bluuebunny/crossref_metadata_2025 huggingface dataset:
Elicitation of children’s understanding of information in pediatric genetic counseling encounters: A discourse‐oriented perspective
Authors: Hui Andy Lok Chung , Zayts‐Spence Olga , Chung Brian Hon‐Yin
Published: November 2021

Affirmation of children's understanding of information provided in genetic counseling encounters is crucial to obtaining children's informed consent/assent in pediatric genetic counseling encounters. It is also important for the proper management of a genetic condition. Currently, there is a relative scarcity of research on how understanding of complex genetic information by children is elicited in the process of pediatric genetic counseling. In this study, we apply theme‐oriented discourse analysis to examine 23 video/audio‐recorded genetic counseling encounters in Hong Kong. The encounters involve children aged between 3 and 17 years old who are suspected to have or diagnosed with Sudden Arrhythmic Death Syndrome (SADS). Specifically, we examine a range of communicative strategies that genetic professionals employ to elicit children's understanding of information in this genetic counseling setting. We also examine how children's epistemic status is negotiated between genetic professionals, parents, and children. The study reveals that genetic professionals typically use direct questioning (e.g., “do you understand?” or “do you have any questions?”). Less typical are examples where genetic professionals explore children's epistemic access and invite children to recall information after they deliver it. The study reveals two discourse strategies that genetic professionals and parents employ to justify a child's low epistemic status: (1) construction of “current ignorance” and “future competence” in children and (2) association with a child's character. In the examined counseling encounters, genetic professionals and parents tend to construct a low epistemic status in younger children and allocate the responsibility for understanding relevant information to the parents and the “future” competent children. The study highlights the impact of genetic professionals’ and parents’ assumptions on children's knowledge and comprehensibility at different ages, and the role that children themselves play in conforming or contesting these assumptions.
Multicenter comparison of totally laparoscopic and totally robotic pancreaticoduodenectomy: Propensity score and learning curve‐matching analyses
Authors: Kim Hyeyeon , Choi Sung Hoon , Jang Jae Young , Choi Munseok , Lee Jae Hoon , Kang Chang Moo
Published: November 2021

Background

Few studies have compared laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD) despite emerging use of minimally invasive pancreaticoduodenectomy (MIPD). The present study therefore compares perioperative outcomes of LPD and RPD patients, and evaluates safety and feasibility of MIPD.

Methods

This retrospective multicenter analysis evaluated MIPD patients through June 2020 performed by three experienced pancreatic surgeons at three different institutions. Perioperative outcomes were compared before and after propensity score‐matching analyses, and learning curves based on operation time were used for additional matching analysis.

Results

Of 362 patients, 282 underwent LPD and 80 underwent RPD. Open conversion rate was significantly higher in LPD (P = .001). There were no significant differences in rates of major complications (Clavien‐Dindo ≥III) and clinically relevant postoperative pancreatic fistula (CR‐POPF). After matching, operation time (P = .001) and hospital stay (P = .027) were significantly shorter in RPD, but there were no differences in major complications and CR‐POPF. Propensity score‐matched comparison after learning curve attainment showed shorter operation time (P = .037) and hospital stay (P = .014) in RPD, and no differences in major complications and CR‐POPF.

Conclusion

RPD had several advantages compared with LPD, including shorter operative time and hospital stay, and lower open conversion rate. Postoperative complications including CR‐POPF showed comparable results in two groups. Both LPD and RPD seemed to be feasible and safe approaches in experienced hands.
Fast T2‐Weighted Imaging With Deep Learning‐Based Reconstruction: Evaluation of Image Quality and Diagnostic Performance in Patients Undergoing Radical Prostatectomy
Authors: Park Jae Chun , Park Kye Jin , Park Mi Yeon , Kim Mi‐hyun , Kim Jeong Kon
Published: November 2021

Background

Deep learning‐based reconstruction (DLR) can potentially improve image quality by reduction of noise, thereby enabling fast acquisition of magnetic resonance imaging (MRI). However, a systematic evaluation of image quality and diagnostic performance of MRI using short acquisition time with DLR has rarely been investigated in men with prostate cancer.

Purpose

To assess the image quality and diagnostic performance of MRI using short acquisition time with DLR for the evaluation of extraprostatic extension (EPE).

Study Type

Retrospective.

Population

One hundred and nine men.

Field Strength/Sequence

3 T; turbo spin echo T2‐weighted images (T2WI), echo‐planar diffusion‐weighted, and spoiled gradient echo dynamic contrast‐enhanced images.

Assessment

To compare image quality, signal‐to‐noise ratio (SNR) and contrast‐to‐noise ratio (CNR) and subjective analysis using Likert scales on three T2WIs (MRI using conventional acquisition time, MRI using short acquisition time [fast MRI], and fast MRI with DLR) were performed. The diagnostic performance for EPE was evaluated by three independent readers.

Statistical Tests

SNR, CNR, and image quality scores across the three imaging protocols were compared using Friedman tests. The diagnostic performance for EPE was assessed using the area under receiver operating characteristic curves (AUCs). P < 0.05 was considered statistically significant.

Results

Fast MRI with DLR demonstrated significantly higher SNR (mean ± SD, 14.7 ± 6.8 vs. 8.8 ± 4.9) and CNR (mean ± SD, 6.5 ± 6.3 vs. 3.4 ± 3.6) values and higher image quality scores (median, 4.0 vs. 3.0 for three readers) than fast MRI. The AUCs for EPE were significantly higher with the use of DLR (0.86 vs. 0.75 for reader 2 and 0.82 vs. 0.73 for reader 3) compared with fast MRI, whereas differences were not significant for reader 1 (0.81 vs. 0.74; P = 0.09).

Data Conclusion

DLR may be useful in reducing the acquisition time of prostate MRI without compromising image quality or diagnostic performance.

Level of Evidence

4

Technical Efficacy

Stage 3
Remote forcing effect of sea surface temperatures in the northern tropical Atlantic on tropical cyclone genesis over the Western North Pacific in July
Authors: Shi Xiaohui , Fang Yin
Published: November 2021

In July 2020, neither genesis nor landfall of typhoons occurred in the western North Pacific (WNP). This was the first time that the “no‐typhoon” phenomenon had occurred since 1949. This study analysed the variation in the tropical cyclone genesis frequency (TCGF) in the WNP in July over the past 40 years, including the corresponding atmospheric background circulation and the possible influence of tropical sea surface temperature (SST). The results revealed that the eastward and northward location of the western Pacific subtropical high (WPSH), the deepened and eastward expanded tropical monsoon trough (TMT) in the WNP, the active convection in the main body of TMT, the weakened southwest water vapour transport of the East Asian summer monsoon, as well as the strengthened and eastward expanded equatorial westerly wind were conducive to the tropical cyclone genesis in the WNP in July. Furthermore, we used regression analysis to explore the possible impact of tropical SSTs. We found that the relatively high SSTs in the northern tropical Atlantic (NTA) in June and July triggered a cyclonic circulation over the tropical East Pacific and NTA, resulting in strong upward motion. The airflow subsidence in the tropical central Pacific then caused the WPSH to extend westward and the easterly airflow on the south side of WPSH to strengthen, which weakened the WNP monsoon trough. Besides, the influence of warming NTA SSTs could be conveyed to the Indian Ocean and indirectly induce the enhancement of WPSH. Such a series of the large‐scale circulation variations were not favourable for tropical cyclone genesis in the WNP. As a result, the TCGF was relatively low in July. Thus, one of the causes of the July 2020 “no‐typhoon” phenomenon in the WNP could be the remote forcing effect of SST in NTA.
Observed and Coupled Model Intercomparison Project 6 multimodel simulated changes in near‐surface temperature properties over Ghana during the 20th century
Authors: Oduro Collins , Shuoben Bi , Ayugi Brian , Beibei Li , Babaousmail Hassen , Sarfo Isaac , Ullah Safi , Ngoma Hamida
Published: November 2021

This article investigates seasonal and annual trends of near‐surface temperature (NST) during the last century (1901–2018) over Ghana. The ability of 24 global climate models (GCMs) from the sixth phase of the Coupled Model Intercomparison Project (CMIP6) to simulate abrupt mean temperature changes in Ghana from 1980 to 2014 was assessed. The trends' magnitude and abrupt changes were detected using Sen Slope Estimator (SSE) and sequential Mann–Kendall (SQMK) tests, respectively. Root mean square difference, correlation coefficient, and mean bias (B) were used to determine the skilfulness of GCMs in simulating NST relative to Climatic Research Unit (CRU TS4.04) datasets. Ghana's Southern belt is characterized by low temperatures, averaging 25°C to 27°C, whilst the northern belt is characterized by high temperatures (29–31°C). The inter‐annual variability of temperature over Ghana exhibits an increasing trend. Findings depict a significant increase in both the annual and seasonal temperatures of Tmin and Tmean, with a steady increase in Tmax. Results revealed the rate of increase had been higher in the country's northern regions (0.5°C) than in the south (0.3–0.4°C) in recent decades. The model performances for the interannual variability of annual and FMAM temperatures are better than their JJAS seasonal performances. The study's overall model ranking shows that Ghana's best performing models for annual, FMAM and JJAS seasons are INM‐CM5‐0, NorCPM1, and KACE‐1‐0‐G, respectively. Observations and comparisons provide useful reference values for a comprehensive assessment of various applications.
Seasonal contrasts between tropical cyclone genesis in the South China Sea and westernmost North Pacific
Authors: Tu Jien‐Yi , Chen Jau‐Ming , Tan Pei‐Hua , Lai Tzu‐Ling
Published: November 2021

Climatologically, tropical cyclone (TC) genesis in the South China Sea (SCS; 108°–120°E, 8°–22°N) and westernmost North Pacific (WmNP; 122°–140°E, 8°–22°N) exhibit different seasonal variability. Maximum TC genesis occurs in July over the WmNP, but in September over the SCS. Based upon genesis potential index (GPI) analysis for the period 1979–2018, the dominant cause of increased TC genesis in the SCS from July to September is a reduction of vertical wind shear of total winds (VWS), while decreased 600‐hPa relative humidity (RH600) acts to suppress TC genesis. Reduced VWS in the SCS is associated with weakening of southwesterly flows and cross‐equatorial southerly flows at 850 hPa and the Tibetan high at 200 hPa. In the WmNP, decreased TC genesis from July to September results from a minor increase in its northern section (north of 15°N) and a major decrease in its southern section (south of 15°N). Decreased TC genesis in the southern section is primarily affected by reduced RH600 and secondly by enhanced VWS. Reduced RH600 is associated with a decrease in total humidity and an increase in 600‐hPa temperature from July to September. Enhanced VWS is mainly caused by intensified entrances of 850‐hPa westerly/southwesterly flows from the SCS and cross‐equatorial flows from tropical oceans in company with weakening of the Pacific subtropical high. The effects of 850‐hPa absolute vorticity and potential intensity associated with the possible maximum wind speed on seasonal variability of TC genesis are insignificant and minor.
A regional view of the linkages between hydro‐climatic changes and deforestation in the Southern Amazon
Authors: Wongchuig Sly , Espinoza Jhan Carlo , Condom Thomas , Segura Hans , Ronchail Josyane , Arias Paola A. , Junquas Clementine , Rabatel Antoine , Lebel Thierry
Published: November 2021

In the last four decades, the Southern Amazon (south of 8°S) has shown changes in the spatial and temporal patterns of its hydro‐climatic components, leading to drier conditions. Due to climate and land‐use changes, this region is considered as a zone under biophysical transition processes. Previous studies have documented a complex interaction between climate and deforestation either on a large‐scale or based on limited in situ data, typically covering the Brazilian Amazon. In this study, we analyse the relationships between hydro‐climate, the surface water‐energy partitioning and an index of regional forest cover change for the period 1981–2018. Additionally, we discretized three regions covering the Bolivian Amazon and the southern portions of the Peruvian and Brazilian Amazon due to their differences in the evolution of land use. In the Bolivian region, a high ratio of forest cover change, exceeding 40–50%, is related to a significant tendency to become water‐limited. This change is associated with decreased rainfall, increased potential evapotranspiration and decreased actual evapotranspiration. Regardless of the region analysed, those that are characterized by a high ratio of forest cover change (>40–50%) show growing imbalance between increasing potential and decreasing actual evapotranspiration. However, in the Peruvian and Brazilian regions, hydro‐climatic conditions remain energy‐limited due to minor rainfall changes. The observed differences in surface water‐energy partitioning behaviour evidence a complex dependence of both sub‐regional (i.e., land cover changes) and large‐scale (i.e., strengthening of the Walker and Hadley circulations) conditions. Our findings indicate a clear link between hydro‐climatic changes and deforestation, providing a new perspective on their spatial variability on a sub‐regional scale.
The effect of 3‐D printed polylactic acid scaffold with and without hyaluronic acid on bone regeneration
Authors: Yun Junseob , Lee Jungwon , Ha Cheol Woo , Park Seong Je , Kim Sungtae , Koo Ki‐Tae , Seol Yang‐Jo , Lee Yong‐Moo
Published: November 2021

Background

Three‐ dimensional (3D) technology has been suggested to overcome several limitations in guided bone regeneration (GBR) procedures because 3D‐printed scaffolds can be easily molded to patient‐specific bone defect site. This study aimed to investigate the effect of 3‐D printed polylactic acid (PLA) scaffolds with or without hyaluronic acid (HA) in a rabbit calvaria model.

Methods

A calvaria defect with a diameter of 15 mm was created in 30 New Zealand white rabbits. The rabbits were randomly allocated into three groups including no graft group (control, n = 10), 3D printed PLA graft group (3D‐PLA, n = 10), and 3D printed PLA with hyaluronic acid graft group (3D‐PLA/HA, n = 10). Five animals in each group were sacrificed at 4 and 12 weeks after surgery. Microcomputed tomography and histologic and histomorphometric analyses were performed.

Results

Over the whole examination period, no significant adverse reactions were observed. There were no statistically significant differences in bone volume (BV) /tissue volume (TV) among the three groups at 4 weeks. However, the highest BV/TV was observed in the 3D‐PLA/HA group at 12 weeks. The new bone area for control, 3D‐PLA, and 3D‐PLA/HA showed no statistical differences at 4 weeks. However, the value was significantly higher in the 3D‐PLA and 3D‐PLA/HA groups compared to the control group at 12 weeks.

Conclusion

The 3D printed PLA scaffolds was biocompatible and integrated well with bone defect margin. They were also provided the proper space for new bone formation. Therefore, 3D printed PLA/HA might be a potential tool to enhance bone augmentation.
Optimal machine learning methods for radiomic prediction models: Clinical application for preoperative T2*‐weighted images of cervical spondylotic myelopathy
Authors: Zhang Meng‐Ze , Ou‐Yang Han‐Qiang , Jiang Liang , Wang Chun‐Jie , Liu Jian‐Fang , Jin Dan , Ni Ming , Liu Xiao‐Guang , Lang Ning , Yuan Hui‐Shu
Published: November 2021

Introduction

Predicting the postoperative neurological function of cervical spondylotic myelopathy (CSM) patients is generally based on conventional magnetic resonance imaging (MRI) patterns, but this approach is not completely satisfactory. This study utilized radiomics, which produced advanced objective and quantitative indicators, and machine learning to develop, validate, test, and compare models for predicting the postoperative prognosis of CSM.

Materials and methods

In total, 151 CSM patients undergoing surgical treatment and preoperative MRI was retrospectively collected and divided into good/poor outcome groups based on postoperative modified Japanese Orthopedic Association (mJOA) scores. The datasets obtained from several scanners (an independent  scanner) for the training (testing) cohort were used for cross‐validation (CV). Radiological models based on the intramedullary hyperintensity and compression ratio were constructed with 14 binary classifiers. Radiomic models based on 237 robust radiomic features were constructed with the same 14 binary classifiers in combination with 7 feature reduction methods, resulting in 98 models. The main outcome measures were the area under the receiver operating characteristic curve (AUROC) and accuracy.

Results

Forty‐one (11) radiomic models were superior to random guessing during CV (testing), with significant increased AUROC and/or accuracy (PAUROC < .05 and/or Paccuracy < .05). One radiological model performed better than random guessing during CV (Paccuracy < .05). In the testing cohort, the linear SVM preprocessor + SVM, the best radiomic model (AUROC: 0.74 ± 0.08, accuracy: 0.73 ± 0.07), overperformed the best radiological model (PAUROC = .048).

Conclusion

Radiomic features can predict postoperative spinal cord function in CSM patients. The linear SVM preprocessor + SVM has great application potential in building radiomic models.
Discrimination and technologies in tourism: Applying critical race theory to future studies
Authors: Johnson Abbie‐Gayle
Published: November 2021

Technology has been intertwined with hospitality and tourism from the 1940s. Current conversations on technology design, racial politics and ethics are almost absent from the tourism literature although wider technology literature focuses on this. Moreover, these technologies are still associated with the tourism industry and affect the business of practitioners and lives of tourists. This research note proposes the application of critical race theory to unravel these industry occurrences. As a result, technologies in tourism studies will not only focus on efficiency and empowerment but also inclusion, which can further enable an investigation into concepts of justice, equality and equity.
Temporal dynamics of symptom change among veterans receiving an integrated treatment for posttraumatic stress disorder and substance use disorders
Authors: Badour Christal L. , Flanagan Julianne C. , Allan Nicholas P. , Gilmore Amanda K. , Gros Daniel F. , Killeen Therese , Korte Kristina J. , Brown Delisa G. , Kolnogorova Kateryna , Back Sudie E.
Published: November 2021

The present study examined temporal patterns of symptom change during treatment for comorbid posttraumatic stress disorders (PTSD) and substance use disorders (SUDs). We hypothesized that PTSD symptom severity would predict subsequent‐session substance use and that this association would be particularly strong among patients who received an integrated treatment versus SUD‐only treatment. Participants were 81 United States military veterans with current PTSD and an SUD who were enrolled in a 12‐week, randomized controlled trial examining the efficacy of an integrated treatment called Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) compared with cognitive behavioral relapse prevention therapy (RP). Lagged multilevel models indicated that PTSD symptom improvement did not significantly predict the likelihood of next‐session substance use (likelihood of use: B = 0.03, SE = 0.02, p = .141; percentage of days using B = ‐0.02, SE = 0.01, p = .172. Neither substance use, B = 1.53, SE = 1.79, p = .391, nor frequency of use, B = 0.26, SE = 0.50, p = .612, predicted next‐session PTSD symptom severity in either treatment condition. Stronger associations between PTSD symptoms and next‐session substance use were expected given the self‐medication hypothesis. Additional research is needed to better understand the temporal dynamics of symptom change as well as the specific mediators and mechanisms underlying symptom change.
Endometrial Abnormalities
Authors: Detti Laura , Christiansen Mary E. , Peregrin‐Alvarez Irene
Published: November 2021

Objectives

We sought to evaluate the diagnostic accuracy of transvaginal ultrasound (TVUS) saline infusion sonohysterogram (SIS), and hysteroscopy for diagnosing endometrial abnormalities and their correlation with histological findings. In addition, we sought to validate the subsistence of a more subtle abnormality called “redundant endometrium” (RE).

Methods

Retrospective cohort study of patients presenting with infertility and diagnosed with endometrial abnormalities who underwent hysteroscopy and pathology evaluation. Each patient underwent TVUS at the first visit regardless of the cycle phase, followed by SIS during proliferative phase, and then hysteroscopy, which was performed when abnormal SIS findings were diagnosed. Endometrial abnormalities were categorized as polyps (EP), RE, or normal. Frequencies of the abnormalities were recorded for the 3 imaging modalities and their sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each.

Results

A total of 105 TVUS and 73 SIS were performed. Because of the frequent association of EP with RE, when all endometrial pathologies were combined, the three diagnostic modalities showed high sensitivity (TVUS 88.9%, SIS 100%, hysteroscopy 82.9%, respectively), but they also showed low specificity (TVUS 56.7%, SIS 56.1%, hysteroscopy 58.2%, respectively). Pathological evaluation showed isolated RE (26 cases), to harbor polyps (19.2%), disordered endometrium (19.2%), and complex atypical hyperplasia (3.8%).

Conclusions

The three diagnostic modalities showed high sensitivity in diagnosing endometrial abnormalities. We identified RE as an independent endometrial abnormality. Benign endometrium is the predominant histology in RE, however, a small proportion harbors endometrial hyperplasia. Based on these results, we advocate further evaluation when this condition is diagnosed with TVUS, or SIS.
A simple‐wave damping model for flexible marsh plants
Authors: Zhang Xiaoxia , Lin Pengzhi , Nepf Heidi
Published: November 2021

Marsh plants are typically composed of leaves attached to a central stem. Both the leaves and the stem are flexible and contribute to wave attenuation. This study developed a model to predict wave damping within a marsh based on a simple representation of the wave‐induced drag on an individual, flexible marsh plant. Specifically, the drag force on the leaves and the stem was represented separately using a scaling law developed for an isolated plant element, and a sheltering coefficient was applied to account for drag reduction on the leaves due to the interaction among the leaves and stem. The wave damping model was validated against laboratory experiments. The model was also compared to measurements of wave dissipation made in the field.
Biotic and abiotic factors control the geomorphic characteristics of channel networks in salt marshes
Authors: Liu Zezheng , Gourgue Olivier , Fagherazzi Sergio
Published: November 2021

Biotic and abiotic processes control the formation and evolution of tidal channel networks. However, which factor regulates the planimetric geometry of the network remains unclear. Here, we compare the geometric properties of tidal channel networks in 14 salt marshes along the coasts of the United States and China. Significant difference in the geometric properties of tidal channel networks was found in salt marshes dominated by different vegetation species. Physical parameters better explained these differences, while vegetation parameters had a weaker effect on the network geometry. Mean marsh elevation and tidal range were found to be the best variables to explain the variability in drainage density, mean unchanneled path length and sinuosity (R2 values range from 0.239 to 0.465), while biotic parameters (i.e., aboveground biomass, stem density, height, and diameter) were only significant predictors for less geometric properties (R2 values range from 0.005 to 0.312). We used multiple regressions to develop sample models, explaining more than 60% of the variability in mean unchanneled path length. Our findings underline the key role of physical factors in shaping tidal channel networks. We conclude that physical processes are more important than vegetation species in determining the long‐term development of tidal channels.
Kerr Frequency Comb Interaction with Raman, Brillouin, and Second Order Nonlinear Effects
Authors: Lin Guoping , Song Qinghai
Published: November 2021

Kerr optical frequency comb as a novel microcomb source has found a variety of key applications from fundamental research to engineering applications. Generation of such microcombs require resonator platforms with small mode volumes and high quality factors, where the interaction of light and matter is resonantly enhanced. In these platforms, other nonlinear photonic effects can be simultaneously excited and interact with Kerr frequency combs. In this review, the focus is on recent progresses on the microcomb development involving its interaction with Raman, Brillouin scattering, and second‐order nonlinear processes such as second harmonic generation (SHG). The resulting transfer of Kerr frequency combs into other spectral windows as referred to Kerr–Raman, Kerr–Brillouin, Kerr–SHG combs is introduced. Additionally, other emerging novel microcombs in microresonators with second‐order nonlinearity including electro‐optical modulation microcombs and quadratic microcombs are reviewed. Challenges and opportunities brought along are also discussed.
Analogous Optical Activity in Free Space Using a Single Pancharatnam–Berry Phase Element
Authors: Liu Sheng , Qi Shuxia , Li Peng , Wei Bingyan , Chen Peng , Hu Wei , Zhang Yi , Gan Xuetao , Zhang Peng , Lu Yanqing , Chen Zhigang , Zhao Jianlin
Published: November 2021

It is commonly believed that optical activity (OA) is manifested mainly in chiral media, but rare in non‐chiral structures. Here, an analog of OA in free space is experimentally demonstrated by using a single liquid‐crystal Pancharatnam–Berry phase element (PBPE), for which the mechanism is highly consistent with that of the traditional OA. The specifically designed PBPE supports the direction‐dependent polarization rotation of a Bessel beam with controllable “rotatory power.” Such a polarization rotation can be revoked by another PBPE with the same structure. Unlike in a chiral medium, this scheme shows simultaneous realization of equivalent leverotation and dextorotation merely by switching the optical element orientation, promising for applications non‐magnetic optical devices such as optical isolators.
Lasing in a Hybrid Rare‐Earth Silicon Microdisk
Authors: Miarabbas Kiani Khadijeh , Frankis Henry C. , Naraine Cameron M. , Bonneville Dawson B. , Knights Andrew P. , Bradley Jonathan D. B.
Published: November 2021

Silicon photonics is an ideal platform for low‐cost, energy‐efficient, and high‐performance optical microsystems. However, because silicon is an inefficient light emitting material, the development of simple, inexpensive, and scalable monolithic amplifiers and light sources has been a significant challenge. Here, optical gain and lasing in an ultra‐compact hybrid rare‐earth silicon microdisk resonator are reported. The microdisk design is straightforward and compatible with the fabrication steps and device dimensions available in all silicon photonics foundries, while the thulium‐doped tellurite gain medium is added in a low‐temperature single‐step sputter deposition. This approach allows for low‐cost and high‐volume wafer‐scale manufacturing and co‐integration of rare‐earth amplifiers and light sources with silicon passive and active devices with no adjustment to standard process flows. The hybrid laser is pumped at standard telecom wavelengths around 1.6 µm and exhibits stable single‐mode emission at 1.9 µm, with an internal slope efficiency of 60% and >1 mW on‐chip output power. The laser is highly promising for emerging communications and sensing applications and opens new possibilities for the development of monolithic rare‐earth optical amplifiers and lasers directly on silicon.
Simplifying Molecular Transport in Polyelectrolyte Multilayer Thin Films
Authors: Pahal Suman , Boranna Rakshith , Prashanth Gurusiddappa R. , Varma Manoj M.
Published: November 2021

The matrix properties of polyelectrolyte multilayer thin films (PEM) are critical in making them a viable candidate for various biomedical applications. The location and ability of molecules to diffuse through the PEM architecture determines their encapsulation and release capabilities in a given matrix for various biomedical applications. The main aim of this review article is to provide a complete understanding of molecular transport on the surface as well as across the bulk of the PEM matrix. Different physiochemical strategies to promote or suppress the diffusivity of various molecules inside the PEM are mentioned in brief. A set of guiding principles is uncovered for getting a complete picture of loading and release of molecules across the PEM structure, which can play a key role in designing a desirable PEM assembly and have important implications for designing multicomponent, targeted and controlled drug‐delivery vehicles. Understanding the molecular diffusivity in PEM stack at the nano and micro scales will help to design superior host materials for biomedical engineering applications.
An integrated FAHP–ZODP approach for strategic marketing information system project selection
Authors: Koohathongsumrit Nitidetch , Luangpaiboon Pongchanun
Published: November 2021

This study presents a new integrated approach based on the fuzzy analytic hierarchy process (FAHP) and zero–one desirability programming (ZODP) for selecting strategic marketing information system projects. The FAHP is employed to prioritize the criteria, and the ZODP is used to select a set of appropriate projects. The proposed integrated FAHP–ZODP approach maximizes the overall desirability value under various objectives, limited resources, and preferences. The findings of this study support decision makers in project selection when conflicting attributes are involved, ensure effective decision making with an understanding of the marketing environment, and assist project management under certain and uncertain environments.
Will tougher environmental policy reduce the employment of industrial enterprises? The heterogeneity analysis based on enterprise level and city level
Authors: Gao Yusen , Hu Changsheng , Yang Yue
Published: November 2021

Using the Two Control Zones policy in China, we analyze the impact of tougher environmental policy on the employment of industrial enterprises through DID and PSM‐DID methods. We find that tougher environmental policy has a positive (negative) employment effect for industrial enterprises above (below) designated size. In the heterogeneity tests, the positive effect is more significant for enterprises with bigger size, stronger R&D capability, less financial constraint, owned by foreign shareholders, and located in eastern provinces. As for the enterprises in heavily polluting industries, tougher environmental regulation may hinder their development.
Endoscopic Characteristics of Dysphagia in Multiple System Atrophy Compared to Parkinson's Disease
Authors: Vogel Annemarie , Claus Inga , Ahring Sigrid , Gruber Doreen , Haghikia Aiden , Frank Ulrike , Dziewas Rainer , Ebersbach Georg , Gandor Florin , Warnecke Tobias
Published: November 2021

Background

Dysphagia is a major clinical concern in multiple system atrophy (MSA). A detailed evaluation of its major endoscopic features compared with Parkinson's disease (PD) is lacking.

Objective

This study systematically assessed dysphagia in MSA compared with PD and correlated subjective dysphagia to objective endoscopic findings.

Methods

Fifty‐seven patients with MSA (median, 64 [interquartile range (IQR): 59–71] years; 35 women) underwent flexible endoscopic evaluation of swallowing using a specific MSA–flexible endoscopic evaluation of swallowing task protocol. Findings were compared with an age‐matched cohort of 57 patients with PD (median, 67 [interquartile range: 60–73] years; 28 women). In a subcohort, subjective dysphagia was assessed using the Swallowing Disturbance Questionnaire and correlated to endoscopy findings.

Results

Patients with MSA predominantly showed symptoms suggestive of oral‐phase disturbance (premature spillage, 75.4%, piecemeal deglutition, 75.4%). Pharyngeal‐phase symptoms occurred less often (pharyngeal residues, 50.9%; penetration/aspiration, 28.1%). In contrast, pharyngeal symptoms were the most common finding in PD (pharyngeal residues, 47.4%). Oral symptoms occurred less frequently in PD (premature spillage, 15.8%, P < 0.001; piecemeal deglutition, 1.8%, P < 0.01). Patients with MSA had a greater risk for oral‐phase disturbances with increased disease severity (P < 0.05; odds ratio, 3.15). Patients with MSA showed a significantly higher intraindividual interswallow variability compared with PD. When correlating Swallowing Disturbance Questionnaire scores with endoscopy results, its cutoff, validated for PD, was not sensitive enough to identify patients with MSA with dysphagia. We developed a subscore for identifying dysphagia in MSA and calculated a new cutoff (sensitivity 85%, specificity 100%).

Conclusions

In contrast with patients with PD, patients with dysphagic MSA more frequently present with oral‐phase symptoms and a significantly higher intraindividual interswallow variability. A novel Swallowing Disturbance Questionnaire MSA subscore may be a valuable tool to identify patients with MSA with early oropharyngeal dysphagia. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
Massachusetts briefing touts supportive housing for homeless
Authors: Canady Valerie A.
Published: November 2021

A Massachusetts supportive housing model that offers an alternative to shelter placement for the homeless was hailed for its success in providing supervised, supportive housing for the hard‐to‐reach homeless population during a legislative briefing last week.
Veterans with PTSD still suffer despite years‐long treatment
Authors: Canady Valerie A.
Published: November 2021

Nearly six in 10 veterans who have been diagnosed with post‐traumatic stress disorder (PTSD) still suffer from the often‐debilitating symptoms of the condition despite months to years of treatment with first‐line therapies, according to a new survey, released by Freespira, developer of digital therapeutic solutions to treat behavioral health conditions.
Joint inversion of seismic and electrical data in saturated porous media
Authors: Garofalo Flora , Socco Laura Valentina , Foti Sebastiano
Published: November 2021

Joint inversion strategies and physical constraints on model parameters may be used to mitigate equivalence problems caused by solution non‐uniqueness. This strategy is quite a common practice in exploration geophysics, where dedicated rock physical studies are usually carried out, while it is not so frequent in near surface geophysics. We use porosity as a constraint among seismic wave velocities and electrical resistivity in a deterministic joint inversion algorithm for surface wave dispersion, P‐wave traveltimes and apparent resistivity from vertical electrical sounding. These data are often available for near surface characterization. We show that the physical constraint among model parameters leads to internally consistent geophysical models in which solution non‐uniqueness is mitigated. Moreover, an estimate of soil porosity is obtained as a relevant side product of the procedure. In particular, we consider a clean sand deposit and hence the appropriate formulations for the computation of porosity from seismic velocities and resistivity are implemented in the algorithm. We first demonstrate how the non‐uniqueness of the solution is reduced in a synthetic case and then we applied the algorithm to a real‐case study. The algorithm is here developed for one‐dimensional condition and for granular soils to better investigate the physical constraint only, but it can be extended to the two‐dimensional or three‐dimensional case as well as to other materials with the adoption of proper rock physical relationships.
Poor diet quality and adverse eating behaviors in young survivors of childhood cancer
Authors: Fleming Catharine A.K. , Murphy‐Alford Alexia J. , Cohen Jennifer , Fleming Michael R. , Wakefield Claire E. , Naumann Fiona
Published: November 2021

Background

The long‐term impact of childhood cancer treatment on dietary intake is likely to be complex, and the length of time dietary behaviors are affected after childhood cancer treatment is unknown.

Aim

The aim of this study was to determine the diet quality in childhood cancer survivors recently off treatment and explore possible contributing factors that may affect diet quality in this population.

Methods

Participants were 65 parents and/or carers of childhood cancer survivors (CCS) (aged 2‐18 years), recently off treatment, and 81 age‐matched controls. Participants completed two self‐administered dietary intake and eating behavior questionnaires. Study data were explored to determine between group differences, bivariate analysis using Spearman correlations was used to determine the relationship between diet quality and identified variables, and hierarchical cluster analysis was completed to characterize specific variables into clusters.

Results

One hundred and forty‐six parents of children aged 2‐18 years completed the study (65 parents of CCS and 81 control). CCS had a significantly poorer diet quality score than the age‐matched controls (32.25 vs 34.83, P = 0.028). CCS had significantly higher parent‐reported rates of “picky eating” behavior than the control group (2.31 vs 1.91; P = 0.044). Factors such as picky eating, emotional overeating, and body mass index z‐score might drive diet quality in survivors.

Conclusions

CCS were found to have poorer diet quality and more likely to have parents report picky eating behaviors. The outcomes highlighted the need for a tailored intervention aimed at improving healthy eating behaviors in CCS after treatment for cancer.
A review on carboxylic acid cross‐linked polyvinyl alcohol: Properties and applications
Authors: Gautam Leela , Warkar Sudhir G. , Ahmad Syed Ishraque , Kant Ravi , Jain Manish
Published: November 2021

Polyvinyl alcohol (PVA) is a nontoxic, biodegradable, and biocompatible polymer and has been used extensively in various fields. Indeed, important features of PVA such as its film‐forming ability, high tensile strength and flexibility, high viscosity, solvent tolerance ability, thermostable nature have made it vital and drawn the attention of scientific community. However, being a water‐soluble polymer, some chemical modifications are required to alter this property of PVA. Cross‐linking is the most attractive and widely used method to change the properties of PVA to make it more valuable material. Different carboxylic acids have already been used for PVA cross‐linking in various applications such as pervaporation, reverse osmosis (RO), wound dressing, drug delivery, and fuel cells. However, a comprehensive study on structure–property correlation of carboxylic acids as PVA cross‐linker is not available. In this review, different available studies on carboxylic acid cross‐linked PVA are summarized and are used to develop structure–property correlations of carboxylic acids as cross‐linker on the properties of cross‐linked PVA. Advantages and limitations of different carboxylic acids as PVA cross‐linker are also summarized for various fields such as tissue engineering, wound dressing, drug delivery, fuel cell/solid polymer electrolyte, pervaporation, desalination and RO solid polymer electrolytes, and food packaging.
Wheelchair hockey improves quality of life in people with neuromuscular disease
Authors: Carraro Elena , Casiraghi Jacopo L. , Bobba Beatrice , Lizio Andrea , Cardella Carolina , Albamonte Emilio , Lunetta Christian , Pozzi Susanna , Sansone Valeria A.
Published: November 2021

Background

Participation in sports is known to have positive effects on people's health and psychosocial well‐being. Recently, physical activity implications for people with disabilities have been explored, showing promising results on quality of life and self‐concept. However, few studies have specifically investigated the effects of participation in adaptive sports on quality of life in patients with neuromuscular disease.

Objective

To evaluate differences in psychosocial well‐being between people affected by a neuromuscular disease who play wheelchair hockey and those who do not. Individuals playing an adaptive sport would report better quality of life, higher physical self‐efficacy scores, and more effective coping strategies, as assessed by self‐reported measures.

Design

Cross‐sectional study.

Setting

Data were collected during clinical follow‐ups at the NEMO Clinical Center in Milan (Italy).

Participants

A total of 25 patients affected by neuromuscular diseases, ages 18 to 40 years, participated in the study.

Interventions

Not applicable.

Main outcome measures

The primary outcome was to compare quality of life between groups. Secondary outcomes were the comparisons of physical self‐efficacy and coping strategies through self‐reported measures.

Results

Wheelchair hockey players scored significantly higher on the Quality of Life Index (specifically on the health/functioning and psychological/spiritual sub‐scales) and reported better physical self‐efficacy and perceived physical ability compared to the control group (i.e., patients who do not participate in any adaptive sport), controlling for age and pathology. On the contrary, no difference was found in coping strategies between the two groups.

Conclusions

This study identified a significant association between participation in wheelchair hockey and improved physical and psychological well‐being of people affected by neuromuscular diseases compared to those who are not involved in adaptive sports.
Centering race/ethnicity: Differences in traumatic brain injury inpatient rehabilitation outcomes
Authors: Warren Karlita L. , García James J.
Published: November 2021

Background

Persons of color have a higher incidence of traumatic brain injury (TBI) and experience disparities in the quality and quantity of interventions received, discharge disposition, functional outcomes, and mortality rate post TBI.

Objective

To examine racial/ethnic differences in rehabilitation outcomes for patients with TBI.

Design

Multiyear (2005‐2016) and retrospective cohort using secondary data analysis from inpatient rehabilitation facilities (IRFs) across the United States.

Setting

eRehabData participating IRFs throughout the United States.

Patients

Forty‐one thousand eight hundred forty‐seven adults with a diagnosis of TBI, admitted to U.S. eRehabData participating IRFs.

Interventions

Not applicable.

Main Outcome Measures

Inpatient rehabilitation functional outcomes and discharge disposition.

Results

Participants were 41,847 non‐Hispanic Whites (NHWs), Hispanics, non‐Hispanic Asians (NHAs), and non‐Hispanic Blacks (NHBs) aged 18‐107 years. NHWs were used as the reference group. NHBs had the longest length of stay (17.65 ± 14.96). At admission, NHB, Hispanic, and NHA races/ethnicities were significantly associated with 1‐3 point lower motor, cognitive, and total Functional Independence Measure (FIM) scores. NHB race was significantly associated with less than 1‐point lower cognitive, motor, and total efficiency FIM scores. At discharge, NHB race was significantly associated with 1‐2 point lower motor, cognitive, and total FIM scores; Hispanics and NHA race were associated with less than 1‐point lower cognitive FIM scores. Compared to NHWs, Hispanic ethnicity was associated with greater odds of a discharge to home (odds ratio = 1.16, 95% confidence interval = 1.06‐1.27).

Conclusion

Contrary to established literature on functionality differences 1 year post TBI, the current study found racial/ethnic differences in functional outcomes during inpatient rehabilitation. These findings suggest a need for cultural competence/sensitivity in the care of racial/ethnic persons and centering potential contributing factors for racial/ethnic differences in TBI rehabilitation outcomes.
The essential oil ofSchinus terebinthifoliusand its nanoemulsion and isolated monoterpenes: investigation of their activity againstCulex pipienswith insights into the adverse effects on non‐target organisms
Authors: Nenaah Gomah E , Almadiy Abdulrhman A , Al‐Assiuty Basma A , Mahnashi Mater H
Published: November 2021

BACKGROUND

The house mosquito,Culex pipiensL. is a harmful species, widespread in urban areas, and considered the primary enzootic vector of West Nile arbovirus. Widespread insecticide resistance in mosquito populations and the environmental risks and toxicity hazards of chemical pesticides make insecticides an inadequate mosquito control strategy. Seeking ecofriendly tools for mosquito control tools has become necessary.

RESULTS

Essential oil (EO) was hydrodistilled from the fruits of Brazilian pepper,Schinus terebinthifoliusRaddi and analyzed using gas chromatography–flame ionization detection and gas chromatography–mass spectrometry. An oil‐in‐water nanoemulsion (particle size 41.3 nm) was developed and characterized from EO using a green low‐energy approach. EO, its nanoemulsion and monoterpenes showed mosquitocidal, repellent and acetylcholinesterase inhibitory activities againstCx. pipiens. A nanoemulsion concentration of 30 μl L–1caused 100% larval mortality after 24 h of exposure, whereas EO,d‐limonene andα‐phellandrene at 60 μl L–1caused 100%, 92.4% and 88.2% larval mortality, respectively. The concentration that killed 50% of organisms (LC50) for larvae after 24 h ranged between 6.8 and 40.6 μl L–1. Upon fumigation, 15.0 μl L–1of nanoemulsion killed 94.5% of adults after 24 h of exposure. LC50values against adults ranged between 5.3 and 31.2 μl L–1. EO products exhibited repellence activity at concentrations between 0.5 and 4.0 μl cm–2. Test materials effectively inhibited the acetylcholinesterase activity of mosquito and were safe toward the non‐target organismsGambusia affinisandEisenia fetida.

CONCLUSION

There is a potential for usingS. terebinthifoliusEO, its nanoemulsion and monoterpenes as ecofriendly natural mosquitocides.