Sonarlogger: Enabling long-term underwater sonar observations.

Coastal seas are under increasing pressure from extreme weather events and sea level rise, resulting in impacts such as changing hydrodynamic conditions, coastal erosion, and marine heat waves. To monitor changes in coastal marine habitats, such as reefs and macrophytes meadows, which add to the resilience of our coasts, consistent, medium- to long-term seafloor observations are needed. This project aims to deliver repeated, high-frequency sonar surveys on a stationary seabed mooring of a specific target area over a period of up to several months. A new stand-alone subsea system, the Sonarlogger, based on a battery pack, low-power logger and a high-resolution scanning sonar, was developed. It allows for long-term deployments with a customisable battery pack, WI-FI download and configurable sleep state. The system has been tested for over 130 days in dynamic coastal environments off the Belgian coast. Combined with auxiliary sensors, such as for measuring currents, waves and turbidity, this system enables comprehensive studies of morphologic changes and changing benthic ecosystems. Moreover, this system has the capacity to provide measurements of coastal environments during storms, where conventional systems may fall short, providing insights into event-based changes of the seafloor.

Diagnostic criteria for temporomandibular disorders-INfORM recommendations: Comprehensive and short-form adaptations for adolescents.

BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for use in adults is in use worldwide. Until now, no version of this instrument for use in adolescents has been proposed. OBJECTIVE: To present comprehensive and short-form adaptations of the adult version of DC/TMD that are appropriate for use with adolescents in clinical and research settings. METHODS: International experts in TMDs and experts in pain psychology participated in a Delphi process to identify ways of adapting the DC/TMD protocol for physical and psychosocial assessment of adolescents. RESULTS: The proposed adaptation defines adolescence as ages 10-19 years. Changes in the physical diagnosis (Axis I) include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for adolescents, (ii) adding two general health questionnaires, one for the adolescent patient and one for their caregivers and (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire. Changes in the psychosocial assessment (Axis II) include (i) adapting the language of the Graded Chronic Pain Scale to be developmentally appropriate for adolescents, (ii) adding anxiety and depression assessment that have been validated for adolescents and (iii) adding three constructs (stress, catastrophizing and sleep disorders) to assess psychosocial functioning in adolescents. CONCLUSION: The recommended DC/TMD, including Axis I and Axis II for adolescents, is appropriate to use in clinical and research settings. This adapted first version for adolescents includes changes in Axis I and Axis II requiring reliability and validity testing in international settings. Official translations of the comprehensive and short-form to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.

Effects of forest degradation classification on the uncertainty of aboveground carbon estimates in the Amazon.

BACKGROUND: Tropical forests are critical for the global carbon budget, yet they have been threatened by deforestation and forest degradation by fire, selective logging, and fragmentation. Existing uncertainties on land cover classification and in biomass estimates hinder accurate attribution of carbon emissions to specific forest classes. In this study, we used textural metrics derived from PlanetScope images to implement a probabilistic classification framework to identify intact, logged and burned forests in three Amazonian sites. We also estimated biomass for these forest classes using airborne lidar and compared biomass uncertainties using the lidar-derived estimates only to biomass uncertainties considering the forest degradation classification as well. RESULTS: Our classification approach reached overall accuracy of 0.86, with accuracy at individual sites varying from 0.69 to 0.93. Logged forests showed variable biomass changes, while burned forests showed an average carbon loss of 35%. We found that including uncertainty in forest degradation classification significantly increased uncertainty and decreased estimates of mean carbon density in two of the three test sites. CONCLUSIONS: Our findings indicate that the attribution of biomass changes to forest degradation classes needs to account for the uncertainty in forest degradation classification. By combining very high-resolution images with lidar data, we could attribute carbon stock changes to specific pathways of forest degradation. This approach also allows quantifying uncertainties of carbon emissions associated with forest degradation through logging and fire. Both the attribution and uncertainty quantification provide critical information for national greenhouse gas inventories.

Professional knowledge acquisition of dental students employed part-time as dental assistants.

INTRODUCTION: Whilst admission to dental school in many jurisdictions requires applicants to shadow dentists or undertake work experience at a dental practice, little is known about the impacts on professional learning when dental students work part-time as dental assistants whilst concurrently studying dentistry. This paper explores what, how and from whom dental students who work as dental assistants acquire professional knowledges during employment. METHODS: This study draws on a qualitative analysis of interviews with sixteen senior dental students who have extra-curricular part-time employment as dental assistants in private dental practices. RESULTS: Analysis produced four themes that relate to students learning in the professional environment: students learn about the responsibilities, rhythms and routines of practice, as well as patient communication and interactions. Students embedded in the dental team noticed and related to the dispositions and the work of dentistry. Students learned from all members of the dental team including clinical and non-clinical staff (reception, administration, laboratory and sterilisation). DISCUSSION: Students used their experiences in a practice setting to further their professional education. The ability to "read" a situation and formulate an appropriate response requires the integration of complex and actionable professional knowledges. CONCLUSION: This research study presents insight into the ways dental students employed as dental assistants are embedded in and learn from the dental team in a critically evaluative manner. Students professionally notice and make sense of complex practice environments whilst undertaking university studies to learn about practice routines, rhythms and responsibilities as well as advancing confidence in relating with patients. This study provides a stimulus for further research about the contribution of workplace experiences to dental education.

Diagnostic criteria for temporomandibular disorders-INfORM recommendations: Comprehensive and short-form adaptations for children.

BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed. OBJECTIVE: The aim of this study was to present comprehensive and short-form adaptations of Axis I and Axis II of the DC/TMD for adults that are appropriate for use with children in clinical and research settings. METHODS: Global Delphi studies with experts in TMDs and in pain psychology identified ways of adapting the DC/TMD for children. RESULTS: The proposed adaptation is suitable for children aged 6-9 years. Proposed changes in Axis I include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for children, (ii) adding a general health questionnaire for children and one for their parents, (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire and (iv) modifying the clinical examination protocol. Proposed changes in Axis II include (i) for the Graded Chronic Pain Scale, to be developmentally appropriate for children, (ii) adding anxiety and depression assessments that have been validated in children and (iii) adding three constructs (stress, catastrophising and sleep disorders) to assess psychosocial functioning in children. CONCLUSION: The recommended DC/TMD, including Axis I and Axis II, for children aged 6-9 years, is appropriate for use in clinical and research settings. This adapted the first version for children includes changes in Axis I and Axis II changes requiring reliability and validity testing in international settings. Official translations to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.

Using Single-Species and Whole Community Stream Mesocosm Exposures for Identifying Major Ion Effects in Doses Mimicking Resource Extraction Wastewaters.

Wastewaters and leachates from various inland resource extraction activities contain high ionic concentrations and differ in ionic composition, which complicates the understanding and effective management of their relative risks to stream ecosystems. To this end, we conducted a stream mesocosm dose-response experiment using two dosing recipes prepared from industrial salts. One recipe was designed to generally reflect the major ion composition of deep well brines (DWB) produced from gas wells (primarily Na+, Ca2+, and Cl-) and the other, the major ion composition of mountaintop mining (MTM) leachates from coal extraction operations (using salts dissociating to Ca2+, Mg2+, Na+, SO42- and HCO3-)-both sources being extensive in the Central Appalachians of the USA. The recipes were dosed at environmentally relevant nominal concentrations of total dissolved solids (TDS) spanning 100 to 2000 mg/L for 43 d under continuous flow-through conditions. The colonizing native algal periphyton and benthic invertebrates comprising the mesocosm ecology were assessed with response sensitivity distributions (RSDs) and hazard concentrations (HCs) at the taxa, community (as assemblages), and system (as primary and secondary production) levels. Single-species toxicity tests were run with the same recipes. Dosing the MTM recipe resulted in a significant loss of secondary production and invertebrate taxa assemblages that diverged from the control at all concentrations tested. Comparatively, intermediate doses of the DWB recipe had little consequence or increased secondary production (for emergence only) and had assemblages less different from the control. Only the highest dose of the DWB recipe had a negative impact on certain ecologies. The MTM recipe appeared more toxic, but overall, for both types of resource extraction wastewaters, the mesocosm responses suggested significant changes in stream ecology would not be expected for specific conductivity below 300 µS/cm, a published aquatic life benchmark suggested for the region.

Bone remodeling following mandibular reconstruction using fibula free flap.

To investigate bone remodelling responses to mandibulectomy, a joint external and internal remodelling algorithm is developed here by incorporating patient-specific longitudinal data. The primary aim of this study is to simulate bone remodelling activity in the conjunction region with a fibula free flap (FFF) reconstruction by correlating with a 28-month clinical follow-up. The secondary goal of this study is to compare the long-term outcomes of different designs of fixation plate with specific screw positioning. The results indicated that the overall bone density decreased over time, except for the Docking Site (namely DS1, a region of interest in mandibular symphysis with the conjunction of the bone union), in which the decrease of bone density ceased later and was followed by bone apposition. A negligible influence on bone remodeling outcome was found for different screw positioning. This study is believed to be the first of its kind for computationally simulating the bone turn-over process after FFF maxillofacial reconstruction by correlating with patient-specific follow-up.

THE VOICE OF THE PATIENT IN OROFACIAL PAIN MANAGEMENT.

As pain cannot be measured objectively, the use of patient reported outcomes (PROs), and specifically dental PROs (dPROs), is essential for adequate assessment and management of the patient with orofacial pain. For orofacial pain conditions, some of the suitable PROs are specific to dentistry and hence can be labelled dPROs, whereas others are not. There is also a need to understand which outcomes and domains are most relevant to the patient with pain complaints within the context of the biopsychosocial model. Acute pain in the orofacial area is most often related to toothache, whereas the most common chronic orofacial pain are temporomandibular disorders. Other chronic pains in the orofacial area include neuropathic pain and unknown or idiopathic pain. PROs have been fundamental in the development of both screening procedures and diagnostic criteria in temporomandibular disorders. PROs are now often a prerequisite for the most common temporomandibular disorder pain diagnoses. Furthermore, PROs form the basis for decision-making with regard to treatment, prognostics, and referrals. Future areas of development include the standardized use of PROs in the screening and diagnostics of the less common orofacial pain conditions, together with development of core outcomes sets and standardized protocols for the use of PROs in evaluation of treatment including efficacy, compliance, adherence, and side-effects.

Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II.

BACKGROUND: Unlike the psychosocial assessment established for adults in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a standardised psychosocial assessment for children and adolescents with TMD complaints has not yet been established. OBJECTIVES: To develop a new standardised instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments. METHODS: A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2 and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophising, sleep problems and stress in children (ages 6-9 years old) and adolescents (ages 10-19 years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritise the suggested instruments from most to least recommended. RESULTS: The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophising, stress and resilience. CONCLUSION: Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.

Frequency of Four-dimensional Oral Health Problems across Dental Fields - a Comparative Survey of Slovenian and International Dentists.

OBJECTIVES: To compare the frequency of patients' oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions. METHODS: An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients' oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients' problems and prevention needs were calculated together with the significance of Slovenian and international dentists' differences based on dental fields and WHO regions. RESULTS: Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1). CONCLUSION: According to the dentists' responses, the frequency of patients' oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields.

Even mild catastrophic thinking is related to pain intensity in individuals with painful temporomandibular disorders.

AIMS: Temporomandibular disorders (TMD) are often associated with psychological comorbidities. One such comorbidity is pain catastrophising, that is, exaggeration of negative consequences of a painful event. The aim was to investigate catastrophising in individuals with painful TMD compared to controls and the association between catastrophising and pain intensity, number of pain sites and functional limitations. METHODS: A community-based sample of 110 individuals (83 women; 20-69 yrs) with painful TMDs (myalgia/arthralgia as per Diagnostic Criteria for TMD) and 190 age- and gender-matched controls (119 women; 20-69 yrs) from the Public Dental services in Västerbotten, Sweden, participated. Associations between catastrophising and functional jaw limitations, respectively, and painful TMD were evaluated with ordinal regression adjusted for the effect of gender and age. Associations (Spearman's correlation) of the Pain catastrophising Scale (PCS) with Jaw Functional Limitation Scale (JFLS-20), pain site number (whole-body pain map), and characteristic pain intensity (CPI) and intergroup comparisons (Mann-Whitney U test) of these variables were also calculated. RESULTS: Levels of catastrophising were associated with TMD pain (OR 1.6, 95%CI 1.1-2.6). Among individuals with painful TMD, catastrophising was correlated to pain intensity (r=0.458, p<0.01) and functional limitations (r=0.294-0.321, p≤0.002), but not to number of pain sites. CONCLUSION: Compared to controls, community-based individuals with painful TMD demonstrated higher levels of pain catastrophising, and this catastrophising was associated with increased pain intensity and jaw dysfunction. The relatively low scores of pain catastrophising suggest that even mild catastrophic thinking is associated with pain perception and jaw function, and should be considered in patient management.

Pediatric patients' reasons for visiting dentists in all WHO regions.

BACKGROUND: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral health-related quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists' assessment, the study aimed to evaluate whether pediatric dental patients' oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. METHODS: Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients' oral health problems and prevention needs were computed. FINDINGS: Data from 101 dentists treating children only and 523 dentists treating children and adults were included. For 90% of pediatric patients, their current oral health problems fit well in the four OHRQoL dimensions. For 91% of oral health problems they intended to prevent in the future were related to these dimensions as well. Both numbers increased to at least 96% when experts analyzed dentists´ explanations of why some oral health problems would not fit these four categories. CONCLUSIONS: The study revealed the four fundamental components of dental patients, i.e., the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) are also applicable for pediatric patients, regardless of whether they have current or future oral health concerns, and should be considered when measuring OHRQoL in the pediatric dental patient population.

Diagnostic criteria for temporomandibular disorders (DC/TMD) for children and adolescents: An international Delphi study-Part 1-Development of Axis I.

BACKGROUND: Since in children and adolescence prevalence is assessed mainly on self-reported or proxy-reported signs and symptoms; there is a need to develop a more comprehensive standardised process for the collection of clinical information and the diagnosis of TMD in these populations. OBJECTIVE: To develop new instruments and to adapt the diagnostic criteria for temporomandibular disorders (DC/TMD) for the evaluation of TMD in children and adolescents. METHOD: A modified Delphi method was used to seek international consensus among TMD experts. Fourteen clinicians and researchers in the field of oro-facial pain and TMD worldwide were invited to participate in a workshop initiated by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM scientific network) at the General Session of the International Association for Dental Research (IADR, London 2018), as the first step in the Delphi process. Participants discussed the protocols required to make physical diagnoses included in the Axis I of the DC/TMD. Thereafter, nine experts in the field were added, and the first Delphi round was created. This survey included 60 statements for Axis I, and the experts were asked to respond to each statement on a five-item Likert scale ranging from 'Strongly disagree' to 'Strongly agree'. Consensus level was set at 80% agreement for the first round, and at 70% for the next. RESULTS: After three rounds of the Delphi process, a consensus among TMD experts was achieved and two adapted DC/TMD protocols for Axis I physical diagnoses for children and adolescents were developed. CONCLUSION: Through international consensus among TMD experts, this study adapted the Axis I of the DC/TMD for use in evaluating TMD in children and adolescents.

Why Patients Visit Dentists - A Study in all World Health Organization Regions.

OBJECTIVE: The dimensions of oral health-related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions. METHODS: Dentists (N = 1580) from 32 countries participated in a web-based survey. For their patients with current oral health problems, dentists were asked whether these problems were related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact or whether they do not fit the aforementioned 4 categories. Dentists were also asked about their patients who intended to prevent future oral health problems. For both patient groups, the proportions of oral health problems falling into the 4 OHRQoL dimensions were calculated. RESULTS: For every 100 dental patients with current oral health problems, 96 had problems related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact. For every 100 dental patients who wanted to prevent future oral health problems, 92 wanted to prevent problems related to these 4 OHRQoL dimensions. Both numbers increased to at least 98 of 100 patients when experts analyzed dentists' explanations of why some oral health problems would not fit the four dimension. For the remaining 2 of 100 patients, none of the dentist-provided explanations suggested evidence against the OHRQoL dimensions as the concepts that capture dental patients' suffering. CONCLUSION: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact capture dental patients' oral health problems worldwide. These 4 OHRQoL dimensions offer a psychometrically sound and practical framework for patient care and research, identifying what is important to dental patients.

Common factors in the presentation and management of chronic temporomandibular disorders and chronic overlapping pain disorders.

The International Association for the Study of Pain has released a new classification scheme for chronic pain. This classification scheme describes chronic pain as either a symptom of a disease (chronic secondary pain) or the disease itself (chronic primary pain). Chronic temporomandibular disorders have many similarities to other proposed chronic overlapping pain disorders, but are classified and managed by dental practitioners as a localized pain condition of the orofacial region. We review the literature to describe the similarities between chronic temporomandibular disorders and chronic overlapping pain disorders, and discuss how this evolving concept may affect the way that dentists approach the diagnosis and management of chronic temporomandibular disorders.

Effects of buccal thickness augmentation on bone remodeling after maxillary anterior implantation.

The biomechanics associated with buccal bone thickness (BBT) augmentation remains poorly understood, as there is no consistent agreement in the adequate BBT to avoid over-loading resorption or over-augmenting surgical difficulty. This study utilizes longitudinal clinical image data to establish a self-validating time-dependent finite element (FE)-based remodeling procedure to explore the effects of different buccal bone thicknesses on long-term bone remodeling outcomes in silico. Based upon the clinical computed tomography (CT) scans, a patient-specific heterogeneous FE model was constructed to enable virtual BBT augmentation at four different levels (0.5, 1.0, 1.5, and 2.0 mm), followed by investigation into the bone remodeling behavior of the different case scenarios. The findings indicated that although peri-implant bone resorption decreased with increasing initial BBT from 0.5 to 2 mm, different levels of the reduction in bone loss were associated with the amount of bone augmentation. In the case of 0.5 mm BBT, overloading resorption was triggered during the first 18 months, but such bone resorption was delayed when the BBT increased to 1.5 mm. It was found that when the BBT reached a threshold thickness of 1.5 mm, the bone volume can be better preserved. This finding agrees with the consensus in dental clinic, in which 1.5 mm BBT is considered clinically justifiable for surgical requirement of bone graft. In conclusion, this study introduced a self-validating bone remodeling algorithm in silico, and it divulged that the initial BBT affects the bone remodeling outcome significantly, and a sufficient initial BBT is considered essential to assure long-term stability and success of implant treatment.

Challenges in the clinical implementation of a biopsychosocial model for assessment and management of orofacial pain.

Distress, suffering and care-seeking behaviour are characteristics of pain-related disease and illness. Pain that transitions from an acute to a chronic phase carries with it the potential of further effects: these include a worsening of the disease or illness; high-impact chronic pain; and substantial personal, societal and economic burden. The biopsychosocial model directly addresses these multiple processes, yet clinical frameworks supporting this model are not universally implemented. This paper explores barriers to clinical implementation of a full biopsychosocial framework for temporomandibular disorders (TMD) and other oro-facial pain (OFP) conditions. In June 2016, INfORM invited OFP researchers to a workshop designed to optimise the DC/TMD Axis-II. Workshop groups identified five sources of implementation barriers: (1) cultures and societies, (2) levels-of-care settings, (3) health services, (4) cross-cultural validity of self-report instruments and (5) provider and patient health literacy. Three core problems emerged: (A) mental health aspects are seldom fully considered, thus impairing the recognition of illness, (B) training in use of validated multi-axial assessment protocols is under-rated and insufficiently used, and (C) clinical assessment often fails to recognise that sensory and emotional dimensions are fundamental aspects of pain. To improve patient care, these barriers and problems require action. Most importantly, TMD/OFP educators and researchers need to coordinate globally and (i) be educated in the biopsychosocial model, (ii) implement evidence-based biopsychosocial guidelines for assessment and management of OFP conditions at their institutions, (iii) incorporate this model in undergraduate and postgraduate dental curricula and (iv) be responsive to stakeholders, including regulatory authorities and practitioners.

Investigation on masticatory muscular functionality following oral reconstruction - An inverse identification approach.

The human masticatory system has received significant attention in the areas of biomechanics due to its sophisticated co-activation of a group of masticatory muscles which contribute to the fundamental oral functions. However, determination of each muscular force remains fairly challenging in vivo; the conventional data available may be inapplicable to patients who experience major oral interventions such as maxillofacial reconstruction, in which the resultant unsymmetrical anatomical structure invokes a more complex stomatognathic functioning system. Therefore, this study aimed to (1) establish an inverse identification procedure by incorporating the sequential Kriging optimization (SKO) algorithm, coupled with the patient-specific finite element analysis (FEA) in silico and occlusal force measurements at different time points over a course of rehabilitation in vivo; and (2) evaluate muscular functionality for a patient with mandibular reconstruction using a fibula free flap (FFF) procedure. The results from this study proved the hypothesis that the proposed method is of certain statistical advantage of utilizing occlusal force measurements, compared to the traditionally adopted optimality criteria approaches that are basically driven by minimizing the energy consumption of muscle systems engaged. Therefore, it is speculated that mastication may not be optimally controlled, in particular for maxillofacially reconstructed patients. For the abnormal muscular system in the patient with orofacial reconstruction, the study shows that in general, the magnitude of muscle forces fluctuates over the 28-month rehabilitation period regardless of the decreasing trend of the maximum muscular capacity. Such finding implies that the reduction of the masticatory muscle activities on the resection side might lead to non-physiological oral biomechanical responses, which can change the muscular activities for stabilizing the reconstructed mandible.

Accounting for location uncertainty in azimuthal telemetry data improves ecological inference.

BACKGROUND: Characterizing animal space use is critical for understanding ecological relationships. Animal telemetry technology has revolutionized the fields of ecology and conservation biology by providing high quality spatial data on animal movement. Radio-telemetry with very high frequency (VHF) radio signals continues to be a useful technology because of its low cost, miniaturization, and low battery requirements. Despite a number of statistical developments synthetically integrating animal location estimation and uncertainty with spatial process models using satellite telemetry data, we are unaware of similar developments for azimuthal telemetry data. As such, there are few statistical options to handle these unique data and no synthetic framework for modeling animal location uncertainty and accounting for it in ecological models.We developed a hierarchical modeling framework to provide robust animal location estimates from one or more intersecting or non-intersecting azimuths. We used our azimuthal telemetry model (ATM) to account for azimuthal uncertainty with covariates and propagate location uncertainty into spatial ecological models. We evaluate the ATM with commonly used estimators (Lenth (1981) maximum likelihood and M-Estimators) using simulation. We also provide illustrative empirical examples, demonstrating the impact of ignoring location uncertainty within home range and resource selection analyses. We further use simulation to better understand the relationship among location uncertainty, spatial covariate autocorrelation, and resource selection inference. RESULTS: We found the ATM to have good performance in estimating locations and the only model that has appropriate measures of coverage. Ignoring animal location uncertainty when estimating resource selection or home ranges can have pernicious effects on ecological inference. Home range estimates can be overly confident and conservative when ignoring location uncertainty and resource selection coefficients can lead to incorrect inference and over confidence in the magnitude of selection. Furthermore, our simulation study clarified that incorporating location uncertainty helps reduce bias in resource selection coefficients across all levels of covariate spatial autocorrelation. CONCLUSION: The ATM can accommodate one or more azimuths when estimating animal locations, regardless of how they intersect; this ensures that all data collected are used for ecological inference. Our findings and model development have important implications for interpreting historical analyses using this type of data and the future design of radio-telemetry studies.

Biomechanical analysis of bone remodeling following mandibular reconstruction using fibula free flap.

Whilst the newly established biomechanical conditions following mandibular reconstruction using fibula free flap can be a critical determinant for achieving favorable bone union, little has been known about their association in a time-dependent fashion. This study evaluated the bone healing/remodeling activity in reconstructed mandible and its influence on jaw biomechanics using CT data, and further quantified their correlation with mechanobiological responses through an in-silico approach. A 66-year-old male patient received mandibular reconstruction was studied. Post-operative CT scans were taken at 0, 4, 16 and 28 months. Longitudinal change of bone morphologies and mineral densities were measured at three bone union interfaces (two between the fibula and mandibular bones and one between the osteotomized fibulas) to investigate bone healing/remodeling events. Three-dimensional finite element models were created to quantify mechanobiological responses in the bone at these different time points. Bone mineral density increased rapidly along the bone interfaces over the first four months. Cortical bridging formed at the osteotomized interface earlier than the other two interfaces with larger shape discrepancy between fibula and mandibular bones. Bone morphology significantly affected mechanobiological responses in the osteotomized region (R2 > 0.77). The anatomic position and shape discrepancy at bone union affected the bone healing/remodeling process.