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Forrer, Aglaia, Philipp M. Scheiwiller, Maamed Mademilov, Mona Lichtblau, Ulan Sheraliev, Nuriddin H. Marazhapov, Stéphanie Saxer, Patrick Bader, Paula Appenzeller, Shoira Aydaralieva, Aybermet Muratbekova, Talant M. Sooronbaev, Silvia Ulrich, Konrad E. Bloch, and Michael Furian. Exercise performance in central Asian highlanders: A cross-sectional study.

Prostate-specific membrane antigen (PSMA) is expressed in most prostate cancers and can be identified by PSMA-ligand imaging, which has already become clinically accepted in several countries in- and outside Europe. PSMA-directed radioligand therapy (PSMA-RLT) with Lutetium-177 (177Lu-PSMA) is currently undergoing clinical validation. Retrospective observational data have documented favourable safety and striking clinical responses. Recent results from a prospective clinical trial (phase II) have been published confirming high response rates, low toxicity and reduction of pain in metastatic castration-resistant prostate cancer (mCRPC) patients who had progressed after conventional treatments. Such patients typically survive for periods less than 1.5 years. This has led some facilities to adopt compassionate or unproven use of this therapy, even in the absence of validation within a randomised-controlled trial. As a result, a consistent body of evidence exists to support efficacy and safety data of this treatment. The purpose of this guideline is to assist nuclear medicine specialists to deliver PSMA-RLT as an "unproven intervention in clinical practice", in accordance with the best currently available knowledge.

Aim To evaluate biological control agents (BCAs) against Fusarium graminearum on infected maize stalks as a means to reduce Fusarium head blight (FHB) in subsequently grown wheat. Methods and Results In the laboratory, BCAs were applied against F. graminearum on maize stalk pieces. Clonostachys rosea inhibited the perithecia development and ascospore discharge when applied before, simultaneously with and after the pathogen. In the field, we simulated a system with high disease pressure, that is, a maize‐wheat rotation under no‐tillage, by preparing maize stalks inoculated with F. graminearum. The infected stalks were treated with formulations of C. rosea selected in vitro or the commercial BCA strain Trichoderma atrobrunneum ITEM908 and exposed to field conditions over winter and spring between winter wheat rows. Monitoring with spore traps and of FHB symptoms, as well as quantification of F. graminearum incidence and DNA in harvested grain revealed significant reductions by C. rosea by up to 85, 91, 69 and 95% compared with an inoculated but untreated positive control, respectively. Deoxynivalenol (DON) and zearalenone (ZEN) contents were reduced by up to 93 and 98%, respectively. Treatments with T. atrobrunneum were inconsistent, with significant reductions of DON and ZEN under warm and wet climatic conditions only. Conclusions The findings support the application of C. rosea against F. graminearum on residues of maize to suppress the primary inoculum of FHB. Significance and Impact of the Study As sustainable agriculture requires solutions to control FHB, hence, the application of C. rosea during the mulching of maize crop residues should be evaluated in on‐farm experiments. ISSN:1364-5072 ISSN:1365-2672

The role of radioiodine therapy (RIT) (used as ablation therapy or adjuvant therapy) following total thyroidectomy for differentiated thyroid cancer (DTC) changed. Major revisions of the American Thyroid Association (ATA) Guidelines in 2015 resulted in significant differences in treatment recommendations in comparison to the European Association of Nuclear Medicine (EANM) 2008 guidelines. Recently, we presented the effects on daily practice for RIT among Swiss Nuclear Medicine centres. We now performed a study at the European level and hypothesized that there is also considerable variability among European experts. We performed a decision-tree-based analysis of management strategies from all members of the EANM thyroid committee to map current practice among experts. We collected data on whether or not RIT is administered, on which criteria these decisions are based and collected details on treatment activities and patient preparation. Our study shows discrepancies for low-risk DTC, where “follow-up only” is recommended by some experts, while RIT with significant doses is used by other experts. E.g., for pT1b tumours without evidence of metastases, the level of agreement for the use of RIT is as low as 50%. If RIT is administered, activities of I-131 range from 1.1 GBq to 3.0 GBq. In other constellations (e.g., pT1a), experts diverge from current clinical guidelines as up to 75% administer RIT in certain cases. For intermediate and high-risk patients, RIT is generally recommended. However, dosing and treatment preparation (rhTSH vs. thyroid hormone withdrawal) vary distinctly. In comparison to the Swiss study, the general level of agreement is higher among the European experts. The recently proposed approach on the use of RIT, based on integrated post-surgery assessment (Martinique article) and results of ongoing prospective randomized studies are likely to reduce uncertainty in approaching RIT treatment. In certain constellations, consensus identified among European experts might be helpful in formulating future guidelines.

The high-power diode-laser industry is dependent on highly qualified production output for fast axis collimation (FAC) lenses in scalable quantities. Not only controlled production processes but also the optical qualification of the final FAC product contribute to this goal. The product qualification approach chosen is based on diode laser collimation by active alignment and automated positioning of the FAC in collimation for the fast axis and imaging in the slow axis, allowing to evaluate the collimation performance with a specific and installed diode laser on individual emitter intensity profiles. We present the automated setup with results for corresponding sensitivity and repeatability analysis for the measurement of residual divergence.

Objective: Internet-based guided self-help (GSH) programs increase accessibility and utilization of evidence-based treatments in binge-eating disorder (BED). We evaluated acceptance and short as well as long-term efficacy of our 8-session internet-based GSH program in a randomized clinical trial with an immediate treatment group, and two waitlist control groups, which differed with respect to whether patients received positive expectation induction during waiting or not. Method: Sixty-three patients (87% female, mean age 37.2 years) followed the eight-session guided cognitive-behavioural internet-based program and three booster sessions in a randomized clinical trial design including an immediate treatment and two waitlist control conditions. Outcomes were treatment acceptance, number of weekly binge-eating episodes, eating disorder pathology, depressiveness, and level of psychosocial functioning. Results: Treatment satisfaction was high, even though 27% of all patients dropped out during the active treatment and 9.5% during the follow-up period of 6 months. The treatment, in contrast to the waiting conditions, led to a significant reduction of weekly binge-eating episodes from 3.4 to 1.7 with no apparent rebound effect during follow-up. All other outcomes improved as well during active treatment. Email-based positive expectation induction during waiting period prior to the treatment did not have an additional beneficial effect on the temporal course and thus treatment success, of binge episodes in this study. Conclusion: This short internet-based program was clearly accepted and highly effective regarding core features of BED. Dropout rates were higher in the active and lower in the follow-up period. Positive expectations did not have an impact on treatment effects.

Since the beginning of the year 2020, the coronavirus-19 disease (COVID-19) pandemic has undoubtedly posed significant challenges to healthcare systems worldwide. It has also affected, in a way previously unimaginable, our lifestyle and the way we relate to each other, not only at work, but also in the community and in the family setting. Healthcare systems worldwide have been forced to make huge alterations to be able to handle the different stages of the pandemic. [...]

In the field of endoscope optics we see more and more zoom designs, realized by tuneable lenses, micro actuators or traditional lens movement in rigid endoscopes with a camera sensor. For such devices, a lighting concept that adapts the beam angle to the current field of view of the zoom optics is desirable. In endoscopes, the light is usually transported from a source to the tip by a light guide or fiber bundle.1 Since it is not feasible to place an optical system at the fiber exit to fulfill the task, one would make use of the fact that a fiber roughly conserves the angular distribution of incident light and transfer the task of variable beam generation to the light source. We present an optical system that performs this task by conventional optical means outside the endoscope. A LED is imaged to the fiber entrance by a system of variable focal length. By choosing the source etendue equal to that of the fiber, it is ensured that the proper magnification of the imaging is accompanied by the specified angular extent. The LED light is first collimated, and the exit pupil of the collimator is imaged by a system of moving and fix lenses. In a final step, we show a design to adapt a colored light source to the variable beam optics.

This study examined the consequences of media exposure to thin ideals compared to pictures of landscapes in healthy young women and women with eating and mixed mental disorders and investigated whether appearance-related cognitive factors and cognitive distortions moderate the effects. Two hundred seventy-five women in a multisite laboratory trial (174 in- or outpatients and 101 healthy women; Mage 22.87 years, SD = 3.94) were exposed to either thin ideals or to landscape pictures and guided through a vivid imagery of these pictures thereafter. Changes in body image dissatisfaction, mood, eating behavior, and physiological markers were assessed. After thin ideal exposure and even more after guided imagery, women's body image dissatisfaction increased and mood declined. The effect on mood was most pronounced in women with eating disorders, less in women with mixed disorders, and smallest in healthy controls. No effects were found on physiological measures. Higher values of appearance-related cognitive factors moderated the effect of thin ideal exposure and guided imagery on all psychological outcomes. Cognitive distortions moderated the effect of thin ideal exposure and guided imagery on mood. Findings indicate an overall susceptibility to viewing thin ideal pictures in magazines in young and especially in women with eating disorders. Though exposure in the laboratory resulted in psychological effects, it did not lead to a physiological stress response. The impact of thin ideal exposure on mood is in line with affect-regulation models in eating disorders, with appearance-related cognitive factors and cognitive distortions potentially accelerating such effects. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Quantum Cascade Lasers are powerful frequency comb sources in the THz and their repetition rate can be stabilized by means of RF injection locking. By exceeding certain RF injection powers, the spectral shape can be changed significantly with often unidentified effect on the temporal intensity profile. Here we perform temporal intensity profile measurements by means of Shifted Wave Interference Fourier Transform Spectroscopy by employing a fast, antenna coupled superconducting NbN Hot Electron Bolometer. We investigate the intensity profile of strong RF injected heterogeneous THz QCLs showing a strongly AM emission. Additionally, we measure fundamental as well as harmonic comb states under reduced RF injection which exhibit a FM emission.

CONTEXT The effective control of Fusarium head blight (FHB) in wheat, mainly caused by the toxigenic fungus Fusarium graminearum, has a significant impact on food safety worldwide. As maize is one of the main hosts of F. graminearum, the risk of infection by this plant pathogen is highest when wheat is grown after maize and infected crop residues are not buried through ploughing. OBJECTIVES This study aimed to investigate the agronomic and economic viability of two innovative cropping systems with the goal to reduce the risk of FHB and mycotoxins in subsequent wheat. These systems were maize-intercropping and cover cropping with different plant species before the wheat growing season under reduced tillage practices. METHODS For the maize-intercropping study, red clover, sudangrass, phacelia, white mustard and Indian mustard were used as intercrops with grain maize and compared with a sole maize crop in a grain maize-winter wheat rotation under no-tillage or reduced tillage. For the cover cropping study, white mustard, Indian mustard and winter pea were used as interval cover crops in a silage maize-spring wheat rotation under no-tillage and compared with treatments without a cover crop, i.e. herbicide or plough applied after silage maize. The incidence of Fusarium head blight causing species and the accumulation of mycotoxins in grains of wheat as well as the crop yield were monitored. In addition, an economic assessment was conducted by calculating the receipts, operating costs and gross margin for each cropping system. RESULTS AND CONCLUSIONS Growing intercrops with maize or interval cover crops in a maize-wheat rotation under reduced tillage decreased mycotoxins in wheat while maintaining wheat yield. The use of white mustard or Indian mustard as intercrops reduced deoxynivalenol in winter wheat by up to 52% compared with maize grown as a sole crop. The use of white mustard, Indian mustard or winter pea as interval cover crops also reduced deoxynivalenol and improved yield in spring wheat by up to 85% and 25%, respectively. Remarkably, the toxin reduction through these cover crops was comparable with that obtained by ploughing. However, due to increased operating costs, we observed economic trade-offs in these innovative cropping systems, i.e. 7–25% reduced gross margin over the entire rotation. SIGNIFICANCE Both cereal growers and consumers can benefit from the recommended practices, which considerably lower the risk of mycotoxin contamination in harvest products while maintaining crop yield. To address the economic trade-offs, policy makers should support innovation in cropping systems, enhancing food safety while also ensuring the economic viability of cereal production systems.

The role of radioiodine treatment following total thyroidectomy for differentiated thyroid cancer is changing. The last major revision of the American Thyroid Association (ATA) Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer in 2015 changed treatment recommendations dramatically in comparison with the European Association of Nuclear Medicine (EANM) 2008 guidelines. We hypothesised that there is marked variability between the different treatment regimens used today.We analysed decision-making in all Swiss hospitals offering radioiodine treatment to map current practice within the community and identify consensus and discrepancies. RESULTS AND CONCLUSION: We demonstrated that for low-risk DTC patients after thyroidectomy, some institutions offered only follow-up, while RIT with significant activities is recommended in others. For intermediate- and high-risk patients, radioiodine treatment is generally recommended. Dosing and treatment preparation (recombinant human thyroid stimulation hormone (rhTSH) vs. thyroid hormone withdrawal (THW)) vary significantly among centres.

Zusammenfassung. Essstörungen können zwar häufig psychotherapeutisch behandelt werden, doch wird die Mehrheit der Betroffenen vor allem aufgrund einer mangelnden Verfügbarkeit ausgebildeter Therapeuten keiner Behandlung zugeführt. Als eine neue Möglichkeit, bei gleichbleibender Anzahl verfügbarer Psychotherapeuten noch mehr Therapieplätze anbieten zu können, wurde in den letzten Jahren die internetbasierte Psychotherapie (e-Therapie) vorgeschlagen und in einigen Pilotprojekten erprobt. Die bisherigen Ergebnisse sind vielversprechend, doch muss vor einer Implementierung in die Regelversorgung noch näher beleuchtet werden, für welche Patienten diese Form der Therapie als gleichwertige Alternative zur klassischen Face-to-Face-Therapie empfohlen werden kann.

Schawlow and Townes theorized that the ratio between the spontaneous emission and stimulated emission in a semiconductor laser defines its linewidth lower limit [1] . However, experiments showed that this intrinsic linewidth is larger, which was later demonstrated to be due to the coupling between the optical gain and the phase noise [2] . The linewidth enhancement factor (LEF) was introduced to quantify this process and as a correction to the linewidth formula in [1] .

Quantum Cascade Lasers (QCLs) are compact and powerful sources of frequency combs in the mid-IR and THz region [1] , [2] . They naturally tend to operate on the fundamental comb state i.e. the mode spacing is given by the round-trip time of the cavity. Lately it was observed that free running mid-IR QCLs operate, under optical feedback reduction, in a so-called harmonic comb state where the mode spacing is a multiple of the fundamental one [3] . The origin arises from a single mode instability close to threshold which evolves to the harmonic state and normally falls into the fundamental comb state. Harmonic combs in the THz were so far only observed in mode-locked THz QCLs [4] .

Lymphatic filariasis causes disfiguring and disabling lymphoedema, which is commonly and frequently exacerbated by acute dermatolymphangioadenitis (ADLA). Affected people require long-term care and monitoring but health workers lack objective assessment tools. We examine the use of an infrared thermal imaging camera as a novel non-invasive point-of-care tool for filarial lower-limb lymphoedema in 153 affected adults from a highly endemic area of Bangladesh. Temperature differences by lymphoedema stage (mild, moderate, severe) and ADLA history were visualised and quantified using descriptive statistics and regression models. Temperatures were found to increase by severity and captured subclinical differences between no lymphoedema and mild lymphoedema, and differences between moderate and severe stages. Toes and ankle temperatures detected significant differences between all stages other than between mild and moderate stages. Significantly higher temperatures, best captured by heel and calf measures, were found in participants with a history of ADLA, compared to participants who never had ADLA, regardless of the lymphoedema stage. This novel tool has great potential to be used by health workers to detect subclinical cases, predict progression of disease and ADLA status, and monitor pathological tissue changes and stage severity following enhanced care packages or other interventions in people affected by lymphoedema.

Delivering clinical decision support (CDS) at the point of care has long been considered a major advantage of computerized physician order entry (CPOE). Despite the widespread implementation of CPOE, medication ordering errors and associated adverse events still occur at an unacceptable level. Previous attempts at indication- and kidney function-based dosing have mostly employed intrusive CDS, including interruptive alerts with poor usability. This descriptive work describes the design, development, and deployment of the Adult Dosing Methodology (ADM) module, a novel CDS tool that provides indication- and kidney-based dosing at the time of order entry. Inclusion of several antimicrobials in the initial set of medications allowed for the additional goal of optimizing therapy duration for appropriate antimicrobial stewardship. The CDS aims to decrease order entry errors and burden on providers by offering automatic dose and frequency recommendations, integration within the native electronic health record, and reasonable knowledge maintenance requirements. Following implementation, early utilization demonstrated high acceptance of automated recommendations, with up to 96% of provided automated recommendations accepted by users.

Acute aortic dissection (AAD) is a rare condition, but together with acute myocardial infarction (AMI) and pulmonary embolism (PE) it belongs to the most relevant and life-threatening causes of acute chest pain. Until now, there has been no specific blood test in the diagnostic workup of AAD. To identify clinically relevant biomarkers for AAD, we applied Proseek® Multiplex assays to plasma samples from patients with AAD, AMI, PE, thoracic aortic aneurysm (TAA), and non-cardiovascular chest pain (nonCVD). Subsequently, we validated top hits using conventional immunoassays and examined their expression in the aortic tissue. Interleukin 10 (IL-10) alone showed the best performance with a sensitivity of 55% and a specificity of 98% for AAD diagnosis. The combination of D-dimers, high-sensitive troponin T (hs-TnT), interleukin 6 (IL-6), and plasminogen activator inhibitor 1 (PAI1) correctly classified 75% of AAD cases, delivering a sensitivity of 83% and specificity of 95% for its diagnosis. Moreover, this model provided the correct classification of 77% of all analyzed cases. Our data suggest that IL-10 shows potential to be a rule-in biomarker for AAD. Moreover, the addition of PAI1 and IL-6 to hs-TnT and D-dimers may improve the discrimination of suspected AAD, AMI, and PE in patients presenting with acute chest pain., Diagnostics, 11 (4)

THz quantum cascade lasers (QCL) frequency combs are recently attracting attention both as valuable sources for THz spectroscopy as well as a model system to study non linear generation and laser dynamics. Harmonic comb state has proven to be emerging in quantum cascade lasers and promoted by an interplay between parametric gain and spatial hole burning. We report here on robust, self-starting harmonic mode locking in double-metal THz quantum cascade lasers. Different harmonic orders can be excited in the same laser cavity depending on the pumping conditions. The harmonic state can be RF injected and frequency pulled. We study the dependence of harmonic state on the laser cavity and we also report results on harmonic state in external cavities under RF injection.

The paper investigates the legitimization of emerging industries in traditional manufacturing areas by focusing on two inner structures: the cognitive and institutional structure. These structures and their interplay inform about the heterogeneity of routes and capabilities to enter legitimization trajectories. We compare two mechatronics clusters, both located in the North-East Italian area, namely in the provinces of Vicenza and Trento. The cases reveal how the evolution and legitimation of emerging industries might surface from bottom-up dynamics related to the technological upgrading of local historical industrial specializations, and from top-down institutional strategies, when the business community remains fragmented.

We report on high temperature, self-starting THz Quantum Cascade Laser harmonic frequency combs. Their coherence is assessed by electrical beatnote measurements and a self-mixing technique and their beatnote can be injection-locked to a RF source.

After an acute hepatitis E (HEV) outbreak in Southern Switzerland, in January 2017 the local public health authorities started an active program of food chain control and public education. In this retrospective study, we analysed all laboratory-confirmed acute cases of HEV infection diagnosed between 2014 and 2020. In the period before the public health intervention, the number of cases increased steadily from 2014 (4 of 40 tests, 10%) reaching a peak in the last quarter of 2016 (42 of 285 tests, 14.7 %). Afterwards, the number of positive cases decreased steadily, reaching its lowest value (0.3%) in the second quarter of 2019. There was a statistically significant difference between the frequency of positive cases and period of testing, i.e., before and after the introduction of the public health interventions. Our study shows that active public health measures to control sausages containing raw pork liver can reduce the prevalence of HEV infection.

Objective: To assess the clinical and esthetic outcomes and patient satisfaction of screw-retained one-piece implant crowns fabricated with zirconia abutments after a 4.5- to 8.8-year follow-up. Material and methods: Thirty-two patients (12 women and 20 men), who received 40 implant single crowns in anterior and premolar sites, were included in this prospective study. All restorations were based on ceramic hand-veneered customized CAD/CAM zirconia abutments. The follow-up consisted of clinical and radiological examinations. The pink esthetic score-white esthetic score (PES-WES) was used to evaluate the esthetic outcome. Patients' satisfaction was assessed via visual analog scale (VAS). Results: Implant and prosthetic survival rates were 100% and 97.5%, respectively. Mean marginal bone loss was -0.17 mm (SD 1.16 mm). Probing depth was ≤4 mm in 98.7% and 5 mm in 1.3% of the sites; 8.3% of them were bleeding on probing positive. No technical or biological complications were observed except for one abutment fracture. The mean PES-WES scores were 7.0 and 7.1, respectively. VAS scores (10-point) of 9.41 for function and 9.26 for esthetics showed high patient satisfaction. Conclusion: After a mean observation period of 6 years and 7 months, screw-retained implant crowns based on veneered customized CAD/CAM zirconia abutments with conical connection showed very good clinical performance and may be recommended for the replacement of missing anterior and premolar teeth. (ClinicalTrials.gov # NCT04370314). Keywords: all-ceramic restorations; dental implant; implant crowns; one-piece implant crowns; screw-retained implant crowns; survival rate; zirconia abutments.

The divergence of laser diodes is asymmetric and must be collimated in the fast-axis and slow-axis to reach an adequate beam shape for most applications. The most common technical solution is a combination of a Fast Axis Lens (FAC) and a Slow Axis Lens (SAC). These optical components are usually made of glass in combination with an anti-reflective optical coating tuned for a specific wavelength range. During the last decade, high power lasers have become more and more powerful and the requirements for specific collimation optics continuously increased. The FAC beam shaping performance is dependent mostly on the lens design and achieved surface quality, while the thermal behavior of the FAC is dependent on the laser power and the optical absorption within the lens. The solution for a low absorption lens for a high power blue laser diode presented in this paper, is a fused silica FAC. It shows excellent thermal properties and reduces heat generation rate by a factor approximately corresponding to the extinction value ratio when compared to other high refractive glass solutions optimized for blue applications.

Psoriasis affects 0.13%-2.1% of children and adolescents. Despite a high unmet need, the current treatment options approved for pediatric psoriasis are limited.To evaluate the efficacy and safety of 2 secukinumab dosage regimens (low dose: 75/75/150 mg; high dose: 75/150/300 mg) stratified and randomized by weight (25 kg, 25 to50 kg, ≥50 kg) and disease severity (moderate, severe) in pediatric patients aged 6-18 years with moderate to severe plaque psoriasis.This is a phase 3, open-label, randomized, multicenter study (NCT03668613).Both secukinumab doses were superior to historical placebo with respect to psoriasis area and severity index (PASI)-75/90 and investigator global assessment 0/1 responses at week 12. The estimated probability of a positive treatment effect (ie, log odds ratio0) for low- or high-dose secukinumab compared to historical placebo is 1 (ie, 100%). For the low and high doses at week 12, the investigator global assessment 0/1 response rates were 78.6% and 83.3%, respectively, and the PASI-90 response rates were 69% and 76.2%, respectively. The PASI-75 response rate was 92.9% for both the doses.This is an open-label study design without a control arm.Secukinumab dosing regimens were efficacious and well tolerated in pediatric patients with moderate to severe plaque psoriasis.

Recently, on-chip quantum-cascade-laser-based frequency combs are gaining increasing attention both in the Mid-IR and in the THz spectral regions. THz devices offer the possibility of filling the gap of comb sources in a spectral region were no table-top comb is available. I will discuss direct THz comb generation from both homogeneous and heterogeneous quantum cascade lasers. Octave spanning emission spectra and comb operation on bandwidth larger than 1 THz are reported for heterogeneous cascades. I will also report on a series of new structures with homogeneous cascade design that feature a very low threshold current density ( 1.8 THz) when driven in the NDR region. This extremely broadband emission in the NDR is studied as well with NEGF simulation and is based on an interplay between strong photon assisted transport due to the highly diagonal transition and domain formation.These structures are also showing RF injection locking with extremely reduced microwave powers. We will discuss locking experiments as well as a method to finely control the repetition rate of the laser based on controlled optical feedback. Time resolved spectral measurements aimed to clarify the physics of field domains in the NDR will be also presented.

We present homogeneous quantum cascade lasers (QCLs) emitting around 3 THz which display bandwidths up to 950 GHz with a single stable beatnote. Devices are spontaneously operating in a harmonic comb state, and when in a dense mode regime they can be injection locked at the cavity roundtrip frequency with very small RF powers down to -55 dBm. When operated in the electrically unstable region of negative differential resistance, the device displays ultra-broadband operation exceeding 1.83 THz (Δf/f=50%) with high phase noise, exhibiting self-sustained, periodic voltage oscillations. The low CW threshold (115 A·cm-2) and broadband comb operation (Δf/f=25%) make these sources extremely appealing for on-chip frequency comb applications.

WE WILL REVIEW RECENT ADVANCES IN THE REALIZATION OF WIDE BANDWIDTH, HIGH PERFORMANCE. FREQUENCY COMB SOURCES BASED ON QUANTUM CASCADE LASERS OPERATING BOTH IN THE THz AND MID-IR REGIONS OF THE E. M. Spectrum. In the Mid-IR, a grating compressor is employed to obtain pulses from a quantum cascade comb operating in CW. IN THE THz, COPPER-BASED DOUBLE METAL WAVE GUIDES ALLOW COMB OPERATION ABOVE LIQUID NITROGEN TEMPERATURE WITH RELATIVE Comb BANDWIDTHS OF 25%. Frequency COMB CONTROL BY MEANS of RF INJECTION AND COUPLED CAVITY SCHEMES WILL BE PRESENTED TOGETHER WITH NEW COMB characterization TECHNIQUES.

The industrial assembly processes for fast axis collimation (FAC) lenses with high power laser diodes are continuously being improved and automated. The system requirements allow for various solutions for the attachment process of the micro-optic component, the standard being active assembly relative to the light emitting laser-diode facet with joining by a UV-curable glue at attachment positions outside of the laser beam-path. To facilitate higher degrees of freedom and to optimize the results in the joining process with tighter tolerances in some critical functions, the FAC mounted on tab is one of the possible solutions and a viable process option. We report the results of high accuracy preassembly of FAC on tab with respect to the specific requirement of a target assembly back focal length within tight tolerance values.

We report about RF injection locking of an homogeneous THz quantum cascade laser operating at 3 THz central frequency. The extremely diagonal nature of the optical transition, combined with low-loss copper-based double-metal waveguides, allow CW operation up to 105 K and CW power in excess of 5.6 mW measured at 80 K. Terahertz emission spanning up to 600 GHz, together with a narrow beatnote, indicate comb operation at 80 K, and strong RF injection clearly modifies the laser spectrum up to 700 GHz spectral bandwidth making these devices ideal candidates for an on-chip dual comb spectrometer.

Statement of problem Studies reporting survival rates along with patient-centered outcomes are necessary to select the appropriate restorative material for crowns and fixed partial dentures (FPDs). However, studies that report the survival and complication rates of lithium disilicate crowns and the performance of zirconia FPDs compared with metal-ceramic FPDs are lacking. Purpose The purpose of this clinical study was to assess the failure and complication incidence of tooth-supported ceramic crowns and FPDs in function for at least 5 years. Groups included were pressed lithium disilicate crowns (CP), veneered pressed lithium disilicate crowns (CV), and computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate crowns (CC). Veneered zirconia-based FPDs (FPDC) were compared with metal-ceramic FPDs (FPDM). Outcomes were survival and failure, success and complications, periodontal conditions, and patient satisfaction assessed at 2 examinations (at baseline ≥1 year after delivery and at the follow-up examination ≥5 years of function). Material and methods Eighty-two participants with 158 restorations (CP=39, CV=16, CC=20, FPDM=30, FPDC=53) were examined (2.38 ±0.96 years after delivery) to form the baseline data. For the prospective follow-up examination, 70 participants with 141 restorations (CP=39, CV=15, CC=16, FPDM=28, FPDC=43) were examined 4.08 ±0.36 years later. Results At the follow-up, restorations were in function for a mean of 6.44 ±1.14 years. Survival rates for crowns were 97.1% (CP=97.4%, CV=100%, and CC=93.8%) and 98.6% for FPDs (FPDM=96.4%, FPDC=100%). Among the 68 crowns, 1 technical and 4 biological complications were recorded. FPDs had more biological and technical complications than crowns (15/149 abutment teeth and 11/71 restorations). Technical complications were seen in 9.3% of zirconia FPDs compared with 25% for metal-ceramic FPDs. Complications were commonly observed at the baseline examination (crowns: 12/75 biological and 1/75 technical; FPDs: 40/174 abutment teeth with biological and 8/83 FPDs with technical complications). The periodontal conditions improved significantly after baseline. The patients reported a high level of satisfaction with the esthetics and function of the crowns and FPDs. Conclusions Survival rate for ceramic crowns and FPDs was 97.9% after a mean observation time of 6.44 ±1.14 years. Biological complications were more commonly observed than technical complications, and complications were more common in FPDs than in crowns. The complication rate was similar for zirconia FPDs and metal-ceramic FPDs. Adherence to strict maintenance measures may have reduced the risk of biological complications.

We report about high temperature comb operation of THz quantum cascade lasers. The extremely diagonal nature of the optical transition combined with low loss copper-based double-metal waveguides allow CW operation up to 105 K and CW power in excess of 5 mW measured at 80 K. Terahertz emission spanning up to 600 GHz together with a narrow beatnote indicate comb operation at 80 K and strong RF injection modifies clearly the laser spectrum up to 700 GHz spectral bandwidth. Such devices show as well robust harmonic mode locking behaviour and their comb state can be controlled by means of an external tuning element.

Background: Onchocerciasis is targeted for elimination with annual community-directed treatment with ivermectin (CDTi). High infection levels were reported in South-West Cameroon, despite ≥ 15 years of CDTi. Methods: A large-scale cross-sectional study was conducted in 2017 in 20 communities in a loiasis-risk area in South-West Cameroon. A mixed-methods approach was used to evaluate factors associated with continued transmission and skin disease. Associations between infection levels, skin disease and adherence to CDTi were assessed using mixed regression modelling. Different community members’ perception and acceptability of the CDTi strategy was explored using semi-structured interviews. Results: Onchocerciasis prevalence was 44·4% among 9,456 participants. 5·9% of adults participated in ≥ 75% of CDTi rounds and 17·5% were systematic non-adherers. Skin disease affected 1/10 participants, including children. Increasing self-reported adherence to CDTi was associated with lower infection levels in participants aged ≥ 15 years but not in children. Adherence to CDTi was negatively influenced by fear of adverse events linked with economic loss and concern of lethal adverse events, and positively influenced by perceived health benefits. Interpretation: High onchocerciasis prevalence and morbidity still occur in South-West Cameroon, including among children born in the CDTi era. Because non-adherence is mostly due to community perception of ivermectin-related adverse events, including death and lack of perceived health benefit, CDTi alone is unlikely to achieve elimination in this area of high transmission. Alternative strategies are needed for onchocerciasis elimination where negative perception of ivermectin is an entrenched barrier to community participation in programmes. Funding Statement: Department for International Development, UK. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This protocol was reviewed and approved by the Liverpool School of Tropical Medicine Research Ethics Committee (reference: 16-027), the Cameroonian National Ethics Committee for Research on Human Health (approval no. 2016/11/838/CE/CNERSH/SP), and the Division of Health Operations Research within the Cameroonian Ministry of Public Health (approval no. 631-03·17). All censused individuals were explained the objectives and procedures of the intervention study. Informed assent was obtained from children and adolescents aged under 18 years with parental consent, and consent was provided by all adult participants.

The introduction of immunologic techniques for rapid viral diagnosis and the availability of high quality commercial reagents have resulted in significant advances in the laboratory diagnosis of viral respiratory infections. Laboratories just beginning in the area of diagnostic virology are advised to direct their efforts at viral isolation using cell types such as human embryonic kidney; immunofluorescence and other techniques of rapid viral diagnosis are recommended when the laboratory is prepared to expand.

PURPOSE The aim of this study was to evaluate the clinical performance of one-piece, screw-retained implant crowns based on hand-veneered computer-aided design/computer-aided manufacture (CAD/CAM) zirconium dioxide abutments with a crossfit connection at least 1 year after insertion of the crown. MATERIALS AND METHODS Consecutive patients who had received at least one Straumann bone level implant and one-piece, screw-retained implant crowns fabricated with CARES zirconium dioxide abutments were reexamined. Patient satisfaction, occlusal and peri-implant parameters, mechanical and biologic complications, radiologic parameters, and esthetics were recorded. RESULTS A total of 50 implant crowns in the anterior and premolar region were examined in 41 patients. The follow-up period of the definitive reconstructions ranged from 1.1 to 3.8 years. No technical and no biologic complications had occurred. At the reexamination, 100% of the implants and reconstructions were in situ. Radiographic evaluation revealed a mean distance from the implant shoulder to the first visible bone-to-implant contact of 0.06 mm at the follow-up examination. CONCLUSION Screw-retained crowns based on veneered CAD/CAM zirconium dioxide abutments with a crossfit connection seem to be a promising way to replace missing teeth in the anterior and premolar region. In the short term, neither failures of components nor complications were noted, and the clinical and radiographic data revealed stable hard and soft tissue conditions.

Municipalities are faced with escalating costs, harder to find resources, and increasing regulatory restrictions in an effort to maintain public utilities. To complicate this situation, communities must address a growing number of individuals who are unable to pay their utility bill. This study is a review of several water utilities in Florida to determine how typical municipal utilities approaches affordability. Factors affecting utilities such as sustainability, rate models, and regulations are examined to the present methodology for an average municipality in addressing the increasing important issue of affordability. This research is a continuation of a longitudinal study to determine how municipalities address increasing costs to maintain their utility while considering those in the community who are less fortunate and cannot continue to absorb the higher costs of water and wastewater.

Introduction: Life-long exposure to hypobaric hypoxia may induce physiologic adaptations in highlanders that modify exercise performance, although, this has not been conclusively studied. Methods: Life-long residents of the Aksay high altitude plateau (altitude 2700-4200m), Kyrgyz Republic, free of clinically overt cardiopulmonary disease were invited to undergo cardio-pulmonary exercise tests with a progressive ramp protocol to exhaustion on a cycle ergometer. Pulmonary gas exchange, ECG and pulse oximetry were continuously measured. Results: 81 highlanders, mean±SD age 47.9±9.8y, 46% women, SpO2 at rest 88±2% were studied at 3200m. Maximal oxygen uptake (V’O2max) and work rate were near the lower limit of normal sea level reference values. Exercise oxygen desaturation was noted but heart rate and ventilatory reserve were not exhausted (table). In multivariable regression analysis, female (coef -6.38, 95%CI -8.46 to -4.30), BMI (coef -0.33, 95%CI -0.57 to -0.08) and systolic blood pressure at rest (coef -0.07, 95%CI -0.14 to -0.01) were significant predictors of V’O2max (ml/kg/min). Conclusions: The results suggest that exercise performance of highlanders studied at altitude of residence is slightly reduced compared to lowlanders at low altitude. Performance is limited by chronic hypobaric hypoxia that is exacerbated during exercise and by a reduced maximal heart rate. Table. Outcomes during final 30 sec of maximal exercise

Double metal waveguide based terahertz quantum cascade lasers have excellent properties in terms of compactness, large bandwidth and low waveguide dispersion. However, as they confine the optical mode to subwavelength dimensions, their far- field is highly divergent. Our antipodal Vivaldi antenna is designed to produce a single-lobed far-field pattern with a beam width of less than 20°, spanning over two octaves in frequency (1.5-4.5 THz). Far-field measurements agree well with numerical simulations.

A homogeneous THz Quantum Cascade Laser with emission spectra spanning over 1.65 THz in a bi-stable, voltage driven regime is presented. A nearly 1 THz emission spectrum in the stable regime showing a narrow electrical beatnote indicating frequency comb operation is observed. Such a narrow beatnote could then be injection locked to an external RF source with powers low as -55 dBm. By increasing the injection power and sweeping the injection frequency spectral emission state can be modified at nominally same bias. Together with the low threshold current density of 115 A/cm-2 this design could lead to octave spanning THz QCL frequency combs.

Terahertz (THz) Quantum Cascade Lasers (QCLs) have been of large interest in the context of very broadband and compact frequency combs in the THz spectral range [1]. For THz QCLs, the double metal waveguide proved to be advantageous in terms of bandwidth, compactness and low dispersion. However, as it confines the optical mode to deeply subwavelength dimensions, the output beam is highly divergent, as displayed in Fig. 1(a). Previous solutions addressing this issue were either impractical or not so broadband [2,3]. To improve the far-field properties of the double metal waveguide across a very large frequency range, we designed, fabricated and characterized a broadband, narrow beam Vivaldi Antenna [4].

THz quantum-cascade lasers (QCLs) are compact semiconductor sources shown to emit over an octave in spectral bandwidth in CW operation [1]. The generation of frequency combs by THz QCLs, based on their internal four-wave mixing featuring narrow beatnotes, was shown and verified for various structures [1,2,4]. The emission over a large spectral range can be achieved by either optimizing the gain and its dispersion [1], cavity mode controlling [3] or compensating the material dispersion by designing a negative cavity dispersion [3]. The wide bandwidth is in general reached by stacking multiple active region (AR) designs to a so called heterogeneous structure featuring a broad gain.

Recently, on-chip quantum-cascade-laser-based frequency combs are gaining increasing attention both in the Mid-IR and in the THz spectral regions. THz devices offer the possibility of filling the gap of comb sources in a spectral region were no table top comb is available. We report on THz comb emission from homogeneous quantum cascade laser structure with a new active region design. It features a very low threshold current density ( 1 THz) extending from 3 THz to 4.2 THz and peculiar broadband behavior in the NDR region suggesting the presence of field domains. Time resolved spectral measurements employing an hot electron bolometer demonstrate the simultaneous lasing of all the modes in the NDR region and beatnote spectroscopy based on self-mixing proves the coherent nature of the broadband laser emission. Active control of the repetition rate is also demonstrated by using an external cavity scheme employing a piezo actuator. This active region is very promising for the future integration in an heterogeneous structure for octave spanning comb operation and also as an homogenous comb device