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To determine the factors related to multiple ventilation tube insertions in children with otitis media with effusion.
A retrospective review was performed of 126 ears of 81 children aged less than 12 years who had undergone insertion of a Paparella type 1 ventilation tube for the first time between August 2012 and March 2018.
Mean age at the first operation was 4.0 ± 2.2 years, and the mean duration of otitis media with effusion before the first ventilation tube insertion was 5.4 ± 4.5 months. Among 126 ears, 80 (63.5 per cent) had a single ventilation tube insertion and 46 (36.5 per cent) had multiple insertions. On multivariate logistic regression, tympanic membrane retraction, serous middle-ear discharge, and early recurrence of otitis media with effusion were independent predictive factors of multiple ventilation tube insertions.
Tympanic membrane retraction, serous middle-ear discharge, and early recurrence of otitis media with effusion after the first tube extrusion are associated with multiple ventilation tube insertions.
It has not been well established whether dietary folate intake reduces the risk of diabetes development. We aimed to clarify the prospective association between dietary folate intake and type 2 diabetes (T2D) risk among 7333 Korean adults aged 40 years or older who were included in the Multi-Rural Communities Cohort. Dietary folate intake was estimated from all 106 food items listed on a FFQ, not including folate intake from supplements. Two different measurements of dietary folate intake were used: the baseline consumption and the average consumption from baseline until just before the end of follow-up. The association between folate intake and T2D risk was determined through a modified Poisson regression model with a robust error estimator controlling for potential confounders. For 29 745 person years, 319 cases of diabetes were ascertained. In multivariable analyses, dietary folate intake was inversely associated with risk of T2D for women, not for men. For women, the incidence rate ratio of diabetes in the third tertile compared with the first tertile was 0·57 (95 % CI 0·38–0·87, Pfor trend=0·0085) in the baseline consumption model and 0·64 (95 % CI 0·43–0·95, Pfor trend=0·0244) in the average consumption model. These inverse associations was found in both normal fasting blood glucose group and impaired fasting glucose group among women. Among non-users of multinutrients and vitamin supplements, the significant inverse association remained. Thus, higher dietary intake of folate is prospectively associated with lower risk of diabetes for women.
The purpose of this study was to investigate whether significant difference exists on radiation dose delivered to organs at risks in megavoltage computed tomography (MVCT) verification using three predefined scanning modes, namely fine (2 mm), normal (4 mm) and coarse (6 mm). This will provide information for the imaging protocol of tomotherapy for the left breast.
Materials and methods
Organ doses were measured using thermoluminescent dosimeters (TLD-100) placed within a female Rando phantom for MVCT imaging. Kruskal–Wallis test was conducted with p<0·05 to evaluate the significant difference between the three MVCT scanning modes.
Statistically significant difference existed in organ absorbed dose between different scan mode selections (p<0·001). Relative to the normal scan selection (4 mm), the absorbed dose to the organs of interests can be scaled down by 0·7 and scaled up by 2·1 for coarse (6 mm) and fine scans (2 mm) respectively.
Optimisation of imaging protocols is of paramount importance to keep the radiation exposure ‘as low as reasonably achievable’. The recommendation of undergoing daily coarse mode for MVCT verification in breast tomotherapy not only mitigates the radiation exposure to normal tissues, but also trims the scan-acquisition time.
We report on the astrometric registration of VLBI images of the SiO and H2O masers in OH 231.8+4.2, the iconic Proto-Planetary Nebula also known as the Calabash nebula, using the KVN and Source/Frequency Phase Referencing. This, for the first time, robustly confirms the alignment of the SiO masers, close to the AGB star, which drives the bi-lobe structure with the water masers in the out-flow.
A new approach is proposed to analyze Bremsstrahlung X-rays that are emitted from laser-produced plasmas (LPP) and are measured by a stack type spectrometer. This new method is based on a spectral tomographic reconstruction concept with the variational principle for optimization, without referring to the electron energy distribution of a plasma. This approach is applied to the analysis of some experimental data obtained at a few major laser facilities to demonstrate the applicability of the method. Slope temperatures of X-rays from LPP are determined with a two-temperature model, showing different spectral characteristics of X-rays depending on laser properties used in the experiments.
Two experiments were conducted to investigate the effects of dietary supplementation of bacteriophage cocktail, probiotics and a combination of these two supplements on performance and gut health of weanling pigs. In Experiment 1, 150 weaned piglets were randomly allotted to three treatments on the basis of BW. The dietary treatments included a basal diet supplemented with 0 (control), 1.0 and 1.5 g/kg bacteriophage cocktail. Pigs fed 1.0 and 1.5 g/kg bacteriophage product had greater (P<0.05) average daily gain (ADG), apparent total tract digestibility of dry matter from day 22 to 35, ileal Lactobacillus spp., villus height (duodenum and jejunum), and fewer coliforms (ileum) and Clostridium spp. (ileum). In Experiment 2, 200 weaned piglets were randomly allotted to four treatments. Dietary treatments included basal diet, basal diet supplemented with 3.0 g/kg fermented probiotic product (P), 1.0 g/kg bacteriophage cocktail (B) and combination of 1.0 g/kg bacteriophage cocktail and 3.0 g/kg fermented probiotic product. Pigs fed bacteriophage cocktail diets had greater (P<0.05) overall ADG, gain to feed ratio (G : F), fecal score from day 8 to day 21, and pigs fed bacteriophage cocktail diets had fewer coliforms (ileum) Clostridium spp. (ileum and cecum). Probiotics significantly increased G : F, colonization of Lactobacillus spp. in ileum. At day 35, bacteriophage treatment group showed greater (P<0.05) villus height of the duodenum, but a deeper crypt in duodenum. The present results indicate that the bacteriophage cocktail had a potential to enhance the performance and gut health of weanling pigs, however their combination with probiotics did not show an interaction.
Δ14C values of leaves of deciduous trees provide a means to map the regional-scale fossil fuel ratio in the atmosphere. We collected a batch of ginkgo (Ginkgo biloba Linnaeus, a deciduous tree) leaf samples from across Korea in the month of July in both 2010 and 2011 to obtain the regional distribution of Δ14C. The Δ14C values of the samples were measured using accelerator mass spectrometry (AMS) at the Korea Institute of Geoscience and Mineral Resources (KIGAM). The average of the Δ14C values from clean air sites in Korea in 2011 measured slightly lower than the average of Δ14C values in 2010. Distribution maps of Δ14C of 2011 and 2010 in Korea were made based on a series of Δ14C values of ginkgo leaf samples from Korea using the Geostatistical and Spatial analyst tools in ESRI's ArcMap software. The distribution maps of Δ14C showed that Δ14C values in the western part of Korea are lower than those in the eastern part of Korea. This is because the western part of Korea is densely populated and contains many industrial complexes, and also because westerly winds from China, containing CO2 from fossil fuel use, blow into Korea. We compared the distribution maps of 2010 and 2011 and tried to find traces of the Fukushima power plant accident in Japan.
Antibiotic treatment for asymptomatic bacteriuria (ASB) is prevalent but often contrary to published guidelines.
To evaluate risk factors for treatment of ASB.
Retrospective observational study.
A tertiary academic hospital, county hospital, and community hospital.
Hospitalized adults with bacteriuria.
Patients without documented symptoms of urinary tract infection per Infectious Diseases Society of America (IDSA) criteria were classified as ASB. We examined ASB treatment risk factors as well as broad-spectrum antibiotic usage and quantified diagnostic concordance between IDSA and National Healthcare Safety Network criteria.
Among 300 patients with bacteriuria, ASB was present in 71% by IDSA criteria. By National Healthcare Safety Network criteria, 71% of patients had ASB; within-patient diagnostic concordance with IDSA was moderate (kappa, 0.52). After excluding those given antibiotics for nonurinary indications, antibiotics were given to 38% (62/164) with ASB. Factors significantly associated with ASB treatment were elevated urine white cell count (65 vs 24 white blood cells per high-powered field, P<.01), hospital identity (hospital C vs A, odds ratio, 0.34 [95% CI, 0.14–0.80], P =.01), presence of leukocyte esterase (5.48 [2.35–12.79], P<.01), presence of nitrites (2.45 [1.11–5.41], P=.03), and Escherichia coli on culture (2.4 [1.2–4.7], P=.01). Of patients treated for ASB, broad-spectrum antibiotics were used in 84%.
ASB treatment was prevalent across settings and contributed to broad-spectrum antibiotic use. Associating abnormal urinalysis results with the need for antibiotic treatment regardless of symptoms may drive unnecessary antibiotic use.
Infect. Control Hosp. Epidemiol. 2016;37(3):319–326
The role of routine intra-operative parathyroid hormone monitoring for sporadic primary hyperparathyroidism is contentious. Satisfactory results can be achieved in high-volume centres. The results of low-volume hospitals are rarely studied.
A retrospective, non-comparative study was conducted. From November 2002 to October 2012, 105 patients with clinically sporadic primary hyperparathyroidism underwent focused parathyroidectomy without intra-operative parathyroid hormone monitoring. Single adenoma was localised on pre-operative ultrasonography or sestamibi scan. The cure rate, surgical complication rate and pathology findings were evaluated.
Most of the operations (63.8 per cent) were performed under local anaesthesia. All but two patients (98.1 per cent) were cured after surgery. There was only one case of double adenomas. No recurrent hyperparathyroidism was observed after a mean follow up of 56.9 months. Surgical complications comprised two cases (1.9 per cent) of transient vocal fold palsy and one case (1.0 per cent) of permanent vocal fold palsy. Seven patients (6.7 per cent) suffered temporary hypocalcaemia.
Satisfactory results of focused parathyroidectomy without routine intra-operative parathyroid hormone monitoring for appropriately selected primary hyperparathyroidism cases can be attained in a low-volume hospital.
We introduce a sensing element, “Molecularly Imprinted Polymer (MIP),” which created by “Molecular Imprinted Technique.” However, the sensitivity of MIP’s based bio-sensors limits for practical applications due to the low sensitivity. To achieve a high sensitivity of MIP’s based sensors, the synthesis of “high affinity receptor or binding sites,” such as “monoclonal particles” is a key objective. In previous studies, affinity distribution plots indicated that “high affinity binding sites” were obtained when the number of binding sites per particle decreased. It means that smaller particles are expected to have higher affinity binding sites compared to larger particles. The result motivated us to produce small-sized MIP’s particles for the achievement of higher sensitivity. Microfluidic Synthesis has taken a great attention to synthesize small particles. However, the microfluidic synthesis gave us a difficulty, especially collections of MIP’s particles from the surface of PDMS-based microchannels due to a sticking problem. Thus, we employed a new approach, which can collect MIP’s particles without any sticking problem from the surface of the reactor. It is a photopatterned MIP’s system generated on the glass surface. We prepared a photomask with micro-sized patterns and then fabricate MIP’s particles on a glass surface by photopolymerization. Uniform MIP’s patterns were printed on the glass surface. The interface between the glass surface and the MIP’s pattern was observed by SEM. Micro-sized MIP’s particles were collected from the glass surface by scratching off the photocured MIP’s patterns.
In February 2012, an outbreak of gastroenteritis was reported in school A; a successive outbreak was reported at school B. A retrospective cohort study conducted in school A showed that seasoned green seaweed with radishes (relative risk 7·9, 95% confidence interval 1·1–56·2) was significantly associated with illness. Similarly, a case-control study of students at school B showed that cases were 5·1 (95% confidence interval 1·1–24·8) times more likely to have eaten seasoned green seaweed with pears. Multiple norovirus genotypes were detected in samples from students in schools A and B. Norovirus GII.6 isolated from schools A and B were phylogenetically indistinguishable. Green seaweed was supplied by company X, and norovirus GII.4 was isolated from samples of green seaweed. Green seaweed was assumed to be linked to these outbreaks. To our knowledge, this is the first reported norovirus outbreak associated with green seaweed.
Enterotoxigenic Escherichia coli (ETEC) is now recognized as a common cause of foodborne outbreaks. This study aimed to describe the first ETEC O169 outbreak identified in Korea. In this outbreak, we identified 1642 cases from seven schools. Retrospective cohort studies were performed in two schools; and case-control studies were conducted in five schools. In two schools, radish kimchi was associated with illness; and in five other schools, radish or cabbage kimchi was found to have a higher risk among food items. Adjusted relative risk of kimchi was 5·87–7·21 in schools that underwent cohort studies; and adjusted odds ratio was 4·52–12·37 in schools that underwent case-control studies. ETEC O169 was isolated from 230 affected students, and was indistinguishable from the isolates detected from the kimchi product distributed by company X, a food company that produced and distributed kimchi to all seven schools. In this outbreak, we found that the risk of a kimchi-borne outbreak of ETEC O169 infection is present in Korea. We recommend continued monitoring regarding food safety in Korea, and strengthening surveillance regarding ETEC O169 infection through implementation of active laboratory surveillance to confirm its infection.
The Ultra-Fast Flash Observatory (UFFO) is a space observatory for optical follow-ups of
gamma ray bursts (GRBs), aiming to explore the first 60 seconds of GRBs optical emission.
UFFO is utilized to catch early optical emissions from GRBs within few sec after trigger
using a Gimbal mirror which redirects the optical path rather than slewing entire
spacecraft. We have developed a 15 cm two-axis Gimbal mirror stage for the UFFO-Pathfinder
which is going to be on board the Lomonosov satellite which is to be launched in 2013. The
stage is designed for fast and accurate motion with given budgets of 3 kg of mass and 3
Watt of power. By employing stepping motors, the slewing mirror can rotate faster than 15
deg/sec so that objects in the UFFO coverage (60 deg × 60 deg) can be targeted in
~1 sec. The obtained targeting resolution is better 2 arcmin using a close-loop
control with high precision rotary encoder. In this presentation, we will discuss details
of design, manufacturing, space qualification tests, as well as performance tests.
The UFFO (Ultra-Fast Flash Observatory) is a GRB detector on board the Lomonosov
satellite, to be launched in 2013. The GRB trigger is provided by an X-ray detector,
called UBAT (UFFO Burst Alarm & Trigger Telescope), which detects X-rays from the GRB
and then triggers to determine the direction of the GRB and then alerts the Slewing Mirror
Telescope (SMT) to turn in the direction of the GRB and record the optical photon fluxes.
This report details the calibration of the two components: the MAPMTs and the YSO crystals
and simulations of the UBAT. The results shows that this design can observe a GRB within a
field of view of ±35° and can trigger in a time scale as short as 0.2 – 1.0 s
after the appearance of a GRB X-ray spike.
The Ultra-Fast Flash Observatory (UFFO), which will be launched onboard the
Lomonosov spacecraft, contains two crucial instruments: UFFO Burst
Alert & Trigger Telescope (UBAT) for detection and localization of Gamma-Ray Bursts
(GRBs) and the fast-response Slewing Mirror Telescope (SMT) designed for the observation
of the prompt optical/UV counterparts. Here we discuss the in-space calibrations of the
UBAT detector and SMT telescope. After the launch, the observations of the standard X-ray
sources such as pulsar in Crab nebula will provide data for necessary calibrations of
UBAT. Several standard stars will be used for the photometric calibration of SMT. The
celestial X-ray sources, e.g. X-ray binaries with bright optical sources
in their close angular vicinity will serve for the cross-calibration of UBAT and SMT.
The Ultra-Fast Flash Observatory (UFFO) Pathfinder for Gamma-Ray Bursts (GRBs) consists
of two telescopes. The UFFO Burst Alert & Trigger Telescope (UBAT) handles the
detection and localization of GRBs, and the Slewing Mirror Telescope (SMT) conducts the
measurement of the UV/optical afterglow. UBAT is equipped with an X-ray detector, analog
and digital signal readout electronics that detects X-rays from GRBs and determines the
location. SMT is equipped with a stepping motor and the associated electronics to rotate
the slewing mirror targeting the GRBs identified by UBAT. First the slewing mirror points
to a GRB, then SMT obtains the optical image of the GRB using the intensified CCD and its
readout electronics. The UFFO Data Acquisition system (UDAQ) is responsible for the
overall function and operation of the observatory and the communication with the satellite
main processor. In this paper we present the design and implementation of the electronics
of UBAT and SMT as well as the architecture and implementation of UDAQ.
We investigated particle acceleration and shock structure associated with an unmagnetized
relativistic jet propagating into an unmagnetized plasma. Strong magnetic fields generated
in the trailing shock contribute to the electrons transverse deflection and acceleration.
We have calculated, self-consistently, the radiation from electrons accelerated in these
turbulent magnetic fields. We found that the synthetic spectra depend on the bulk Lorentz
factor of the jet, its temperature and strength of the generated magnetic fields. We have
also investigated accelerated electrons in strong magnetic fields generated by kinetic
shear (Kelvin-Helmholtz) instabilities. The calculated properties of the emerging
radiation will guide our understanding of the complex time evolution and/or spectral
structure in gamma-ray bursts, relativistic jets in general, and supernova remnants.
The dynamics of influenza A viral load in respiratory samples collected from adult A(H1N1)pdm09 influenza patients were investigated. Three respiratory specimens were obtained every 2–4 days and clinical findings were recorded at the time each specimen was collected. A total of 105 serial specimens were collected from 35 patients. Viral clearance was more rapid in patients aged 15–29 years than patients aged 30–49 years (P < 0·01) or ⩾50 years (P < 0·01). Hospitalized patients showed slow viral clearance compared to outpatients (P < 0·01). Resolution of cough and headache was correlated with viral load reduction in respiratory specimens. Viral shedding was found in 17 patients (48·6%) 5 days after symptom onset. Time to hospital visit after symptom onset was significantly correlated with prolonged viral shedding (odds ratio 9·0, 95% confidence interval 1·56–51·87, P = 0·01). These findings will contribute to infection control aspects with respect to managing patients with influenza virus infections.
The objectives of this study were to investigate the muscle fiber characteristics of the pectoralis major muscle, and its relation to growth performance in the random bred control (RBC) and heavy weight (HW) Japanese quail lines at 42 days of age. The HW line had greater body (232.0 v. 100.2 g, P < 0.001) and pectoralis major muscle (19.0 v. 6.2 g, P < 0.001) weights than the RBC line. Color differences were observed between the superficial and deep regions of the pectoralis major muscle, with the superficial region showing a higher value of lightness than the deep region of the RBC or HW lines (P < 0.001). The percentage of the superficial region in the pectoralis major muscle was higher in the HW line compared with the RBC line (46.2% v. 38.0%, P = 0.017). There were no significant differences in the total fiber number in the superficial and deep regions between the two quail lines (P = 0.718). The HW quail line showed a larger mean fiber cross-sectional area (CSA; 375.5 v. 176.6 μm2, P < 0.001) and type IIA fiber CSA (243.7 v. 131.9 μm2, P < 0.001) than the RBC quail line. The HW line also had greater CSA percentage (60.2% v. 34.2%, P < 0.001) and number percentage (41.6% v. 14.2%, P < 0.001) of type IIB fibers, although there were no significant differences in type IIB fiber CSA between the RBC and HW lines (P = 0.219). Therefore, greater body and muscle weights of the HW line are caused by differences in muscle fiber characteristics, especially the proportion of type IIB fiber and the CSA of type IIA fiber, compared with the RBC line. The results of this study suggest that muscle fiber hypertrophy has more impact on body and muscle weights of the different quail lines than muscle fiber hyperplasia.