A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients

The supraclavicular island flap has been widely used in head and neck reconstruction, providing an alternative to the traditional techniques like regional or free flaps, mainly because of its thin skin island tissue and reliable vascularity. Head and neck patients who require large reconstructions usually present poor clinical and healing conditions. An early experience using this flap for late-stage head and neck tumour treatment is reported. Forty-seven supraclavicular artery flaps were used to treat head and neck oncologic defects after cutaneous, intraoral and pharyngeal tumour resections. Dissection time, complications, donor and reconstructed area outcomes were assessed. The mean time for harvesting the flaps was 50 min by the senior author. All donor sites were closed primarily. Three cases of laryngopharyngectomy reconstruction developed a small controlled (salivary) leak that was resolved with conservative measures. Small or no strictures were detected on radiologic swallowing examinations and all patients regained normal swallowing function. Five patients developed donor site dehiscence. These wounds were treated with regular dressing until healing was complete. There were four distal flap necroses in this series. These necroses were debrided and closed primarily. The supraclavicular flap is pliable for head and neck oncologic reconstruction in late-stage patients. High-risk patients and modified radical neck dissection are not contraindications for its use. The absence of the need to isolate the pedicle offers quick and reliable harvesting. The arc of rotation on the base of the neck provides adequate length for pharyngeal, oral lining and to reconstruct the middle and superior third of the face. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Paralelización del código de desenredo y suavizado de mallas de tetraedros "S.U.S Code"

Máster Universitario en Sistemas Inteligentes y Aplicaciones Numéricas en Ingeniería (SIANI)

Optisch detektierte Magnetresonanz an NV-Zentren in Diamant

Die rasante Entwicklung der Computerindustrie durch die stetige Verkleinerung der Transistoren führt immer schneller zum Erreichen der Grenze der Si-Technologie, ab der die Tunnelprozesse in den Transistoren ihre weitere Verkleinerung und Erhöhung ihrer Dichte in den Prozessoren nicht mehr zulassen. Die Zukunft der Computertechnologie liegt in der Verarbeitung der Quanteninformation. Für die Entwicklung von Quantencomputern ist die Detektion und gezielte Manipulation einzelner Spins in Festkörpern von größter Bedeutung. Die Standardmethoden der Spindetektion, wie ESR, erlauben jedoch nur die Detektion von Spinensembles. Die Idee, die das Auslesen von einzelnen Spins ermöglich sollte, besteht darin, die Manipulation getrennt von der Detektion auszuführen.rn Bei dem NV−-Zentrum handelt es sich um eine spezielle Gitterfehlstelle im Diamant, die sich als einen atomaren, optisch auslesbaren Magnetfeldsensor benutzen lässt. Durch die Messung seiner Fluoreszenz sollte es möglich sein die Manipulation anderer, optisch nicht detektierbaren, “Dunkelspins“ in unmittelbarer Nähe des NV-Zentrums mittels der Spin-Spin-Kopplung zu detektieren. Das vorgeschlagene Modell des Quantencomputers basiert auf dem in SWCNT eingeschlossenen N@C60.Die Peapods, wie die Einheiten aus den in Kohlenstoffnanoröhre gepackten Fullerenen mit eingefangenem Stickstoff genannt werden, sollen die Grundlage für die Recheneinheiten eines wahren skalierbaren Quantencomputers bilden. Die in ihnen mit dem Stickstoff-Elektronenspin durchgeführten Rechnungen sollen mit den oberflächennahen NV-Zentren (von Diamantplatten), über denen sie positioniert sein sollen, optisch ausgelesen werden.rnrnDie vorliegende Arbeit hatte das primäre Ziel, die Kopplung der oberflächennahen NV-Einzelzentren an die optisch nicht detektierbaren Spins der Radikal-Moleküle auf der Diamantoberfläche mittels der ODMR-Kopplungsexperimente optisch zu detektieren und damit entscheidende Schritte auf dem Wege der Realisierung eines Quantenregisters zu tun.rn Es wurde ein sich im Entwicklungsstadium befindende ODMR-Setup wieder aufgebaut und seine bisherige Funktionsweise wurde an kommerziellen NV-Zentrum-reichen Nanodiamanten verifiziert. Im nächsten Schritt wurde die Effektivität und Weise der Messung an die Detektion und Manipulation der oberflächennah (< 7 nm Tiefe) implantieren NV-Einzelzenten in Diamantplatten angepasst.Ein sehr großer Teil der Arbeit, der hier nur bedingt beschrieben werden kann, bestand aus derrnAnpassung der existierenden Steuersoftware an die Problematik der praktischen Messung. Anschließend wurde die korrekte Funktion aller implementierten Pulssequenzen und anderer Software-Verbesserungen durch die Messung an oberflächennah implantierten NV-Einzelzentren verifiziert. Auch wurde der Messplatz um die zur Messung der Doppelresonanz notwendigen Komponenten wie einen steuerbaren Elektromagneten und RF-Signalquelle erweitert. Unter der Berücksichtigung der thermischen Stabilität von N@C60 wurde für zukünftige Experimente auch ein optischer Kryostat geplant, gebaut, in das Setup integriert und charakterisiert.rn Die Spin-Spin-Kopplungsexperimente wurden mit dem sauerstoffstabilen Galvinoxyl-Radikalals einem Modell-System für Kopplung durchgeführt. Dabei wurde über die Kopplung mit einem NVZentrum das RF-Spektrum des gekoppelten Radikal-Spins beobachtet. Auch konnte von dem gekoppelten Spin eine Rabi-Nutation aufgenommen werden.rn Es wurden auch weitere Aspekte der Peapod Messung und Oberflächenimplantation betrachtet.Es wurde untersucht, ob sich die NV-Detektion durch die SWCNTs, Peapods oder Fullerene stören lässt. Es zeigte sich, dass die Komponenten des geplanten Quantencomputers, bis auf die C60-Cluster, für eine ODMR-Messanordnung nicht detektierbar sind und die NV-Messung nicht stören werden. Es wurde auch betrachtet, welche Arten von kommerziellen Diamantplatten für die Oberflächenimplantation geeignet sind, für die Kopplungsmessungen geeignete Dichte der implantierten NV-Zentren abgeschätzt und eine Implantation mit abgeschätzter Dichte betrachtet.

Comparison of randomized treatments for late whiplash

BACKGROUND: To compare 4 different treatment strategies in patients with late whiplash syndrome. METHODS: Patients were randomly assigned to one of the following treatment groups: infiltration, physiotherapy, or medication. Group allocation was stratified according to gender, age, and education. Additionally, patients of each group were randomized 1:1 to cognitive-behavioral therapy (CBT) or no CBT. Patients were assessed at baseline, after an 8-week treatment period, and 3 and 6 months later. Main outcome measures were subjective outcome rating, pain intensity, and working ability. RESULTS: Of 91 enrolled patients, 73 completed the study; 62% were women. After treatment, 47 patients (64%) were subjectively improved (48%), or free of symptoms (16%), with a preponderance of women (73% vs 50%, p = 0.047). There was no difference regarding outcomes among the 3 treatment groups in men and women. The most robust difference was achieved with CBT, associated with a higher rate of recovery (23% vs 9%), and improvement (53% vs 42%) (p = 0.024), and with a gender difference (p = 0.01). All treatments significantly improved pain intensity and working ability. CONCLUSION: Intensive therapy in late whiplash syndrome can achieve improvement of different outcome measures including working ability in two-thirds of patients, more effective in women, persisting beyond 6 months in half. Additional cognitive-behavioral therapy was the most effective treatment modality. Classification of evidence: This interventional study provides Class III evidence that CBT used as an adjunct to infiltration, medication, or physiotherapy increases improvement rates in persons with late whiplash syndrome.

[Verification of normative values for the Swiss version of the Freiburg speech intelligibility test.]

BACKGROUND AND OBJECTIVE: In the Swiss version of the Freiburg speech intelligibility test five test words from the original German recording which are rarely used in Switzerland have been exchanged. Furthermore, differences in the transfer functions between headphone and loudspeaker presentation are not taken into account during calibration. New settings for the levels of the individual test words in the recommended recording and small changes in calibration procedures led us to make a verification of the currently used normative values.PATIENTS AND METHODS: Speech intelligibility was measured in 20 subjects with normal hearing using monosyllabic words and numbers via headphones and loudspeakers.RESULTS: On average, 50% speech intelligibility was reached at levels which were 7.5 dB lower under free-field conditions than for headphone presentation. The average difference between numbers and monosyllabic words was found to be 9.6 dB, which is considerably lower than the 14 dB of the current normative curves.CONCLUSIONS: There is a good agreement between our measurements and the normative values for tests using monosyllabic words and headphones, but not for numbers or free-field measurements.

Use of outdoor ranges by laying hens in different sized flocks.

In studies assessing outdoor range use of laying hens, the number of hens seen on outdoor ranges is inversely correlated to flock size. The aim of this study was to assess individual ranging behavior on a covered (veranda) and an uncovered outdoor run (free-range) in laying hen flocks varying in size. Five to ten percent of hens (aged 9–15 months) within 4 small (2–2500 hens), 4 medium (5–6000), and 4 large (≥9000) commercial flocks were fitted with radio frequency identification (RFID) tags. Antennas were placed at both sides of all popholes between the house and the veranda and the veranda and the free-range. Ranging behavior was directly monitored for approximately three weeks in combination with hourly photographs of the free-range for the distribution of hens and 6h long video recordings on two parts of the free-range during two days. Between 79 and 99% of the tagged hens were registered on the veranda at least once and between 47 and 90% were registered on the free-range at least once. There was no association between the percentage of hens registered outside the house (veranda or free-range) and flock size. However, individual hens in small and medium sized flocks visited the areas outside the house more frequently and spent more time there than hens from large flocks. Foraging behavior on the free-range was shown more frequently and for a longer duration by hens from small and medium sized flocks than by hens from large flocks. This difference in ranging behavior could account for the negative relationship between flock size and the number of hens seen outside at one point of time. In conclusion, our work describes individual birds’ use of areas outside the house within large scale commercial egg production.

Normal Thyroid Function and the Risk of Atrial Fibrillation: the Rotterdam Study

CONTEXT Hyperthyroidism is an established risk factor for atrial fibrillation (AF), but information concerning the association with variations within the normal range of thyroid function and subgroups at risk is lacking. OBJECTIVE This study aimed to investigate the association between normal thyroid function and AF prospectively and explore potential differential risk patterns. DESIGN, SETTING, AND PARTICIPANTS From the Rotterdam Study we included 9166 participants ≥ 45 y with TSH and/or free T4 (FT4) measurements and AF assessment (1997-2012 median followup, 6.8 y), with 399 prevalent and 403 incident AF cases. MAIN OUTCOME MEASURES Outcome measures were 3-fold: 1) hazard ratios (HRs) for the risk of incident AF by Cox proportional-hazards models, 2) 10-year absolute risks taking competing risk of death into account, and 3) discrimination ability of adding FT4 to the CHARGE-AF simple model, an established prediction model for AF. RESULTS Higher FT4 levels were associated with higher risks of AF (HR 1.63, 95% confidence interval, 1.19-2.22), when comparing those in the highest quartile to those in lowest quartile. Absolute 10-year risks increased with higher FT4 in participants ≤ 65 y from 1-9% and from 6-12% in subjects ≥ 65 y. Discrimination of the prediction model improved when adding FT4 to the simple model (c-statistic, 0.722 vs 0.729; P = .039). TSH levels were not associated with AF. CONCLUSIONS There is an increased risk of AF with higher FT4 levels within the normal range, especially in younger subjects. Adding FT4 to the simple model slightly improved discrimination of risk prediction.

El movimiento estudiantil reformista frente al primer episodio de la 'laica o libre' (mayo de 1956)

En mayo de 1956 se libró en la Argentina el primer episodio del conflicto "laica o libre". Así se llamó al enfrentamiento entre reformistas, contrarios al artículo 28 del decreto-ley 6.403 que permitía a las universidades privadas otorgar títulos habilitantes, y católicos favorables al mismo. En este contexto, se registró un ascendente proceso de tomas estudiantiles de secundarios y universidades. El conflicto le costó el cargo al católico ministro de Educación nacional Atilio Dell'Oro Maini y a los rectores de las universidades de Buenos Aires (UBA) y de Córdoba (UNC). No obstante las tensas implicancias que el mismo deparó dentro del gobierno de la autoproclamada "Revolución Libertadora", poco se conoce sobre él. En este artículo iniciaré su estudio. Para ello reconstruiré los hechos a través de los diarios La Nación y La Prensa, entre otras fuentes y bibliografía. Particularmente concentraré mi atención en el estudiantado reformista de la UBA

La mise en voix del Cantar del Mio Cid y el Códice de Vivar

En los últimos años, en el estudio de la mise en voix del Cantar de Mio Cid se ha privilegiado el plano musical de la interpretación. Sin descuidar esta dimensión, propongo volver sobre el plano textual y codicológico, ante la pobre evidencia preservada sobre aspectos rigurosamente musicales: las condiciones de su conservación en un códice de interés historiográfico, el conocimiento indirecto de la interpretación musical de la épica medieval, lagunas en el conocimiento de las técnicas de cantilación medieval clericales o laicas, la influencia que pudieron tener (o no) variantes locales como el canto mozárabe o el canto eugeniano, etc.

El movimiento estudiantil reformista frente al primer episodio de la 'laica o libre' (mayo de 1956)

En mayo de 1956 se libró en la Argentina el primer episodio del conflicto "laica o libre". Así se llamó al enfrentamiento entre reformistas, contrarios al artículo 28 del decreto-ley 6.403 que permitía a las universidades privadas otorgar títulos habilitantes, y católicos favorables al mismo. En este contexto, se registró un ascendente proceso de tomas estudiantiles de secundarios y universidades. El conflicto le costó el cargo al católico ministro de Educación nacional Atilio Dell'Oro Maini y a los rectores de las universidades de Buenos Aires (UBA) y de Córdoba (UNC). No obstante las tensas implicancias que el mismo deparó dentro del gobierno de la autoproclamada "Revolución Libertadora", poco se conoce sobre él. En este artículo iniciaré su estudio. Para ello reconstruiré los hechos a través de los diarios La Nación y La Prensa, entre otras fuentes y bibliografía. Particularmente concentraré mi atención en el estudiantado reformista de la UBA

La mise en voix del Cantar del Mio Cid y el Códice de Vivar

En los últimos años, en el estudio de la mise en voix del Cantar de Mio Cid se ha privilegiado el plano musical de la interpretación. Sin descuidar esta dimensión, propongo volver sobre el plano textual y codicológico, ante la pobre evidencia preservada sobre aspectos rigurosamente musicales: las condiciones de su conservación en un códice de interés historiográfico, el conocimiento indirecto de la interpretación musical de la épica medieval, lagunas en el conocimiento de las técnicas de cantilación medieval clericales o laicas, la influencia que pudieron tener (o no) variantes locales como el canto mozárabe o el canto eugeniano, etc.

El movimiento estudiantil reformista frente al primer episodio de la 'laica o libre' (mayo de 1956)

En mayo de 1956 se libró en la Argentina el primer episodio del conflicto "laica o libre". Así se llamó al enfrentamiento entre reformistas, contrarios al artículo 28 del decreto-ley 6.403 que permitía a las universidades privadas otorgar títulos habilitantes, y católicos favorables al mismo. En este contexto, se registró un ascendente proceso de tomas estudiantiles de secundarios y universidades. El conflicto le costó el cargo al católico ministro de Educación nacional Atilio Dell'Oro Maini y a los rectores de las universidades de Buenos Aires (UBA) y de Córdoba (UNC). No obstante las tensas implicancias que el mismo deparó dentro del gobierno de la autoproclamada "Revolución Libertadora", poco se conoce sobre él. En este artículo iniciaré su estudio. Para ello reconstruiré los hechos a través de los diarios La Nación y La Prensa, entre otras fuentes y bibliografía. Particularmente concentraré mi atención en el estudiantado reformista de la UBA

La mise en voix del Cantar del Mio Cid y el Códice de Vivar

En los últimos años, en el estudio de la mise en voix del Cantar de Mio Cid se ha privilegiado el plano musical de la interpretación. Sin descuidar esta dimensión, propongo volver sobre el plano textual y codicológico, ante la pobre evidencia preservada sobre aspectos rigurosamente musicales: las condiciones de su conservación en un códice de interés historiográfico, el conocimiento indirecto de la interpretación musical de la épica medieval, lagunas en el conocimiento de las técnicas de cantilación medieval clericales o laicas, la influencia que pudieron tener (o no) variantes locales como el canto mozárabe o el canto eugeniano, etc.

Seagrass and associated benthic community data derived from field surveys at Low Isles, Great Barrier Reef, conducted July-August, 1997

The distribution of seagrass and associated benthic communities on the reef and lagoon of Low Isles, Great Barrier Reef, was mapped between the 29 July and 29 August 1997. For this survey, observers walked or free-dived at survey points positioned approximately 50 m apart along a series of transects. Visual estimates of above-ground seagrass biomass and % cover of each benthos and substrate type were recorded at each survey point. A differential handheld global positioning system (GPS) was used to locate each survey point (accuracy ±3m). A total of 349 benthic survey points were examined. To assist with mapping meadow/habitat type boundaries, an additional 177 field points were assessed and a georeferenced 1:12,000 aerial photograph (26th August 1997) was used as a secondary source of information. Bathymetric data (elevation below Mean Sea Level) measured at each point assessed and from Ellison (1997) supplemented information used to determine boundaries, particularly in the subtidal lagoon. 127.8 ±29.6 hectares was mapped. Seagrass and associated benthic community data was derived by haphazardly placing 3 quadrats (0.25m**2) at each survey point. Seagrass above ground biomass (standing crop, grams dry weight (g DW m**-2)) was determined within each quadrat using a non-destructive visual estimates of biomass technique and the seagrass species present identified. In addition, the cover of all benthos was measured within each of the 3 quadrats using a systematic 5 point method. For each quadrat, frequency of occurrence for each benthic category was converted to a percentage of the total number of points (5 per quadrat). Data are presented as the average of the 3 quadrats at each point. Polygons of discrete seagrass meadow/habitat type boundaries were created using the on-screen digitising functions of ArcGIS (ESRI Inc.), differentiated on the basis of colour, texture, and the geomorphic and geographical context. The resulting seagrass and benthic cover data of each survey point and for each seagrass meadow/habitat type was linked to GPS coordinates, saved as an ArcMap point and polygon shapefile, respectively, and projected to Universal Transverse Mercator WGS84 Zone 55 South.

Thalassiosira weissflogii attachment assay and phylogenetic affiliation of bacterial isolates from samples of the German Wadden Sea

Aggregation of algae, mainly diatoms, is an important process in marine systems leading to the settling of particulate organic carbon predominantly in the form of marine snow. Exudation products of phytoplankton form transparent exopolymer particles (TEP), which acts as the glue for particle aggregation. Heterotrophic bacteria interacting with phytoplankton may influence TEP formation and phytoplankton aggregation. This bacterial impact has not been explored in detail. We hypothesized that bacteria attaching to Thalassiosira weissflogii might interact in a yet-to-be determined manner, which could impact TEP formation and aggregate abundance. The role of individual T. weissflogii-attaching and free-living new bacterial isolates for TEP production and diatom aggregation was investigated in vitro. T. weissflogii did not aggregate in axenic culture, and striking differences in aggregation dynamics and TEP abundance were observed when diatom cultures were inoculated with either diatom-attaching or free-living bacteria. The data indicated that free-living bacteria might not influence aggregation whereas bacteria attaching to diatom cells may increase aggregate formation. Interestingly, photosynthetically inactivated T. weissflogii cells did not aggregate regardless of the presence of bacteria. Comparison of aggregate formation, TEP production, aggregate sinking velocity and solid hydrated density revealed remarkable differences. Both, photosynthetically active T. weissflogii and specific diatom-attaching bacteria were required for aggregation. It was concluded that interactions between heterotrophic bacteria and diatoms increased aggregate formation and particle sinking and thus may enhance the efficiency of the biological pump.