Search

Mathematical modeling is increasingly used to inform cervical cancer control policies, and model-based evaluations of such policies in women living with human immunodeficiency virus (HIV) are an emerging research area. We did a scoping review of published literature to identify research gaps and inform future work in this field. We systematically searched literature up to April 2022 and included mathematical modeling studies evaluating the effectiveness or cost-effectiveness of cervical cancer prevention strategies in populations including women living with HIV. We extracted information on prevention strategies and modeling approaches. We screened 1504 records and included 22 studies, almost half of which focused on South Africa. We found substantial between-study heterogeneity in terms of strategies assessed and modeling approaches used. Fourteen studies evaluated cervical cancer screening strategies, 7 studies assessed human papillomavirus vaccination (with or without screening), and 1 study evaluated the impact of HIV control measures on cervical cancer incidence and mortality. Thirteen conducted cost-effectiveness analyses. Markov cohort state-transition models were used most commonly (n = 12). Most studies (n = 17) modeled the effect of HIV by creating HIV-related health states. Thirteen studies performed model calibration, but 11 did not report the calibration methods used. Only 1 study stated that model code was available upon request. Few model-based evaluations of cervical cancer control strategies have specifically considered women living with HIV. Improvements in model transparency, by sharing information and making model code publicly available, could facilitate the utility of these evaluations for other high disease-burden countries, where they are needed for assisting policy makers. • Women living with human immunodeficiency virus (HIV) are disproportionally affected by cervical cancer. Nevertheless, it is unclear whether and how the rising number of mathematical modeling studies examining comparative effectiveness and cost-effectiveness of cervical cancer control policies consider women living with HIV in their models. • We found 22 model-based evaluations of cervical cancer control strategies that specifically considered women living with HIV. Almost half of the studies focused on South Africa. There was substantial heterogeneity regarding cervical cancer control policies assessed, type of population modeled, and modeling approaches used. Only 1 study stated that model code was available upon request. • Although mathematical modeling of cervical cancer control strategies is a rapidly growing field and women living with HIV are disproportionally affected by cervical cancer, few studies have considered the impact of HIV. Moreover, half of the studies focused on South Africa, and evaluations in other settings with high HIV and cervical cancer burden are lacking. Improving model transparency could facilitate the expansion of model-based evaluations to other high disease-burden countries. [ABSTRACT FROM AUTHOR]

• Spatiotemporal tree species diversity changes are analyzed by forest inventory data. • Small-scale species richness change considered tree size and taxonomic affiliation. • Regional variation in species richness was mainly due to past land-use history. • Site, stand and climate affected plots-level species gains, and management losses. • Spruce was a loser, beech and fir were winners in the study period (1983–2006) Knowledge regarding tree species dynamics is essential to understand forest responses to the environment, and to evaluate management options in adapting forest ecosystems to future climates. As maintaining tree species diversity and promoting structural stand heterogeneity are among the strategic elements in adapting forest management to climate change, the monitoring tree diversity is an ongoing challenge. Large-scale forest inventories have been proposed as a suitable basis for forest diversity analysis on large spatial and temporal scales. We used Swiss forest inventory data (NFI) to analyse temporal changes in tree species richness on small plots from 1983 to 2006. For two size groups of trees ('small' trees with dbh from 12 to 35 cm from plots with 200 m2 area, and 'large' trees with dbh ≥ 36 cm from plots with 500 m2 area), we identified the number and the tree species appearing ('gains') or disappearing ('losses') from each plot during the study period, and related these changes to site, stand and management characteristics. We found that species richness change was size-dependent and varied largely due to regional differences in the past land-use history of the Swiss forests. 'Gains' of 'small' trees were higher in stands with diverse vertical structure, with less competitive pressure as well as in warm environments, whereas 'gains' of 'large' trees were mostly related to climate and were highest in warm and moderately moist habitats. 'Losses' in both tree-size groups were mainly promoted by management. Our analysis suggests high vulnerability of Picea abies and high competitiveness of Fagus sylvatica , and underlines the potential of Abies alba in forming future Swiss forests. Despite of the silvicultural paradigm to create more species rich forests, most silvicultural interventions decreased small-scale species richness. This calls for further studies on the effect of management on tree species diversity. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Predicting ingrowth is important for estimating the future development of forests. • Ingrowth is a stochastic process with a zero-inflated distribution. • The number of ingrowth trees was predicted better by ZIP than by NB or ZINB. • Diameter of ingrowth trees was adequately predicted with the Weibull distribution. • Species were sufficiently ascribed to ingrowth trees by multinomial regression. Abstract Accurate and representative prediction of ingrowth is essential for modeling forest development. Besides the number of ingrowth trees, the basic tree attributes diameter and species are also important. In this study, these three characteristics were modeled based on data from the Swiss National Forest Inventory (NFI). The study covered large gradients of stand conditions and climate variables, making the models suitable to predict ingrowth under climate change. As the number of ingrowth trees per plot included more zeros than is expected for a Poisson distribution, we used three alternative probability distributions: zero-inflated Poisson distribution (ZIP), negative binomial distribution (NB) and zero-inflated negative binomial distribution (ZINB). Models with each of the three variants were fitted with and without random effects, resulting in six different model types. Model selection was performed backward using the BIC criterion. Of the final models, ZIP showed the best predictions of independently observed number of ingrowth trees. Our results indicate that the number of ingrowth trees strongly depended on the development stage of forests and on stand basal area, while temperature and precipitation, nitrogen deposition and water holding capacity each had a lower but still significant and plausible effect. The Weibull function was used to describe the probability distribution of the diameter of ingrowth trees and parameters were estimated using the Likelihood approach. The diameter of ingrowth trees was larger where there was a better site index and decreased with increasing stand density. Further, twelve species groups of ingrowth trees were fitted with a multinomial regression approach and showed clear dependence on climate: the probability of spruce and larch ingrowth clearly decreased with increasing temperature, whilst all other tree species profited from warmer conditions. The probability of fir, beech and ash ingrowth increased with increasing basal area, demonstrating the relevance of shade tolerance. The most important variable for predicting the species of ingrowth was the leading tree species group in a plot. [ABSTRACT FROM AUTHOR]

Highlights • We show how to optimize both for risk and for asset allocation. • Optimization of individual goals possible. • Introduction of novel concept of compensation portfolio. • Bridging Modern Portfolio Theory (MPT) and Behavioral Portfolio Theory (BPT). Abstract We successfully show that it is possible to optimize both for risk and for asset allocation without compromising the optimization of individual goals by introducing the novel concept of a compensation portfolio. Therefore, we solve for the global vs. local optimization paradox by bridging Modern Portfolio Theory (MPT) and Behavioral Portfolio Theory (BPT). [ABSTRACT FROM AUTHOR]

Abstract Background Oleoylethanolamide (OEA) is an endocannabinoid that controls food intake, energy expenditure and locomotor activity. Its anorexigenic effect appears to be mediated by PPARα, but the tissue where the presence of this receptor is required for OEA to inhibit feeding is unknown as yet. Previous studies point to a possible role of proximal enterocytes and neurons of the nodose ganglion. Materials and Methods Acute intraperitoneal OEA effects on food intake, energy expenditure, respiratory exchange ratio (RER) and locomotor activity were studied in control mice (PPARα-loxP) and intestinal (Villin-Cre;PPARα-loxP) or nodose ganglion (Phox2B-Cre;PPARα-loxP) specific PPARα knockout mice placed in calorimetric cages. Results OEA administration to both intestinal and nodose ganglion PPARα knockout mice decreased food intake, RER (leading to increased lipid oxidation) and locomotor activity as in control mice. However, while OEA injection acutely decreased energy expenditure in controls, this effect was not observed in mice devoid of PPARα in the intestine. Conclusion These results indicate that the OEA effect on food intake is independent from the presence of PPARα in the intestine and the nodose ganglion, while the impact of OEA on energy expenditure requires the presence of PPARα in the intestine. Highlights • As previously described, OEA administration decreases food intake. • This effect is independent from PPARα in the intestine and nodose ganglion. • OEA administration decreases energy expenditure. • This outcome requires the presence of PPARα in the intestine. [ABSTRACT FROM AUTHOR]

The aim of this work was the generation of a multifunctional nanopolymeric system that incorporates IR-780 dye, a near-infrared (NIR) imaging probe that exhibits photothermal and photodynamic properties; and a derivate of α-tocopheryl succinate (α-TOS), a mitochondria-targeted anticancer compound. IR-780 was conjugated to the hydrophilic segment of copolymer PEG- b -polyMTOS, based on poly(ethylene glycol) (PEG) and a methacrylic derivative of α-tocopheryl succinate (MTOS), to generate IR-NP, self-assembled nanoparticles (NPs) in aqueous media which exhibit a hydrophilic shell and a hydrophobic core. During assembly, the hydrophobic core of IR-NP could encapsulate additional IR-780 to generate derived subspecies carrying different amount of probe (IR-NP-eIR). Evaluation of photo-inducible properties of IR-NP and IR-NP-eIR were thoroughly assessed in vitro . Developed nanotheranostic particles showed distinct fluorescence and photothermal behavior after excitation by a laser light emitting at 808 nm. Treatment of MDA-MB-453 cells with IR-NP or IR-NP-eIR resulted in an efficient internalization of the IR-780 dye, while subsequent NIR-laser irradiation led to a severe decrease in cell viability. Photocytoxicity conducted by IR-NP, which could not be attributed to the generation of lethal hyperthermia, responded to an increase in the levels of intracellular reactive oxygen species (ROS). Therefore, the fluorescence imaging and inducible phototoxicity capabilities of NPs derived from IR-780-PEG- b -polyMTOS copolymer confer high value to these nanotheranostics tools in clinical cancer research. Statement of Significance Multifunctional polymeric nanoparticles (NPs) that combine imaging and therapeutic properties are highly valuable in cancer treatment. In this paper we describe the development of NPs that are fluorescent in the near-infrared (NIR). This is important for their visualization in living tissues that present low absorption and low autofluorescence in this wavelength region (between 700 and 1000 nm). Moreover, NPs present photothermal and photodynamic properties when NIR irradiated: the NPs produce an efficient increment of temperature and increase the intracellular reactive oxygen species (ROS) when laser irradiated at 808 nm. These tuneable photoinduced properties make the NPs highly cytotoxic after NIR irradiation and provide a new tool for highly precise cancer treatment. [ABSTRACT FROM AUTHOR]

Objective The outcomes of patients undergoing band removal alone without an additional bariatric procedure after laparoscopic gastric banding are not well reported. We seek to close this gap in the literature. Setting Cantonal Hospital & University Teaching Hospital, Switzerland Methods In this retrospective study, we investigated 21 patients who underwent band removal with a mean follow-up of 63 months. Weight regain, co-morbidities, and quality of life were assessed. Results The laparoscopic gastric bandings were implanted at a mean initial body mass index (BMI) of 44.6 kg/m 2 . The bands remained in situ for an average of 87.7 months (range: 14–185 mo). The reasons for band removal included band slippage in 9 cases (42.9%), band penetration in 6 cases (28.6%), leakage, port infection, and patient request in 2 cases (9.5% each). The average BMI at the time of band removal was 34.9 kg/m 2 . At 62.9 months after band removal, patients regained an average of 17.3 kg and attained a mean BMI of 41.0 kg/m 2 . Co-morbidities such as type 2 diabetes, arterial hypertension, obstructive sleep apnea, and psychiatric disorders worsened during the follow-up period. Thirteen of 21 patients rated their quality of life as bad, 5 as mediocre, and only 3 as good. Only 2 patients said they would undergo a gastric banding procedure again. The patients achieved an average of−.6 points on the Moorehead-Ardelt quality of life score, which indicates a fair quality of life. Conclusion This study finds that reversal of gastric banding procedures with removal of the banding system alone leads to weight regain, deterioration of physical and psychiatric co-morbidities, and low quality of life scores. [ABSTRACT FROM AUTHOR]

As a primary factor of technological innovation, process orientation contributes significantly to an organization's overall productivity and quality improvement. While this proposition has been confirmed for profit-oriented organizations of various industries, little research exists that validates the same statement in the healthcare sector. This paper proposes and evaluates a theoretical model that investigates the effect of process orientation on hospitals' competitiveness and performance. The concept of the balanced scorecard is applied to comprehensively cover all facets that constitute healthcare quality innovation. A set of hypotheses is proposed conceptualizing the direct and indirect effects of process orientation on hospitals' performance (identified as patient satisfaction and financial performance) through an increase of integral competitiveness (identified as workforce conditions, operational performance and clinical quality). The model is empirically tested by means of a questionnaire-based survey among clinical and administrative management of hospitals in Switzerland. 145 complete questionnaires from 129 hospitals are analyzed. Statistical results affirm that process orientation significantly enhances hospital performance. Workforce conditions and clinical quality prove to have a significant positive effect on patient satisfaction, whereas the hypothesized positive effect of operational efficiency on patient satisfaction is not supported. Moreover, results attest the positive effect of workforce conditions and operational efficiency on financial performance, while rejecting the effect of clinical quality on financial performance. [ABSTRACT FROM AUTHOR]

Tree growth is strongly influenced, among other factors, by climate. Much knowledge regarding climate–growth relationships has been gained by studying tree rings. However, sufficient tree-ring data is rarely available if climate effects are required to be representative for large spatial scales, for example, in order to be used in scenario models to estimate forest development under climate change. Alternative data sources include large-scale forest inventories, although these usually provide lower temporal resolutions than tree rings. When working with temporally sparsely-resolved growth data, the question of how climate–growth relationships aggregate over time becomes relevant. To overcome this trade-off between spatial representativeness and temporal resolution, this study aims at optimally using the information contained in the annual resolution of tree rings to derive recommendations regarding the choice of climate variables for modeling tree growth based on forest inventories. We evaluated for Picea abies and Fagus sylvatica , which part of the year (spring, summer, vegetation period, whole year) and whether mean or extreme climatic conditions within inventory intervals should be taken into consideration. A three-step approach was used: (1) we used response functions to quantify the effect of monthly precipitation and temperature on annual basal area increments, (2) we temporally aggregated the annual basal area increments to hypothetical intervals of five and ten years, and correlated them with climate means and extremes – from different parts of the year – within the aggregated intervals, and (3) we fitted linear mixed-effects models to simultaneously quantify the effects of the climate variables, site characteristics and the years of the hypothetical inventories. The results did not generally differ between both species. Variables based on conditions during the whole year and partly during spring performed better than variables based on conditions during summer or the vegetation period. Defining the year as the period between October of the previous year and September of the current year allows possible lag effects of previous autumn and winter conditions to be taken into consideration. Mean climatic conditions reached or exceeded the correlations of the extremes and mostly performed similar to or better than the extremes in the models. Our results indicate that these relationships are insensitive to the often arbitrarily determined years, in which inventories take place. These findings can serve as basic recommendations for the choice of climate variables when modeling climate effects on multi-year growth of P. abies and F. sylvatica in the European lowlands. [ABSTRACT FROM AUTHOR]

Abstract: A navigation-assisted multidisciplinary network to improve the interface between radiology, surgery, radiotherapy, and pathology in the field of head and neck cancer is described. All implicated fields are integrated by a common server platform and have remote data access in a ready-to-use format. The margins of resection and exact locations of biopsies are mapped intraoperatively. The pathologist uses the numerical coordinates of these samples to precisely trace each specimen in the anatomical field. Subsequently, map-guided radiotherapy is planned. In addition to the benefits of image-guided resection, this model enables radiotherapy planning according to the specific coordinates of the resection defect plus any residually affected sites identified by the pathologist. Irradiation of adjacent healthy structures is thereby minimized. In summary, the navigation-assisted network described grants timely multidisciplinary feedback between all fields involved, attains meticulous pathological definition, and permits optimized coordinate-directed radiotherapy. [Copyright &y& Elsevier]

Highlights: [•] We present a new method for tree age estimation based on a nonlinear mixed model. [•] The method predicts tree age as accurately as a traditional polynomial method. [•] For the new method, a high potential to further improve the accuracy is identified. [•] Methodological advantages of the new method allow for non-invasive applications. [Copyright &y& Elsevier]

Abstract: Background: Conventional maxillofacial reconstruction often leads to suboptimal results due to inaccurate planning or surgical difficulties in adjusting a free flap and osteosynthesis plates into a three-dimensional defect. Objectives: To justify the importance of patient-specific intraoperative guides in complex maxillofacial reconstruction. Clinical example: A 40-year old patient underwent a left hemimaxillectomy for an adenoid cystic carcinoma of the palate. Six years later, massive recurrence required radical resection of the left orbit and reconstruction with cranial bone grafts and a free latissimus dorsi flap. Postoperative radiotherapy resulted in local osteoradionecrosis. Surgical revision and restoration of the maxillary defect with a prefabricated fibula flap was performed. The authors provide ample information on the application of computer-aided design and manufacturing (CAD-CAM) and rapid prototyping at each reconstructive step. Discussion: Stereolithographic models enable simulation of the resective and reconstructive phases, prebending of reconstruction plates and fabrication of surgical guides. Conclusions: Optimal restitution of complex maxillofacial defects requires meticulous planning of the surgical and prosthetic phases and effective transfer of the plan to the operating room through patient specific guides. CAD-CAM technology and stereolithographic models represent an effective strategy to achieve this. Improved patient outcomes and intraoperative efficiency certainly offset the inherent increase in costs. [Copyright &y& Elsevier]

Summary: Background: Meticillin-resistant Staphylococcus aureus (MRSA) infections increase hospital costs primarily by prolonging patient length of stay (LOS). Aim: To estimate the health-economic burden of MRSA infections at a Swiss University hospital using different analytical approaches. Methods: Excess LOS was estimated by: (i) multistate modelling comparing MRSA-infected and MRSA-free patients with MRSA infection as time-dependent exposure; (ii) matching MRSA-infected patients with a cohort of MRSA-uninfected patients. The economic impact was assessed by: (i) comparing cost estimates between MRSA-infected and MRSA-free patients and multiplying excess LOS by bed-day cost; (ii) comparing real costs between MRSA-infected and MRSA-colonized non-infected patients. Findings: The crude mean LOS was 37.3, 33.0 and 8.8 days for MRSA-infected, MRSA-colonized and MRSA-free patients, respectively. Excess LOS attributable to MRSA infection was 11.5 [95% confidence interval (CI): 7.9–15] or 15.3 days according to multistate modelling and matched analysis, respectively. The likelihood of discharge after MRSA infection was significantly reduced (adjusted hazard ratio: 0.69; 95% CI: 0.59–0.81). Average bed-day costs for MRSA-infected patients were 1.49- and 1.26-fold higher than for the general population hospitalized in acute wards and MRSA-colonized patients, respectively. MRSA infection resulted in an average additional cost of about 800 Swiss francs per day. Conclusions: This analysis emphasizes the financial impact of MRSA infections, demonstrates the importance of accounting for time-dependent bias and confirms that multistate modelling is a valid strategy for estimating excess LOS and costs after MRSA infection. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to evaluate whether a bone substitute can be used to promote bony union in patients undergoing maxillary advancement after Le Fort l osteotomy. Nine patients were treated bilaterally with Le Fort I osteotomies and maxillary advancements of 5mm or less. In each patient, one gap was grafted with the bone substitute Bio-Oss® Collagen (BOC). The contralateral site was left empty and served as control. After 6 months there were still empty gaps in the control sites of three patients, while in the grafted sites all gaps were completely filled with bone. The histomorphometric analysis performed with biopsies from the region of the original gap showed a similar amount of new bone in both groups, however, in the test group the mean overall amount of the mineralized fraction was higher compared to the control group (test site 65.0±6.2%, control site 38.9±32.6%). The bone substitute seemed to be a suitable material to promote bony union in Le Fort I osteotomies. Further studies are needed to analyse whether this technique is efficient in preventing relapse and promoting bony union in larger advancements. [Copyright &y& Elsevier]

Summary: Objective: Previous skin carriage of methicillin-resistant Staphylococcus aureus (MRSA) leads frequently to empiric antibiotic MRSA coverage for skin & soft tissue infections. Methods: Retrospective cohort study of orthopaedic patients hospitalized at Geneva University Hospitals (MRSA prevalence; 30%); community-acquired MRSA excluded. Results: A total of 378 skin and soft tissue infections in 346 patients were retrieved. Overall cure was achieved in 330 episodes (87%) after a median antibiotic administration of 15 days. Among all episodes, 102 revealed a positive current MRSA status (during 2 weeks preceding infection; 27%) and 70 (19%) were MRSA carriers in the past. Sensitivity, specificity, positive and negative predictive values of current MRSA skin carriage to predict abscesses due to MRSA were 0.68, 0.77, 0.19, and 0.97, respectively. Fifty-four current MRSA carriers (54/102, 53%) and 30 past carriers (43%) were successfully treated with a non-MRSA antibiotic agent. In multivariate Cox regression analysis, anti-MRSA coverage (hazard ratio 1.2, 95%CI 0.5–2.8) and duration of antibiotic therapy (HR 1.0, 95%CI 0.96–1.02) did not influence treatment failure among patients with positive MRSA carriage. Conclusions: Current or past HA-MRSA skin carriage poorly predicts the need for anti-MRSA coverage for the antibiotic treatment of skin and soft tissue infections in hospitalized orthopaedic patients. [Copyright &y& Elsevier]

Purpose: The purpose of this in vitro investigation was to determine whether the pattern, angle of placement, or size of positional screws affected their ability to resist vertical loads resembling mastication in the bilateral sagittal split osteotomy system. Materials and Methods: Standardized bone substitutes were secured with three 12- to 16 mm-long, 1.85-, 2.0-, 2.1-, and 2.4-mm outer diameter, self-tapping titanium screws (Synthes, Solothurn, Switzerland) in various patterns using a positional screw technique. These patterns included transbuccal triangular, intraoral triangular, and transbuccal linear patterns. The models were secured in a jig and subjected to vertical loads by a mechanical testing unit (1475 UPM; Zwick, Ulm, Germany) until failure. Loading test data analysis was based on peak load values resulting in mechanical deformation of the system (1-, 3-, and 5-mm displacement), maximal force, and stiffness (load/displacement slope curve) for each group. Means and standard deviations were derived and compared for statistical significance using univariate analysis of variance with a confidence level of 95% (P values < .05). Results: The designed study demonstrated that 1.85- and 2.0-mm-diameter positional screws provided similar stability in all 3 setups. Three screws placed in an inverted L pattern at 90° (simulating a transbuccal approach) showed significantly higher resistance to vertical forces for advancement movements at 1-, 3-, and 5-mm displacement when compared with the inverted L group of screws placed at an angle (intraoral approach) or 3 screws in a linear pattern placed at 90° (transbuccal approach) (P < .01). Conclusions: Under the conditions tested in this in vitro study, differences in the load resistance of positional screws placed in a transbuccal or intraoral approach could be demonstrated depending on the fixation technique. The transbuccal group of 3 screws in an inverted L pattern showed significantly greater stability than the intraoral group of 3 screws placed in an inverted L pattern and the transbuccal group of 3 screws in a linear pattern. Resistance to vertical loads with 1.85-mm screws was similar to that with the standard 2.0-mm screws in all 3 setups. The results of this study suggest that the angle of screw placement (surgical approach) and pattern have a greater influence on the stability of the bilateral sagittal split osteotomy system than the screw size. [Copyright &y& Elsevier]

Purpose: The purpose of this study was to develop a motion simulator capable of recreating and recording the full range of mandibular motions in a cadaveric preparation for an intact temporomandibular joint (TMJ) and after total joint replacement. Material and Methods: A human cadaver head was used. Two sets of tracking balls were attached to the forehead and mandible, respectively. Computed tomographic (CT) scan was performed and 3-dimensional CT models of the skull were generated. The cadaver head was then dissected to attach the muscle activation cables and mounted onto the TMJ simulator. Realistic jaw motions were generated through the application of the following muscle forces: lateral pterygoid muscle, suprahyoid depressors (geniohyoid, mylohyoid, and digastric muscles), and elevator muscles. To simulate muscle contraction, cables were inserted into the mandible at the center area of each muscle''s attachment. To provide a minimum mouth closing force at the initial position, the elevator muscles were combined at the anterior mandible. During mandibular movement, each motion was recorded using a high-resolution laser scanner. The right TMJ of the same head was reconstructed with a total TMJ prosthesis. The same forces were applied and the jaw motions were recorded again. CT scan was performed and 3-dimensional CT models of the skull with TMJ prosthesis were generated. Results: Mandibular motions, before and after TMJ replacement, with and without lateral pterygoid muscle reattachment, were re-created in a cadaveric preparation. The laser-scanned data during the mandibular motion were used to drive 3-dimensional CT models. A movie for each mandibular motion was subsequently created for motion path analysis. Compared with mandibular motion before TMJ replacement, mandibular lateral and protrusive motions after TMJ replacement, with and without lateral pterygoid muscle reattachment, were greatly limited. The jaw motion recorded before total joint replacement was applied to the mandibular and prostheses models after total TMJ replacement. The condylar component was observed sinking into the fossa during jaw motion. Conclusion: A motion simulator capable of re-creating and recording full range of mandibular motions in a cadaveric preparation has been developed. It can be used to simulate mandibular motions for the intact TMJ and total joint prosthesis, and to re-create and record their full range of mandibular motions. In addition, the full range of the recorded motion can be re-created as motion images in a computer. These images can be used for motion path analysis and to study the causation of limited range of motion after total joint replacement and strategies for improvement. [Copyright &y& Elsevier]

Abstract: Temporomandibular joint (TMJ) reconstruction with a TMJ Concepts total joint prosthesis (TMJ Concepts, Ventura, USA) requires a precise 3D model of the jaws in centric occlusion. The authors present a virtual procedure for repositioning the lower jaw in centric occlusion to obtain a precise stereolithographic model for TMJ reconstruction using a custom-made total joint prosthesis in a case of TMJ ankylosis and anterior open bite. [ABSTRACT FROM AUTHOR]

Summary: Objectives: In the treatment of prosthetic joint infections (PJI), the benefit of antibiotic therapy for more than 6 weeks after surgery is uncertain. We compared PJI cure rates according to the duration of antibiotics, 6 versus 12 weeks. Methods: A prospective observational non-randomized study in Geneva University Hospitals 1996–2007. Results: A total of 144 PJI (62 hip arthroplasties, 62 knee arthroplasties, and 20 hip hemiarthroplasties) were included with a prolonged follow-up ranging from 26 to 65 months. Surgical treatment included 60 débridements with implant retention, 10 one-stage exchanges of the prosthesis, 57 two-stage exchanges, and 17 Girdlestone procedures or knee arthrodeses. Seventy episodes (49%) received 6 weeks antibiotic therapy and 74 episodes, 12 weeks. Cure was achieved in 115 episodes (80%). Cure rate did not change according to the duration of intravenous antibiotics (>8 days, 8–21 days, >21 days) (Kruskal–Wallis-test; p = 0.37). In multivariate analysis, none of the following parameters was statistically significantly associated with cure: two-stage exchange (odds ratio 1.1,95%CI 0.2–4.8); number of débridements (0.9, 0.4–1.9); six weeks antibiotherapy (2.7, 0.96–8.3); duration of intravenous course (1.0, 0.96–1.03); sinus tract (0.6, 0.2–1.7); or MRSA infection (0.5, 0.2–1.5), although implant retention showed a tendency for less cure (0.3, 0.1–1.1). Conclusions: Following surgery for treatment of PJI, antibiotic therapy appears able to be limited to a 6-week course, with one week of intravenous administration. This approach needs confirmation in randomized trials. [ABSTRACT FROM AUTHOR]

Background & Aims: Phosphatase and tensin homologue deleted on chromosome 10 (PTEN) is a tumor suppressor and a regulator of insulin sensitivity in peripheral tissues. In the liver, PTEN deletion increases insulin sensitivity, but induces steatosis, steatohepatitis, and hepatocellular carcinoma. Here, we investigated the pathophysiologic mechanisms regulating PTEN expression in the liver and the development of steatosis. Methods: PTEN expression was evaluated in the liver of rats and human beings having metabolic syndrome. Signaling pathways regulating PTEN expression and lipid accumulation in hepatocytes were examined in vitro. Results: PTEN expression is down-regulated in the liver of rats having steatosis and high plasma levels of fatty acids, as well as in steatotic human livers. Unsaturated fatty acids inhibited PTEN expression in HepG2 cells via activation of a signaling complex formed by the mammalian target of rapamycin (mTOR) and nuclear factor-κB (NF-κB). Down-regulation of PTEN expression induced steatosis by affecting import, esterification, and extracellular release of fatty acids. Conclusions: Hepatic steatosis can be mediated by alterations of PTEN expression in hepatocytes exposed to high levels of unsaturated fatty acids. Furthermore, our data revealed interaction between mTOR and NF-κB, suggesting cross-talk between these 2 pathways. [Copyright &y& Elsevier]

Summary Obesity and type 2 diabetes are associated with metabolic defects and adipose tissue inflammation. Foxp3 + regulatory T cells (Tregs) control tissue homeostasis by counteracting local inflammation. However, if and how T cells interlink environmental influences with adipocyte function remains unknown. Here, we report that enhancing sympathetic tone by cold exposure, beta3-adrenergic receptor (ADRB3) stimulation or a short-term high-calorie diet enhances Treg induction in vitro and in vivo . CD4 + T cell proteomes revealed higher expression of Foxp3 regulatory networks in response to cold or ADRB3 stimulation in vivo reflecting Treg induction. Specifically, Ragulator-interacting protein C17orf59, which limits mTORC1 activity, was upregulated in CD4 + T cells by either ADRB3 stimulation or cold exposure, suggesting contribution to Treg induction. By loss- and gain-of-function studies, including Treg depletion and transfers in vivo , we demonstrated that a T cell-specific Stat6/Pten axis links cold exposure or ADRB3 stimulation with Foxp3 + Treg induction and adipose tissue function. Our findings offer a new mechanistic model in which tissue-specific Tregs maintain adipose tissue function. [ABSTRACT FROM AUTHOR]

An abstract of the article "MALDI MS Imaging of Amyloid," by Markus Stoeckli and colleagues is presented.