SARS-CoV-2 infections amongst personnel providing home care services for older persons in Stockholm, Sweden.

BACKGROUND: In Sweden, home care services is a major external contact for older persons. METHODS: Five home care service companies in Stockholm, Sweden, enrolled 405 employees to a study including serum IgG to SARS-CoV-2 and SARS-CoV-2 virus in throat swabs. RESULTS: 20.1% (81/403) of employees were seropositive, about twice as many as in a simultaneously enrolled reference population (healthcare workers entirely without patient contact, n = 3671; 9.7% seropositivity). 13/379 employees (3.4%) had a current infection (PCR positivity). Amongst these, 5 were also seropositive and 3 were positive with low amounts of virus. High amounts of virus and no antibodies (a characteristic for presymptomatic COVID-19) were present in 5 employees (1.3%). CONCLUSIONS: Personnel providing home services for older persons appear to be a risk group for SARS-CoV-2. Likely presymptomatic employees can be readily identified by screening. Increased protection of employees and of the older persons they serve is warranted.

Fermentation of lignocellulosic hydrolysate by the alternative industrial ethanol yeast Dekkera bruxellensis.

AIM: Testing the ability of the alternative ethanol production yeast Dekkera bruxellensis to produce ethanol from lignocellulose hydrolysate and comparing it to Saccharomyces cerevisiae. METHODS AND RESULTS: Industrial isolates of D. bruxellensis and S. cerevisiae were cultivated in small-scale batch fermentations of enzymatically hydrolysed steam exploded aspen sawdust. Different dilutions of hydrolysate were tested. None of the yeasts grew in undiluted or 1:2 diluted hydrolysate [final glucose concentration always adjusted to 40 g l⁻¹ (0.22 mol l⁻¹)]. This was most likely due to the presence of inhibitors such as acetate or furfural. In 1:5 hydrolysate, S. cerevisiae grew, but not D. bruxellensis, and in 1:10 hydrolysate, both yeasts grew. An external vitamin source (e.g. yeast extract) was essential for growth of D. bruxellensis in this lignocellulosic hydrolysate and strongly stimulated S. cerevisiae growth and ethanol production. Ethanol yields of 0.42 ± 0.01 g ethanol (g glucose)⁻¹ were observed for both yeasts in 1:10 hydrolysate. In small-scale continuous cultures with cell recirculation, with a gradual increase in the hydrolysate concentration, D. bruxellensis was able to grow in 1:5 hydrolysate. In bioreactor experiments with cell recirculation, hydrolysate contents were increased up to 1:2 hydrolysate, without significant losses in ethanol yields for both yeasts and only slight differences in viable cell counts, indicating an ability of both yeasts to adapt to toxic compounds in the hydrolysate. CONCLUSIONS: Dekkera bruxellensis and S. cerevisiae have a similar potential to ferment lignocellulose hydrolysate to ethanol and to adapt to fermentation inhibitors in the hydrolysate. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study investigating the potential of D. bruxellensis to ferment lignocellulosic hydrolysate. Its high competitiveness in industrial fermentations makes D. bruxellensis an interesting alternative for ethanol production from those substrates.

Evidence for a spin-aligned neutron-proton paired phase from the level structure of (92)Pd.

Shell structure and magic numbers in atomic nuclei were generally explained by pioneering work that introduced a strong spin-orbit interaction to the nuclear shell model potential. However, knowledge of nuclear forces and the mechanisms governing the structure of nuclei, in particular far from stability, is still incomplete. In nuclei with equal neutron and proton numbers (N = Z), enhanced correlations arise between neutrons and protons (two distinct types of fermions) that occupy orbitals with the same quantum numbers. Such correlations have been predicted to favour an unusual type of nuclear superfluidity, termed isoscalar neutron-proton pairing, in addition to normal isovector pairing. Despite many experimental efforts, these predictions have not been confirmed. Here we report the experimental observation of excited states in the N = Z = 46 nucleus (92)Pd. Gamma rays emitted following the (58)Ni((36)Ar,2n)(92)Pd fusion-evaporation reaction were identified using a combination of state-of-the-art high-resolution γ-ray, charged-particle and neutron detector systems. Our results reveal evidence for a spin-aligned, isoscalar neutron-proton coupling scheme, different from the previous prediction. We suggest that this coupling scheme replaces normal superfluidity (characterized by seniority coupling) in the ground and low-lying excited states of the heaviest N = Z nuclei. Such strong, isoscalar neutron-proton correlations would have a considerable impact on the nuclear level structure and possibly influence the dynamics of rapid proton capture in stellar nucleosynthesis.

Communications: Elementary oxygen electrode reactions in the aprotic Li-air battery.

We discuss the electrochemical reactions at the oxygen electrode of an aprotic Li-air battery. Using density functional theory to estimate the free energy of intermediates during the discharge and charge of the battery, we introduce a reaction free energy diagram and identify possible origins of the overpotential for both processes. We also address the question of electron conductivity through the Li(2)O(2) electrode and show that in the presence of Li vacancies Li(2)O(2) becomes a conductor.

Effective charge of the (pi)h(11/2) orbital and the electric field gradient of Hg from the Yrast structure of 206Hg.

The gamma-ray decay of excited states of the two-proton hole nucleus, 206Hg, has been identified using Gammasphere and 208Pb+238U collisions. The yrast states found include a T(1/2) = 92(8) ns 10(+) isomer located above the known 5(-) isomer. The B(E2;10(+)-->8(+)) strength is used to derive the quadrupole polarization charge induced by the h(11/2) proton hole. Also, the implied quadrupole moment has been used to provide an absolute scale for the electric field gradient of Hg in Hg metal.

Magic nucleus 132Sn and its one-neutron-hole neighbor 131Sn.

Prompt and delayed gamma-ray cascades in doubly magic 132Sn and its neighbor 131Sn have been studied at Gammasphere using a 248Cm fission source. Isotopic assignments of unknown gamma rays were based on coincidences with known transitions in A = 112-116 Pd fission partners. The yrast level spectra of both tin nuclei are interpreted using empirical nucleon-nucleon interactions from the 132Sn and 208Pb regions. Results include identification of the (nuf(7/2)h(-1)(11/2))9(+) aligned state in 132Sn and of extensive (nuf(7/2)h(-2)(11/2)), (nuf(7/2)d(-1)(3/2)h(-1)(11/2)) and (nuh(-1)(11/2)x3(-)) multiplets in 131Sn. The previously reported beta(-) decay of an unusual 131In high-spin isomer to levels in 131Sn is also elucidated.

Temporomandibular dysfunction in patients treated with orthodontics in combination with orthognathic surgery.

Fifty-two patients with malocclusions underwent orthodontic treatment in combination with orthognathic surgery involving a Le Fort I and/or sagittal split osteotomy. Approximately 5 years after surgery, the patients were examined for signs and symptoms of temporomandibular disorders (TMD). The frequencies were found to be low in comparison with epidemiological studies in this field. The aesthetic outcome and chewing ability were improved in most patients (about 80 per cent). Some of the patients had reported recurrent and daily headaches before treatment. At examination, only two patients had reported having a headache once or twice a week, while all the others suffered from headaches less often or had no headache at all. Eighty-three per cent of the patients reported that they would be prepared to undergo the orthodontic/surgical treatment again with their present knowledge of the procedure. This study shows that orthodontic/surgical treatment of malocclusions not only has a beneficial effect on the aesthetic appearance and chewing ability, but also results in an improvement in signs and symptoms of TMD, including headaches.

Treated and untreated recovery from alcohol misuse: environmental influences and perceived reasons for change.

This Swedish study compared assisted and unassisted subjects with different long-term drinking outcomes with regard to drinking patterns, significant life events, and attributions as to what initiated and maintained recovery. It was found that both recovery, independent of help-seeking status, and help-seeking, independent of long-term outcome, were preceded by prolonged harmful drinking consequences and increasing negative stress. Initial attempts to solve the drinking problem were followed by a significant reduction in life stress, but stable recovery was uniquely associated with stability and/or major improvements in the life context. Unassisted recovery was more often gradual in character and/ or motivated by positive incentives than assisted recovery. Possible clinical and social-political implications are discussed.

Two-stage maxillary sinus reconstruction with endosseous implants: a prospective study.

The aim of this prospective study was to evaluate the results of 2-stage maxillary sinus reconstruction using titanium implants placed into iliac corticocancellous bone blocks previously grafted to the floor of sinuses. Fifty consecutive patients received 314 Brånemark implants of varying lengths; 202 implants were placed in the grafted bone and 112 were placed in the adjacent anterior maxillary alveolar process, which had received buccal onlay bone grafts. Follow-up time was 9 to 48 months after implant placement, which was accomplished 5 months after bone grafting. Eighty-four percent of the implants were integrated into the grafted sinuses and 75% were integrated into the anterior graft. Six patients (12%) lost implants in strategic positions, leading to secondary implant placement prior to fabrication of fixed prostheses. Thirty-eight patients (76%) received fixed prostheses. Only 5 individuals (10%) attained permanent implant-anchored overdentures. One patient lost all implants. The total implant survival rate (80.9%) and the survival rate of the fixed prostheses (100%) compare favorably with other reports.

Importance of bone graft quality for implant integration after maxillary sinus reconstruction.

OBJECTIVE: The aim of this study was to determine whether bone quality, as assessed by osteometry and histologic parameters, can be used to predict implant integration in conjunction with maxillary sinus reconstruction. STUDY DESIGN: Twelve patients with severely atrophied maxillary alveolar processes were treated through use of a two-stage surgical reconstructive strategy with implant placement 4 months after bone grafting. Bone biopsy specimens taken from the iliac crest peroperatively and from the sinus inlay sites 1, 2, 4, 6, or 12 months postoperatively were analyzed by light microscopy and osteomorphometry. Bone mineral content was measured by osteometry. RESULTS: Osteometric and osteomorphometric data (trabecular bone volume [%], assessment of chromatin staining, and an osteocyte index) registered for the biopsy specimens were not statistically correlated with implant failure. CONCLUSIONS: Prognostic evaluation of implant survival is difficult. The tested methods did not contribute to the improvement of guidelines for the clinical handling of these patients.

Stability of Le Fort I osteotomy with advancement: a comparison of single maxillary surgery and a two-jaw procedure.

PURPOSE: This study compared single maxillary surgery and a two-jaw procedure in patients who underwent one-piece Le Fort I advancement without bone grafting. PATIENTS AND METHODS: Fifty-three patients had Le Fort I osteotomy performed using a standard technique. Twenty-two patients had maxillary surgery alone, and 31 patients additionally had a bilateral sagittal split ramus osteotomy performed. Both rigid and nonrigid fixation were used. The postoperative movement of the maxilla was investigated, comparing cephalograms taken preoperatively, 2 to 3 days postoperatively, and at least 6 months postoperatively. A computer program was used to superimpose the three radiographs. RESULTS: No difference in postoperative stability was found when the two surgical procedures were compared, and no correlation between magnitude of advancement and degree of relapse could be identified (P > .05). Nonrigid fixation in patients receiving only maxillary surgery resulted in greater postoperative forward movement of the maxilla (P = .022). CONCLUSION: This study indicates that postoperative stability of the maxilla in a two-jaw procedure is equivalent to that of single maxillary surgery. Nonrigid fixation in single maxillary surgery reduces the need for postoperative orthodontics.

Sensibility following sagittal split osteotomy in the mandible: a prospective clinical study.

Bilateral sagittal split osteotomy may be associated with postoperative sensory deficiency in the area innervated by the inferior alveolar nerve. The aim of this study was to assess the neurosensory response of the inferior alveolar nerve after such surgery. Fifty consecutive patients receiving mandibular setback or advancement were investigated. Four different neurosensory tests were used: light touch, pin prick, static two-point discrimination, and vibration thresholds. These tests were performed preoperatively, 2 days, as well as 3 months and 12 months postoperatively. The methodologic error was found negligible. The pin prick and light touch tests as well as vibratory thresholds often disclosed a short period of decreased local sensibility, whereas static two-point discrimination displayed a slightly more extended postoperative sensory reduction. The patients did not experience any practical problems or essential drawbacks postoperatively. The only variable significantly associated with neurosensory disturbance was age. In conclusion, bilateral sagittal split osteotomy, when properly performed, must be considered a safe and reliable surgical technique, even from a neurosensory point of view.

Sinus inlay bone augmentation: comparison of implant positioning after one- or two-staged procedures.

PURPOSE: This study was undertaken to compare implant angulation and position after one- or two-stage sinus inlay bone augmentation. PATIENTS AND METHODS: Twenty patients were retrospectively selected; group 1 (n = 10) was operated on with a one-stage procedure, and group 2 (n = 10) with a two-stage operation. Casts processed for the final permanent or temporary bridgework were collected and photographed from an oblique anterior view paralleling the alveolar crest on the right and left sides, as well as from an occlusal view. The angle between impression pins inserted in the abutments relative to the true vertical was recorded. In the occlusal view, the midpoints of the abutments were related to an individual computerized superimposed parabola. RESULTS: The implants inserted during the one-stage procedure were generally placed more palatally (Wilcoxon rank sum test, P = .0101) and angled more palatally (P = .0009) compared with those placed with the two-stage operation. CONCLUSION: This study showed that the two methods of treating patients by sinus inlay bone augmentation differed significantly with regard to placement and angulation of the implants. A two-stage procedure seems to offer the surgeon more optimal conditions for positioning the implants.

A comparison of skeletal stability after mandibular advancement and use of two rigid internal fixation techniques.

PURPOSE: Two different methods of rigid fixation were compared for postoperative stability 6 months after mandibular advancement for treatment of Class II malocclusion. MATERIAL AND METHODS: Sixty (30 + 30) patients from two different oral and maxillofacial units treated for a Class II malocclusion by bilateral saggital split osteotomy (BSSO), and two different methods of internal rigid fixation were prospectively investigated. Two groups (S1, n = 15; S2, n = 15) had bicortical noncompressive screws inserted in the gonial area through a transcutaneous approach, and the other two groups (P1, n = 15; P2, n = 15) had the bone segments fixed with unicortical screws and miniplates on the lateral surface of the mandibular body. Cephalograms were taken preoperatively, 2 days postoperatively and 6 months after the operation. A computer program was used to superimpose the three cephalograms and to register the mandibular advancement and postoperative change both sagittally and vertically. RESULTS: These were minor differences in the advancement and postoperative changes between the four groups, but statistically no significant difference was shown in either sagittal or vertical directions. However, statistically verified differences proved that increasing age was associated with a smaller amount of postsurgical relapse. Low-angle cases (ML/NSL < 25 degrees) had a bigger amount of surgical (P = .0008) and postsurgical (P = .0195) movement compared with the patients in the high-angle group (ML/NSL < 38 degrees). Using a multiple regression test, a positive correlation was also shown between the amount of surgical advancement and the amount of postsurgical instability (P = .018). CONCLUSIONS: This prospective dual-center study indicates that the two different methods of internal rigid fixation after surgical advancement of the mandible by BSSO did not significantly differ from each other, and it is up to the individual operator to choose the method for internal rigid fixation.

Frequency of patients with acute asthma in relation to ozone, nitrogen dioxide, other pollutants of ambient air and meteorological observations.

OBJECTIVE: To study the association of the daily frequency of registration of patients with acute asthma at the emergency department of a central hospital in the south-west of Sweden with levels of air pollution and meteorological observations. METHODS: A retrospective longitudinal study was made of asthma patients taken from a hospital registry. This information was correlated with measurements of ozone, nitrogen dioxide, sulphur dioxide, toluene, temperature and relative humidity. Patients were from the catchment area of the Central Hospital of Halmstad containing around 120,000 inhabitants. A total of 4127 visits of patients with acute asthma to the emergency department at the Central Hospital of Halmstad were registered during a period of 1247 days from January 1990 to May 1993. The differential optical absorption spectroscopy (DOAS) technique was used to monitor levels of air pollutants over a distance of 1000 m in the central part of the town of Halmstad. Data on temperature, relative humidity, precipitation, wind speed and wind direction for the time period were supplied by the Swedish Meteorological and Hydrological Institute (SMHI). RESULTS: There were many statistically significant correlations between the levels of air pollutants and the meteorological measurements and a strong negative correlation between ozone and nitrogen dioxide. There was a statistically significant effect on asthma visits in children of low temperature and high nitrogen dioxide levels, and on asthma visits in adults of high temperature and high levels of ozone. CONCLUSIONS: There was a different reaction pattern in children and adults with asthma regarding temperature and ozone/nitrogen dioxide. The strong correlations between temperature and air pollution and between the levels of ozone and nitrogen dioxide made the true relation between asthma, air pollution and temperature hard to evaluate statistically.

Patients' assessment of surgical removal of mandibular third molars. An inquiry study.

The aim of this study was to find out patients' experience of pain and discomfort in connection with removal of lower third molars under local anaesthesia. Patients consecutively referred to the Oral and Maxillofacial Unit in Halmstad for removal of lower impacted third molars were the selection for this study. Three surgeons operated 294 lower third molars under local anaesthesia. The Visual Analogue Scale was used to register pain at several occasions during the surgical performance. The patients experienced the operation as an acceptable procedure and the most painful event during the operation was the injection of local anaesthetic solution. The study showed that the surgical procedure was very well tolerated by the patients with only a minor incident of inconvenience or excessive pain.

Paths to recovery from substance misuse: change of lifestyle and the role of treatment.

Controlled outcome studies have, on the whole, failed to demonstrate more than rather weak and short-lived effects of substance misuser treatment. There is, at the same time, growing evidence that people often recover from substance misuse problems without the help of formal treatment. This state of affairs has, not least in times of economic recession, been taken as an argument for cutting fundings of treatment facilities and other forms of formal help. This article questions that present knowledge necessarily justifies such conclusions. We do know that even severe misusers are sometimes capable of changing their way of life. We do not, however, know very much about the circumstances and situations-planned or not and designated as "treatment" or something else-that contribute to such change processes. A closer integration of two research areas-outcome research and research on "spontaneous recovery"-is proposed as a way of learning more about the possible interplay between "real life" events, various formal interventions, and change of life style.