Two- and three-piece implants to boost data generation in preclinical in vivo research-A short technical report.

The purpose of this technical report is to present two novel experimental implant designs to boost data generation in preclinical in vivo research. Specifically, the report describes the rationale and the components of (1) a two-piece experimental implant suitable for a small animal platform (e.g., the rabbit femur/tibial epiphysis model), consisting of a threaded apical- and a coronal cylindrical piece, which is intended for collecting two types of biomechanical data, and (2) a three-piece experimental implant suitable for a large animal platform (e.g., the mini-pig mandible model), consisting of an apical "wound chamber", which allows the collection of histological/histomorphometrical data, and a middle threaded and coronal cylindrical piece, which also allow the collection of two types of biomechanical data. The increased volume of information generated from a single experiment in a small animal platform, using the proposed two-piece implant design, may assist in a more qualified decision-making process, on whether it is relevant to proceed to further assessment using a large animal platform. Furthermore, the increased volume of information generated in a single animal experiment either in a small or large animal platform, using the proposed two- and three-piece implants, respectively, likely decreases the number of animals otherwise needed for collecting the same information with standard one-piece implants and, thus, contributes to the reduction/refinement elements of the 3R principle

Cementum and enamel surface mimicry influences soft tissue cell behavior.

AIMS To test whether titanium surface roughness disparity might be used to specifically guide the behavior of gingiva fibroblasts and keratinocytes, thereby improving the quality of soft tissue (ST) integration around abutments. METHODS Titanium discs resembling the roughness of enamel (M) or cementum (MA) were created with normal or increased hydrophilicity and used as substrates for human fibroblasts and keratinocytes. Adhesion and proliferation assays were performed to assess cell-type specific responses upon encountering the different surfaces. Additionally, immunofluorescence and qPCR analyses were performed to study more in depth the behavior of fibroblasts and keratinocytes on MA and M surfaces, respectively. RESULTS While enamel-like M surfaces supported adhesion, growth and a normal differentiation potential of keratinocytes, cementum-emulating MA surfaces specifically impaired the growth of keratinocytes. Vice versa, MA surfaces sustained regular adhesion and proliferation of fibroblasts. Yet, a more intimate adhesion between fibroblasts and titanium was achieved by an increased hydrophilicity of MA surfaces, which was associated with an increased expression of elastin. CONCLUSION The optimal titanium implant abutment might be achieved by a bimodal roughness design, mimicking the roughness of enamel (M) and cementum with increased hydrophilicity (hMA), respectively. These surfaces can selectively elicit cell responses favoring proper ST barrier by impairing epithelial downgrowth and promoting firm adhesion of fibroblasts

Primary stability and osseointegration comparing a novel tapered design tissue-level implant with a parallel design tissue-level implant. An experimental in vivo study.

OBJECTIVES The aim of the present study was to compare a novel tapered, double-threaded self-tapping tissue-Level design implant (TLC) to a well-established parallel walled tissue-level (TL) implant in terms of primary and secondary stability over time. MATERIALS AND METHODS Test TLC (n = 10/per timepoint) and control TL (n = 10/per timepoint) implants were placed in the mandible of minipigs and left for submerged healing for 3, 6, and 12 weeks. Maximum insertion torque and implant stability quotient (ISQ) were measured for each implant at placement. Osseointegration and cortical bone maintenance were histologically evaluated by measuring total bone-to-implant contact (BIC) and first bone-to-implant contact (fBIC). RESULTS A significantly higher maximum insertion torque was measured for the test implant TLC compared to the control TL implant (57.83 ± 24.73 Ncm and 22.62 ± 23.16 Ncm, respectively; p < .001). The mean ISQ values were comparable between the two implant types (75.00 ± 6.70 for TL compared to 75.40 ± 3.20 for TLC, p = .988). BIC was comparable between both implant types at each of the evaluated time points. The fBIC was found to be significantly more coronal at 12 weeks for the TLC implant compared to the TL implant (0.31 ± 0.83 mm for TLC compared to -0.22 ± 0.85 for TL, p = .027). CONCLUSION The novel tapered tissue level design implant showed improved primary stability and an overall improved crestal bone height maintenance compared to the parallel walled design at 12 weeks

Assessing the osseointegration potential of a strontium releasing nanostructured titanium oxide surface: A biomechanical study in the rabbit tibia plateau model.

OBJECTIVES To investigate the impact of a Ti-Sr-O technology, applied to either a turned surface or an SLA surface, on the mechanical robustness of osseointegration, benchmarked against the SLActive surface. MATERIAL AND METHODS Ti discs (6.25-mm-diameter and 2-mm-thick) with three different surfaces were inserted on the proximal-anterior part of the tibial plateau of adult Swedish loop rabbits: (I) turned surface modified with Ti-Sr-O (turned + Ti-Sr-O), (II) SLA surface modified with Ti-Sr-O (SLA + Ti-Sr-O), and (III) SLActive surface (SLActive). Following a healing period of 2 weeks and 4 weeks, the pull-out (PO) force needed to detach the discs from the bone was assessed, as a surrogate of osseointegration. RESULTS The SLActive surface exhibited statistically significant higher median PO forces, compared with the SLA + Ti-Sr-O surfaces at both 2- and 4 weeks post-op (p > .05). In this study, no single turned + Ti-Sr-O surface disk was integrated. CONCLUSIONS The tested Ti-Sr-O technology failed to enhance osseointegration; however, this finding may be related to the inappropriateness of the rabbit tibia plateau model for assessing third-generation implant surface technologies, due to the limited diffusion and clearance at the disk-bone interface

Organizational and Environmental Context for Including Advanced Practice Providers in UPMC Hospitalist Models

This study qualitatively examines the environmental and organizational context driving the implementation of advanced practice providers (APPs) in hospital medicine at UPMC. We utilized a comparison case study methodology, including field observation and semi-structured interviews at two hospital medicine programs. We identified three distinct models of APPs in hospital medicine, including the Team Approach, Divide and Conquer, and a Hybrid model, and linked the evolution of these models to contextual factors. Our findings present unique insight into the roles of APPs on UPMC hospital medicine teams. We show that environmental pressures, organizational initiatives, and clinician experience can influence APP roles

Assessing minipig compact jawbone quality at the microscale

Preclinical studies often require animal models for in vivo experiments. Particularly in dental research, pig species are extensively used due to their anatomical similarity to humans. However, there is a considerable knowledge gap on the multiscale morphological and mechanical properties of the miniature pigs’ jawbones, which is crucial for implant studies and a direct comparison to human tissue. In the present work, we demonstrate a multimodal framework to assess the jawbone quantity and quality for a minipig animal model that could be further extended to humans. Three minipig genotypes, commonly used in dental research, were examined: Yucatan, G ̈ottingen, and Sinclair. Three animals per genotype were tested. Cortical bone samples were extracted from the premolar region of the mandible, opposite to the teeth growth. Global morphological, compositional, and mechanical properties were assessed using micro-computed tomography (micro-CT) together with Raman spectroscopy and nano- indentation measurements, averaged over the sample area. Local mineral-mechanical relationships were investigated with the site-matched Raman spectroscopy and micropillar compression tests. For this, a novel femtosecond laser ablation protocol was developed, allowing high-throughput micropillar fabrication and testing without exposure to high vacuum. At the global averaged sample level, bone relative mineralization demonstrated a significant difference between the genotypes, which was not observed from the complementary micro-CT measurements. Moreover, bone hardness measured by nanoindentation showed a positive trend with the relative mineralization. For all genotypes, significant differences between the relative mineralization and elastic properties were more pronounced within the osteonal regions of cortical bone. Site-matched micropillar compression and Raman spectroscopy highlighted the differences between the genotypes’ yield stress and mineral to matrix ratios. The methods used at the global level (averaged over sample area) could be potentially correlated to the medical tools used to assess jawbone toughness and morphology in clinics. On the other hand, the local analysis methods can be applied to quantify compressive bone mechanical properties and their relationship to bone mineralization

Implementation of the Quasi‐equilibrium Tropical Circulation Model 2 (QTCM2): Global simulations and convection sensitivity to free tropospheric moisture

The implementation of the Quasi‐equilibrium Tropical Circulation Model 2 (QTCM2), an intermediate level complexity model, is described. Following the approach of Sobel and Neelin (2006), an explicit, prognostic atmospheric boundary layer (ABL) of fixed depth is added to a free troposphere (FT) containing one baroclinic and one barotropic mode. QTCM2 is shown to simulate reasonable climatologies of temperature, moisture, winds, and precipitation, albeit with only modest improvements relative to the predecessor single vertical mode version, QTCM1. The addition of an ABL increases the sharpness of horizontal precipitation and moisture gradients, and the separation of the moisture profile into ABL and FT components allows investigation into the separate roles of these two components in modulating deep convection. Model sensitivity to various convection parameters is explored, with contrasting precipitation responses often seen within the cores of convecting regions and along their margins

Development and validation of a risk model for prediction of hazardous alcohol consumption in general practice attendees : the PredictAL study

Background: Little is known about the risk of progression to hazardous alcohol use in people currently drinking at safe limits. We aimed to develop a prediction model (predictAL) for the development of hazardous drinking in safe drinkers. Methods: A prospective cohort study of adult general practice attendees in six European countries and Chile followed up over 6 months. We recruited 10,045 attendees between April 2003 to February 2005. 6193 European and 2462 Chilean attendees recorded AUDIT scores below 8 in men and 5 in women at recruitment and were used in modelling risk. 38 risk factors were measured to construct a risk model for the development of hazardous drinking using stepwise logistic regression. The model was corrected for over fitting and tested in an external population. The main outcome was hazardous drinking defined by an AUDIT score >= 8 in men and >= 5 in women. Results: 69.0% of attendees were recruited, of whom 89.5% participated again after six months. The risk factors in the final predictAL model were sex, age, country, baseline AUDIT score, panic syndrome and lifetime alcohol problem. The predictAL model's average c-index across all six European countries was 0.839 (95% CI 0.805, 0.873). The Hedge's g effect size for the difference in log odds of predicted probability between safe drinkers in Europe who subsequently developed hazardous alcohol use and those who did not was 1.38 (95% CI 1.25, 1.51). External validation of the algorithm in Chilean safe drinkers resulted in a c-index of 0.781 (95% CI 0.717, 0.846) and Hedge's g of 0.68 (95% CI 0.57, 0.78). Conclusions: The predictAL risk model for development of hazardous consumption in safe drinkers compares favourably with risk algorithms for disorders in other medical settings and can be a useful first step in prevention of alcohol misuse

Fabrication and extreme micromechanics of additive metal microarchitectures

The mechanical performance of metallic metamaterials with 3-dimensional solid frames is typically a combination of the geometrical effect ("architecture") and the characteristic size effects of the base material ("microstructure"). In this study, for the first time, the temperature- and rate-dependent mechanical response of copper microlattices has been investigated. The microlattices were fabricated via a localized electrodeposition in liquid (LEL) process which enables high-precision additive manufacturing of metal at the micro-scale. The metal microlattices possess a unique microstructure with micron sized grains that are rich with randomly oriented growth twins and near-ideal nodal connectivity. Importantly, copper microlattices exhibited unique temperature (-150 and 25 degree C) and strain rate (0.001~100 s-1) dependent deformation behavior during in situ micromechanical testing. Systematic compression tests of fully dense copper micropillars, equivalent in diameter and length to the struts of the microlattice at comparable extreme loading conditions, allow us to investigate the intrinsic deformation mechanism of copper. Combined with the post-mortem microstructural analysis, substantial shifts in deformation mechanisms depending on the temperature and strain rate were revealed. On the one hand, at room temperature (25 degree C), dislocation slip based plastic deformation occurs and leads to a localized deformation of the micropillars. On the other hand, at cryogenic temperature (-150 degree C), mechanical twinning occurs and leads to relatively homogeneous deformation of the micropillars. Based on the intrinsic deformation mechanisms of copper, the temperature and strain rate dependent deformation behavior of microlattices could be explained

Methodologies for model parameterization of virtual CTs for measurement uncertainty estimation

AbstractX-ray computed tomography (XCT) is a fast-growing technology for dimensional measurements in industrial applications. However, traceable and efficient methods to determine measurement uncertainties are not available. Guidelines like the VDI/VDE 2630 Part 2.1 suggest at least 20 repetitions of a specific measurement task, which is not feasible for industrial standards. Simulation-based approaches to determine task specific measurement uncertainties are promising, but require closely adjusted model parameters and an integration of error sources like geometrical deviations during a measurement. Unfortunately, the development of an automated process to parameterize and integrate geometrical deviations into XCT models is still an open issue. In this work, the whole processing chain of dimensional XCT measurements is taken into account with focus on the issues and requirements to determine suitable parameters of geometrical deviations. Starting off with baseline simulations of different XCT systems, two approaches are investigated to determine and integrate geometrical deviations of reference measurements. The first approach tries to iteratively estimate geometric deviation parameter values to match the characteristics of the missing error sources. The second approach estimates those values based on radiographs of a known calibrated reference object. In contrast to prior work both approaches only use a condensed set of parameters to map geometric deviations. In case of the iterative approach, some major issues regarding unhandled directional dependencies have been identified and discussed. Whereas the radiographic method resulted in task specific expanded measurements uncertainties below one micrometre even for bi-directional features, which is a step closer towards a true digital twin for uncertainty estimations in dimensional XCT