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Transoral robotic surgery is frequently described, driven by the desire to offer a less morbid alternative to chemoradiation. However, the objective evaluation of post-operative function has rarely been reported. Therefore, high-resolution manometry was used in this study to evaluate the impact of changes in peri-operative swallowing function on pharyngeal pressure events.
Ten patients with various stages of oropharyngeal cancer underwent transoral surgery. High-resolution manometry and videofluoroscopic swallow studies were performed before surgery and two months afterwards. The following parameters were obtained: velopharyngeal and mesopharyngeal post-deglutitive upper oesophageal sphincter pressures, velo-meso-hypopharyngeal contractile integral, upper oesophageal sphincter relaxation pressure, and pharyngeal velocity.
There was no significant difference in pharyngeal pressure or contractile integral pre- versus post-operatively. However, pharyngeal velocity was significantly higher post-operatively than pre-operatively.
High-resolution manometry showed that transoral surgery in patients without pre-operative dysphagia preserved pharyngeal constriction. However, transoral surgery might produce scar formation in the pharynx, which could lead to narrowing of the pharynx.
Studies on community-acquired pneumonia (CAP) and pneumococcal pneumonia (PP) related to the 13-valent pneumococcal conjugate vaccine (PCV13) introduction in Asia are scarce. This study aimed to investigate the epidemiological and microbiological determinants of hospitalised CAP and PP after PCV13 was introduced in Japan. This observational hospital-based surveillance study included children aged ⩽15 years, admitted to hospitals in and around Chiba City, Japan. Participants had bacterial pneumonia based on a positive blood or sputum culture for bacterial pathogens. Serotype and antibiotic-susceptibility testing of Streptococcus pneumoniae and Haemophilus influenzae isolates from patients with bacterial pneumonia were assessed. The CAP hospitalisation rate per 1000 child-years was 17.7, 14.3 and 9.7 in children aged <5 years and 1.18, 2.64 and 0.69 in children aged 5–15 years in 2008, 2012 and 2018, respectively. There was a 45% and 41% reduction in CAP hospitalisation rates, between the pre-PCV7 and PCV13 periods, respectively. Significant reductions occurred in the proportion of CAP due to PP and PCV13 serotypes. Conversely, no change occurred in the proportion of CAP caused by H. influenzae. The incidence of hospitalised CAP in children aged ⩽15 years was significantly reduced after the introduction of PCV13 in Japan. Continuous surveillance is necessary to detect emerging PP serotypes.
Recently huge amount of dust Mdust ≃ 106−7M⊙ in galaxies at z = 7–8 has been discovered by ALMA observations. The suggested timescale of the dust production was a few–several×108 yr, while the stellar mass was several × 109M⊙. This amount of dust cannot be easily explained only by a supply from supernovae if we consider the dust destruction by reverse shocks. We propose that these values can be consistently explained if we take into account the grain growth in the interstellar medium (ISM). This scenario successfully reproduces the evolution of the dust mass, as well as the SFR, and stellar mass simultaneously. We conclude that even at such an early epoch of the Universe, the dust grain growth in the ISM plays a significant role in galaxies.
The spectral energy distribution (SED) model should treat the evolution of a galaxy from its birth. Dust in galaxies affects the formation and evolution of galaxies in various ways. For example, dust grains scatter and absorb stellar emitted ultraviolet (UV) photons and re-emit the radiation at infrared (IR) wavelengths. In this work, we construct a galaxy SED model based on our dust evolution model (Asano et al. 2013a,b, 2014) with a rigorous treatment of the chemical evolution. To reduce the computational cost, we adopt mega-grain approximation (MGA; (MGA; Inoue, 2005). MGA regards a high density dusty region as a huge size (10 pc) dust grain for calculating dust scattering. In this approximation, we can solve the radiative transfer easily and provide SEDs and attenuation curves of galaxies. This model can be used to fit any galaxy in the wavelength range of 10 nm-3 mm.
We present ALMA detection of the [O iii] 88 μm line and 850 μm dust continuum emission in a Y-dropout Lyman break galaxy, MACS0416_Y1. The [O iii] detection confirms the object with a spectroscopic redshift to be z = 8.3118±0.0003. The 850 μm continuum intensity (0.14 mJy) implies a large dust mass on the order of 4×106M⊙. The ultraviolet-to-far infrared spectral energy distribution modeling, where the [O iii] emissivity model is incorporated, suggests the presence of a young (τage ≍ 4 Myr), star-forming (SFR ≍ 60M⊙yr−1), and moderately metal-polluted (Z ≍ 0.2Z⊙) stellar component with a stellar mass of 3 × 108M⊙. An analytic dust mass evolution model with a single episode of star formation does not reproduce the metallicity and dust mass in ≍ 4 Myr, suggesting an underlying evolved stellar component as the origin of the dust mass.
In endoscopic cricopharyngeal myotomy, surgeons sometimes have concerns about performing an adequate incision with only a narrow intra-cavital view from one direction. In order to overcome these issues, fluoroscopic radiography was used during endoscopic cricopharyngeal myotomy.
Peri-operative fluoroscopic radiography was utilised to check the position of the diverticuloscope, and to confirm the extent of the incision during surgery. A balloon catheter was used to determine whether the cricopharyngeal muscle was sufficiently resected. Blood loss, peri-operative complications, and functional oral swallowing scale and penetration aspiration scale scores were evaluated.
In 12 out of 15 patients, intra-operative fluoroscopic radiography showed the diverticuloscope positioned in the post-cricoid area, and the cricopharyngeal muscle was raised and the surgery completed without adverse effect. Swallowing functions improved following surgery.
Intra-operative fluoroscopy might improve endoscopic cricopharyngeal myotomy by allowing surgeons to confirm the extent of resection, and by reducing peri-operative morbidity and complication rates.
We aimed to verify the effectiveness of real-time reverse transcription (rRT) polymerase chain reaction (PCR) for detecting cases of modified measles (M-Me) and for predicting super-spreader candidates through the experience of a measles outbreak dominated by M-Me in Yamagata, Japan, during March–April 2017. We applied rRT-PCR to specimens from 35 cases of M-Me, nine cases of typical measles (T-Me) and nine cases of prodromal stage of T-Me (P-Me). From rRT-PCR among the M-Me cases, peripheral blood mononuclear cells (PBMC) showed the highest positive rate (80.0%), followed by throat swab (48.6%), urine (33.3%) and serum (3.1%). The negative result of PBMC in M-Me cases was recovered by the result of a throat swab. In specimens of PBMC, throat swab and urine, M-Me group showed the significantly higher cycle of threshold (i.e., lower viral load) in the rRT-PCR than T-Me and P-Me groups, respectively. Furthermore, three super-spreaders in T-Me or P-Me showed an extremely low cycle of threshold in their throat swab specimens. rRT-PCR using PBMC and throat swab might be helpful for clinical management and measles control by certain detection of M-Me cases and by predicting super-spreading events resulting from measles cases with the high viral load.
Elastocaloric materials exhibit extraordinary cooling potential, but the repetition of cyclic mechanical loadings during long-term operation of cooling systems requires the refrigerant material to have long fatigue life. This article reviews the fundamental cause of fatigue from aspects of initiation and propagation of fatigue cracks in shape-memory alloys (SMAs) that are used as elastocaloric materials, and highlights recent advances in using compression to overcome fatigue by curtailing the generation of surfaces associated with crack propagation. Compression is identified as a key means to extend fatigue lifetime in engineering design of elastocaloric cooling drive mechanisms. We summarize the state-of-the-art performance of different SMAs as elastocaloric materials and discuss the influence of low cyclic strains and high resistance to transformation. We present integration of compression-based material assemblies into a cooling system prototype and optimization of the system efficiency using work recovery and related measures.
We have investigated an influence of positive polarization charges generated at an interface between GaN barrier/p-AlGaN EB (Electron Blocking) layer in a blue-LED. Simulation results suggested that such polarization charges caused an electron overflow from QWs. The simulation results also indicated that sufficient acceptor doping at the interface could neutralize the positive polarization charges and suppress the electron overflow. We then demonstrated the electron overflow caused by the positive polarization charges and its suppression with sufficient Mg doping at the interface by monitoring emissions from an additional second QW inserted between the p-EB layer and the p-GaN layer. Finally we conclude that the contribution of the electron overflow is not significant for the efficiency droop in blue-LEDs.
We investigated MOVPE growth conditions for AlInN layers with high growth rates and obtained 0.5µm/h with smooth surfaces. We found that short gas mixing time, relatively high growth temperature, and very low In/Al supply ratio were key growth parameters in order to obtain the AlInN layers with high growth rate and smooth surface simultaneously. AlInN/GaN DBRs grown under such growth conditions showed smooth surfaces and a reflectivity of over 99%.
This study examined whether the occurrence of late neck metastasis in early tongue squamous cell carcinoma can be predicted by evaluating HMGB1 (high mobility group box 1) expression in the primary lesion.
A case–control study was conducted. The cases comprised 10 patients with late neck metastasis. The controls consisted of 16 patients without recurrence. All were examined immunohistochemically for HMGB1 protein expression. The odds ratio for late neck metastasis in relation to HMGB1 was estimated.
Results for HMGB1 were dichotomised into positive staining scores (score, 5–7) and negative scores (0–4). Six cases (60 per cent) and four controls (25 per cent) were HMGB1-positive. Although no significant result was seen, compared with HMGB1-negative patients the odds ratio for late neck metastasis in HMGB1-positive patients was 3.8 (95 per cent confidence interval, 0.6–26.5) after adjusting for other factors.
In the present study, immunohistochemical study of HMGB1 in early tongue squamous cell carcinoma did not appear to be very useful for predicting occult neck metastasis. Further study is necessary to clarify the relationship between HMGB1 expression and late neck metastasis in early tongue squamous cell carcinoma.
Multiwavelength Spectral Energy Distributions (SEDs) of far-infrared (FIR) galaxies detected in the AKARI South Ecliptic Poles Survey (ADF-S) allow to trace differences between [Ultra]-Luminous Infrared Galaxies ([U]LIRGS) and other types of star-forming galaxies (SF).
Gallium nitride (n-type) films of thickness 300nm were grown on c-plane sapphire substrates using plasma assisted molecular beam epitaxy (PA-MBE). High resolution X-ray diffraction and photoluminescence measurements were used to confirm the crystalline and optical qualities of the grown films. Metal-semiconductor Schottky diodes were fabricated using Pt as the Schottky metal and Al as the Ohmic metal contact. Metal-insulator-semiconductor Schottky diodes were also fabricated using HfO2 (10nm) as the insulator material. Diode parameters like barrier height and ideality factor were extracted from I-V measurements. Introduction of HfO2 as the insulator layer leads to better rectifying behavior (forward to reverse current ratio improves from 5.1 to 8.9) with a reduction in reverse leakage current (by 7.4 times), increase in barrier height (from 0.62eV to 0.74eV) and a reduction in ideality factor (from 6 to 4.1) of the Schottky diode.