Pure rotation in the temporomandibular joint during jaw opening? A digital motion analysis.

OBJECTIVE: In the temporomandibular joint two separate movements of rotation and translation occur in two articular spaces during mouth opening. Over the years, the approach has changed considerably, but it is still subject to controversy as to which of these movement is involved in the initial stage of mouth opening. In the present study, the extent of rotation and translation was investigated in the first 5 mm of mouth opening. MATERIALS AND METHODS: The study was carried out on 46 volunteers. Anamnesis was taken and patients were examined. For the investigation, an ultrasonic digital motion analyser (KaVo Arcus Digma 2) was applied. The measurements were made after calibration to an arbitrary axis. Each participant performed three open-close movements in succession, starting from maximum intercuspal position. RESULTS: Data were statistically processed using cubic spline interpolation. Linear regression was then used. The resulting line is significantly (p < 0.0001) different from the horizontal that represents only rotational movement. CONCLUSION: The results show that during mouth opening from maximum intercuspal position, translation is present continuously in addition to rotation. Therefore, it might be time to re-evaluate the principle of a pure rotational approach.

A concept for multi-winner tenders for medicinal products with balancing between efficient prices, long-term competition and sustainability of supply.

Achieving price efficiency via tenders, the sustainability of competition, and the prevention of shortages are hot topics in the debates about shaping the pharmaceutical markets. Single-winner tenders receive growing criticism for concentrating on achieving low prices at the expense of the long-term maintenance of a competitive pharmaceutical industry, the security of continuous supply, and disregarding the therapeutic needs of patient populations with specific conditions. This paper aims at drafting a concept to assist the design of multi-winner tenders for medicinal products with a focus on supply and sales guarantees, price efficiency, and equity in access. The concept shall be generally applicable to all kinds of medicinal products including generics, biosimilars, and on-patent products in the out- and in-patient sector. Principles for multi-winner tenders for medicinal products are set and a number of delimitations are made in order to get rid of factors that prevent clairvoyance amid the various pricing and reimbursement systems when designing a concept. The steps to plan and implement a multi-winner tendering procedure are drafted on the basis of the defined principles. The tender should consist of planning, bidding, preparation, sales, and evaluation phases. Pharmaceutical companies shall make bids with price and quantity pairs, which shall be ranked by prices and if applicable then taking into account other factors. The tenderer shall predefine market shares to the various places of the ranking. A double ceiling shall be applicable for the sales of the winners: their sales must not exceed their quantity offer and the predefined market share applicable to their place in the ranking. The implementation of the concept will require the careful adjustment of the tender conditions to the specificities of the pharmaceutical market concerned on the one hand and to the local pricing and reimbursement system on the other hand.

PAMPA study of the temperature effect on permeability.

The purpose of this work was to investigate the temperature dependence of permeability measured by PAMPA method. The effective permeability (logPe) of seven drugs representing diverse structures and different acid-base properties was determined on three membrane models (GIT, BBB, Skin). The incubation temperature was varied in the range of 15-55 °C with ten degree steps. The intrinsic permeability (logP0) of the compounds is in linear relation with temperature (T). The slope of the logP0=aT+b regression equation is a good measure of the temperature effect on permeability. Results show intensive and significant temperature dependence of permeability influenced by the properties of the compounds and also by the selected PAMPA model. The Skin PAMPA(™) proved to be the most sensitive on temperature alteration, though GIT and BBB PAMPA results were also affected. The compound with acid function showed the lowest temperature dependence, while the permeability of bases increased considerably in response to the increasing temperature. The importance of human-relevant incubation conditions at in vitro assays is concluded for the better in vivo prediction.

Soil mobility of surface applied polyaromatic hydrocarbons in response to simulated rainfall.

Polyaromatic hydrocarbons (PAHs) are emitted from a variety of sources and can accumulate on and within surface soil layers. To investigate the level of potential risk posed by surface contaminated soils, vertical soil column experiments were conducted to assess the mobility, when leached with simulated rainwater, of six selected PAHs (naphthalene, phenanthrene, fluoranthene, pyrene, benzo(e)pyrene and benzo(ghi)perylene) with contrasting hydrophobic characteristics and molecular weights/sizes. The only PAH found in the leachate within the experimental period of 26 days was naphthalene. The lack of migration of the other applied PAHs was consistent with their low mobilities within the soil columns which generally paralleled their log K oc values. Thus, only 2.3 % of fluoranthene, 1.8 % of pyrene, 0.2 % of benzo(e)pyrene and 0.4 % of benzo(ghi)perylene were translocated below the surface layer. The PAH distributions in the soil columns followed decreasing power relationships with 90 % reductions in the starting levels being shown to occur within a maximum average depth of 0.94 cm compared to an average starting depth of 0.5 cm. A simple predictive model identifies the extensive time periods, in excess of 10 years, required to mobilise 50 % of the benzo(e)pyrene and benzo(ghi)perylene from the surface soil layer. Although this reduces to between 2 and 7 years for fluoranthene and pyrene, it is concluded that the possibility of surface-applied PAHs reaching and contaminating a groundwater aquifer is unlikely.