bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduction in Medicaid Rebates Paid by Pharmaceutical Manufacturers for Outpatient Infused, Injected, Implanted, Inhaled, or Instilled Drugs: The 5i Loophole
Authors: Dickson Sean , Gabriel Nico , Gellad Walid , Hernandez Inmaculada
Published: July 2022

Context: When nonretail pharmacy sales exceed 70% of sales, manufacturers of infused, injected, implanted, inhaled, or instilled (5i) drugs are required to calculate average manufacturer price (AMP) under a different methodology than that used for drugs predominantly distributed through retail channels. Specifically, the modified methodology includes pharmacy benefit manager (PBM) rebates in the calculation of AMP for 5i drugs. The modified methodology reduces manufacturers' Medicaid rebate liability and increases net costs to the Medicaid program.

Methods: The authors identified 15 5i drugs predominantly dispensed through the nonretail setting. Using 2013–2017 data from Medicaid, Medicare, SSR Health, and 340B program eligibility, they estimated differences in AMP, Medicaid rebates, and net Medicaid costs under both the standard and 5i AMP methodologies.

Findings: AMP was 42% lower, on average, under the 5i methodology than under the standard methodology. From 2013–2017, Medicaid rebates under the 5i methodology were 82% lower than under the standard methodology, resulting in manufacturers of these 15 drugs reducing their Medicaid rebate liability by $1.1 billion in five years.

Conclusions: Inclusion of PBM rebates in the calculation of AMP for 5i drugs significantly reduced Medicaid rebates, resulting in higher Medicaid spending. This may incentivize manufacturers to shift sales to nonretail channels. To remove this incentive, policy makers should consider excluding PBM rebates from the calculation of AMP for 5i drugs.
Exercise-Induced Fatigue in Hamstring versus Quadriceps Muscles and Consequences on the Torque–Duration Relationship in Men
Authors: MASSAMBA ANASTHASE , HUCTEAU ELYSE , MALLARD JORIS , DUCROCQ GUILLAUME P. , FAVRET FABRICE , HUREAU THOMAS J.
Published: July 2022

Purpose

The present study investigated the mechanisms of neuromuscular fatigue in quadriceps and hamstring muscles and its consequences on the torque–duration relationship.

Methods

Twelve healthy men performed a 5-min all-out exercise (3-s contraction, 2-s relaxation) with either quadriceps or hamstring muscles on separate days. Central fatigue and peripheral fatigue were quantified via changes in pre- to postexercise voluntary activation (VA) and potentiated twitch (PTw) torque evoked by supramaximal electrical stimulation, respectively. Critical torque was determined as the mean torque of the last six contractions, whereas W′ was calculated as the torque impulse done above critical torque.

Results

After exercise, maximal voluntary contraction (MVC) decreased to a greater magnitude (P < 0.001) in quadriceps (−67% ± 9%) compared with hamstring (−51% ± 10%). ∆PTw was also greater in quadriceps compared with hamstring (−69% ± 15% vs 55% ± 10%, P < 0.01), whereas central fatigue only developed in quadriceps (∆VA, −25% ± 28%). Hamstring demonstrated reduced critical torque compared with quadriceps (60 ± 12 vs 97 ± 26 N·m, P < 0.001) as well as drastically lower W′ (1001 ± 696 vs 8111 ± 2073 N·m·s, P < 0.001). No correlation was found between quadriceps and hamstring for any index of neuromuscular fatigue (∆MVC, ∆PTw, or ∆VA).

Conclusions

These findings revealed that hamstring presented different etiology and magnitude of neuromuscular fatigue compared with quadriceps. The absence of correlation observed between quadriceps and hamstring fatigue parameters (∆MVC, ∆PTw, or ∆VA) suggests no interrelation in fatigue etiology between these two muscle groups within individuals and, therefore, highlights the need to investigate specifically hamstring muscle fatigue.
Current status and future developments in predicting outcomes in radiation oncology
Authors: Niraula Dipesh , Cui Sunan , Pakela Julia , Wei Lise , Luo Yi , Ten Haken Randall K , El Naqa Issam
Published: July 2022

Advancements in data-driven technologies and the inclusion of information-rich multiomics features have significantly improved the performance of outcomes modeling in radiation oncology. For this current trend to be sustainable, challenges related to robust data modeling such as small sample size, low size to feature ratio, noisy data, as well as issues related to algorithmic modeling such as complexity, uncertainty, and interpretability, need to be mitigated if not resolved. Emerging computational technologies and new paradigms such as federated learning, human-in-the-loop, quantum computing, and novel interpretability methods show great potential in overcoming these challenges and bridging the gap towards precision outcome modeling in radiotherapy. Examples of these promising technologies will be presented and their potential role in improving outcome modeling will be discussed.
Covid-19 associated shoulder girdle calcific myositis: a novel entity
Authors: Al-Khudairi Naji , Dulay Gurdeep S , Witham Fiona
Published: July 2022

Objective:

To investigate the prevalence, describe the radiological features, and consider the clinical sequelae of COVID-19- associated shoulder girdle calcific myositis.

Methods:

All patients who underwent a CT pulmonary angiogram study at our institution (Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom) in April and May 2020, January 2021, and July 2021 were included. A total of 1239 CT pulmonary angiogram studies for 1201 patients were reviewed. Patients with COVID-19 and associated shoulder girdle calcific myositis were identified. Their electronic patient records were reviewed. The patients’ demographics, serum inflammatory markers, and proning history were recorded.

Results:

Of the 364 patients in Wave 1, 71 patients (19.5%) had COVID-19, and of those, 2 patients (2.8%) had shoulder girdle calcific myositis. Of the 521 patients in Wave 2, 354 patients (67.9%) had COVID-19, and of those, 3 patients (0.8%) had shoulder girdle calcific myositis. Of the 316 patients in Wave 3, 37 patients (11.7%) had COVID-19, and of those, 1 patient (2.7%) had shoulder girdle calcific myositis. The overall prevalence was 1.3%. The most common site of calcific myositis was within the subscapularis muscle.

Conclusion:

COVID-19-associated shoulder girdle calcific myositis is a rare extrapulmonary musculoskeletal manifestation of COVID-19. Early recognition and increased awareness of this disease entity, in our experience, aids in reducing patient morbidity and improving long-term functional outcome.

Advances in knowledge:

We have reported a novel disease entity associated with COVID-19, in the form of shoulder girdle calcific myositis. We have described the common imaging features and discussed our experience of management and clinical sequelae.
ALARP: when does reasonably practicable become rather pricey?
Authors: Kotre Colin John
Published: July 2022

The Ionising Radiations Regulations 2017 require employers to restrict radiation doses to their employees and the public to be As Low As Reasonably Practicable. This article looks at the boundary between what might be considered to be reasonable and unreasonable in protecting staff and the general public in the field of hospital-based diagnostic radiology. A simple test for locating this boundary based on a cost–benefit approach is devised and its use illustrated using hospital-based radiation protection examples. It is concluded that a cost–benefit calculation based on the legal definition of As Low As Reasonably Practicable may have some use in the support of radiation protection decision-making in the hospital environment, but only within the context of existing legal, practical and ethical considerations.
Methods and tools to support instructional quality in online discussions in massive open online courses
Authors: Ντούρμας Αναστάσιος-Ιωάννης
Published: July 2022

Η διατριβή ασχολείται με τους τρόπους βελτίωσης και διατήρησης της ποιότητας του εκπαιδευτικού σχεδιασμού στα Μαζικά Ανοικτά Διαδικτυακά Μαθήματα (MOOCs). Πιο συγκεκριμένα, ο στόχος μας είναι να υποστηρίξουμε τη λήψη αποφάσεων από τους επαγγελματίες των MOOC (π.χ. σχεδιαστές διδασκαλίας, εκπαιδευτές) κατά την εκτέλεση, δηλαδή όταν το μάθημα είναι ενεργό, σχετικά με θέματα ποιότητας διδασκαλίας. Το κύριο κενό που καλύπτουμε είναι ότι οι υπάρχουσες μελέτες αξιολόγησης της διδακτικής ποιότητας δεν αξιολογούν τις υποστηρικτικές στρατηγικές που υιοθετούνται από το διδακτικό προσωπικό (δηλ. τους διευκολυντές των μαθητών) για την υποστήριξη των μαθητών στο φόρουμ. Για να αντιμετωπίσουμε αυτό το κενό ακολουθούμε μια ερευνητική μεθοδολογία τριών φάσεων. Στην πρώτη φάση πραγματοποιούμε τρεις μελέτες περιπτώσεων που επεκτείνουν την υπάρχουσα εμπειρική έρευνα σχετικά με τα χαρακτηριστικά παρέμβασης και τα προβλήματα των διευκολυντών μαθητών σε μαθήματα διαφορετικού γνωστικού αντικειμένου. Στη δεύτερη φάση, εκτελούμε μια εις βάθος μελέτη περίπτωσης στην οποία παρέχουμε εμπειρικά στοιχεία σχετικά με τις κύριες διδακτικές προσεγγίσεις που υιοθετούν οι διευκολυντές μαθητών σε φόρουμ MOOC και ξεδιπλώνουμε τα προβλήματα ποιότητας που συνδέονται με αυτές. Στη συνέχεια, προχωράμε στη διαμόρφωση μιας μεθοδολογίας βασισμένης στα δεδομένα, η οποία έχει ως στόχο να καθοδηγήσει τους προγραμματιστές συστημάτων-εργαλείων MOOC στο σχεδιασμό εργαλείων που βοηθούν τους εκπαιδευτές να παρακολουθούν τέτοιες διδακτικές προσεγγίσεις και να υποστηρίζουν τη λήψη αποφάσεων κατά την εκτέλεση. Στην τελευταία φάση, χρησιμοποιούμε την καθοδηγούμενη από δεδομένα μεθοδολογία για να σχεδιάσουμε και να αναπτύξουμε ένα εργαλείο εκτέλεσης που υποστηρίζει τη λήψη αποφάσεων των εκπαιδευτών σε MOOC. Συγκεκριμένα, παρέχουμε μια απόδειξη της έννοιας όσον αφορά τη σκοπιμότητα και τη χρησιμότητα της προτεινόμενης μεθοδολογίας στη σχεδίαση νέων εφαρμογών λογισμικού. Η συνεισφορά αυτή αξιολογήθηκε κατά τη διάρκεια της ερευνητικής διαδικασίας τριών μελετών περίπτωσης που πραγματοποιήθηκαν σε περιβάλλοντα MOOC και μιας σειράς ημιδομημένων συνεντεύξεων με εμπειρογνώμονες.
Human papillomavirus (HPV) detection in vaginal self-samples: evaluation of eNat® as an alternative suspension medium to ThinPrep®PreservCyt® for vaginal swabs
Authors: Giubbi Chiara , Martinelli Marianna , Vallini Ivan , Paganoni Silvia , Dafa'alla Tarig , Perdoni Federica , Musumeci Rosario , Wu Winnie , Castriciano Santina , Romano Paolo , Cocuzza Clementina E.
Published: July 2022

Human Papillomavirus (HPV) testing on self-collected samples allows for improved coverage rates of cervical cancer (CC) screening programs. ThinPrep®PreservCyt® (HOLOGIC®, USA) medium is widely used for the suspension of cervical and vaginal self-samples. However, this medium is costly, toxic, and flammable, involving special handling procedures which make its use difficult in screening programs, particularly in low- and middle-income countries.

This pilot study aimed to evaluate the analytical performance of eNat® (Copan SpA), an alternative non-alcohol-based suspension medium, compared to ThinPrep®PreservCyt® (HOLOGIC®) for high-risk HPV (hrHPV) detection in vaginal self-collected swabs using three different real-time polymerase chain reaction (RT-PCR) HPV assays: Anyplex™II HPV28 (Seegene, Korea), Papilloplex® High Risk HPV (GeneFirst, UK), and HPV OncoPredict (Hiantis, Italy).

30 women, referred to colposcopy, were enrolled in this observational, prospective pilot study and asked to collect two vaginal self-taken samples, which were suspended in 5 mL of ThinPrep®PreservCyt® or eNat®. Nucleic acids were extracted from 200 μL using Microlab Nimbus platform (Seegene, Korea) and tested with the three different RT-PCR full-genotyping high-risk HPV assays. The HPV results of vaginal samples resuspended in the two different media were compared to those obtained from the reference clinician-collected cervical sample from the same woman.

hrHPV detection in vaginal self-samples suspended in both media demonstrated a substantial agreement with cervical samples with the three assays under-investigation (0.667<k<0.796). Moreover, the discordances between vaginal self-samples collected from the same woman were found only in cases of normal cytology or low-grade cytological lesions and were generally related to low hrHPV viral loads as indicated by the quantitative HPV OncoPredict assay (6.24E+02 copies/10,000 cells).

The study's preliminary findings demonstrated a very good agreement between cervical and vaginal self-collected samples suspended in ThinPrep®PreservCyt® and eNat®, suggesting that the latter could represent a good alternative medium in HPV screening programs based on self-collection.
An exploration of prenatal breastfeeding self-efficacy: a scoping review protocol
Authors: McGovern Liz , Geraghty Aisling , McAuliffe Fionnuala , O'Reilly Sharleen
Published: July 2022

Objective: To synthesise the evidence on prenatal breastfeeding self-efficacy, including identifying concepts and theoretical frameworks that underpin its development, the evidence on its measurement, interventions used to improve it, and association with breastfeeding outcomes.

Background: Breastfeeding self-efficacy is described as a woman’s self-belief and confidence in her perceived ability to breastfeed. It is a modifiable measure that is strongly associated with breastfeeding outcomes such as initiation, exclusivity, and duration. Interventions aimed at increasing self-efficacy are often in the postnatal period and have been shown to be effective at improving breastfeeding outcomes. The prenatal period appears to be underexplored in the literature and yet focusing on enhancing it may have the potential for further improvements in self-efficacy and on subsequent breastfeeding outcomes. A comprehensive knowledge synthesis on prenatal breastfeeding self-efficacy is lacking.

Methods: The search will include databases across health, psychology, sociology, and the grey literature on breastfeeding guidance. Once the PCC framework (Problem: breastfeeding, Concept: self-efficacy, Context: prenatal period) is met, sources of evidence from any contextual setting will be eligible for inclusion. Limits will not be applied on geographic location or year of publication. The PRISMA-ScR flow diagram of search and study selection will be used to report final figures. Two independent reviewers will perform title and abstract screening, full-text review, and data extraction. Data will be charted to provide a logical and descriptive summary of the results that align with the objectives.

Conclusion: The results will provide an understanding of what has been done in the space and what gaps exist, informing recommendations for the timing of measurement and the design of prenatal interventions.
Academic Ethos in the Times of the McDonaldisation of Universities – a Few Reflections on the Consequences of the Economisation and Financialisation of Science
Authors: Nizioł Krystyna
Published: July 2022

Historically, universities not only played an educational and research role, but also created culture. It was also expressed by the academic ethos. At the same time, along with the advancement of the globalisation of economic processes, there is a tendency to apply the market approach in their case, which results in the economisation and financialisation of science. The clash of these two worlds, i.e. the academic ethos embedded in academic values ​​and the economic approach to the functions of universities, is manifested, for example, in their McDonaldisation. As a consequence, universities focus on those aspects of their activities that are economically effective, including, for example, providing specialised educational services for student – clients. This process may result in universities losing their character, and thus becoming centres of creative inspiration and scientific discourse between scientists. Therefore, the aim of this study is to try to answer the following research questions: first, what are the consequences for universities of their economisation and financialisation, and, second, how their McDonaldisation affects the academic ethos. The study uses the dogmatic, legal and comparative methods.
A Philosophical Analysis of the Recent Controversy about “Islamo-leftism” in French Academia
Authors: Stamenkovic Philippe
Published: July 2022

In February 2021, the French Minister of Higher Education and Research, Frédérique Vidal, ordered an inquiry – to be led by the French National Centre for Scientific Research – about the alleged “Islamo-leftism” (islamo-gauchisme) which, according to her, was corrupting French academia. Vidal's concern was, purportedly, to distinguish “what falls under academic research and what falls under militancy and opinion”. She had in mind, in particular, recent interdisciplinary fields in the social sciences, such as Postcolonial Studies. Her statements caused a controversy in French academia as well as outside. The goal of this paper is to present this controversy and analyse it in light of the philosophical literature on autonomy of, and values in, science.

After recalling the political and institutional context of the controversy (1st part), I present Vidal’s intervention (2nd part) and various reactions to it, which can roughly be classified pro and contra Vidal's statements (3rd part). I then provide a philosophical discussion of the controversy (4th part), by recalling the philosophical debate to which it is related (the autonomy of, and the values in science), and analysing the assumptions, arguments and actions of both camps. I show in particular that a political intervention inside the very production of academic knowledge implies a strong risk of censorship (whether self-inflicted, intra-academic or extra-academic), and that letting academia self-regulate itself with respect to the validation of knowledge remains the best way to go. I conclude with the deeper questions raised by this controversy: the social role of universities, and the institutional aspects of scientific knowledge validation.
Optimizing the First Response to Sepsis: An Electronic Health Record-Based Markov Decision Process Model
Authors: Rosenstrom Erik , Meshkinfam Sareh , Ivy Julie Simmons , Goodarzi Shadi Hassani , Capan Muge , Huddleston Jeanne , Romero-Brufau Santiago
Published: July 2022

Sepsis is considered a medical emergency where delays in initial treatment are associated with increased morbidity and mortality, yet there is no gold standard for identifying sepsis onset and thus treatment timing. We leverage electronic health record (EHR) data with clinical expertise to develop a continuous-time Markov decision process (MDP) optimal stopping model that identifies the optimal first intervention action (anti-infective, fluid, or wait). To study the impact of initial treatment of patients at risk for developing sepsis, we define the delayed treatment population who received delayed treatment upon admission or during hospitalization and serves as an approximation of the natural history of sepsis. We apply the optimal first treatment policy to sample patient visits from the nondelayed treatment population. This analysis indicates the average risk of death could be reduced by approximately 2.2%, the average time until treatment could be reduced by 106 minutes, and the average severity of the treatment state could be reduced by 15.5% compared with the treatment they received in the hospital. We study the properties of the optimal policy to define an easily interpretable initial treatment heuristic that considers a patient’s organ dysfunction, location, and septic shock status. This generalizable framework can inform personalized treatment of patients at risk for sepsis.

History: This paper has been accepted for the Decision Analysis Special Issue on Emerging Topics in Health Decision Analysis.

Funding: This material is based upon work supported by the National Science Foundation [Grant 1522107 (North Carolina State University), 1522106 (Mayo Clinic), and 1833538 (Drexel University)].
When Worse Is Better: Strategic Choice of Vendors with Differentiated Capabilities in a Complex Cocreation Environment
Authors: Gupta Shubham , Roy Abhishek , Kumar Subodha , Mudambi Ram
Published: July 2022

The growing complexity of consulting, new product development, and information technology projects has led firms to increasingly adopt the strategy of collaborative value cocreation with their vendors. Although such value cocreation often involves a client firm engaging with more than one vendor, research in this field has primarily focused on single-vendor cocreation, whereas research on multivendor sourcing has rarely considered collaborative value cocreation. We bridge this gap by studying a cocreation environment involving a client, a primary vendor, and a potential secondary vendor. Examining the trade-offs that arise in the strategic interactions among the three firms, we derive novel insights about how these interactions differ from those under one-vendor cocreation, and from those under traditional multivendor sourcing. Specifically, we demonstrate that the client can sometimes be better off by adding a secondary vendor that is less efficient than the primary one; and a more expensive primary vendor can sometimes make the client less inclined to add the secondary vendor. The client’s decision to add the secondary vendor is driven by the value per unit of output rather than purely cost or efficiency parameters. We show that in such collaborative environments, the primary vendor benefits from the addition of a secondary vendor whenever it benefits the client. The conceptual and managerial insights drawn from our research contribute to a better theoretical and practical understanding of strategic decision making by firms in multivendor cocreation environments that are increasingly becoming prevalent.

This paper was accepted by Jayashankar Swaminathan, operations management.

Supplemental Material: Data and the e-companion are available at https://doi.org/10.1287/mnsc.2022.4490 .
Dental Braces as IMF in Pediatric Population or in Children; A Conservative Concept
Authors: Madhusudhan Kempaiah Siddaiah
Published: July 2022

Mandibular fracture is less common in children. Fracture management is a complex issue in children that needs immediate diagnosis and appropriate treatment to ensure favorable outcome. Intermaxillary fixation (IMF) is an integral part in the management facial bone fractures. Conventional methods have disadvantages, like the risk of transmission of blood-borne diseases, stressful procedures, and mutilation to teeth, tooth buds, and also periodontium. Use of orthodontic bracket and elastics as IMF is an effective and efficient alternative technique in management of mandibular fracture because it removes the disadvantages of standard Intermaxillary fixation and provides a stable occlusal & functional thereafter.
The role of the health visitor in child and infant skincare
Authors: Boddy Bethany
Published: July 2022

Bethany Boddy explores the evidence base behind common childhood skin conditions and the role of the health visitor in promoting health and wellbeing
CPD article: How to create a dog friendly clinic
Authors: Stagg Malcolm
Published: July 2022

For many reasons, dogs can find visiting the veterinary surgery challenging. This article discusses the need to understand dogs' feelings and observe their body language, providing examples of how the veterinary environment might impact canine emotional wellbeing. Recommendations are provided for stress reduction adaptations to improve the veterinary experience.

Approaches to handling are also discussed, including the importance of considering the dog's perspective of these. The use of low stress handling techniques are promoted, with examples provided for common clinical treatment and necessary interactions, as well as general guiding principles.

The importance of the owner within the dog's lifelong veterinary journey is also highlighted, with considerations including owner emotional state, ability to support their dog emotionally, and knowledge of their dog's normal reactions.

Preventative measures to better prepare a dog for the clinic environment, such as puppy appointments, are alluded to with references to detailed resources provided.
Chair Development on the Basis of Body Pressure Distribution—A Research Effort*
Authors: Denes Levente , Bencsik Balazs , Horvath Peter Gyorgy , Antal Reka Maria
Published: July 2022

Surveys and studies show that more and more employees perform high- or low-skilled white-collar work predominantly in sitting postures. Therefore, comfortable sitting plays an important role in reducing the risk of musculoskeletal disorders and other harmful effects. Research efforts focus on reducing these risks by designing ergonomic chairs with multiple adjustment possibilities, allowing the chair to fit to the user's body shape or assuring a dynamic seating where the user's lower body is in continuous movement. This article summarizes the results of a research effort that evaluated the effect of several factors on sitting comfort based on body pressure distribution. The effects of foam elasticity, foam layer arrangement order, and seat support elasticity were investigated as well as the chair seat type (kneeling chair, saddle chair). Results were used to determine the optimal chair cushion including the layered foam system and seat support type. On the basis of our findings a new ergonomic chair was developed combining the advantages of static and dynamic sitting.
Evidence-Based Early Home Visiting for Mothers and Parents With Intellectual Disability: Home Visitor Perceptions and Practices
Authors: West Allison L. , Dibble Kate E.
Published: July 2022

Evidence-based maternal, infant, and early home visiting (EBHV) is a potential strategy to support parent and child health and well-being among families headed by a parent with an intellectual disability (ID). Little is known about the capacity of EBHV programs to meet the needs of parents with ID effectively. This study examined home visitor practices and perceptions of services for parents with ID. Home visiting staff recruited from a national practice-based research network participated in web-based surveys. Practices and perceptions varied widely across sites and were associated with home visitor knowledge and self-efficacy and site implementation supports, such as policies, curricula, and community collaboration. More work is needed to understand and strengthen EBHV services for parents with ID.
Ultraviolet-visible light compass method based on local atmospheric polarization characteristics in adverse weather conditions
Authors: Li Yuyang , Wang Xia , Pan Yihua , Li Leilei , Chen Jiabin
Published: July 2022

Bionic polarization navigation has attracted extensive attention because of its strong
anti-interference performance and no accumulation of errors over time.
However, very few studies have fully considered the influence of
adverse weather conditions such as cloudy and overcast weather, which
play a key role in navigation accuracy. Therefore, we propose an
adaptive ultraviolet-visible light compass method based on local
atmospheric polarization characteristics applicable to various weather
conditions. The proposed method transforms the heading determination
problem into a multiclassification problem by using a weather
recognition technique. Ultraviolet detection is used to weaken the
depolarization effect of cloud particles and to obtain more accurate
skylight polarization patterns. Then, on the basis of screening
effective data, the sun direction vector is calculated by using the
electric vector direction and is finally combined with the
astronomical calendar to achieve navigation. The experimental results
confirm that, compared to the other methods, the designed algorithm
can suppress the interference of clouds better and adapt to complex
weather conditions. Under cloudy and overcast conditions, the heading
angle error is reduced to less than 2°.
Statistical properties of a partially coherent vector beam with controllable spatial coherence, vortex phase, and polarization
Authors: Zhang Hao , Wang Haiyun , Lu Xingyuan , Zhao Xuechun , Hoenders Bernhard J. , Zhao Chengliang , Cai Yangjian
Published: July 2022

We report on a partially coherent radially polarized power-exponent-phase vortex (PC-RP-PEPV) beam with various distributions of intensity, controllable coherence width, vortex phase, and polarization. The statistical properties of the PC-RP-PEPV beam depend on topological charge, power order, polarization states, and coherence width, which differ from those of conventional radially polarized beams. Here, the initial radial polarization state will transform to complex ellipse polarization state during propagation. By modulating the topological charge of the PC-RP-PEPV beam, the intensity structure of the beam can be adjusted from circular to polygonal. Finally, PC-RP-PEPV beams were experimentally generated, and were consistent with numerical simulation results. This work has applications in optical manipulation, optical measurements, and optical information processing.
Hybrid integrated ultralow-linewidth and fast-chirped laser for FMCW LiDAR
Authors: Tang Liwei , Li Liangbo , Li Jiachen , Chen Minghua
Published: July 2022

Narrow linewidth and fast-chirped frequency are essential in frequency-modulated continuous-wave lasers. We introduce a laser that meets these requirements by coupling a distributed feedback laser with an external high-Q microring resonator, where a bulky stacked piezoelectric chip is attached to the resonator for fast tuning. The laser demonstrates an ultranarrow intrinsic linewidth of 22 Hz in the self-injection-locked state. Actuated by the bulky piezoelectric chip, the maximum triangular actuation bandwidth can reach 100 kHz. The driving voltage is filtered to avoid a resonant mechanical mode, obtaining the minimum residual linearity error at 10 kHz with a 4.2 GHz tuning range. A light detection and ranging system was set up for a proof-of-concept experiment, demonstrating a high detection precision with standard deviations of 2.7 and 4.0 cm for targets at 15 and 30 m, respectively.
Transmission data rate improvement by InGaN barriers in GaN-based blue micro-LEDs for visible light communication
Authors: Huang Zhen , Tao Renchun , Li Duo , Rao Zhiwei , Yuan Zexing , Li Tai , Chen Zhaoying , Yuan Ye , Kang Junjie , Liang Zhiwen , Wang Qi , Tian Pengfei , Shen Bo , Wang Xinqiang
Published: July 2022

A GaN-based blue micro-light-emitting diode (µ-LED) array using InGaN as barriers for In0.18Ga0.82N/In0.015Ga0.985N multiple quantum wells (MQWs) is fabricated. Compared with a conventional device using GaN as barriers, the light output power (8.8 mW) exhibits an enhancement of two times. In addition, an increased transmission data rate up to 1.50 Gbps is demonstrated in a visible light communication protype. These prominent improvements are believed to relate to the suppressed quantum-confined Stark effect and the decreased defect/dislocation density in MQWs using InGaN barriers, both of which allow for higher luminescence efficiency and optical power. Consequently, the resultant higher signal-to-noise ratio in the data transmission process leads to an enhanced data rate.
Combinatorial Gli activity directs immune infiltration and tumor growth in pancreatic cancer
Authors: Scales Michael K. , Velez-Delgado Ashley , Steele Nina G. , Schrader Hannah E. , Stabnick Anna M. , Yan Wei , Mercado Soto Nayanna M. , Nwosu Zeribe C. , Johnson Craig , Zhang Yaqing , Salas-Escabillas Daniel J. , Menjivar Rosa E. , Maurer H. Carlo , Crawford Howard C. , Bednar Filip , Olive Kenneth P. , Pasca di Magliano Marina , Allen Benjamin L.
Published: July 2022

Proper Hedgehog (HH) signaling is essential for embryonic development, while aberrant HH signaling drives pediatric and adult cancers. HH signaling is frequently dysregulated in pancreatic cancer, yet its role remains controversial, with both tumor-promoting and tumor-restraining functions reported. Notably, the GLI family of HH transcription factors (GLI1, GLI2, GLI3), remain largely unexplored in pancreatic cancer. We therefore investigated the individual and combined contributions of GLI1-3 to pancreatic cancer progression. At pre-cancerous stages, fibroblast-specific Gli2/Gli3 deletion decreases immunosuppressive macrophage infiltration and promotes T cell infiltration. Strikingly, combined loss of Gli1/Gli2/Gli3 promotes macrophage infiltration, indicating that subtle changes in Gli expression differentially regulate immune infiltration. In invasive tumors, Gli2/Gli3 KO fibroblasts exclude immunosuppressive myeloid cells and suppress tumor growth by recruiting natural killer cells. Finally, we demonstrate that fibroblasts directly regulate macrophage and T cell migration through the expression of Gli-dependent cytokines. Thus, the coordinated activity of GLI1-3 directs the fibroinflammatory response throughout pancreatic cancer progression.
Health selection on self-rated health and the healthy migrant effect: Baseline and 1-year results from the health of Philippine Emigrants Study
Authors: Bacong Adrian Matias , Hing Anna K. , Morey Brittany , Crespi Catherine M. , Kabamalan Maria Midea , Lee Nanette R. , Wang May C. , de Castro A. B. , Gee Gilbert C.
Published: July 2022

Studies of migration and health focus on a “healthy migrant effect” whereby migrants are healthier than individuals not migrating. Health selection remains the popular explanation of this phenomenon. However, studies are mixed on whether selection occurs and typically examine migrants post-departure. This study used a novel pre-migration dataset to identify which health and social domains differ between migrants and their non-migrant counterparts and their contribution to explaining variance in self-rated health by migrant status at pre-migration and 1-year later. Data were used from the baseline and 1-year follow-up of the Health of Philippine Emigrants Study (HoPES). We used multivariable ordinary least squares regression to examine differences in self-rated health between migrants to the U.S. and a comparable group of non-migrants at baseline (premigration) and one year later, accounting for seven domains: physical health, mental health, health behavior, demographics, socioeconomic factors and healthcare utilization, psychosocial factors, and social desirability. A migrant advantage was present for self-rated health at baseline and 1-year. Accounting for all domains, migrants reported better self-rated health compared to non-migrants both at baseline (β = 0.32; 95% CI = 0.22, 0.43) and at 1-year (β = 0.28; 95% CI = 0.10, 0.46). Migrant status, health behavior, and mental health accounted for most of the variance in self-rated health both at baseline and 1-year follow-up. This analysis provides evidence of migrant health selection and nuanced understanding to what is being captured by self-rated health in studies of migrant health that should be considered in future research.
Demographic profiles of contact lens wearers and their association with lens wear characteristics in Trinidad and Tobago: A retrospective study
Authors: Ezinne Ngozika E. , Bhattarai Dipesh , Ekemiri Kingsley K. , Harbajan Gabrielle N. , Crooks Anesha C. , Mashige Khathutshelo P. , Ilechie Alex A. , Zeried Ferial M. , Osuagwu Uchechukwu L.
Published: July 2022

Purpose

Contact lenses (CL) remain a popular mode of refractive error correction globally and in the Caribbean, mostly among young people. However, no data on the characteristics of the CL population wearers in the Caribbean is available. This study reported on the characteristics of CL wearers and the associated factors in Trinidad and Tobago (T&T).

Methods

This retrospective study reviewed the clinical records of 243 CL wearers who attended the University of the West Indies (UWI) optometry clinic between 2017 and 2018. Data on their demographic profiles, CL wearing characteristics including lens type, material, purpose of wear, replacement schedule and lens care systems were extracted and analyzed. The associations between the demographic characteristics and CL wearing characteristics were also determined.

Results

About half of the CL wearers used them for fashion (more among those aged 18 to 30 years, 61.0%), therapeutic (more among those <18 years, 43.8%, P = 0.001) and refractive error correction purposes (more in those >40 years, P = 0.001). Females were more likely to use CLs for fashion compared with males (67.0% versus 40.7%). Age (P<0.0005) and gender (P = 0.030) were associated with the lens materials. Those aged 18–30 years were more likely use hydrogels compared with the younger ones (64.1% versus 25.0%). Rigid gas permeable (RGP) CL use was more common in males than females (21.8% versus 10.9%, P = 0.031). Daily disposables were predominantly used by younger respondents (18–30 years old, 31.3%, P < 0.001) and more in females than males (66.7% vs 49.4%, P = 0.040).

Conclusion

The study found that the CL appears to be more commonly worn for fashion in younger females and for refractive error correction in older males. Age, gender, and employment status were the main determinants of lens wear among respondents attending the university clinic in T&T.
Genomic landscapes of canine splenic angiosarcoma (hemangiosarcoma) contain extensive heterogeneity within and between patients
Authors: Wong Shukmei , Ehrhart E. J. , Stewart Samuel , Zismann Victoria , Cawley Jacob , Halperin Rebecca , Briones Natalia , Richter Keith , Sivaprakasam Karthigayini , Perdigones Nieves , Contente-Cuomo Tania , Facista Salvatore , Trent Jeffrey M. , Murtaza Muhammed , Khanna Chand , Hendricks William P. D.
Published: July 2022

Cancer genomic heterogeneity presents significant challenges for understanding oncogenic processes and for cancer’s clinical management. Variation in driver mutation frequency between patients with the same tumor type as well as within an individual patients’ cancer can shape the use of mutations as diagnostic, prognostic, and predictive biomarkers. We have characterized genomic heterogeneity between and within canine splenic hemangiosarcoma (HSA), a common naturally occurring cancer in pet dogs that is similar to human angiosarcoma (AS). HSA is a clinically, physiologically, and genomically complex canine cancer that may serve as a valuable model for understanding the origin and clinical impact of cancer heterogeneity. We conducted a prospective collection of 52 splenic masses from 43 dogs (27 HSA, 15 benign masses, and 1 stromal sarcoma) presenting for emergency care with hemoperitoneum secondary to a ruptured splenic mass. Multi-platform genomic analysis included matched tumor/normal targeted sequencing panel and exome sequencing. We found candidate somatic cancer driver mutations in 14/27 (52%) HSAs. Among recurrent candidate driver mutations,TP53was most commonly mutated (30%) followed byPIK3CA(15%),AKT1(11%), andCDKN2AIP(11%). We also identified significant intratumoral genomic heterogeneity, consistent with a branched evolution model, through multi-region exome sequencing of three distinct tumor regions from selected primary splenic tumors. These data provide new perspectives on the genomic landscape of this veterinary cancer and suggest a cross-species value for using HSA in pet dogs as a naturally occurring model of intratumoral heterogeneity.
Classification of motor imagery EEG using deep learning increases performance in inefficient BCI users
Authors: Tibrewal Navneet , Leeuwis Nikki , Alimardani Maryam
Published: July 2022

Motor Imagery Brain-Computer Interfaces (MI-BCIs) are AI-driven systems that capture brain activity patterns associated with mental imagination of movement and convert them into commands for external devices. Traditionally, MI-BCIs operate on Machine Learning (ML) algorithms, which require extensive signal processing and feature engineering to extract changes in sensorimotor rhythms (SMR). In recent years, Deep Learning (DL) models have gained popularity for EEG classification as they provide a solution for automatic extraction of spatio-temporal features in the signals. However, past BCI studies that employed DL models, only attempted them with a small group of participants, without investigating the effectiveness of this approach for different user groups such as inefficient users. BCI inefficiency is a known and unsolved problem within BCI literature, generally defined as the inability of the user to produce the desired SMR patterns for the BCI classifier. In this study, we evaluated the effectiveness of DL models in capturing MI features particularly in the inefficient users. EEG signals from 54 subjects who performed a MI task of left- or right-hand grasp were recorded to compare the performance of two classification approaches; a ML approach vs. a DL approach. In the ML approach, Common Spatial Patterns (CSP) was used for feature extraction and then Linear Discriminant Analysis (LDA) model was employed for binary classification of the MI task. In the DL approach, a Convolutional Neural Network (CNN) model was constructed on the raw EEG signals. Additionally, subjects were divided into high vs. low performers based on their online BCI accuracy and the difference between the two classifiers’ performance was compared between groups. Our results showed that the CNN model improved the classification accuracy for all subjects within the range of 2.37 to 28.28%, but more importantly, this improvement was significantly larger for low performers. Our findings show promise for employment of DL models on raw EEG signals in future MI-BCI systems, particularly for BCI inefficient users who are unable to produce desired sensorimotor patterns for conventional ML approaches.
Hospital length of stay among children with and without congenital anomalies across 11 European regions—A population-based data linkage study
Authors: Urhoj Stine Kjaer , Tan Joachim , Morris Joan K. , Given Joanne , Astolfi Gianni , Baldacci Silvia , Barisic Ingeborg , Brigden Joanna , Cavero-Carbonell Clara , Evans Hannah , Gissler Mika , Heino Anna , Jordan Sue , Lutke Renée , Odak Ljubica , Puccini Aurora , Santoro Michele , Scanlon Ieuan , de Walle Hermien E. K. , Wellesley Diana , Zurriaga Óscar , Loane Maria , Garne Ester
Published: July 2022

Background

Congenital anomalies are a leading cause of childhood morbidity, but little is known about the long-term outcomes.

Objective

To quantify the burden of disease in childhood for children with congenital anomalies by assessing the risk of hospitalisation, the number of days spent in hospital and proportion of children with extended stays (≥10 days).

Methods

European population-based record-linkage study in 11 regions in eight countries including children with congenital anomalies (EUROCAT children) and without congenital anomalies (reference children) living in the same regions. The children were born between 1995 and 2014 and were followed to their tenth birthday or 31/12/2015. European meta-analyses of the outcome measures were performed by two age groups, <1 year and 1–4 years.

Results

99,416 EUROCAT children and 2,021,772 reference children were linked to hospital databases. Among EUROCAT children, 85% (95%-CI: 79–90%) were hospitalised in the first year and 56% (95%-CI: 51–61%) at ages 1–4 years, compared to 31% (95%-CI: 26–37%) and 25% (95%-CI: 19–31%) of the reference children. Median length of stay was 2–3 times longer for EUROCAT children in both age groups. The percentages of children with extended stays (≥10 days) in the first year were 24% (95%-CI: 20–29%) for EUROCAT children and 1% (95%-CI: 1–2%) for reference children. The median length of stay varied greatly between congenital anomaly subgroups, with children with gastrointestinal anomalies and congenital heart defects having the longest stays.

Conclusions

Children with congenital anomalies were more frequently hospitalised and median length of stay was longer. The outlook improves after the first year. Parents of children with congenital anomalies should be informed about the increased hospitalisations required for their child’s care and the impact on family life and siblings, and they should be adequately supported.
COVID-19 vaccination policies under uncertain transmission characteristics using stochastic programming
Authors: Gujjula Krishna Reddy , Gong Jiangyue , Segundo Brittany , Ntaimo Lewis
Published: July 2022

We develop a new stochastic programming methodology for determining optimal vaccination policies for a multi-community heterogeneous population. An optimal policy provides the minimum number of vaccinations required to drive post-vaccination reproduction number to below one at a desired reliability level. To generate a vaccination policy, the new method considers the uncertainty in COVID-19 related parameters such as efficacy of vaccines, age-related variation in susceptibility and infectivity to SARS-CoV-2, distribution of household composition in a community, and variation in human interactions. We report on a computational study of the new methodology on a set of neighboring U.S. counties to generate vaccination policies based on vaccine availability. The results show that to control outbreaks at least a certain percentage of the population should be vaccinated in each community based on pre-determined reliability levels. The study also reveals the vaccine sharing capability of the proposed approach among counties under limited vaccine availability. This work contributes a decision-making tool to aid public health agencies worldwide in the allocation of limited vaccines under uncertainty towards controlling epidemics through vaccinations.
Problems with using comparative analyses of avian brain size to test hypotheses of cognitive evolution
Authors: Hooper Rebecca , Brett Becky , Thornton Alex
Published: July 2022

There are multiple hypotheses for the evolution of cognition. The most prominent hypotheses are the Social Intelligence Hypothesis (SIH) and the Ecological Intelligence Hypothesis (EIH), which are often pitted against one another. These hypotheses tend to be tested using broad-scale comparative studies of brain size, where brain size is used as a proxy of cognitive ability, and various social and/or ecological variables are included as predictors. Here, we test how robust conclusions drawn from such analyses may be. First, we investigate variation in brain and body size measurements across >1000 bird species. We demonstrate that there is substantial variation in brain and body size estimates across datasets, indicating that conclusions drawn from comparative brain size models are likely to differ depending on the source of the data. Following this, we subset our data to the Corvides infraorder and interrogate how modelling decisions impact results. We show that model results change substantially depending on variable inclusion, source and classification. Indeed, we could have drawn multiple contradictory conclusions about the principal drivers of brain size evolution. These results reflect concerns from a growing number of researchers that conclusions drawn from comparative brain size studies may not be robust. We suggest that to interrogate hypotheses of cognitive evolution, a fruitful way forward is to focus on testing cognitive performance within and between closely related taxa, with an emphasis on understanding the relationship between informational uncertainty and cognitive evolution.