University Of Bern Research Articles

Analyzing the impact of surgical technique on intraoperative adverse events in laparoscopic Roux-en-Y gastric bypass surgery by video-based assessment.

Despite high-level evidence that variations of surgical technique in laparoscopic Roux-en-Y gastric bypass (LRYGB) are correlated with postoperative outcomes and might be linked to intraoperative adverse events (iAEs), there are a paucity of studies analyzing iAEs in depth. The impact of surgical technique on the temporal occurrence of iAEs regarding phases and steps of LRYGB has not been studied so far. The objective of this study was to analyze the impact of variance in surgical technique on temporal occurrence, frequency, and type of iAEs in a multicentric dataset of LRYGB videos. MultiBypass140, a video dataset containing 70 LRYGB surgeries each from Strasbourg University Hospital (StrasBypass70) and Bern University Hospital (BernBypass70) was annotated with surgical phases, iAE type, and grade. The cumulative severity of iAEs per procedure was measured using the SEVERE score and correlated with procedure duration. Surgical technique significantly differed between StrasBypass70 and BernBypass70 (omentum division: 94% vs. 36%, p < 0.01; closure of mesenteric defects: 100% vs. 21%, p < 0.01). In MultiBypass140, a total of 797 iAEs were analyzed. The most iAE-prone phases were gastric pouch creation, gastrojejunal, and jejunojejunal anastomosis creation containing 77% (616/797) of all iAEs. StrasBypass70 showed significantly more iAEs in the omentum division (23 vs. 5, p < 0.01), Petersen space closure (13 vs. 1, p < 0.01), and mesenteric defect closure phases (34 vs. 1, p < 0.01) compared to BernBypass70. In both centers, SEVERE score was correlated with procedure duration. In BernBypass70, insufficient closure of anastomosis was significantly more frequent in patients with postoperative complications (0.2 ± 0.6 vs. 0.0 ± 0.1, p < 0.01). Variations of the LRYGB technique between centers influence the temporal occurrence and frequency of iAEs. The frequency and severity of iAEs are correlated with procedure duration.

A new portable sampler of atmospheric methane for radiocarbon measurements

Abstract. Radiocarbon (14C) is an optimal tracer of methane emissions, as 14C measurements enable distinguishing between fossil methane and biogenic methane (CH4). However, 14C measurements in atmospheric methane are still rare, mainly because of the technical challenge of collecting enough carbon for 14C analysis from ambient air samples. In this study, we address this challenge by advancing the system in Zazzeri et al. (2021) into a much more compact and portable sampler and by coupling the sampler with the MICADAS (MIni CArbon DAting System) accelerator mass spectrometry (AMS) system at ETH Zurich, using a gas interface. Here, we present the new sampler setup, the assessment of the system contamination and a first inter-laboratory comparison with LARA (Laboratory for the Analysis of Radiocarbon with AMS) at the University of Bern. With our sampling line, we achieved a very low blank, 0.7 µgC compared to 5.5 µgC in Zazzeri et al. (2021), and a sample precision of 0.9 %, comparable with other measurement techniques for 14CH4, while reducing the sample size to 60 L of air. We show that this technique, with further improvements, will enable routine 14CH4 measurements in the field for an improved understanding of CH4 sources.

A randomized controlled trial comparing immersive virtual reality games versus nitrous oxide for pain reduction in common outpatient procedures in pediatric surgery

BackgroundChildren often experience anxiety and pain during minor surgical procedures, prompting the search for effective pain management strategies beyond traditional pharmaceutical approaches. This study aims to evaluate the efficacy of virtual reality (VR) as a pain reduction method in pediatric outpatient surgical interventions compared to the standard use of nitrous oxide. The research questions explore pain reduction levels, patient preferences, enjoyment during VR use, and the time limit of the VR application.MethodsThe study employs a randomized controlled trial design, utilizing VR technology and nitrous oxide in separate groups in 100 children at the age from 6 to 15 undergoing minor surgical procedures. Outcomes are monitored directly after the intervention and two weeks following the procedure. The primary outcome measure is the pain level, assessed using visual face and visual analog scales. Secondary outcomes are the fun and/or fear experienced during the intervention, the willingness to undergo the same procedure again (if necessary), and whether there is a time limit with the VR application compared to nitrous oxide. The study also considers adverse events and safety measures.DiscussionThe study aims to address a significant research gap in pediatric pain management strategies, as it is the first randomized controlled trial designed to compare pain levels using VR versus a control group with nitrous oxide analgosedation in children undergoing minor surgical procedures. Preliminary evidence suggests VR may offer a viable alternative to traditional pain management methods, as VR technology could be an effective distraction and pain management tool for pediatric patients undergoing outpatient surgical procedures.Trial registrationClinicalTrials.gov NCT05510141. Registered on August 22, 2022. Virtual Reality Games in Pediatric Surgery—Full Text View—ClinicalTrials.gov.Trial sponsorThe principal investigator, Cordula Scherer act as the Sponsor, Clinic for pediatric surgery, Inselspital, Bern University Hospital, CH 3010 Bern, Switzerland.

Role of pre-sacral sentinel lymph nodes in endometrium and cervical cancer: experience with minimally invasive indocyanine green sentinel lymph node mapping.

The aim of this study was to examine the role of pre-sacral sentinel lymph nodes (SLNs) in patients with uterine cancer. This retrospective cohort study includes patients with endometrial or cervical cancer who underwent minimally invasive indocyanine green SLN mapping at the Bern University Hospital from December 2012 to December 2022. A complete ultra-staging of the SLNs was performed in all cases. A total of 616 patients with uterine cancer were included in this study. The mean age was 61.6 years (standard deviation ± 13.8) and mean body mass index 28.2 kg/m2 (standard deviation ± 7.3). Endometrial cancer was present in 466 patients, and 150 patients were diagnosed with cervical cancer. The overall SLN detection rate was 97.7%. In total, 2462 SLNs were removed, with a median number of 3 SLNs (range; 0-20) per patient. In 95 patients, the SLN showed tumor involvement comprising macro-metastasis in 74 patients (12.0%), micro-metastasis in 17 patients (2.8%), and isolated tumor cells in four patients (0.6%). In 170 patients, 384 pre-sacral SLNs were removed. Pre-sacral SLNs were more often seen in patients with cervical cancer (35.3%) than in those with endometrial cancer (25.1%) (p = .021); Three patients had macro-metastasis in the pre-sacral SLNs, accounting for 0.5% of the entire cohort. These three patients had high-grade endometrial cancer, and all had a concurrent positive pelvic SLN mapping result. In our study, indocyanine green SLN mapping revealed pre-sacral SLN in one-third of patients with cervical and one-fourth of those with endometrial cancer. Pre-sacral SLN metastasis was present in 0.5% of all study patients. The relevance of pre-sacral SLNs seems to be limited to patients with high-risk endometrial cancer.

Sub-Tenon's Block in Patients with Previous Encircling Band Surgery-A Feasibility Study.

Introduction: During the COVID-19 pandemic, reducing aerosol-generating procedures became fundamental, particularly in ophthalmic surgeries traditionally performed under general anesthesia (GA). Regional anesthesia, such as sub-Tenon's block (STB), is widely used in vitreoretinal surgeries, offering a safer alternative by avoiding airway manipulation. However, the altered orbital anatomy in patients with previous scleral explant surgery creates unique challenges to STB application. This study aims to evaluate the effectiveness, safety, and feasibility of STB in patients after encircling band surgery. Methods: This retrospective analysis included 46 patients with a history of scleral explant surgery, undergoing vitreoretinal procedures at the Bern University Hospital. All procedures were conducted under STB with either analgosedation or GA for additional support when required. An ophthalmic surgeon or an experienced anesthesiologist performed the STBs. Data collected included block success rate, procedural difficulty, incidence of chemosis, and patient satisfaction. The Institutional Ethics Committee approved this study, and all participants provided informed consent. Results: STB was successfully administered in 93.5% of cases, with only three unsuccessful blocks. Block placement was rated as easy in 55% of cases, moderately difficult in 28%, and difficult in 17%. Chemosis was observed in 24% of patients, with severe cases in only 4%. Patient satisfaction scores were high, with most patients expressing satisfaction with the STB procedure. Conversion to GA was required in only one case due to alcohol withdrawal-related agitation. Discussion: The high success rate and minimal complications suggest that STB is a feasible and safe alternative to GA in patients with prior scleral buckling surgery. The altered orbital anatomy presents potential challenges, including scar tissue and compartmentalization, which may lead to patchy anesthesia. However, the use of STB avoids the risks associated with GA and may be especially beneficial for elderly or frail patients. Future studies should further investigate the hemodynamic implications of STB in these cases and the potential for ultrasound-guided techniques to improve accuracy and safety.

Advancing Personalised Bladder Cancer Treatment

We spoke to Prof. Marianna Kruithof-de Julio and her team at the University of Bern about their research which involves using patient-derived organoids to improve bladder cancer treatment. Their work aims to tailor therapies based on individual tumor profiles, addressing the disease’s high heterogeneity and recurrence rates

Gender and role differences of lecturer and student perspectives on sex- and gender-based medicine in the medical curriculum – a cross-sectional survey

BackgroundSex- and gender-based medicine (SGBM) addresses differences between males/men and females/women with regard to clinical manifestation, diagnostics, treatment and outcomes of diseases. The implementation of SGBM in the medical curriculum varies, and data on the knowledge of lecturers and students about SGBM is scarce. This study aims to evaluate the perceived importance and knowledge of SGBM among lecturers and students.MethodsThis cross-sectional observational survey was conducted using a questionnaire, including ranked with a Likert Scale. Statistical analysis was performed with the Chi-squared test. All lecturers and students at the Bern University Medical School in Switzerland were invited to voluntarily participate.Results114 (34.1%) lecturers and 903 (41.4%) students participated in the survey. Women perceived education of SGBM to be of greater importance than men in lecturer and student subgroups respectively (lecturers women vs. men median 6.0 vs. 5.0, P = 0.011; students 6.0 vs. 5.0, P < 0.001). No significant differences between genders of self-reported knowledge of SGBM were found (lecturers women vs. men median 4.0 vs. 4.0, P = 0.624; students 3.0 vs. 4.0, P = 0.562). There were significant differences in the perception of the SGBM being actively addressed in lectures between lecturers and students (59.4% vs. 28.8%, P < 0.001) and whether the curriculum should include SGBM (strongly agree 28.9% vs. 51.3%, P < 0.001).ConclusionWomen lecturers and students consider teaching of SGBM during medical studies to be more important than men. Lecturers perceived the amount of SGBM already included in the lectures to be greater compared to students.

Incidental findings of borderline ovarian tumor or ovarian cancer - real-world data on surgical and oncological outcomes.

Centralization of ovarian cancer treatment is associated with higher rates of optimal surgery and longer survival. However, preoperative diagnosis of ovarian cancer is challenging and some diagnoses are made incidentally after surgery. This study investigated the surgical and oncological outcomes of patients with incidental findings of borderline ovarian tumors or ovarian cancer who were centralized postoperatively and treated with a two-stage surgical procedure, and compared these with those of patients with adnexal masses of suspected malignancy who were offered a single-stage surgical procedure with intraoperative frozen section in a tertiary hospital. A database of 390 patients with adnexal masses and surgical treatment at the Bern University Hospital, Switzerland was retrospectively reviewed to identify patients with borderline ovarian tumors or ovarian cancer between 2010 and 2020. Among 390 patients with adnexal masses, 223 were diagnosed with a borderline ovarian tumor or ovarian cancer. Compared with patients with suspected malignancy and a centralized single-stage surgical procedure, patients with an incidental postoperative malignancy diagnosis and a two-stage surgical procedure underwent more surgical interventions (1.3 vs. 2.1 p<.001) and had a longer time interval from diagnosis to initiation of chemotherapy (33.3 vs. 45.1 p=.005) and to completion of surgical cytoreduction (31.9 vs. 73.7 days, p<.001). However, there were no differences in the rates of complete cytoreduction (90.0% vs. 93.2%, p=.719), intraoperative (11.3% vs. 13.7%, p=.664) or postoperative (38.7% vs. 37.0%, p=.884) complication rates, and number of hospitalization days (11.1 vs. 12.0 days, p=.369). An incidental diagnosis of malignancy with postoperative referral was neither associated with an increased risk of recurrence (hazard ratio (HR) 0.8, 95% confidence interval (CI) 0.6-1.8, p=.839) nor death (HR 0.7, 95% CI 0.4-1.1, p=.113), and there was no difference in mean recurrence-free survival between the study subgroups. Although patients with incidental findings of borderline ovarian tumors or ovarian cancer treated with a two-stage surgical procedure had a longer time to completion of surgical staging and initiation of chemotherapy, our results showed no negative impact on oncological outcomes.

Uptake of Dual Antiplatelet Therapy After High-Risk Transient Ischemic Attack at a University Hospital.

Multiple randomized controlled trials have demonstrated that dual antiplatelet therapy (DAPT) significantly reduces the risk of subsequent stroke as compared to aspirin monotherapy after high-risk transient ischemic attack (TIA) or minor ischemic stroke. We sought to evaluate the uptake of DAPT after high-risk TIA at a single center. We conducted a retrospective cohort study of consecutive TIA patients admitted via the Emergency Department (ED) of Bern University Hospital (1/1/2018-12/31/2019). We use descriptive statistics to detail cohort characteristics and compared patients treated with DAPT to those not treated. Statistical significance was set at α = 0.05 and all tests of comparison were two-sided. A total of 383 TIA patients were seen during the study period, 247 were eligible for DAPT. Among those eligible for DAPT, mean age was 72years and 51% were female. A total of 49 (19.8%) eligible TIA patients were treated with DAPT; use of DAPT significantly increased from 2018 to 2019. Patients admitted to the stroke unit or intensive care unit (n = 33) had a significantly higher proportion of DAPT treatment as compared to those admitted to the general neurology ward or discharged to home from the ED. DAPT use was also significantly higher in patients with large artery atherosclerotic disease (n = 23) as compared to other etiological subtypes and significantly higher among patients who arrived to the ED within 24h of symptom onset (n = 178). In conclusion, we found that only 2 out of every 10 high-risk TIA patients received DAPT in the years following its introduction in the clinical practice. Our results suggest that strategies to improve the uptake of new, evidence-based secondary stroke prevention treatment after high-risk TIA are needed.

7906 Nanoencapsulated Curcumin-Piperine Complex: A Breakthrough In Targeting CYP17A1 For Castration Resistant Prostate Cancer Therapy

Abstract Disclosure: J. Yakubu: None. Nanoencapsulated Curcumin-Piperine Complex: A Breakthrough in Targeting CYP17A1 for Castration Resistant Prostate Cancer Therapy. Jibira Yakubu a,b,c, Oya Taritd, Evangelos Natsaridisd, Amit V. Pandey a,ba Translational Hormone Research Program, Department of Biomedical Research, Faculty of Medicine, b Paediatric Endocrinology, Diabetology and Metabolism, University Children’s Hospital, Inselspital, Bern, c Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland. d Biointerfaces, Institute of Chemistry and Bioanalytics, University of Life Sciences FHNW, Muttenz, Switzerland. Abstract: Androgens play a pivotal role in prostate cell survival and are implicated in both early-stage and advanced, castration-resistant prostate cancer (CRPC). In CRPC patients on CYP17A1 inhibitors, the development of drug resistance and hypertensive crisis through the inhibition of CYP21A2 and or its substrate are a recognized challenge. Given its crucial role in androgen production, CYP17A1 has become a major target for cancer therapies. In this study, we employed a mini-evaporation technique to nanoencapsulate curcumin, exploring its impact on CYP17A1 activity in human adrenal NCI-H295R cells. We performed steroid profiling with LC-MS, as well as gene and protein expression studies. Initial results demonstrated that curcumin nanoparticles exhibited superior efficacy in reducing CYP17A1 activity compared to known drug Abiraterone acetate. Curcumin and piperine combined in nano-capsules greatly increased the inhibitory effects on CYP17A1 activity. Furthermore, ongoing studies include western blot investigation of the drug's interaction with the CYP17A1 protein and cell cycle effects. We confirmed the efficacy of our nano formulation by testing its impact on the growth of androgen-sensitive prostate cancer cell lines. Notably, nanoencapsulation improved curcumin's inhibitory effects on DHEA production via CYP17A1. Surprisingly, the curcumin-piperine nano-capsules enhanced these effects while having no effect on CYP21A2, offering a promising option for prostate cancer treatment. Our study reveals the promise of nanoencapsulated curcumin-piperine as a game-changing method for targeting CYP17A1 for improved prostate cancer therapy. The synergistic benefits observed in our study open new avenues for addressing the difficulties associated with androgen deprivation therapy. Funding: Cancer Research Switzerland grant number: KFS 5557-02-2022 Presentation: 6/3/2024

Thermal tides in the middle atmosphere at mid-latitudes measured with a ground-based microwave radiometer

Abstract. In recent decades, theoretical studies and numerical models of thermal tides have gained attention. It has been recognized that tides have a significant influence on the dynamics of the middle and upper atmosphere; as they grow in amplitude and propagate upward, they transport energy and momentum from the lower to the upper atmosphere, contributing to the vertical coupling between atmospheric layers. The superposition of tides with other atmospheric waves leads to non-linear wave–wave interactions. However, direct measurements of thermal tides in the middle atmosphere are challenging and are often limited to satellite measurements in the tropics and at low latitudes. Due to orbit geometry, such observations provide only a reduced insight into the short-term variability in atmospheric tides. In this paper, we present tidal analysis from 5 years of continuous observations of middle-atmospheric temperatures. The measurements were performed with the ground-based temperature radiometer TEMPERA (TEMPErature RAdiometer), which was developed at the University of Bern in 2013 and was located in Bern (46.95° N, 7.45° E) and Payerne (46.82° N, 6.94° E). TEMPERA achieves a temporal resolution of 1–3 h and covers the altitude range between 25–50 km. Using an adaptive spectral filter with a vertical regularization (ASF2D) for the tidal analysis, we found maximum amplitudes for the diurnal tide of approximately 2.4 K, accompanied by seasonal variability. The maximum amplitude was reached on average at an altitude of 43 km, which also reflected some seasonal characteristics. We demonstrate that TEMPERA is suitable for providing continuous temperature soundings in the stratosphere and lower mesosphere with a sufficient cadence to infer tidal amplitudes and phases for the dominating tidal modes. Furthermore, our measurements exhibit a dominating diurnal tide and smaller amplitudes for the semidiurnal and terdiurnal tides in the stratosphere.

Emerging Patterns, Collaboration, and Impact of Scientific Production on Hyaluronic Acid in Dentistry: A Bibliometric Analysis

Abstract Aim: This observational, descriptive, retrospective presentation aimed to analyze the emerging patterns, collaboration, and impact of scientific production on hyaluronic acid (HA) in dentistry. Materials and Methods: A bibliometric analysis of research indexed in Scopus from January 2018 to May 2024 was performed. Emerging patterns, collaboration, impact, Bradford’s law, and Lotka’s law were applied. In addition, thematic maps were designed to visualize the connections between authors and countries. Results: A total of 767 documents from 176 diverse sources were analyzed, identifying 3437 authors. Articles were the most common type of document. The author of the highest scientific output was Sculean Anton of the University of Bern, Switzerland. Most of the articles were published in first-quartile journals, with Clinical Oral Investigation and Journal of Thermal Analysis and Calorimetry having the highest number of publications. The University of Bern in Switzerland was the institution with the highest research output. Conclusion: This study provides a comprehensive overview of the academic production of HA in dentistry. The results highlight the importance of international collaboration and the concentration of scientific production in certain institutions and journals. These findings may be useful to researchers and institutions seeking to understand and navigate the field of HA in dentistry.

Entropy parameter optimization for epileptic seizure detection: A parallel approach

Brain Computer Interface (BCI) – one of the recent advancements in the field of Bioinformatics which offers a real-time support for the people, who are affected by chronic neurological disorders. Owing to the rapid progression of Electroencephalogram (EEG) – based BCI system, the detection of epileptic seizures has become much simpler. However, accurate detection through visual inspection is tedious, time-consuming and prone to error. Thus, automation has become inevitable and for automating the epileptic seizure detection, entropies are appropriate as the nature of EEG signals are complex, arrhythmic, ephemeral, and non-stationary. Several renowned entropies are widely applied, nevertheless, the existing models fail to identify the optimal parameters of the entropies which greatly influences the performance of the Machine Learning models that could make better predictions. Hence to address the aforementioned issue, this paper presents a parallel machine learning based farmland fertility algorithm which optimizes the parameters of various entropies thereby detecting Epileptic Seizures in a systematic way. A novel weighted fitness function has been designed based on Kullback-Leibler Divergence (KLD). The extracted features are further classified using state-of-the-art classifiers. The overall performance of the proposed algorithm was evaluated using the EEG dataset obtained from University of Bonn, Germany, University of Bern and Indian EEG, New Delhi and the results show the supremacy of the proposed model in terms of sensitivity, specificity, precision, F1-score, G-mean and classification accuracy.

Interlaboratory comparison of phosphatidylethanol in dried blood spots using different sampling devices.

Phosphatidylethanol (PEth) has become an important marker to assess drinking behaviour and monitor abstinence. Despite its increasing use, knowledge on robustness and standardization and comparability of methods and results are still limited. In 2022, the first international consensus for the use of PEth and its interpretation was published. To establish an experience-based foundation for further harmonization, three rounds of interlaboratory comparison using microsamples were conducted. Participating laboratories sent their sampling devices to the laboratory of Forensic Toxicology at the University of Bern, where for each round, four different authentic blood samples were applied to the devices and sent back. The PEth 16:0/18:1 target concentrations covered a range between 16 and 474 ng/mL (0.023 and 0.676 μmol/L, respectively) and included sample concentrations close to the decision limits of 20 and 200 ng/mL (0.025 and 0.28 μmol/L, respectively). Evaluation of the results based on guidelines by Horwitz and the Society of Toxicological and Forensic Chemistry (GTFCh) showed that 73% of all participating laboratories quantified and reported all samples (N = 4 for each round) within the acceptable limits. More than 90% quantified and reported at least one sample within the acceptable limits.

External Validation of Serologic Scores for the Detection of Liver Steatosis Among People With HIV.

Fatty liver index (FLI) and hepatic steatosis index (HSI) are serologic scores used to detect liver steatosis. However, their diagnostic performance in people with HIV (PWH) remains unclear. We performed an external validation of FLI and HSI in the Swiss HIV Cohort Study. We systematically performed vibration-controlled transient elastography (VCTE) among Swiss HIV Cohort Study participants at Bern University Hospital between November 2019 and August 2021. Individuals with viral hepatitis and pregnant women were excluded. We defined liver steatosis as controlled attenuation parameter ≥248 dB/m using VCTE. Model discrimination was assessed with the C-index and model calibration with calibration plots. A decision curve analysis was performed to compare the clinical usefulness of both scores. Of 321 participants, 91 (28.4%) were female, the median age was 51.4 years (IQR, 42-59), 230 (71.7%) were Caucasian, and 164 (51.1%) had a body mass index >25 kg/m2. VCTE-confirmed liver steatosis was present in 158 (49.2%). Overall, 125 (38.9%) had an FLI ≥60, and 128 (39.9%) had an HSI ≥36. At these cutoffs, the C-index to diagnose liver steatosis was 0.85 for FLI (95% CI, .80-.89) and 0.78 for HSI (95% CI, .73-.83). Whereas FLI was well calibrated, HSI overestimated the risk for steatosis. Both models showed a positive net benefit, with FLI having a greater net benefit when compared with HSI. FLI and HSI are valid tools to detect liver steatosis in PWH. FLI should be the preferred score, given its better performance and greater clinical usefulness.

A Comparison of Oral Function in Older In- and Outpatients: An Observational Study.

(1) Background: Insufficient data exist regarding oral function among older adults in Europe. Therefore, we aimed to assess and compare oral function between older in- and outpatients and identify predictors of low masticatory performance. (2) Methods: Patients were consecutively recruited from the outpatient center (n = 31) and the inpatient geriatric department (n = 31) at a tertiary University Hospital in Switzerland in 2023. Assessments on oral function included the total number of intraoral eruptive teeth, number of supporting zones with dentures, maximal bite force (Dental Prescale II, Fuji Film Corp., Tokyo, Japan), and masticatory performance (Hue-Check Gum©, University of Bern, Bern, Switzerland) using a visual (SA1-SA5) and a digital (SD_Hue) scale. The visual and digital assessment of masticatory performance showed a strong correlation (Kendall tau = 0.83). Low masticatory performance was defined as SA-Grade 1-2 (vs. SA3-SA5 as reference). In a multivariate model adjusting for age, sex, and clinical setting, we investigated associations of maximal bite force, few eruptive teeth, and few supporting zones with low masticatory performance. (3) Results: Mean age was 81.9 (standard deviation (sd) 5.2) years, and 62.9% were female. Overall, maximal bite force was 247 N (sd 261). A total of 39 patients (63.9%) had a low masticatory performance, 62.9% a low maximal bite force, and 50% a low number of eruptive teeth (<10). Masticatory performance, number of eruptive teeth, and maximal bite force did not significantly differ between in- and outpatients. The number of supporting zones was significantly higher in outpatients compared to inpatients (median 4, interquartile range (IQR) 4-4; vs. 4, IQR 2-4; p = 0.03). In the multivariate model, maximal bite force and a low number of eruptive teeth were independently associated with low masticatory performance (adjusted odds ratio 7.4 (95% CI, 1.8-30.4; p < 0.01), and OR 7.8 (95% CI, 1.7-36.4; p < 0.01), respectively). (4) Conclusions: Impaired oral function is highly prevalent in both European older in- and outpatients to a similar degree. The association of low masticatory performance with maximal bite force and with a low number of eruptive teeth may indicate that a basic screening should include either of these parameters to identify impaired oral function.

Education, innovation and research in wooden architecture and construction in the Alps

The essay explores the importance of teaching and research in the building cultures of specific territories, with a particular focus on the use of wood in construction. Through interviews with experts from research centres and universities, such as Andreja Kutnar from InnoRenew CoE in Slovenia, Frédéric Pichelin from the Bern University of Applied Sciences in Switzerland, and Florian Court from the Haute École du Bois et de la Forêt association in France, the essay highlights how such institutions are promoting innovation and sustainable development in the wooden construction sector. Kutnar emphasises the importance of interdisciplinary and holistic research to develop renewable materials and improve the quality of the built environment. Pichelin discusses how innovation can emerge from the integration of new technologies and biobased materials, while Court addresses the challenge of industrialising wood production processes while preserving unique local characteristics. The essay also examines future challenges for wooden architecture in the Alps, such as climate change and the need for sustainable resources, highlighting projects like VETA/NOVA developed by the Bern University of Applied Sciences, which aims to develop guidelines for the restoration of historic wooden buildings. Finally, it discusses the possibility of translating global prerogatives into a local context, influencing the contemporary architectural identity of the Alps and its multidimensional impact on the territory.

Was kennzeichnet einen Holzbau?

The new online encyclopaedia www.holzbaukultur.ch from the Bern University of Applied Sciences presents Swiss timber buildings across six centuries and shows lineages of development. The wide range of examples initiates a debate about the characteristics of timber buildings. Switzerland is generally associated with craftsmanship and traditional timber buildings in the Alpine region. The attempt to develop timber architecture in the spirit of modernism in the 20th century was not very successful. The proportion of timber in total building volume decreased significantly. In recent decades, Swiss timber construction, which is now highly technologised, has repositioned itself, and architecture and structural planning have come closer together and realised remarkable, pioneering projects. Timber construction is now the subject of urban spaces and must find new forms accordingly. The approaches to these new forms have so far been very different. Answering the question “What characterises timber construction?” therefore appears to be a key to the visibility and success of a forward-looking Swiss timber construction culture.

Epidemiology of maxillofacial trauma in elderly patients receiving oral anticoagulant or antithrombotic medication; a Swiss retrospective study

BackgroundThe percentage of elderly trauma patients under anticoagulation and antiplatelet agents has been rising lately. As newer agents are introduced, each comes with its own advantages and precautions. Our study covered elderly patients admitted to the ED with maxillofacial trauma while on anticoagulation (AC) or antiplatelet therapy (APT). We aimed to investigate the demographic characteristics, causes, and types of maxillofacial trauma, along with concomitant injuries, duration of hospitalisation, haemorrhagic complications, and the overall costs of care in the emergency department (ED).MethodsData were gathered from the ED of Bern University Hospital. In this retrospective analysis, patients over 65 of age were included, who presented at our ED with maxillofacial trauma between 2013 and 2019 while undergoing treatment with therapeutic AC/APT.ResultsThe study involved 188 patients with a median age of 81 years (IQR: 81 [74; 87]), of whom 55.3% (n=104) were male. More than half (54.8%, n=103) were aged 80 years or older. Cardiovascular diseases were present in 69.7% (n=131) of the patients, with the most common indications for AC/APT use being previous thromboembolic events (41.5%, n=78) and atrial fibrillation (25.5%, n=48). The predominant cause of facial injury was falls, accounting for 83.5% (n=157) of cases, followed by bicycle accidents (6.9%, n=13) and road-traffic accidents (5.3%, n=10). The most common primary injuries were fractures of the orbital floor and/or medial/lateral wall (60.1%, n=113), zygomatic bone (30.3%, n=57), followed by isolated orbital floor fractures (23.4%, n=44) and nasal bone fractures (19.1%, n=36). Fractures of the mandible occurred in 14.9% (n=28). Facial hematomas occurred in 68.6% of patients (129 cases), primarily in the midface area. Relevant facial bleeding complications were intracerebral haemorrhage being the most frequent (28.2%, n=53), followed by epistaxis (12.2%, n=23) and retrobulbar/intraorbital hematoma (9%, n=17). Sixteen patients (8.5%) experienced heavy bleeding that required emergency treatment. The in-hospital mortality rate was 2.1% (4 cases).ConclusionsThis study indicates that falls are the leading cause of maxillofacial trauma in the elderly, with the most common diagnoses being orbital, zygomatic, and nasal fractures. Haemorrhagic complications primarily involve facial hematomas, especially in the middle third of the face, with intracerebral haemorrhage being the second most frequent. Surgical intervention for bleeding was required in 8.5% of cases. Given the aging population, it is essential to improve prevention strategies and update safety protocols, particularly for patients on anticoagulant/antiplatelet therapy (AC/APT). This can ensure rapid diagnostic imaging and prompt treatment in emergencies.

An Interview with APPLE Lecture Speaker Dr. Ross Perlin

On April 26th, 2024, the Studies in Applied Linguistics and TESOL (SALT) journal interviewed Dr. Ross Perlin, an invited speaker for the 2024 APPLE Lecture Series hosted by the Applied Linguistics and TESOL program at Teachers College, Columbia University. Dr. Ross Perlin is a linguist, writer, and translator focused on exploring and supporting linguistic diversity. His book Language City: The Fight to Preserve Endangered Mother Tongues in New York was just released by Grove in the US and the UK. Since 2013, he has been co-director of the Endangered Language Alliance in New York, managing research projects on mapmaking, documentation, policy, and public programming for urban linguistic diversity. He also teaches linguistics at Columbia. His writing has appeared in the New York Times, The Guardian, Harpers, and elsewhere. His first book, Intern Nation: How to Earn Nothing and Learn Little in a Brave New Economy, ignited national conversation about unpaid work. He has an MA in language documentation and description from the University of London (SOAS) and a PhD in linguistics from the University of Bern.