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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.
Silicon has attracted particular attention as a potential high capacity material for lithium based batteries. However, the application of Si-based electrodes remains challenging, in major part due to its significant irreversible energy loss during cycling. Here isothermal microcalorimetry (IMC) is demonstrated to be a precise and operando characterization method for tracking a battery's thermal behaviour and deconvoluting the contributions from electrochemical polarization, entropy change, and parasitic reactions. Cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and x-ray powder diffraction (XRD) further elucidate the Si reactivity in conjunction with the IMC.
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.
Solid state batteries are an emerging alternative to traditional liquid electrolyte cells that provide potential for safe and high-energy density power sources. This report describes a self-forming, solid state battery based on the Li/I2 couple using an LiI-rich LiI(3-hydroxypropionitrile)2 electrolyte (LiI–LiI(HPN)2). As the negative and positive active materials are generated in situ, the solid electrolyte–current collector interfaces play a critical role in determining the electrochemical response of the battery. Herein, we report the investigation of solid electrolyte–current collector interfaces with a self-forming LiI–LiI(HPN)2 solid electrolyte and the role of varying interface design in reducing resistance during cycling.
Lithium solid-state composite electrolytes (LiSCEs) provide the opportunity for long life spans, low self-discharge, high reliability, high energy density, and safety. Additionally, this class of electrolytes can be used in electrolytically formed solid-state batteries (EFBs), which may promote reductions in cell manufacturing costs due to their simplicity of design and permit the formation of batteries with diverse architectures. Herein, we provide a discussion of LiSCEs, highlight some of the recent progress in EFB development, and present a forward outlook.
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.
Emerging applications require batteries to have both high energy and high power which are not necessarily compatible. The typical inverse relationship between power and energy in batteries is often due to the slow ion diffusion in electrode materials. While the optimization of current battery technology may be sufficient to fully address this issue, we present here that novel chemistry-focused strategies based on new fundamental understanding of materials may be applied to lead to the development of a new generation of batteries that store energy sufficiently and deliver it rapidly.
The effect of tunnel cations on tunnel size in α-MnO2 structured (hollandite, cryptomelane) materials has long been of interest, as the tunnel size effects catalytic and transport properties. Previous research on the tunnel size has focused on potassium cryptomelane (KxMn8O16). This paper uses synthetic control of silver content in AgxMn8O16 to investigate the effect that tunnel silver occupancy has on the lattice parameters. Materials with silver (x) content between 1.14 and 1.66 were synthesized, synchrotron diffraction and Rietveld Refinement was used to determine lattice parameters. The lattice parameters were found to contract as silver content increases (from 9.774 Å to 9.738 Å), in contrast to previous investigations of other tunnel cations.
ZnFe2O4 (ZFO) represents a promising anode material for lithium ion batteries, but there is still a lack of deep understanding of the fundamental reduction mechanism associated with this material. In this paper, the complete visualization of reduction/oxidation products irrespective of their crystallinity was achieved experimentally through a compilation of in situ X-ray diffraction, synchrotron based powder diffraction, and ex-situ X-ray absorption fine structure data. Complementary theoretical modelling study further shed light upon the fundamental understanding of the lithiation mechanism, especially at the early stage from ZnFe2O4 up to LixZnFe2O4 (x = 2).