Search

Background: Dysphagia is commonly evaluated using videofluoroscopy (VFS). As its ratings are usually subjective normal-abnormal ratings, objective measurements have been developed. We compared the inter-rater reliability of the usual VFS ratings to the objective measurement VFS ratings and evaluated their clinical relevance., Methods: Two blinded raters analyzed the subjective normal-abnormal ratings of 77 patients' VFS. Two other blinded raters analyzed the objective measurements of pharyngeal aerated area with bolus held in the oral cavity (PAhold), the pharyngeal area of residual bolus during swallowing (PAmax), the pharyngeal constriction ratio (PCR), the maximum pharyngoesophageal segment opening (PESmax), pharyngoesophageal segment opening duration (POD), airway closure duration (ACD), and total pharyngeal transit time (TPT). We evaluated the inter-rater agreement in the subjective ratings and the objective measurements. Clinical utility analysis compared the measurements with the VFS findings of pharyngeal phase abnormality, penetration/aspiration, and cricopharyngeal relaxation., Results: In the pharyngeal findings, the subjective analysis inter-rater agreement was mainly moderate to strong. The strongest agreements were on the pharyngeal residues and penetration/aspiration findings. The objective measurements had fair to good inter-rater agreement. Clinical utility analysis found statistically significant connections between TPT and pharyngeal phase abnormality, normal PCR and lack of penetration/aspiration, and normal PESmax and normal cricopharyngeal relaxation., Conclusions: The subjective analysis had moderate to strong inter-rater agreement in the pharyngeal VFS findings, especially concerning pharyngeal residues and penetration/aspiration detection, reflecting the efficacy and safety of swallowing. The objective measurements had fair to good inter-observer reproducibility and could thus improve the reliability of VFS diagnostics., Level of Evidence: 4., Competing Interests: The authors have no other funding, financial relationships, or conflict of interest to disclose., (© 2024 The Author(s). Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)

Background: Videofluoroscopy (VFS) is the gold standard in evaluating dysphagia. Water swallow tests (WST) and the Eating Assessment Tool (EAT-10) are commonly used in dysphagia screening. We aimed to determine the feasibility of WST and EAT-10 as screening tools for referral to VFS., Methods: Patients (n = 150, median age: 70.0 years, range: 19-92 years, 58.7% female) referred to VFS completed the WST and EAT-10 before the examination. In the WST, we evaluated both the qualitative parameters (coughing, possible change in voice) and quantitative parameters (average drinking bolus size, swallowing speed). Correlations of EAT-10 total scores and WST parameters to the VFS findings were analyzed both individually and combined., Results: In the WST, the most specific (89.7%) predictor of normal VFS findings was the absence of coughing, and the most sensitive (79.1%) parameter to predict abnormal findings was a bolus size of ≤20 mL. Using a combination of coughing and a bolus size ≤20 mL (simplified WST), the sensitivity of predicting abnormal findings increased to 83.5%. The most sensitive (84.6%) predictor of penetration/aspiration was failing any parameter in the WST. Lack of coughing indicated an absence of penetration/aspiration with an 82.5% specificity. Swallowing speed or combining the EAT-10 results with the WST results did not enhance the sensitivity or specificity of the WST for predicting the VFS results., Conclusions: Coughing and average drinking bolus size are the most important parameters in WST when screening for referral to VFS, whereas the swallowing speed does not seem to be useful. The WST is superior to EAT-10 in predicting VFS findings., Level of Evidence: 4 Laryngoscope, 134:1349-1355, 2024., (© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Objective: Tonsillectomy is an effective treatment for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome. Tonsillotomy has a milder operative risk profile and postoperative morbidity in children than tonsillectomy. We aimed to compare the efficacy of tonsillotomy to observation-only in children with PFAPA syndrome at a 3-month follow-up., Methods: This was a randomized multicenter trial with sequential design. Participants were randomized into a tonsillotomy group and a control group that was only observed. The trial started in 1/2017 and was accomplished in 12/2021 with 16 patients (10 boys, six girls, the mean age 4.2 years). The symptoms were monitored with daily symptom diaries., Results: After the 3-month follow-up, 7/8 patients (87.5%) in the tonsillotomy group and 2/8 (25%) patients in the control group were free from PFAPA symptoms (95% CI 13% to 87%; p = 0.0021). The mean number of days with fever was 2.6 (SD 3.7) in the tonsillotomy group and 8.0 (SD 6.5) days in the control group (n = 8) (p = 0.06). Mean number of fever days compatible with PFAPA syndrome was 0.8 (SD 1.4) in the tonsillotomy group and 6.5 (SD 6.0) in the control group (95%CI -10% to -1%; p = 0.007). Rescue tonsillectomy was needed for all patients in the control group and none of the patients in the tonsillotomy group., Conclusions: Tonsillotomy might be an effective treatment option for children with PFAPA syndrome. Further studies are needed to clarify the long-term efficacy of tonsillotomy for treating PFAPA., Level of Evidence: 2 Laryngoscope, 134:968-972, 2024., (© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Our aim was to validate a Finnish version of the Eating Assessment Tool (F-EAT-10) for clinical use and to test its reliability and validity in a multicenter nationwide study. Normative data were acquired from 180 non-dysphagic participants (median age 57.0 years, 62.2% female). Dysphagia patients (n = 117, median age 69.7 years, 53.0% female) referred to fiberoptic endoscopic evaluation of swallowing (FEES) completed F-EAT-10 before the examination and after 2 weeks. Patients underwent the 100-ml water swallow test (WST) and FEES was evaluated using the following three scales: the Yale Pharyngeal Residue Severity Rating Scale, Penetration-Aspiration Scale, and the Dysphagia Outcome Severity Scale. An operative cohort of 19 patients (median age 75.8 years, 57.9% female) underwent an endoscopic operation on Zenker's diverticulum, tight cricopharyngeal muscle diagnosed in videofluorography, or both. Patients completed the F-EAT-10 preoperatively and 3 months postoperatively. The cut-off score for controls was < 3 (sensitivity 94.0%, specificity 96.1%) suggesting that ≥ 3 is abnormal. Re-questionnaires for test-retest reliability analysis were available from 92 FEES patients and 123 controls. The intraclass correlation coefficient was excellent for the total F-EAT-10 score (0.93, 95% confidence interval 0.91-0.95). Pearson correlation coefficients were strong (p < 0.001) for each of the questions and the total score. Internal consistency as assessed by Cronbach's alpha was excellent (0.95). Some correlations between findings in FEES and 100-ml WST with F-EAT-10 were observed. The change in subjective symptoms of operative patients paralleled the change in F-EAT-10. F-EAT-10 is a reliable, valid, and symptom-specific patient-reported outcome measure for assessing dysphagia among Finnish speakers., (© 2021. The Author(s).)

Objectives: Tracheobronchial stenting has an established role in the palliation of malignant central airway obstruction (CAO). The purpose of this study is to describe the experience with self-expanding metal airway stents in 2 tertiary referral centres, covering a third of the population of Finland., Methods: Patients referred to and treated with airway stenting for malignant CAO using self-expanding metal-stents were identified from electronic patient records, and data were collected using a structured Endoscopic Lower Airway Management instrument. Statistical analysis to reveal factors affecting patient benefit and survival was carried out., Results: A total of 101 patients (mean age 65.8) and 116 procedures were identified. Procedure-related mortality was rare (3/101 patients) and complications infrequent. The median survival was 2.3 months [95% confidence interval (CI): 1.4-3.1). Stent benefit was not significantly affected by clinical characteristics. Survival was impacted by the use of adjunct procedures [hazard ratio (HR) 0.36, 95% CI: 0.23-0.58, P < 0.001), procedural urgency (HR 0.40; 95% CI: 0.23-0.71, P = 0.002) and post-treatment chemoradiotherapy (HR 0.29, 95% CI: 0.15-0.56, P < 0.001)., Conclusions: The beneficial impact observed supports the further use of tracheobronchial stenting in malignant CAO. The use of self-expanding metal stents is encouraged., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Battery energy storage (BES) systems have high capital costs and low operational costs. This means that in order to introduce profitable BES applications, a high utilization rate should be achieved. The target of this study was to analyze the profitability of the BES system connected to a low voltage distribution network. The BES system is used for the power system's frequency containment reserve (FCR-D) and to minimize customer interruption costs (CIC) according to the Finnish regulation model. Investment costs, including the required power electronic converters as well as the costs related to the lifetime decrease of the BES system during the 15-year period, are taken into account in the economic analysis. The FCR-D and CIC mitigation incomes are based on real measured data from the Finnish TSO and DSO. According to the results, the BES is a profitable investment if both FCR-D cost and CIC mitigation are used. Copyright © 2018 Praise Worthy Prize S.r.l. - All rights reserved. [ABSTRACT FROM AUTHOR]

Purpose: Radiation scattering from bone reconstruction materials can cause problems from prolonged healing to osteoradionecrosis. Glass fiber reinforced composite (FRC) has been introduced for bone reconstruction in craniofacial surgery but the effects during radiotherapy have not been previously studied. The purpose of this study was to compare the attenuation and back scatter caused by different reconstruction materials during radiotherapy, especially FRC with bioactive glass (BG) and titanium., Methods: The effect of five different bone reconstruction materials on the surrounding tissue during radiotherapy was measured. The materials tested were titanium, glass FRC with and without BG, polyether ether ketone (PEEK) and bone. The samples were irradiated with 6 MV and 10 MV photon beams. Measurements of backscattering and dose changes behind the sample were made with radiochromic film and diamond detector dosimetry., Results: An 18% dose enhancement was measured with a radiochromic film on the entrance side of irradiation for titanium with 6 MV energy while PEEK and FRC caused an enhancement of 10% and 4%, respectively. FRC-BG did not cause any measurable enhancement. The change in dose immediately behind the sample was also greatest with titanium (15% reduction) compared with the other materials (0-1% enhancement). The trend is similar with diamond detector measurements, titanium caused a dose enhancement of up to 4% with a 1 mm sample and a reduction of 8.5% with 6 MV energy whereas FRC, FRC-BG, PEEK or bone only caused a maximum dose reduction of 2.2%., Conclusions: Glass fiber reinforced composite causes less interaction with radiation than titanium during radiotherapy and could provide a better healing environment after bone reconstruction., (© 2019 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.)

Objectives:: The aim was to compare titanium and glass fibre-reinforced composite (FRC) orbital floor implants using cone beam CT (CBCT). FRC implants are nonmetallic and these implants have not been analysed in CBCT images before. The purpose of this study is to compare the artefact formation of the titanium and the FRC orbital floor implants in CBCT images., Methods:: One commercially pure titanium and one S-glass FRC with bioactive glass particles implant were imaged with CBCT using the same imaging values (80 kV, 1 mA, FOV 60 × 60 mm). CBCT images were analysed in axial slices from three areas to determine the magnitude of the artefacts in the vicinity of the implants. Quantified results based on the gray values of images were analysed using analysis-of-variance., Results:: Compared to the reference the gray values of the titanium implant are more negative in every region of interest in all slices (p < 0.05) whereas the gray values of the FRC implant differ statistically significantly in less than half of the examined areas., Conclusions:: The titanium implant caused artefacts in all of the analysed CBCT slices. Compared to the reference the gray values of the FRC implant changed only slightly and this feature enables to use wider imaging options postoperatively.

BACKGROUND: Wood has been used as a model material for the development of novel fiber-reinforced composite bone substitute biomaterials. In previous studies heat treatment of wood was perceived to significantly increase the osteoconductivity of implanted wood material.AIM: The objective of this study was to examine some of the changing attributes of wood materials that may contribute to improved biological responses gained with heat treatment.METHODS: Untreated and 140°C and 200°C heat-treated downy birch (Betula pubescens Ehrh.) were used as the wood materials. Surface roughness and the effect of pre-measurement grinding were measured with contact and non-contact profilometry. Liquid interaction was assessed with a dipping test using two manufactured liquids (simulated blood) as well as human blood. SEM was used to visualize possible heat treatment-induced changes in the hierarchical structure of wood.RESULTS: The surface roughness was observed to significantly decrease with heat treatment. Grinding methods had more influence on the surface contour and roughness than heat treatment. The penetration of the human blood in the 200°C heat-treated exceeded that in the untreated and 140°C heat-treated materials. SEM showed no significant change due to heat treatment in the dry-state morphology of the wood.DISCUSSION: The results of the liquid penetration test support previous findings in literature concerning the effects of heat treatment on the biological response to implanted wood. Heat-treatment has only a marginal effect on the surface contour of wood. The highly specialized liquid conveyance system of wood may serve as a biomimetic model for the further development of tailored fiber-composite materials. [ABSTRACT FROM AUTHOR]

Objective: Narrow band imaging (NBI) improves diagnosis of laryngopharyngeal cancer, but most reported NBI studies are from experienced centers. Feasibility reports on use at everyday outpatient departments are needed., Study Design: Researcher-initiated, prospective, multicenter., Methods: Participating physicians were instructed in NBI technique during a 4-hour meeting. Patients underwent an examination that included endoscopy with white light (WL) high-definition (HD) TV and NBI filter in the selected time period. All suspicious lesions were biopsied. The medical records of patients with NBI negative findings were evaluated 6 months after the visit to detect all possible malignant lesions coming into view at mucosal sites. These were considered as false-negative cases, enabling long-term assess to the positive predictive value (NPV) of the protocol., Results: We enrolled 125 patients. Of those, 84 (67.2%) were males and the median age was 65 years (range, 35-91). In analysis of the accuracy of WL HD TV and NBI against biopsy, the sensitivity and specificity of WL HD TV were 62% and 81%, respectively; and the sensitivity and specificity of NBI were 100% and 84%, respectively. The diagnostic accuracy of NBI was significantly better (P < 0.05). When analyzing medical records 6 months after the initial examination, we found three patients who had been diagnosed with a malignant lesion (NPV of NBI of 96.8%)., Conclusion: Narrow band imaging is readily implemented in an everyday outpatient practice, and there seems to be better detection rates of dysplastic/carcinoma lesions with HD NBI compared to HD WL., Level of Evidence: 2b. Laryngoscope, 127:1821-1825, 2017., (© 2017 The American Laryngological, Rhinological and Otological Society, Inc.)

Objectively determined single-number-quantities (SNQs) describing the airborne sound insulation of a façade should correspond to the subjective perception of annoyance to road traffic sounds transmitted through a façade. The reference spectra for spectrum adaptation terms C and Ctr in standard ISO 717-7 (International Organization for Standardization, 2013) are not based on psycho-acoustic evidence. The aim of this study is to develop reference spectra which result in SNQs that explain the subjective annoyance of road traffic sounds transmitted through a façade well. Data from a psycho-acoustic experiment by Hongisto, Oliva, and Rekola [J. Acoust. Soc. Am. 144(2), 1100–1112 (2018)] were used. The data included annoyance ratings for road traffic sounds (five different spectrum alternatives) attenuated by the façade (twelve different sound insulation spectrum alternatives), rated by 43 participants. The reference spectrum for each road traffic spectrum was found using mathematical optimization. The performance of the acquired SNQs was estimated with nested cross-validation. The SNQs determined with the optimized reference spectra performed better than the existing SNQs for two road traffic spectra out of five and for an aggregate of the five road traffic sound types. The results can be exploited in the development of standardized SNQs. [ABSTRACT FROM AUTHOR]

Chiral emission exhibiting a large degree of circular polarization (DCP) is important in diverse applications ranging from displays and optical storage to optical communication, bioimaging, and medical diagnostics. Although chiral luminescent materials can generate chiral emissions directly, they frequently suffer from either low DCP or low quantum efficiencies. Achieving high DCP and quantum efficiencies simultaneously remains extremely challenging. This review introduces an alternative approach to chiral emission. Chiral emission with large DCP can be readily achieved by combining conventional achiral emitters with chiral metasurfaces. Particularly, this article focuses on recent experimental and theoretical studies on perovskite metasurfaces and metacavities that employ achiral perovskite materials. First, chiral photoluminescence from extrinsic and intrinsic perovskite metasurfaces is explained together with theoretical discussions on metasurface design based on reciprocity and critical coupling. Chiral photoluminescence from other achiral materials is also explained. Subsequently, chiral electroluminescence from perovskite metacavities and other achiral materials is discussed. Finally, it is concluded with future perspectives. This review provides physical insights into how ideal chiral emission can be realized by optimizing the design of metasurfaces and metacavities. Compact chiral light sources with both near‐unity DCP and strong emission intensities can have far‐reaching consequences in a wide range of future applications. [ABSTRACT FROM AUTHOR]

Purpose: Voice and swallowing are distinct functions that share anatomical and physiological properties; however, research investigating their intersection is limited. The purpose of this scoping review was to explore the literature surrounding the relationship between voice and swallowing measures in healthy adults and those with non-degenerative disorders. Specifically, we aimed to elucidate whether objective voice measures could be used as correlates of swallowing function. Method: We systematically searched four databases (Embase, PubMed, CINAHL, and Web of Science) for relevant literature using a combination of key words and controlled vocabulary generated from the Yale Mesh Analyzer. The inclusion criteria consisted of peer-reviewed studies in the English language that reported on healthy adults and/or patients with non-degenerative neurological disorders and pulmonary diseases and contained instrumental and/or objective voice and swallowing measures. Two raters completed the abstract screening process followed by independent full-text reviews. Case studies, review studies, gray literature, or abstract-only studies were excluded. Results: Among 5,485 screened studies, 182 were fully reviewed, with only 11 studies meeting the inclusion criteria. Eight studies found an association between voice and swallowing objective measures, whereas the other three did not. Significant voice measures that were related to swallowing safety and/or physiology included maximum fundamental frequency (F0), F0 range, maximum phonation time, biomechanics of effortful pitch glides, and voice onset time. Conclusions: Although there was heterogeneity in the measures used, specific objective voice measures showed promise in clinical practice as a screening tool for dysphagia. Further investigations are needed to validate the clinical utility of these measures across diverse patient populations. [ABSTRACT FROM AUTHOR]

The aim of the study was to perform treatment of juniper wood to obtain wood material with a density and mechanical properties comparable to bone, thus producing a potential material for use in osteosynthesis bone implants. In the first step, partial delignification of wood sample was obtained by Kraft cooking. The second step was extraction with ethanol, ethanol–water mixture, saline, and water to prevent the release of soluble compounds and increase biocompatibility. In the last step, the thermal densification at 100 °C for 24 h was implemented. The results obtained in the dry state are equivalent to the properties of bone. The swelling of chemically pre-treated densified wood was reduced compared to chemically untreated densified wood. Samples showed no cytotoxicity by in vitro cell assays. The results of the study showed that it is possible to obtain noncytotoxic wood samples with mechanical properties equivalent to bones by partial delignification, extraction, and densification. However, further research is needed to ensure the material's shape stability, water resistance, and reduced swelling. [ABSTRACT FROM AUTHOR]

To evaluate the use and complications of a prophylactic percutaneous endoscopic gastrostomy (PEG) in head and cancer patients in our institute. A retrospective study of 194 consecutive patients with a newly diagnosed upper aero digestive tract malignancy who underwent mainly prophylactic PEG tube placement. The procedure is relatively safe: 15 (7.7%) of the complications were considered serious; no deaths occurred. Of the patients 23 (12.5%) did not use the PEG tube at all, but it was not possible to single out a group of patients in which this could be predicted. The majority of the patients were considered to benefit from the prophylactic PEG insertion.

Background: A novel, bioactive, fiber-reinforced composite implant is a solution to address the shortcomings in craniofacial bone reconstruction. A longitudinal clinical investigation with a follow-up time of 4 years was conducted., Methods: A cranial bone reconstruction with the implant was performed on 12 patients. In these patients, the reasons for craniotomies resulting in craniofacial bone defects were traumatic and spontaneous intracranial bleeding as well as infections to the primary reconstruction material. The implant material consisted of a supporting fiber-reinforced framework, porous inner layers, and a bioactive glass (BG; S53P4) filling. The framework and the porous layers were made of a bisphenol-a-glycidyl methacrylate and triethyleneglycoldi-methacrylate (pBisGMA-pTEGDMA) resin matrix, which was reinforced with silanized E-glass., Results: In clinical examinations and skull X-rays, the implants were in original positions providing the expected functional and aesthetic outcome at all time points., Conclusion: The implants functioned appropriately, which would provide a potential solution for craniofacial bone reconstruction in the future., (Copyright © 2013 Wiley Periodicals, Inc.)

Aim: The aim of this study was to compare the osteoconductivity and suitability of three biomaterials used as particulate fillers; S53P4 bioactive glass, allogeneic fresh frozen bone and coral-derived calcium carbonate., Materials and Methods: Materials were implanted into drill-holes in the femoral condyles of adult rabbits. Follow-ups were performed at 3, 6, 12 and 24 weeks. Host-response, osteoconductivity, bonding and filler-effect were evaluated by SEM, EDXA and histology and histomorphometry to evaluate., Results: All three materials were found to be biocompatible and osteoconductive. Defects filled with allograft seemed to have more bone at 24 weeks, although no statistically significant difference in new bone growth was found. In earlier time points, coral, however, was observed to degrade more quickly, leaving more empty space in the defects, thus making it a less suitable filler for cavitary defects., Conclusion: At all time points there was less filler material (i.e. biomaterial and new bone) in coral-filled defects than in BAG or allograft filled defects (p < 0.05).

Aim: Risk of psychosis is defined by the presence of positive psychotic-like symptoms, by subtle self-perceived cognitive and perceptual deficiencies, or by decreased functioning with familial risk of psychosis. We studied the associations of psychiatric outpatients' self-reported functioning and interpersonal relationships with vulnerability to and risk of psychosis., Methods: A total of 790 young patients attending psychiatric outpatient care completed the PROD screen [Heinimaa M, Salokangas RKR, Ristkari T, Plathin M, Huttunen J, Ilonen T, et al. PROD-screen - a screen for prodromal symptoms of psychosis. Int J Meth Psychiatr Res 2003;12:92-04.], including questions on functioning, interpersonal relationships and subtle specific (psychotic-like) and non-specific symptoms. Vulnerability to psychosis was assessed employing the patient's written descriptions of specific symptoms. Of the patients vulnerable to psychosis, those at current risk of psychosis were assessed using the Bonn Scale for Assessment of Basic Symptoms [Schultze-Lutter F, Klosterkötter J. Bonn scale for assessment of basic symptoms - prediction list, BSABS-P. Cologne: University of Cologne; 2002] and the Structured Interview for Positive symptoms [Miller TJ, McGlashan TH, Rosen JL, Somjee L, Markovich PJ, Stein K, et al. Prospective diagnosis of the initial prodrome for schizophrenia based on the structured interview for prodromal syndromes: preliminary evidence of interrater reliability and predictive validity. Am J Psychiatry 2002;159:863-65.]., Results: In all, 219 patients vulnerable to and 55 patients at current risk of psychosis were identified. Vulnerability to psychosis was associated with all items of functioning and interpersonal relationships. Current risk of psychosis, however, was associated only with the subjectively reported negative attitude of others. Negative attitude of others was also associated with feelings of reference at both vulnerability and risk levels., Conclusion: The subjective experience of negative attitude of others towards oneself may be an early indicator of psychotic development.

Background and Purpose: Polymer technology has provided solutions for filling of bone defects in situations where there may be technical or biological complications with autografts, allografts, and metal prostheses. We present an experimental study on segmental bone defect reconstruction using a polymethylmethacrylate-(PMMA-) based bulk polymer implant prosthesis. We concentrated on osteoconductivity and surface characteristics., Material and Methods: A critical size segment defect of the rabbit tibia in 19 animals aged 18-24 weeks was reconstructed with a surface porous glass fiber-reinforced (SPF) prosthesis made of polymethylmethacrylate (PMMA). The biomechanical properties of SPF implant material were previously adjusted technically to mimic the properties of normal cortical bone. A plain PMMA implant with no porosity or fiber reinforcement was used as a control. Radiology, histomorphometry, and scanning electron microscopy (SEM) were used for analysis of bone growth into the prosthesis during incorporation., Results: The radiographic and histological incorporation model showed good host bone contact, and strong formation of new bone as double cortex. Histomorphometric evaluation showed that the bone contact index (BCI) at the posterior surface interface was higher with the SPF implant than for the control. The total appositional bone growth over the posterior surface (area %) was also stronger for the SPF implant than for controls. Both bone growth into the porous surface and the BCI results were related to the quality, coverage, and regularity of the microstructure of the porous surface., Interpretation: Porous surface structure enhanced appositional bone growth onto the SPF implant. Under load-bearing conditions the implant appears to function like an osteoconductive prosthesis, which enables direct mobilization and rapid return to full weight bearing.

Deciduous wood, birch, pretreated by a technique combining heat and water vapor was applied for the reconstruction of bone defects in the knee joint of rabbits. It was observed that wood showed characteristic properties to be incorporated by the host bone during observation time of 4, 8, and 20 weeks. The natural channel structure of wood served as a porous scaffold, allowing host bone growth as small islets into the wood implants. The other properties of heat-treated wood, such as bioactivity, good handling properties, and sufficient biomechanical properties, might be additional favorable factors for the application of wood as a natural composite material for bone and cartilage repair. At the interface of the surfaces of wood and living bone, bonding occurred. The Chemical Interface Model for bonding bone to wood consists of the reactive ions, such as hydroxyl groups --OH, and covalent bonding as well as hydrogen bonding, which originate from both wood and bone. The bone tissue trauma, with its reactive Ca(2+) and PO(4) (3-) ions, proteins, and collagen, available for interaction at ionic and nanolevel, are associated with the complicated chemistry in the cellular response of the early bone healing process. It was concluded that heat-treated wood acted like a porous biomaterial scaffold, allowing ongrowth and ingrowth of bone and cartilage differentiation on its surface, and demonstrating osteoconductive contact, bonding at the interface.

The increasing use of nonlinear loads in power systems introduces voltage and current components at non-fundamental frequencies, leading to harmonic distortion, which negatively impacts electrical and electronic devices. A common mitigation strategy involves identifying harmonic sources and installing filters nearby. However, due to the high cost of power quality (PQ) meters, comprehensive harmonic level monitoring across the entire power system is impractical. To address this, various methodologies for Harmonic State Estimation (HSE) have been developed, which estimate distortion levels on unmonitored system buses using data from a minimal set of monitored ones. Many HSE techniques rely on optimization algorithms with numerous tuning parameters, complicating their application. This paper proposes a novel methodology for fundamental frequency power flow and harmonic state estimation using the Jaya algorithm, which is characterized by fewer tuning parameters for easier adjustment. It also introduces a strategy to determine the minimal number of buses that need monitoring to achieve system observability. The methodology is validated on the IEEE-14 and IEEE-30 bus systems, demonstrating its effectiveness. The results of the proposed methodology are compared with those obtained using Evolutionary Strategies (ESs), highlighting its enhanced accuracy and computational efficiency. [ABSTRACT FROM AUTHOR]

Excitation energy transport can be significantly enhanced by strong light–matter interactions. In the present work, we explore intriguing features of coherent transient exciton wave packet dynamics on a lossless disordered polaritonic wire. Our main results can be understood in terms of the effective exciton group velocity, a new quantity we obtain from the polariton dispersion. Under weak and moderate disorder, we find that the early wave packet spread velocity is controlled by the overlap of the initial exciton momentum distribution and its effective group velocity. Conversely, when disorder is stronger, the initial state is nearly irrelevant, and red-shifted cavities support excitons with greater mobility. Our findings provide guiding principles for optimizing ultrafast coherent exciton transport based on the magnitude of disorder and the polariton dispersion. The presented perspectives may be valuable for understanding and designing new polaritonic platforms for enhanced exciton energy transport. [ABSTRACT FROM AUTHOR]

We developed a microfluidic system for vibrational polariton studies, which consists of two microfluidic chips: one for solution mixing and another for tuning an infrared cavity made of a pair of gold mirrors and a PDMS (polydimethylsiloxane) spacer. We show that the cavity of the system can be accurately tuned with either piezoelectric actuators or microflow-induced pressure to result in resonant coupling between a cavity mode and a variational mode of the solution molecules. Acrylonitrile solutions were chosen to prove the concept of vabriational strong coupling (VSC) of a C≡N stretching mode with light inside the cavity. We also show that the Rabi splitting energy is linearly proportional to the square root of molecular concentration, thereby proving the relevance and reliability of the system for VSC studies. [ABSTRACT FROM AUTHOR]

This manuscript presents a comprehensive review of recent advancements in electrical distribution networks, with a specific focus on the incorporation of direct current (DC) applications. The research aims to comprehensively address the current and future aspects of DC, spanning from the distribution level to the utilization level. The renewed interest in DC power systems has led to the investigation of several transitional challenges in recent years. A significant portion of these efforts has been dedicated to determining the feasibility of applying DC to specific use cases. Additionally, the literature has explored design considerations such as system architecture and voltage levels, the integration of DC into existing distribution networks, load flow (LF) computations, and the distinct safety concerns associated with DC power systems. In this paper, the various research endeavors are categorized, evaluated, and scrutinized to assess the current state of the transition from a purely alternating current (AC) distribution system to a solely DC or hybrid AC/DC distribution system. A bibliometric analysis is conducted, constructing a network of co-occurrence based on author-provided keywords, which reveals the primary research foci in this domain. The barriers hindering the widespread adoption of DC distribution systems and potential solutions are also discussed. Moreover, this article synthesizes ongoing efforts to address these obstacles and delineates future research directions by emphasizing the existing knowledge gaps. [ABSTRACT FROM AUTHOR]

Bowl-shaped plasmonic whispering gallery mode (WGM) resonators were fabricated from a 10-nm-thick metal (Al, Ag, or Au) plasmonic layer that was covered with a 100-nm-thick 4,4′-bis(N-carbazolyl)-1,1′-biphenyl spacer layer and a 250-nm-thick 2,7-bis[9,9-di(4-methylphenyl)-fluoren-2-yl]-9,9-di(4-methylphenyl)fluorene light-emitting layer; the layer structure was grown on a 20-μm-diameter silica microsphere. When compared with a reference structure without the plasmonic layer, the resonators, which included either Al or Ag, showed almost the same threshold excitation intensities for generation of amplified spontaneous emission (ASE). This result indicates that the ease of light amplification in the plasmonic resonators was comparable to that in the reference structure. Excitons that exist in the vicinity of metal thin films are generally easy to quench because propagating surface plasmon polaritons (SPPs) absorb the exciton energy. Therefore, the observed comparability demonstrates that the plasmonic WGM resonators overcome this quenching effect on ASE via localization of the SPPs in the vicinity of the excitons. [ABSTRACT FROM AUTHOR]

It is a matter of debate whether the discipline independence in discipline formation narrows its interdisciplinarity. It is also less well understood how disruptive works emerge in investigative practice rather than a theory‐driven approach. Aggregation‐induced emission (AIE) is an atypical photophysical phenomenon, in which the whole (aggregate) is brighter than the sum of its parts (single molecule). Through measuring and computing the cognitive extent and evolution of research on AIE, including topics, epistemic‐social collaborative networks, interdisciplinarity, emergent concepts, core concept networks and knowledge flow, this study shows that a cross‐research scales concept and its practice can establish new bridges in the sciences and promote disruptive work. Focusing on mesoscale entities, scientists from many different branches of science are involved in theoretical research on mechanisms, as well as developing different AIE systems for applications. The data analysis in this study provides details showing how non‐reductionist concepts based on new scientific discoveries cross traditional disciplinary boundaries and aggregate interdisciplinary research. The emergence and evolution of the AIE field implies that scientists may be motivated to embrace nonreductionist ideas at different research scales, leading to a more permeable field boundary. [ABSTRACT FROM AUTHOR]

Overcoming the optical diffraction limit and reducing the size of optoelectronic integrated circuits have become requirements for the rapidly increasing demand for data transmission and novel functionality. These goals can be achieved by applying a surface plasmon mode that can attain subwavelength confinement. In this Tutorial, we discuss the operation principle and development of the surface plasmon amplification of the stimulated emission of radiation and the newly developed plasmonic nanolasers that play essential roles in reducing system sizes. Nanowire-type surface plasmon polariton (SPP) nanolasers with semiconductor–insulator–metal structures were developed and integrated with graphene, which offers numerous advantages to SPP nanolasers. Furthermore, the electrical modulation mechanism of nanolasers on graphene–insulator–metal (GIM) platform was also verified, which can recognize integrated SPP detectors. Therefore, we propose using an integrated plasmonic circuit on the GIM platform to provide multiple functionalities in a compact footprint. [ABSTRACT FROM AUTHOR]

We aimed to fine-tuning the Timed Water Swallow Test (TWST) screening procedure to provide the most reliable prediction of the Flexible Endoscopic Evaluation of Swallowing (FEES) assessment outcomes, with age, sex, and the presence of clinical signs of dysphagia being considered in the assessment. Participants were healthy people and patients with suspected dysphagia. TWST performance and participants' reported dysphagia symptoms were assessed in terms of their utility in predicting the outcome of a FEES assessment the same day. The FEES assessors were blinded to the nature of the TWST performance. The water swallowing capacity levels and clinical observations during a screening performance that were indicative of dysphagia/no symptoms in FEES were determined. Convergent validity was assessed as the agreement with the Functional Oral Intake Scale (FOIS) in the FEES assessment. TWST predicted FEES findings (aspiration and dysphagia) with a sensitivity of 72 and 45% and a specificity of 75% and 80%, respectively. Extended analysis of the TWST procedure (eTWST) identified aspiration (sensitivity = 92%, specificity = 62%) and dysphagia (sensitivity = 70%, and specificity = 72%) more accurately and showed a high correlation with FOIS (ɸ = 0.37). Excellent inter-rater reliability was further observed (Kw = 0.83). The extended evaluation of TWST performance has superior criterion validity to that of TWST. eTWST displayed high convergent validity and excellent interrater reliability. We therefore believe that eTWST can be highly relevant for clinical dysphagia screening., (© 2024. The Author(s).)

Background: Dysphagia is considered a complication in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, AECOPD may have risk factors for dysphagia. Methods: Through a cross-sectional study, which included 100 patients with AECOPD. General information, Pulmonary function, COPD assessment test (CAT) and modified Medical Research Council (mMRC) were collected by questionnaire. The questionnaires were administered by uniform-trained investigators using standard and neutral language, and swallowing risk was assessed by using a water swallow test (WST) on the day of patient admission. Results: Among the 100 included patients, 50(50%) were at risk of swallowing. Multivariate analysis using logistic regression analysis showed that age ≥ 74 years old, mMRC ≥ level 2, hospitalization days ≥ 7 days and the use of BIPAP assisted ventilation were important influencing factors for swallowing risk in patients with AECOPD. Conclusion: Patients with AECOPD are at risk for dysphagia, assessing age, mMRC, hospitalization days and the use of BIPAP assisted ventilation can be used to screen for swallowing risk, thus contributing to the implementation of early prevention measures. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of fluoxetine on swallowing function, neurotrophic factors, and psychological status in patients with dysphagia after acute ischemic stroke (AIS). A total of 118 patients with dysphagia after AIS who were diagnosed and treated in our hospital from July 2020 to March 2022 were selected as the study objects with 59 cases in each group. Patients in the control group underwent routine treatment and swallowing rehabilitation without fluoxetine. Patients in the study group received routine treatment, swallowing rehabilitation, and fluoxetine treatment. The quality of life was compared according to the Generic Quality of Life Inventory-74 (CQOLI-74). Patients were followed for 90 days, and the grades were compared with the Modified Rankin Scale (mRS). The total effective rate of the study group was 84.75%, which was higher than that of the control group with 62.71% (χ 2 = 7.394, P < 0.05). The life quality scores of the two groups were both dramatically elevated compared to those before the treatment, and the study group had a sensibly higher life quality score than the control group (P < 0.05). The proportion of grade 4~5 in the study group was significantly lower than that in the control group (χ 2 = 492, P < 0.05). The total incidence of adverse reactions in the control group was 5.08% (3/59), which was significantly lower than that in the study group with 11.86% (7/59) (χ 2 = 1.748, P = 0.186). Fluoxetine has a significant effect on the treatment of dysphagia after AIS by enhancing the recovery of dysphagia and promoting the recovery of neurological function., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Airway invasion is common in patients with Parkinson's disease (PD) and can cause serious complications. However, a PD-related dysphagic pattern has not been clearly elucidated. In this study, 53 patients with early to moderate PD were enrolled to undergo a videofluoroscopic study of swallowing evaluation (VFSS) and a battery of neuropsychological assessments. A set of VFSS variables (three visuoperceptual, nine temporal, and six spatial) were measured. The main effects of bolus viscosity and volume on airway invasion were calculated. Statistical analyses were performed to determine key kinematic factors of airway invasion for swallowing each bolus type. Airway invasion frequency was significantly higher for liquid boluses (liquid vs. pudding P < 0.001; liquid vs. honey P = 0.006). Laryngeal vestibule closure reaction time (LVCrt) was the key kinematic factor of airway invasion for 3 ml liquid swallow (P = 0.040), anterior displacement of hyoid bone was the key kinematic factor for both 5 ml and 10 ml liquid swallows (P = 0.010, 0.034, respectively). Male sex and advanced Hoehn and Yahr stage were significantly related to reduced anterior displacement of hyoid bone. These results reveal the dysphagic pattern related to PD, demonstrating that prolonged LVCrt and reduced anterior displacement of hyoid bone are two crucial kinematic factors contributing to airway invasion during the liquid swallow. In addition, hyoid bone dysfunction was correlated with disease severity and male sex. Our findings warrant further investigation of the pathophysiological mechanism of dysphagia in PD and would guide clinical intervention., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

A Pinuselliottii wood was thermally modified at 200 °C for 2 h and then treated by in situ polymerization with furfuryl alcohol (FA) using a vacuum-pressure process to investigate the influence of furfurylation on a thermally treated wood. The presence of poly(furfuryl alcohol) (PFA) was confirmed by micrographs (SEM and CLSM), which also showed that it reached internal spaces between cracks originated in the previous heat treatment. Chemical changes from furfurylation were detected by infrared spectroscopy, especially in the previously thermally treated wood. The wood modified by the combined thermorretification/furfurylation treatment presented similar esthetic attributes compared to the furfurylated wood. Compared to the isolated treatments, the combined treatment caused an increase of 150–260% in the evaluated mechanical properties and 5–10% in thermal stability. The two-step treated pine wood also showed higher levels of surface and bulk hydrophobicity and resistance against white-rot fungus. [ABSTRACT FROM AUTHOR]

Resin-based dental materials have been one of the ideal choices among various materials in the treatment of dental caries. However, resin-based dental materials still have some drawbacks, such as the lack of inherent antibacterial activity. Extensive research has been conducted on the use of novel quaternary ammonium monomers (QAMs) to impart antibacterial activity to dental materials. This review provides a comprehensive overview of the recent advances in quaternary ammonium monomers (QAMs) for dental applications. The current progress and limitations of QAMs are discussed based on the evolution of their structures. The functional diversification and enhancement of QAMs are presented. QAMs have the potential to provide long-term antibacterial activity in dental resin composites, thereby prolonging their service life. However, there is a need to balance antibacterial performance with other material properties and the potential impact on the oral microbiome and general health. Finally, the necessity for further scientific progress in the development of novel quaternary ammonium monomers and the optimization of dental resin formulations is emphasized. [ABSTRACT FROM AUTHOR]

Advanced head and neck cancer (HNC) is functionally and aesthetically destructive, and despite significant advances in therapy, overall survival is poor, financial toxicity is high, and treatment commonly exacerbates tissue damage. Although response and durability concerns remain, antibody-based immunotherapies have heralded a paradigm shift in systemic treatment. To overcome limitations associated with antibody-based immunotherapies, exploration into de novo and repurposed small molecule immunotherapies is expanding at a rapid rate. Small molecule immunotherapies also have the capacity for chelation to biodegradable, bioadherent, electrospun scaffolds. This article focuses on the novel concept of targeted, sustained release immunotherapies and their potential to improve outcomes in poorly accessible and risk for positive margin HNC cases. [ABSTRACT FROM AUTHOR]