases, as well as medRxiv/bioRxiv preprint servers were searched up to November 25th, 2023. Articles investigating the persistence of SARS-CoV-2 RNA in plasma, stool, urine or nasal/oral swab samples in patients with post-COVID symptoms were included. Methodological quality was assessed using the Newcastle–Ottawa Scale or Cochrane's Risk of Bias (Rob) tool. From 322 studies identified, six studies met all inclusion criteria. The sample included 678 COVID-19 survivors (52 % female, aged from 29 to 66 years). The methodological quality was moderate in 88 % of the studies (n=5/6). Three papers investigated the presence of SARS-CoV-2 RNA in plasma, three studies in nasal/oral swabs, two studies in stool samples, one in urine and one in saliva. The follow-up was shorter than two months (<60 days after) in 66 % of the studies (n=4/6). The prevalence of SARS-CoV-2 RNA ranged from 5 to 59 % in patients with post-COVID symptoms the first two months after infection, depending on the sample tested, however, SARS-CoV-2 RNA was also identified in COVID-19 survivors without post-COVID symptoms (one study). Available evidence can suggest the presence of persistent SARS-CoV-2 RNA in post-COVID patients in the short term, although the biases within the studies do not permit us to make firm assumptions. The association between post-COVID symptoms and SARS-CoV-2 RNA in the samples tested is also conflicting. The lack of comparative group without post-COVID symptoms limits the generalizability of viral persistence in post-COVID-19 condition. [ABSTRACT FROM AUTHOR]

This 1-year longitudinal study investigated the effects of adolescents' depressed mood on perceived parental and peer warmth during the transition to young adulthood. We hypothesized that ethnicity would moderate such effects. As part of a larger study, 511 adolescents (154 European, 205 Hispanic, and 152 Asian Americans) participated in this research. They were surveyed shortly before their high school graduation and again 1 year later. Analyses based on 2-wave cross-lagged models showed that higher levels of initial depressive symptoms predicted lower levels of subsequent perceived parental and peer warmth for European Americans. For Asian Americans, higher initial depressed mood was significantly associated with lower levels of perceived peer warmth and was marginally associated with lower levels of parental warmth. In contrast, the erosion of parental and peer warmth was not evident for Hispanic Americans. The role of culture in the erosion of parental and peer warmth during life transitions was discussed. © 2009, Society for Research on Adolescence.

Background Occult scaphoid fractures on initial radiographs of an injury are a diagnostic challenge to physicians. Although artificial intelligence models based on the principles of deep convolutional neural networks (CNN) offer a potential method of detection, it is unknown how such models perform in the clinical setting. Questions/purposes (1) Does CNN-assisted image interpretation improve interobserver agreement for scaphoid fractures? (2) What is the sensitivity and specificity of image interpretation performed with and without CNN assistance (as stratified by type: normal scaphoid, occult fracture, and apparent fracture)? (3) Does CNN assistance improve time to diagnosis and physician confidence level?. Methods This survey-based experiment presented 15 scaphoid radiographs (five normal, five apparent fractures, and five occult fractures)with andwithout CNNassistance to physicians in a variety of practice settings across the United States and Taiwan. Occult fractures were identified by follow-up CT scans or MRI. Participants met the following criteria: Postgraduate Year 3 or above resident physician in plastic surgery, orthopaedic surgery, or emergency medicine; hand fellows; and attending physicians. Among the 176 invited participants, 120 completed the survey and met the inclusion criteria. Of the participants, 31% (37 of 120) were fellowship-trained hand surgeons, 43% (52 of 120) were plastic surgeons, and 69% (83 of 120) were attending physicians. Most participants (73% [88 of 120]) worked in academic centers, whereas the remainder worked in large, urban private practice hospitals. Recruitment occurred between February 2022 and March 2022. Radiographs with CNNassistancewere accompanied by predictions of fracture presence and gradient-weighted class activation mapping of the predicted fracture site. Sensitivity and specificity of the CNN-assisted physician diagnoses were calculated to assess diagnostic performance. We calculated interobserver agreement with the Gwet agreement coefficient (AC1). Physician diagnostic confidence was estimated using a self-assessment Likert scale, and the time to arrive at a diagnosis for each case was measured. Results Interobserver agreement among physicians for occult scaphoid radiographs was higher with CNN assistance than without (AC1 0.42 [95% CI 0.17 to 0.68] versus 0.06 [95% CI 0.00 to 0.17], respectively). No clinically relevant differences were observed in time to arrive at a diagnosis (18 ± 12 seconds versus 30 ± 27 seconds, mean difference 12 seconds [95% CI 6 to 17]; p < 0.001) or diagnostic confidence levels (7.2 ± 1.7 seconds versus 6.2 ± 1.6 seconds; mean difference 1 second [95% CI 0.5 to 1.3]; p < 0.001) for occult fractures. Conclusion CNN assistance improves physician diagnostic sensitivity and specificity as well as interobserver agreement for the diagnosis of occult scaphoid fractures. The differences observed in diagnostic speed and confidence is likely not clinically relevant. Despite these improvements in clinical diagnoses of scaphoid fractures with the CNN, it is unknown whether development and implementation of such models is cost effective. [ABSTRACT FROM AUTHOR]

The integration of vestibular, visual and body cues is a fundamental process in the perception of self-motion and is commonly experienced in an upright posture. However, when the body is tilted in an off-vertical orientation these signals are no longer aligned relative to the influence of gravity. In this study, the perceived timing of visual motion was examined in the presence of sensory conflict introduced by manipulating the orientation of the body, generating a mismatch between body and vestibular cues due to gravity and creating an ambiguous vestibular signal of either head tilt or translation. In a series of temporal-order judgment tasks, participants reported the perceived onset of a visual scene simulating rotation around the yaw axis presented in virtual reality with a paired auditory tone while in an upright, supine and side-recumbent body position. The results revealed that the perceived onset of visual motion was further delayed from zero (i.e., true simultaneity between visual onset and a reference auditory tone) by approximately an additional 30 ms when viewed in a supine or side-recumbent orientation compared to an upright posture. There were also no significant differences in the timing estimates of the visual motion between all the non-upright orientations. This indicates that the perceived timing of visual motion is negatively impacted by the presence of conflict in the vestibular and body signals due to the direction of gravity and body orientation, even when the mismatch is not in the direct plane of the axis of rotation. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is an aggressive primary malignancy of the liver and is the third most common cause of cancer‐related global mortality. There has been a steady increase in treatment options for HCC in recent years, including innovations in both curative and non‐curative therapies. These advances have brought new challenges and necessary improvements in strategies of disease monitoring, to allow early detection of HCC recurrence. Current serological and radiological strategies for post‐treatment monitoring and prognostication and their limitations will be discussed and evaluated in this review. [ABSTRACT FROM AUTHOR]

The Taiwan–China competition in the grey zone area of the South China Sea is an extension of the confrontation between the Republic of China (Taiwan) and the People's Republic of China (PRC) in the Taiwan Strait. Diplomatic isolation, geographic constraint and inadequacy in deterrent credibility represent the major challenges for Taiwan against China's expansionism in the region. This article examines Taiwan's evolving positions in the South China Sea and explores Taiwan's strategy of a point-line-surface defence framework to counter Beijing's threats of grey zone activities. [ABSTRACT FROM AUTHOR]