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To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy.
Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre- and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model.
Mean pre-intervention Penetration Aspiration Scale and National Institutes of Health Swallow Safety Scale scores were 8 ± 0 and 6 ± 0 respectively in sheep and human cadavers, with 100 per cent intra- and inter-species reproducibility. These scores improved to 1 ± 0 and 2 ± 0 post-laryngohyoid suspension (p < 0.01). Aerodigestive tract residue was 18.6 ± 2.4 ml at baseline, 15.4 ± 3.8 ml after laryngotracheal separation and 3.0 ± 0.7 ml after total laryngectomy (p < 0.001).
The ovine model displayed perfect intra- and inter- species reliability for the Penetration Aspiration Scale and Swallow Safety Scale. Less aerodigestive tract residue after narrow-field laryngectomy suggests that swallowing outcomes after total laryngectomy are superior to those after laryngotracheal separation.
Following an unusually heavy rainfall in June 2009, a community-wide outbreak of Campylobacter gastroenteritis occurred in a small Danish town. The outbreak investigation consisted of (1) a cohort study using an e-questionnaire of disease determinants, (2) microbiological study of stool samples, (3) serological study of blood samples from cases and asymptomatic members of case households, and (4) environmental analyses of the water distribution system. The questionnaire study identified 163 cases (respondent attack rate 16%). Results showed a significant dose-response relationship between consumption of tap water and risk of gastroenteritis. Campylobacter jejuni belonging to two related flaA types were isolated from stool samples. Serum antibody levels against Campylobacter were significantly higher in cases than in asymptomatic persons. Water samples were positive for coliform bacteria, and the likely mode of contamination was found to be surface water leaking into the drinking-water system. This geographically constrained outbreak presented an ideal opportunity to study the serological response in persons involved in a Campylobacter outbreak. The serology indicated that asymptomatic persons from the same household may have been exposed, during the outbreak period, to Campylobacter at doses that did not elicit symptoms or alternatively had been exposed to Campylobacter at a time prior to the outbreak, resulting in residual immunity and thus absence of clinical signs.
General arguments for optimized coronagraphy in the search for planets are presented. First, off-axis telescopes provide the best telescopic platforms for use with coronagraphy, and telescope fabrication technology now allows the fabrication of such telescopes with diameters of up to 6.5 m. We show that in certain circumstances a smaller telescope with an off-axis primary has a signal-to-noise advantage compared with larger Cassegrain telescopes. Second, to fully exploit the advantages of the coronagraph for suppressing stray light, it is necessary to use a high Strehl ratio adaptive optics system. This can be best achieved initially with modest aperture telescopes of 3–4 m in diameter. Third, application of simultaneous differential imaging and simultaneous polarimetric techniques are required to reach the photon-limit of coronagraphic imaging. These three developments, if pursued together, will yield significant improvements in the search for planets.
To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.
Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995–2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion.
Twenty-seven centres across ten European countries.
Women (64 %) and men (36 %) aged 35–74 years (n 36 020).
Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38–43 % for women and 41–45 % for men within Mediterranean countries compared with 16–27 % for women and 20–26 % for men in central and northern European countries. Likewise, a south–north gradient was found for daily energy intake from snacks, with 13–20 % (women) and 10–17 % (men) in Mediterranean countries compared with 24–34 % (women) and 23–35 % (men) in central/northern Europe.
We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.
The reliability of InAlGaN multiple quantum well LEDs emitting around 308 nm has been investigated. The UV-B LEDs were stressed at constant current and current density, while the heat sink temperature was varied between 15°C and 80°C. The results reveal two different modes of the decrease of the optical power during aging. First, a fast reduction of the optical power within the first 100 h (mode 1) can be observed, followed by a slower degradation for operation times >100 h (mode 2). Mode 1 can be described as an initial degradation activation process which saturates after a certain time, whereas the second degradation mode can be described by a square-root time dependence of the optical power, suggesting a diffusion process to be involved. Both degradation modes are accompanied by changes of the I-V characteristic, particularly the reverse-bias leakage current and the drive voltage. Furthermore, the degradation behavior is strongly influenced by the temperature. Both, the maximum reduction of the optical power and the increase of the leakage current become stronger at higher temperatures.
In endangered and local pig breeds of small population sizes, production has to focus on alternative niche markets with an emphasis on specific product and meat quality traits to achieve economic competiveness. For designing breeding strategies on meat quality, an adequate performance testing scheme focussing on phenotyped selection candidates is required. For the endangered German pig breed ‘Bunte Bentheimer’ (BB), no breeding program has been designed until now, and no performance testing scheme has been implemented. For local breeds, mainly reared in small-scale production systems, a performance test based on in vivo indicator traits might be a promising alternative in order to increase genetic gain for meat quality traits. Hence, the main objective of this study was to design and evaluate breeding strategies for the improvement of meat quality within the BB breed using in vivo indicator traits and genetic markers. The in vivo indicator trait was backfat thickness measured by ultrasound (BFiv), and genetic markers were allele variants at the ryanodine receptor 1 (RYR1) locus. In total, 1116 records of production and meat quality traits were collected, including 613 in vivo ultrasound measurements and 713 carcass and meat quality records. Additionally, 700 pigs were genotyped at the RYR1 locus. Data were used (1) to estimate genetic (co)variance components for production and meat quality traits, (2) to estimate allele substitution effects at the RYR1 locus using a selective genotyping approach and (3) to evaluate breeding strategies on meat quality by combining results from quantitative-genetic and molecular-genetic approaches. Heritability for the production trait BFiv was 0.27, and 0.48 for backfat thickness measured on carcass. Estimated heritabilities for meat quality traits ranged from 0.14 for meat brightness to 0.78 for the intramuscular fat content (IMF). Genetic correlations between BFiv and IMF were higher than estimates based on carcass backfat measurements (0.39 v. 0.25). The presence of the unfavorable n allele was associated with increased electric conductivity, paler meat and higher drip loss. The allele substitution effect on IMF was unfavorable, indicating lower IMF when the n allele is present. A breeding strategy including the phenotype (BFiv) combined with genetic marker information at the RYR1 locus from the selection candidate, resulted in a 20% increase in accuracy and selection response when compared with a breeding strategy without genetic marker information.
Norovirus outbreaks occur frequently in Denmark and it can be difficult to establish whether apparently independent outbreaks have the same origin. Here we report on six outbreaks linked to frozen raspberries, investigated separately over a period of 3 months. Norovirus from stools were sequence-typed; including extended sequencing of 1138 bp encompassing the hypervariable P2 region of the capsid gene. Norovirus was detected in 27 stool samples. Genotyping showed genotype GI.Pb_GI.6 (polymerase/capsid) with 100% identical sequences. Samples from five outbreaks were furthermore identical over the variable capsid P2 region. In one outbreak at a hospital canteen, frozen raspberries was associated with illness by cohort investigation (relative risk 6·1, 95% confidence interval 3·2–11). Bags of raspberries suspected to be the source were positive for genogroup I and II noroviruses, one typable virus was genotype GI.6 (capsid). These molecular investigations showed that the apparently independent outbreaks were the result of one contamination event of frozen raspberries. The contaminated raspberries originated from a single producer in Serbia and were originally not considered to belong to the same batch. The outbreaks led to consultations and mutual visits between producers, investigators and authorities. Further, Danish legislation was changed to make heat-treatment of frozen raspberries compulsory in professional catering establishments.
Clinical and ethical implications of personality and mood changes in Parkinson's disease (PD) patients treated with subthalamic deep brain stimulation (STN-DBS) are under debate. Although subjectively perceived personality changes are often mentioned by patients and caregivers, few empirical studies concerning these changes exist. Therefore, we analysed subjectively perceived personality and mood changes in STN-DBS PD patients.
In this prospective study of the ELSA-DBS group, 27 PD patients were assessed preoperatively and 1 year after STN-DBS surgery. Two categories, personality and mood changes, were analysed with semi-structured interviews. Patients were grouped into personality change yes/no, as well as positive/negative mood change groups. Caregivers were additionally interviewed about patients’ personality changes. Characteristics of each group were assessed with standard neurological and psychiatric measurements. Predictors for changes were analysed.
Personality changes were perceived by six of 27 (22%) patients and by 10 of 23 caregivers (44%). The preoperative hypomania trait was a significant predictor for personality change perceived by patients. Of 21 patients, 12 (57%) perceived mood as positively changed. Higher apathy and anxiety ratings were found in the negative change group.
Our results show that a high proportion of PD patients and caregivers perceived personality changes under STN-DBS, emphasizing the relevance of this topic. Mood changed in positive and negative directions. Standard measurement scales failed to adequately reflect personality or mood changes subjectively perceived by patients. A more individualized preoperative screening and preparation for patients and caregivers, as well as postoperative support, could therefore be useful.
We report on mid-infrared (600 – 4000 cm-1), refection-type optical-Hall effect measurements on epitaxial graphene grown on C-face silicon carbide and present Landau-level transition features detected at 1.5 K as a function of magnetic field up to 8 Tesla. The Landau-level transitions are detected in reflection configuration at oblique incidence for wavenumbers below, across and above the silicon carbide reststrahlen range. Small Landau-level transition features are enhanced across the silicon carbide reststrahlen range due to surface-guided wave coupling with the electronic Landau-level transitions in the graphene layer. We analyze the spectral and magnetic-field dependencies of the coupled resonances, and compare our findings with previously reported Landau-level transitions measured in transmission configuration [4,5,6]. Additional features resemble transitions previously assigned to bilayer inclusion , as well as graphite . We discuss a model description to account for the electromagnetic polarizability of the graphene layers, and which is sufficient for quantitative model calculation of the optical-Hall effect data.
This paper shows that control of foodborne disease outbreaks may be challenging even after establishing the source of infection. An outbreak of Salmonella Typhimurium U323 infections occurred in Denmark from March to September 2010, involving 172 cases. Before the detection of human cases, several positive isolates of the outbreak strain had been found in a particular pig slaughterhouse and thus early traceback, investigation and control measures were possible. Several batches of pork and pork products were recalled and the slaughterhouse was closed twice for disinfection. No single common food item was identified as the outbreak source, but repeated isolation of the outbreak strain from the slaughterhouse environment and in pork and products as well as patient interviews strongly suggested different pork products as the source of infection. Furthermore, a matched case-control study identified a specific ready-to-eat spreadable pork sausage (teewurst) as the source of a sub-outbreak (matched odds ratio 17, 95% confidence interval 2·1–130).
We demonstrate that the anisotropic optical response of metal (cobalt) slanted columnar thin films (STF) at THz frequencies strongly depends on the dielectric properties of the dielectric ambient surrounding the slanted columnar thin films. An effective medium dielectric function approach is used to describe the combined optical response of metal slanted columnar thin film and dielectric ambient. Our observations indicate that metal (cobalt) slanted columnar thin films can be used as sensors which will enable detection and characterization of minute amounts of dielectrics at THz frequencies, such as for flow-based detection of liquid chemical constituents.
Tin oxide thin films on glass are used in a variety of applications ranging from transparent conductors to coupling layers to wear resistant coatings. The mechanical properties and wear resistance are crucial to most applications of tin oxide films. In the present study, ultrathin tin oxide films were sputter-deposited on the two different glass substrates. Nanoindentation, nanoscratch and nanowear experiments were performed on the tin oxide films with different thickness using a Hysitron TriboScope at different loads. Hardness and Young's modulus of elasticity were determined from the depth sensing load-displacement data. A lower friction coefficient was observed on the thinner film using the ramping load scratch test. Critical loads were determined by the ramping load scratch test and multi-slide nanowear tests on the tin oxide film deposited on the alkali contained commercial float glass (LOF-P16) glass. Discussion on the effect of surface chemistry on the mechanical properties was made.
One of the major issues of joint implants is their loss (detachment) and subsequent failure after a limited number of years in application. Understanding and improving cell adhesion to implanting materials to extend lifespan, lubrication, and self-regeneration properties are therefore substantially important. In this research, we investigate effects of surface properties, such as wettabilty and texture on cell culture for the purpose of biotribological applications. Materials used are polyurethane, polyvinyl alcohol, and glass. Surface analysis indicates that surface structures have profound impact on cells growth.
Silicon is the dominating material for the fabrication of MEMS devices,
especially in high volume production. However, metals with their typical
properties are used to enhance or enable the functionality of MEMS. In
contrast to microelectronic technologies, not only the electrical but also
the mechanical and optical behavior of metals could be helpful. New
requirements in MEMS technologies demand optimized processes in
metallization for the fabrication of microstructures.
This paper presents some metallization applications and related technology
development in the field of MEMS.
Miniaturized single-chamber solid-oxide fuel cells (SC-SOFC) are a promising class of devices for portable power generation required in the operation of distributed networks of microelectromechanical systems (MEMS) in harsh environments. The single-face configuration, which consists of interdigitated (comb-like) array of electrodes on an yttria-stabilized zirconia (YSZ) electrolyte substrate, is of particular interest because of the ease of high-temperature microfluidic packaging and integration with MEMS. The primary design consideration for this configuration is the minimization of electrode widths and inter-electrode spacings to dimensions on the order of a few micrometers. This is necessary to minimize polarization resistance and increase fuel cell efficiency. Achieving these geometries using standard microfabrication methods is difficult because of the thickness, porosity, and complex chemistries of the electrodes. Here, we report the development of an innovative and rapid method for manufacturing SC-SOFCs with interdigitated electrodes using robot-controlled direct-writing. The main steps consist of: (i) formation of inks (or suspensions) using anode (NiO-YSZ) and cathode (lanthanum strontium manganite) powders, (ii) pressure-driven extrusion of inks through a micronozzle using a robot-controlled platform, and (iii) sequential sintering to form the fuel cell. The first-generation SC-SOFC device, with electrode widths of 130 μm and inter-electrode spacing of 300 μm, has been manufactured using direct-write microfabrication. The electrodes have been extensively characterized using electron microscopy and x-ray diffraction to assess porosity and to confirm phase identity. The primary process parameters in this approach are the particle size and size distribution, rheological properties of the suspension, extrusion pressure, nozzle size, stage velocity, and sintering conditions. As the first step in the development of detailed process-structure-performance correlations for the fuel cells, we have studied the effects of extrusion pressure (in the range 30-40 bar) and stage velocity (in the range 0.2-2.0 mm/s) on the geometry and size of electrodes, for fixed suspension viscosity and nozzle diameter. An optimal combination of speed and pressure has been identified and catalogued in the form of process maps. Similarly, the particle size distribution of the anode and cathode powders is found to have a significant effect on the microstructure, especially porosity, of the sintered electrodes. The implications of these results for the design of the next generation of SC-SOFC, with reduced electrode dimensions and improved electrochemical performance, will be discussed.