42 research outputs found
Acoustic and physiologic analyses of hyperfunctional voice disorders
No full text"This study investigated the acoustic and physiologic correlates of vocal fatigue in 10 speakers with vocal nodules and 10 normal speakers in a natural environment and during an experimentally induced vocal fatigue speaking task. All subjects were examined by an otolaryngologist for the presence or absence of vocal nodules. Furthermore, experimental subjects' voices were rated as ""abnormal"" while the normal subjects' voices were rated as ""normal"" by three independent listeners.""Acoustic (fundamental frequency, jitter, shimmer and signal-to-noise ratio) and physiologic (closed-to-open ratios of electroglottograph waveforms) measures were obtained for each subject over three consecutive days at three target times: ""morning"" or two hours after waking; ""afternoon"" or seven hours after waking; and ""evening"" or twelve hours after waking. On the fourth consecutive day two hours after waking, subjects read orally for 60 minutes using a loud voice (75-80 dB SPL at 30 cm microphone-to-mouth distance). Every twenty minutes subjects were interrupted to obtain acoustic and electroglottographic data."The results showed no significant differences between the groups regarding a pattern of change in the measures across time in a natural environment. Only fundamental frequency and signal-to-noise ratio varied from morning to evening over the three days for individual subjects in both groups. During the prolonged reading task, both groups tended to increase fundamental frequency from baseline to 60 minutes. Signal-to-noise ratio increased from baseline to 60 minutes in the experimental group, but remained relatively stable across time in the normal group. With this exception, no other differences between the groups were found regarding a pattern of change in the acoustic or physiologic measures.It was interesting that the closed-to-open ratio was the only measure that clearly differentiated the experimental from the control group. Specifically, the experimental subjects demonstrated lower closed-to-open ratios than the control subjects. The lack of significant changes over time in the voices of the two groups, or differences between them, both in a natural and controlled conditions, suggests a need to re-evaluate the traditional assumptions regarding the dynamics of vocal fatigue.Made available in DSpace on 2011-05-07T14:07:45Z (GMT). No. of bitstreams: 2
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NDLS Communicator: Week of 11.13.22
No full textThe Latest News ND Law honors Professor Judy Fox and alumna Tia Paulette at the inaugural Rev. David T. Link Public Interest Banquet ND Law connects students and law firms at Meet the Employers Diversity Fellowship event \u27Religious Liberty Issues in Healthcare\u27 panelists offer insights on legal and cultural challenges in healthcare Sherif Girgis was quoted in the NRB article, 303 Creative Set to Be Heard by the Supreme Court.
Student News ND Law Moot Court Board hosts seventh annual religious freedom tournament Religious Liberty Student Cohort for 2022-2023 named
Events Monday, Nov. 14: SBA Thanksgiving Food Drive is happening all week in Eck Commons. The Future of Human Space Exploration with Notre Dame\u27s Dr. Clive Neal, 12:30 p.m., 1140 Eck Hall of Law Law & Economics workshop with Dean Lueck, Indiana University and Julio A. Ramos Pastrana, Penn State, 12:30 p.m., 2130 Eck Hall of Law Tuesday, Nov. 15: Art and Cultural Heritage in the International Law Context with Mary Ellen O\u27Connell, 12:15 p.m., 3140 Eck Hall of Law Battle of the Bills: A lunchtime chat with Bill Kelley and Fr. Bill Dailey, 12:30 p.m., 3130 Eck Hall of Law JLEPP, Vol 37 Speaker Series: The Morality of Markets with Dr. James Otteso, Notre Dame/Deloitte Center for Ethical Leadership, 12:30 p.m., 1140 Eck Hall of Law Wednesday, Nov. 16: Q&A with SpaceX\u27s Senior Counsel Rachel Lovejoy, 12:30 p.m., 3130 Eck Hall of Law Humanity as Commodity: The Modern Form of Slavery with Fr. Jeff Bayhim, founder of Metanoia Manor, a residential facility in Louisiana that provides a place of refuge for girls who have been victims of human trafficking, 12:30 p.m., McCartan Courtroom Thursday, Nov. 17: Reflections on Dobbs v. Jackson Women\u27s Health Org with Scott Stewart, Solicitor General, Mississippi Attorney General\u27s Office, 12:30 p.m., 1140 Eck Hall of Law Friday, Nov. 18: 2022 JLEG Symposium , 9 a.m. to 3:15 p.m., McKenna Hall. The JLEG Symposium is an all-day educational seminar with professors from outside the university that will discuss the legal ramifications of the Dobbs decision. Football Friday Speaker: Larissa Herczeg \u2796: Trends in Real Estate Investments, 11 a.m., McCartan Courtroom SCELF Speaker: Wendi Li, Counsel for the Brooklyn Nets, 12:30 p.m., 2171 Eck Hall of Law Saturday, Nov. 19 Notre Dame vs. Boston College, 2:30 p.m.
Around the Watercooler Congratulations to Christine and Kelly Holst-Haley on the arrival of their new son, Miles Kelly Holst-Haley
Are toxins from harmful algae a factor involved in the decline of harbour seal populations in Scotland?
No full textFirstly this study builds on the investigation initiated by Hall and Frame (2010),
which found that Scottish harbour seals were exposed to domoic acid (DA), a
potent natural neurotoxin produced by phytoplankton. Using the same sample
collection technique to gather urine and faecal material from various
populations around Scotland with differing population trajectories (Lonergan et
al., 2007), the objective was to investigate not only exposure to DA, but also
other groups of toxins such as paralytic shellfish poisoning (PSP) toxins and
the lipophilic toxins okadaic acid (OA) and dinophysis toxins (DTXs). Toxins
from harmful algae are thought to be potential causative factors in the ongoing harbour seal decline in some regions of Scotland (Hall and Frame,
2010).
This investigation was initiated because Pseudo-nitzschia (which produces
DA) in particular was found to be highly prevalent in the phytoplankton
communities in Scotland (Fehling et al., 2004; Stobo et al., 2008) and indeed
was first observed at increased concentrations at around the time the harbour
seal populations were observed as declining (Lonergan et al., 2007; Stobo et
al., 2008). Prior to 2000 harbour seal populations in Scotland were largely
stable or increasing. In addition DA exposure has had a devastating effect on
the California sea lions (CSL) from the US west coast, where morbidity and
mass mortality has occurred as a result of exposure (Goldstein et al., 2008;
Gulland et al., 2002; Lefebvre et al., 1999; Scholin et al., 2000). In addition to
the toxin analysis in urine and faecal samples, blood samples were collected
and health parameters such as white blood cell and differential cell counts
were investigated. Plasma cortisol concentrations and parasite faecal egg
counts were additionally investigated as parameters indicative of adrenal
function and parasite burden. CSL exposed to DA have significantly lower
blood cortisol levels and higher eosinophil counts (Gulland et al., 2012) so it
was possible that these indicators of effects might also be seen in the harbour
seals. High parasite loads are often associated with high eosinophil levels
(Klion and Nutman, 2004) so these data were needed to ensure any positive relationships found were linked to DA and were not a consequence of parasite
burdens.
The work presented in this thesis highlights the effect of exposure to the
neurotoxin DA and documents that Scottish harbour seals are exposed to
multiple toxins such as PSP toxins, OA and DTX-2 (Chapter 2, Chapter 4).
Immunomodulatory effects of DA exposure such as lymphocytopenia and
monocytosis are also reported. In general, harbour seals from the east coast
and Northern Isles, where the decline in abundance has been greatest, had
higher levels of DA in their excreta than animals from the west coast. The
concentrations in the faeces and urine samples were generally low but time
since exposure was unknown. Uptake of DA, PSP toxins, OA and DTXs in
randomly selected fish from the east coast of Scotland in the Firth of Forth
was investigated (Chapter 3), where benthic, flat and pelagic fish are shown
to be vectors of toxin transfer and emphasis is drawn to flatfish as they seem
to accumulate higher levels of toxins than the other species analysed. This
indicates that harbour seals foraging off the east coast are likely to regularly
encounter toxic prey that could impair their health.
In addition to live captured harbour seals, samples from dead stranded marine
mammals (including cetaceans and in particular harbour porpoise) found a
range of species in Scottish waters were exposed to both DA and PSP toxins
(Chapter 4). A monitoring tool to rapidly determine chronic DA exposure in
blood samples was published recently for DA exposed CSLs and in Chapter 5
this monitoring technique was attempted in phocid seals, and where it failed to
be replicated or validated which questions its function as a DA monitoring tool.
Questions regarding how quickly a marine mammal excretes DA from the
body have been discussed in the literature and in Chapter 6 an experiment
was set up to measure the clearance of DA by using a biomarker (Iohexol).
Iohexol was successfully measured in plasma samples from captive harbour
seals following oral intake, where concentration and time of the iohexol peak
was identified together with the calculation of its half-life. These results
indicate the approximate elimination rate of DA (and potentially other
hydrophilic toxins) and can be used to better interpret urine levels of DA measured in wild caught harbour seals. Collectively the results of this
research will enable the risk posed by the ingestion of various toxins present
in the Scottish marine food chain to marine mammals (particularly harbour
seals but also harbour porpoise and grey seals) to be assessed
Iowa History and Culture : A Bibliography of Materials Published Between 1952 and 1986, 1989
No full textThis bibliography was compiled by two reference librarians, Patricia Dawson and David Hudson with the goal of making it easier of tracking down material on Iowa history and culture. This supplements the Iowa History Reference Guide published in 1952 by William Petersen
Improving Written Language and Exploring Attitudes towards Learning English in Primary Age ESL Learners in Brunei Darussalam
No full textThis research was conducted in the small sultanate of Brunei Darussalam on the island of Borneo where the researcher was working as an English language teacher at a government primary school. Although the majority of students’ first language is Bruneian Malay, English is also an important component of the Bruneian curriculum, and is taught from new entrant level. From Year 1, Mathematics and Science are also taught in English and students sit Cambridge University examinations in these three subjects at secondary school. As these are examinations for native speakers, a high standard of English is necessary for academic success.
The main goals in this research were to investigate whether a journal writing programme would improve the English writing of primary students and to suggest to what extent their differing attitudes towards learning English affect success in writing tasks.
The research used the context of a case study of ten students in Years 4, 5 and 6 participating in a weekly journal writing programme to focus on four aims:
• to document any changes or improvements in students’ written English over the course of ten months through a comparison of writing samples at the beginning and end of the programme;
• to observe any changes in student attitudes towards the writing programme and their relationship with the teacher;
• to ascertain basic attitudes or challenges towards learning and using English at school and at home;
• to suggest any connection between the findings for the above aims and actual academic achievement in end of year English examinations.
A mixed-methods approach was used for this research which collected five different types of data and was conducted in two parts. A background context for the study was first established by surveying peers from the same school about their attitudes towards English and any challenges they face. School examination results were also studied. A range of data was then collected from the case study students which included their own survey responses, examination results, written journal entries and classroom observations by the teacher.
A major finding of this research study was the significantly improved deeper writing features exhibited in the journal writing entries. Students’ sense of audience, personal voice, and quality of vocabulary improved far more than would be expected from normal writing maturation in this timeframe. There is evidence of a high degree of student engagement during journal writing, often due to personally motivating topics. The opportunity to share ideas through written dialogue with their teacher resulted in the development of strong teacher student relationships. Findings surrounding the issues of modeling correct language in context, code switching to enhance understanding of new language and the explicit teaching of vocabulary are also examined.
This research provides several other significant findings. There is strong evidence primary age students at all ability levels value English and would like to improve their academic results. Differences in gender were discovered with more boys than girls finding writing the most difficult English skill. Boys were also more likely to fail examinations. Interesting data is provided about the feedback teachers provide writers, and a major finding was that classroom English tasks were not able to be completed successfully by approximately half of all students. There are interesting findings about the strong beliefs students hold on being taught the other core subjects of Mathematics and Science using the English language.
Finally, this research makes an important contribution to understanding how young learners’ attitudes towards a second or subsequent language affect their ability to do the task and to eventual task success or failure. A major implication for educators from this research is that many students are likely to highly benefit from a differentiated English programme in primary school which supports the varied learning needs of all students.
Although this research was conducted in Brunei, many of the findings may also be applicable to ESL teaching programmes in other parts of Asia and around the world at a time of strong international interest and growth in English second language teaching
Schools of Anglo-Saxon stone sculpture in the north Midlands.
No full textThis thesis concerns the identification of schools of Anglo-Saxon stone sculpture in the the north
Midlands. It also contains a critical examination of the assumptions which have tended to
underlie previous studies of this subject. The term 'school' can be interpreted in different ways,
but is defined here as groups of sculptured monuments which are associated by common design
elements and appear to be a product of some form of localised organisation.
The research produced a large database of information for each sculptured stone monument in
the research area. The results of the analysis of this material are as follows:
An analytical method has been devised to identify objectively the schools and their geographical
distribution in terms of their design elements. Six different schools of sculpture have been
Identified in the research area. it is found that architectural sculpture does not appear to be
directly related to any of the schools: only free-standing sculpture shows such cohesion.
The geographical distribution of each school was compared with our understanding of land
divisions. It was found that the schools do not appear to relate to any ecclesiastical provision, but
to secular land units or settlement groups. In most cases these are likely to have been those
existing during the period of Viking settlement
The distribution of the sculpture is compared with our limited historical knowledge and this
suggests that most of the monuments can be dated to the first half of the tenth century. They
may have been erected as a result of the reconquest of Viking held territory, by the English.
Evidence, mainly from the types of stone used in the manufacture of the monuments, suggests
that they were likely to have been crafted at each site and were not the product of centralised
'workshops'
pach350
No full textPalo Alto
C e n t e n n
Byxbee, John F. 78, 79, 218
Cabana 196
Cable Co-op 32, 58
cable television 58
California 14, 55, 148
California Avenue 33, 187, 188
depot site 119
present depot built 150
California Coastal Conservancy 58
California Council of Indians 295
California Democratic Council 60
California Interscholastic Fed. 129
Calif Japanese Exclusion
League 287
California Lands Building 193
California Legislature 35
California Military Academy 144
California National Guard
signal corps started 202
California Paint and Wallpaper 187
California Railroad Commission 218
California State Telegraph 201
California State Woman Suffrage
Educational Association 26, 297
California Supreme Court
backed 1.5-mile law 64
California Teachers Association 138
CalTrain 151-153
Camelot Gardens 116
Cameron, Donaldina 282, 283
Camp Fremont 4, 72, 92, 230, 303
Spanish flu epidemic 167, 168
campaign committees 57, 58
Campbell, Jim 273
Campbell, Mary Grafton 70
Campbell, W. Matlock 104
campus construction halted 29
campus grammar school
built by Mrs. Stanford 123
canneries 201
Caperon, Jean-Baptiste Paulin 21
Card, Lockhart 274
Cardinal, the 279
Cardinal Cafe 284
Cardinal Hotel 112
Cardinal Manor 116
Carey, George J. 89
Carl Holvick 194
Carl Swenson 195
Carlson, Richard C. 315
Carnegie, Andrew 48, 71
Carpenters Hall 119, 265
Carrasco, Tony 120
Casa Real 112
Casaday, G. Arthur 254
Casanueva, Francisco 20
Case of "the Negro Johnson" 282
Casper, Gerhard 314
Castilleja Hall 141, 142, 254, 269
Castilleja School for Girls 43,
141, 142
Leonard Ely Fine Arts Center 142
Castle, Don 274
Cathcart, Arthur M. 51, 230
Cathcart, Patti 81
Catholic Community of Palo Alto
and Stanford 253
census tract 5113 83
Center for Creativity & Growth 305
Center for Continuing Study of the
California Economy 315
Central Pacific Railroad 39
Big Four 2, 35
Central Valley Project 221
Chabad of Greater South Bay 266
Chan, Mari 295
Chang, Tom 267
channel improvements 98
Channing Avenue School 125, 129
Channing House 7, 99, 179, 195
Chapel Car Emmanuel 253
Charles, E.W. 165
Charles, Isabel Peck 228
Charles, Samuel W. 228
Chautauquas 90
chemical waste problems 223, 314
Chen, Clement 198
chicken feathers 222
Children's Health Council 141, 179
Children's Hospital at Stanford 179
Children's Library 2, 111
Children's Theatre 1, 76, 77, 120
Chinese 29, 267, 281
Chinese Community Center of the
Peninsula 119, 295
Chinese eateries 283, 284
Chinese New Year dinner 284
Chinese slave girl case 228, 282
Christensen, C.H. 51
Christian Life Center 259
Christiansen, Jack 279
Christmas flood of 1955 97
Christmas Tree Lane 103
chrysanthemum growers 7
Chua, Amelia 250
church buses 259
church life, early 69
Church of Jesus Christ of the
Latter-day Saints 259
Church of the Nazarene 259
Churchill Avenue 150
circuses 90
Citizens' Committee of 100 277
City Cafe 284
Civic Forum 74
Civic League 74
Civic League of Palo Alto 57
civil defense 237
Civil War 149
Clark, Arthur B. 4, 29, 111, 251
first Mayfield mayor 29
Clark, Birge 111, 112, 120, 128,
131, 195
Clark, David 131
Clark, Esther 173, 174, 179
Clark, Keith 278
Clark, Sarah Mitchell 72
Clark, William 174
Clarke ranch 109
Clarke's Landing 18, 27
Clarke, Jeremiah 18, 27, 249
Clay, Roy 294
clean air and water 308
Cleaver, Eldridge and Kathleen 294
Clemo, William 235
Cliff, Frank B. 240
Clifton, Gene 242
climate 8, 11
Clogenson, Eugenie 21
Co-op Markets 198
Coan, Kelly 274
Coast Radio Company 202
coast redwoods set-aside 302
Coastwise 117
cocktail, first legal downtown 66
Cody, George "Tad" 119
Cogswell, Elinor V. 138, 156, 172,
190, 282, 305
Cole, Lester 242
Coleman mansion 144
College Terrace 1, 21, 28, 29, 71,
88, 105, 161, 244
initially named Palo Alto 28, 41
Collier, Kenneth 256
color line battles 293
Colored Citizens' Club 288
Committee for Good Government
54,57
Committee for Green Foothills 307
communications center 214
Community Association for the
Retarded (C.A.R.) 141, 180
Community Center Commission 74
Community Council of Northern
Santa Clara County 83
Community House 51, 72
commuter service, rail 150, 153
Company L, California National
Guard 72, 294, 303
compatibility of buildings 121
components suppliers 214
comprehensive plan 314
compulsory military training 303
computer innovations 1, 213
computer science 135
Comstock, Kirke 56
Concerned Citizens of Palo Alto 310
condominium units 118
Congdon & Crome 184, 198
Congdon, Clark 273
Congregation Ahavas Yisroel-
Lubavitch 266
Congregation Beth Am 265
Congregation Kol Emeth 265
congressional election, special 60
conservation 306
conserve beneficial
environment 297
construction 6, 7, 195
conventions, small to middling 196
conversion to peacetime 97
Cooley's Landing 150
Cooley, Charles P. 51, 92, 230
Corcoran (Justesen), Mildred 54
Cordell, LaDoris H. 240
Cordes, Henry 274
Corliss steam engine 221
Cornish & Carey 192, 198
Corte Madera Reservoir 220
cosmopolitan consciousness 309
Cottrell, Edwin A. 51, 53, 218
Couch, Doug 192
Council for the Arts - Palo Alto
Area (CAPA) 81
Council of Churchwomen 66
Council of P-TAs 66
country estates 21, 150
county road 147
couples, two-salary 7
Coutts, Peter 21, 27, 28
Covenant Presbyterian Church 265
Cowell Student Health Service 174
Cowles, Omar 274
Coxhead, Ernest 109
Cramer, Frank 124, 143
Cramer, Karen 275
Crane, Whitfield 81
Cranston, Alan 60
Crary, Ruth (Mrs. Charles J.) 132
Creative Initiative Foundation 311
Creekside School 136
Crescent Park 110, 235
Crescent Park School 132, 136
Crespi, Juan 11, 14
Cribbs, Anne Warner 276
Crist, Frank Lee 61, 66, 131
Crist, Griffiths, Schulz & Biorn
195
Crist, Skip (Frank Lee, Jr.) 274
Crocker, Julian 136
Crosby, Elisha O. 18, 23, 24
Crothers, George E. 38
cryonics society 7
Cubberley Community Center
267, 295
Cubberley High School 59, 79, 133,
136, 140, 144, 274
Cubberley Theatre 78
Cubberley, Ellwood Patterson 133
cultural and recreational programs
extended to new neighborhoods 78
Cultural Center 6, 80
cultural groups, city-assisted 71
cultural life 69
Cumberland Presbyterian
Church 249
Cumming, Bruce C. 227, 244
Cummings, Robert 277
Cupertino 130, 140, 156
curb your dog campaign 52
curfew 56
curricula, post-Sputnik 134
Curry, David 228, 229
Curtice, Jack 279
Curtner ranch/tract 109, 110
Cutting, Windsor 174
D-Day 97
Dahl Plumbing 198
Dahl, John and Louis 183
Dailey, Gardner 110
Daily Palo Alto 89, 283
dairies and farms 116
Daley, J.B. 109
Dalmadge, Gerald 208
Danneberg, Robert 151
Danon, Elizabeth 145
Daughters of the American
Revolution 72
Daughters, George 174
DAvenport exchange 214
David Starr Jordan Junior
High School. See Jordan.
Davidson, Cy 274
Davis, Frank 107
Davis, Joseph 174
Davis, W.T. 196
Day, Doris 196
Dayan mansion 108
De Anza College 140
De Anza, Juan Bautista 15
de Forest, Lee 201, 203, 207
de Lemos House 113
de Lemos, Pedro 112
De Luxe Dance Hall 235
de Mesa, Dollie 288
Dean Witter & Co. 196
Dean, William 109
DeBona, Eve 267
Debs, Robert J. 54, 307
Decker House 104
Decker, Charles 104
Delta Tau Delta house 106
Democratic presidential nominees
since '64 usual P.A. winners 60
Democrats, liberal 2
demolished residences 121
Dengler, Herbert "Putt" 12
Denmark, Grant 274
density 58
33
Social enterprise and social entrepreneurship in practice.
No full textIn my practice experience and exploration of literature, I discovered that there are limited examples and research about organisations that aim to change from a charity to a social enterprise. In addition to this, there are limited knowledge and understanding about what social enterprise and social entrepreneurship are and a lack of frameworks that will enable one to know a social enterprise and social entrepreneur when you see one. This research, therefore, is an exploration of social enterprise and social entrepreneurship in practice, arriving at working definitions and frameworks. It examines the process, experiences and challenges that come with an organisation - Age Concern Bexley - changing from a charity to a social enterprise. The research then shares the experiences and the challenges that come with such organisational change
The research also examines and exposes my role and experiences - as the Chief Executive, social entrepreneur, leader and change agent, during this period. The research
then provides an insight into the self-discovery, self evaluation and reflections of a social entrepreneur in practice, especially from the insider practitioners' perspective, thereby enabling seeing social enterprise and social entrepreneurship from the lens of a social
entrepreneur. This research does not look into the issues surrounding governance during this change; as recent researches concluded that governance have little impact in this context( Young,2006). My view is that governance is importany and relevant; although the experience during this research does highlight that it was not a major issue. However,I would recommend it as an area of and for future research. The research combines empiricism and rationalism with iterations. In the research, I applied methodical pluralism as overarching research methodology by applying a portfolio of methodologies, using different methods to gather necessary data from different sources. The research contributest o practice with the establishment of a social enterprise service at Age Concern Bexley whilst also developing a set of high-level challenges that organisations that aim to explore social enterprise need to be aware of and how to manage them. The research contributes to theory by arriving at a working definition and framework of social enterprise. It also provides a better understanding of social entrepreneurship in practice and the role of a social entrepreneur as a leader and change agent. Other contributions to theory are the employment of metaphors to explain organisational change,the application of socio-psychological theory of labelling to explain the deviancy of social enterprise and social entrepreneurship and argument for sector differentiation, that is, social enterprise as a distinct sector. Some other contributions to practice are the showcasing of social enterprise in practice, the establishment of Bexley Social Enterprise Consortium, the establishment of an international development social enterprise organisation - Hephzibah - and the aim of
establishing a social enterprise academy in Nigeria. These are to enable me put into further practice, what I have learnt through this research. The research concludes that the practice of social enterprise is here to stay, that social entrepreneurial organisations need social entrepreneurs in leadership and that it will be challenging for existing charities to convert in totality to social enterprises.
1
Development and characterisation of an in vitro human gut model to study the biofilm mode of growth of clostridium difficile and the indigenous gut microbiota
No full textClostridium difficile infection (CDI) is associated with significant patient morbidity, mortality and financial burden. Until recently, antimicrobial treatment options were limited to metronidazole and vancomycin, but both agents are associated with recurrence rates of approximately 20%.
The human gastrointestinal tract harbours a complex microbial community which exist in planktonic and sessile form. Sessile organisms are known to cause chronic infection such as cystic fibrosis. Mucosal biofilms exist on surfaces of the gastrointestinal tract, but the existence and role of C. difficile in these structures remains unknown.
The present study describes the process undertaken to adapt and validate an in vitro human gut model to study the planktonic and biofilm mode of growth of C. difficile and the indigenous gut microbiota. A triple stage chemostat gut model, primed with a human faecal emulsion was used to induce and treat simulated CDI. A glass rod system was incorporated into the third vessel to facilitate the formation and subsequent analysis of mixed-species biofilms.
Sessile and planktonic gut microbiota and C. difficile populations within an in vitro gut model are similar in the absence of antimicrobial intervention. Differences in behaviours of the two modes of growth are evident upon antimicrobial administration, with a delayed response in sessile populations. The sessile mode of growth of C. difficile within mature biofilm structures is complex and variable. Within the redesigned biofilm gut model, sessile C. difficile remained in spore form for the duration of the experiment, despite induction of simulated CDI, treatment of CDI and recurrence of disease evident within planktonic communities.
Recalcitrant spores within biofilms may be seeded into the planktonic fluid of the gut model after apparent successful initial treatment and contribute to recurrence of CDI. The role of sessile C. difficile in recurrent CDI should be further investigated
