The position of the mental foramen in dentate and edentulous mandibles: clinical and surgical relevance

Background: The knowledge of the exact location of the mental foramen (MF) in dentate and edentulous mandibles is clinically important when constructing complete dentures, performing anaesthetic block of the lower-anterior teeth area and intervening in the MF nearby area. In edentulous mandibles, the bone resorption after teeth loss makes the mental nerve (MN) prone to damage due to the extreme location of the MF very close to the alveolar crest (AC). Chronic compression on the MN may result in pain in the area of MN distribution (ipsilateral face and cheek area) and numbness at the lower lip. The purpose of the current study is to evaluate the exact position of the MF, calculating the distances MF-superior border of the AC and MF-inferior border of the mandible (IBM) in dentate and edentulous mandibles. Materials and methods: One hundred and two (36 edentulous and 66 dentate) adult dry Greek mandibles were studied. Results: In 9 out of 36 edentulous mandibles (25%), the MF was found nearby the AC, while in 27 edentulous mandibles (75%), the MF was located at an average distance 6.4 mm from the AC and 12.6 mm from the IBM. In 38 out of 66 dentate mandibles (57.6%), the MF was located at an average distance 13.6 mm from the AC and 15.2 mm from the IBM. The dental status significantly affected (p = 0.001) the distances MF-AC and MF-IBM. Side symmetry was observed for both dentate and edentulous mandibles (p = 0.39 and p = 0.45). Conclusions: The MF is an important landmark and its location needs to be considered prior to dental implants placement in order to avoid the MN injury and related complications. The position of MF is altered in edentulous mandibles compared with the dentate ones. The MF is a symmetric structure in Greeks

TheoryGuru: A Mathematica Package to Apply Quantifier Elimination Technology to Economics

We consider the use of Quantifier Elimination (QE) technology for automated reasoning in economics. There is a great body of work considering QE applications in science and engineering but we demonstrate here that it also has use in the social sciences. We explain how many suggested theorems in economics could either be proven, or even have their hypotheses shown to be inconsistent, automatically via QE. However, economists who this technology could benefit are usually unfamiliar with QE, and the use of mathematical software generally. This motivated the development of a Mathematica Package TheoryGuru, whose purpose is to lower the costs of applying QE to economics. We describe the package's functionality and give examples of its use.Comment: To appear in Proc ICMS 201

SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study

Objective: There is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection. Design: A prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken. Primary outcome measure was severity of AP. Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality. Multilevel logistic regression was used to compare the two groups. Results: 1777 patients with AP were included during the study period from 1 March to 23 July 2020. 149 patients (8.3%) had concomitant SARS-CoV-2 infection. Overall, SARS-CoV-2-positive patients were older male patients and more likely to develop severe AP and ARDS (p<0.001). Unadjusted analysis showed that SARS-CoV-2-positive patients with AP were more likely to require ICU admission (OR 5.21, p<0.001), local complications (OR 2.91, p<0.001), persistent organ failure (OR 7.32, p<0.001), prolonged hospital stay (OR 1.89, p<0.001) and a higher 30-day mortality (OR 6.56, p<0.001). Adjusted analysis showed length of stay (OR 1.32, p<0.001), persistent organ failure (OR 2.77, p<0.003) and 30-day mortality (OR 2.41, p<0.04) were significantly higher in SARS-CoV-2 co-infection. Conclusion: Patients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, worse clinical outcomes, prolonged length of hospital stay and high 30-day mortality

The position of the mental foramen in dentate and edentulous mandibles: Clinical and surgical relevance

Background: The knowledge of the exact location of the mental foramen (MF) in dentate and edentulous mandibles is clinically important when constructing complete dentures, performing anaesthetic block of the lower-anterior teeth area and intervening in the MF nearby area. In edentulous mandibles, the bone resorption after teeth loss makes the mental nerve (MN) prone to damage due to the extreme location of the MF very close to the alveolar crest (AC). Chronic compression on the MN may result in pain in the area of MN distribution (ipsilateral face and cheek area) and numbness at the lower lip. The purpose of the current study is to evaluate the exact position of the MF, calculating the distances MF-superior border of the AC and MF-inferior border of the mandible (IBM) in dentate and edentulous mandibles. Materials and methods: One hundred and two (36 edentulous and 66 dentate) adult dry Greek mandibles were studied. Results: In 9 out of 36 edentulous mandibles (25%), the MF was found nearby the AC, while in 27 edentulous mandibles (75%), the MF was located at an average distance 6.4 mm from the AC and 12.6 mm from the IBM. In 38 out of 66 dentate mandibles (57.6%), the MF was located at an average distance 13.6 mm from the AC and 15.2 mm from the IBM. The dental status significantly affected (p = 0.001) the distances MF-AC and MF-IBM. Side symmetry was observed for both dentate and edentulous mandibles (p = 0.39 and p = 0.45). Conclusions: The MF is an important landmark and its location needs to be considered prior to dental implants placement in order to avoid the MN injury and related complications. The position of MF is altered in edentulous mandibles compared with the dentate ones. The MF is a symmetric structure in Greeks. © Copyright 2017 Via Medica

Methoni Mw 6.8 rupture and aftershocks distribution from a dense array of OBS and land seismometers, offshore SW Hellenic subduction

Along the south-western offshore Hellenic subduction zone, the overriding Aegean upper plate above the Mediterranean oceanic lithosphere generates uncommon large earthquakes on the offshore megathrust fault. The largest subduction thrust event, for half a century, has been the 14 February 2008 Methoni earthquake (Mw = 6.8) that occurred offshore of the southwest coast of Peloponnesus. We conducted micro-seismicity experiments around the rupture area and forearc domain -between Peloponnesus and Crete- using ocean bottom seismometers (OBS) jointly with land-based seismological stations. Our first experiment in 2006, had revealed an association of the Matapan Trough, a 400-km-long forearc basin, with local seismicity clustering and a possible gap in activity over the later Methoni rupture area. Here we present new data of post-Methoni seismic activity, recorded during a time-span of 11 months, beginning in October 2008 within the period of proposed afterslip on the megathrust, by an extended and dense seismic array consisting of up to 33 OBS. A minimum 1D velocity model was constructed for the region to provide better constraints on absolute locations and double-difference relocation was applied to produce an enhanced image of the spatial distribution of hypocenters. The high resolution earthquake locations confirm correlation of the Matapan Trough with local seismicity as a regional feature, also filling up the previously observed gap. Over the Methoni rupture area, we constrain seismicity to be located mainly within the upper plate. Hypocenters are also resolved above the updip and downdip edges of the rupture area, respectively. Seismic activity provides hints of upper plate structures which were activated in response to post-seismic deformation spreading within the forearc crust. Our findings highlight the characteristics of a megathrust domain which is related with a highly deformable overriding plate and controlled by a segmented lower plate topography. © 2020 Elsevier B.V

An "all 5 mm ports" technique for laparoscopic day-case anti-reflux surgery: A consecutive case series of 205 patients.

INTRODUCTION Laparoscopic anti-reflux surgery is conventionally performed using two 10/12 mm ports. While laparoscopic procedures reduce post-operative pain, the use of larger ports invariably increases discomfort and affects cosmesis. We describe a new all 5 mm ports technique for laparoscopic anti-reflux surgery and present a review of our initial experience with this approach. METHODS All patients undergoing laparoscopic fundoplication over a 35 month period from February 2013 under the care of a single surgeon were included. A Lind laparoscopic fundoplication was performed using an all 5 mm port technique. Data was recorded prospectively on patient demographics, operating surgeon, surgical time, date of discharge, readmissions, complications, need for re-intervention, and reasons for admission. RESULTS Two hundred and five consecutive patients underwent laparoscopic fundoplication over the study period. The all 5 mm port technique was used in all cases, with conversion to a 12 mm port only once (0.49%). Median operating time was 52 min 185 (90.2%) patients were discharged as day cases. Increasing ASA grade and the presence of a hiatus hernia were associated with the need for overnight stay with admission required in 33% of patients with ASA 3, compared to 4% with ASA 1 (p = 0.001), and 29% of those with a hiatus hernia vs. 5% without (p < 0.001). No port-related complications occurred, and no patients developed recurrence of reflux symptoms. A single patient required mesh repair of a large hiatus hernia. CONCLUSION The all 5 mm ports approach to laparoscopic anti-reflux surgery is a safe, efficient, and cost-effective technique which facilitates same day discharge and minimises port related complications. National commissioning guidelines in the UK should target quality improvements in anti-reflux surgery based around day-case management. This would improve the service for these patients and culminate in cost savings for the NHS

Hysteresis identification using nonlinear state-space models

Most studies tackling hysteresis identification in the technical literature follow white-box approaches, i.e. they rely on the assumption that measured data obey a specific hysteretic model. Such an assumption may be a hard requirement to handle in real applications, since hysteresis is a highly individualistic nonlinear behaviour. The present paper adopts a black-box approach based on nonlinear state-space models to identify hysteresis dynamics. This approach is shown to provide a general framework to hysteresis identification, featuring flexibility and parsimony of representation. Nonlinear model terms are constructed as a multivariate polynomial in the state variables, and parameter estimation is performed by minimising weighted least-squares cost functions. Technical issues, including the selection of the model order and the polynomial degree, are discussed, and model validation is achieved in both broadband and sine conditions. The study is carried out numerically by exploiting synthetic data generated via the Bouc-Wen equations