External wavelength stabilization of grating coupled surface emitting lasers and applications

In this dissertation, we explore a semiconductor optical device configuration based on non-resonant diffraction grating coupler. These devices are coupled with monolithic and external wavelength selection elements to form the resonant cavity lasing at ~980nm. Different configurations of these external and monolithic lasers in one-dimensional (1-D) and two-dimensional (2-D) array were fabricated and experimentally studied under quasi-continuous wave (QCW) and pulsed pump current conditions. The lasers are also utilized in blue light generation through nonlinear second harmonic generation (SHG). Diffractive micro-optical beam shaping optics were designed and fabricated for a compact multi-wavelength high peak power blue light source

Possible mechanism behind the hard-to-swallow property of oil seed pastes

Roasted and crushed oil-rich seeds, such as sesame paste and peanut butter, both share a common structure and elicit an apparent sensation of thickening in the mouth. Working with sesame paste, as an example, the force needed to compress sesame paste:water mixtures peaked at 25% added water. The adhesive force required to pull a plunger from the surface was bimodal with peaks at around 15 and 25% hydration. It is postulated that when introduced to the mouth, water from the saliva is absorbed by the paste leading to a hard, adhesive material that sticks to the palate and the tongue, making these materials hard to swallow. It is hypothesized that the shared hard-to-swallow behaviour exhibited by other oil seed pastes/butters is due to a similar hydration process in the mouth

Early outcomes of gastrostomy feeding in paediatric allogenic bone marrow transplantation: A retrospective cohort study

Background: Nutrition support is an essential component of care for a child undergoing bone marrow transplantation (BMT). Enteral nutrition (EN) is becoming increasingly recognised as having advantages over parenteral nutrition (PN) and recommended as first-line nutrition support. EN has traditionally been provided via nasogastric tube (NGT). Gastrostomies avoid certain complications associated with NGTs and could provide a preferential alternative. Aims: To compare nutritional and post-transplantation outcomes during admission, the primary outcome being PN use, between children who had a gastrostomy placed prophylactically prior to BMT versus those who had not. Methods: Electronic medical records of children transplanted between January 2014 and May 2018 within a single-centre were retrospectively reviewed. Outcomes between the gastrostomy group (n = 54) and non-gastrostomy group (n = 91) were compared. Results: Multivariate regression analyses showed children in the gastrostomy group were less likely to require PN (odds ratio (OR) 0.4; 95% confidence interval (CI) 0.2–0.9; P = 0.049), initiated PN later if required (hazard ratio 0.6; 95% CI 0.4–0.8; P = 0.005), more often received EN as first-line nutrition support (P < 0.001) and more frequently required EN post-discharge (OR 2.4; 95% CI 1.1–5.4; P = 0.029). No differences were found between groups on length of admission, day 100 overall survival, incidence of graft-versus-host-disease, positive blood cultures and changes in weight or albumin during admission. Conclusions: Providing EN via gastrostomy is feasible in this population and may be more acceptable to older children than NGTs. Weighing up the potential benefits against the potential risks of prophylactic gastrostomy placement in these high-risk children is a challenging decision. Further research investigating safety, longer-term outcomes and family perceptions of gastrostomy feeding is required

Traumatic dental injury research: on children or with children?

Background and aim: It is widely acknowledged that children should participate in healthcare decisions, service development and even setting research agendas. Dental traumatology is a major component of paediatric dentistry practice and research. However, little is known about young patients’ contribution to new knowledge in this field. The aim of the study was to establish the extent to which children are involved in contemporary dental trauma research and to evaluate the quality of the related literature. Material and methods: A systematic review of the dental trauma literature was conducted from 2006-2014. The electronic databases, MEDLINE and Scopus, were used to identify relevant studies. The selected papers were independently examined by five calibrated reviewers. Studies were categorised by the degree of children’s involvement and appraised using a validated quality assessment tool. Results: The initial search yielded 4,374 papers. After application of the inclusion and exclusion criteria only 96 studies remained. Research on children accounted for 87.5% of papers and a proxy was involved in 4.2%. Children were engaged to some degree in only 8.3% of studies and there were no studies where children were active research participants. In the quality assessment exercise papers scored, on average, 57% (range=14-86%). Conclusion: There is scope to encourage more active participation of children in dental trauma research in the future. Furthermore, there are some areas where the quality of research could be improved overall

Cost-effectiveness of Implementing Low-Tidal Volume Ventilation in Patients With Acute Lung Injury

Background: Despite widespread guidelines recommending the use of lung-protective ventilation (LPV) in patients with acute lung injury (ALI), many patients do not receive this lifesaving therapy. We sought to estimate the incremental clinical and economic outcomes associated with LPV and determined the maximum cost of a hypothetical intervention to improve adherence with LPV that remained cost-effective. Methods: Adopting a societal perspective, we developed a theoretical decision model to determine the cost-effectiveness of LPV compared to non-LPV care. Model inputs were derived from the literature and a large population-based cohort of patients with ALI. Cost-effectiveness was determined as the cost per life saved and the cost per quality-adjusted life-years (QALYs) gained. Results: Application of LPV resulted in an increase in QALYs gained by 15% (4.21 years for non-LPV vs 4.83 years for LPV), and an increase in lifetime costs of $7,233 per patient with ALI ($99,588 for non-LPV vs $106,821 for LPV). The incremental cost-effectiveness ratios for LPV were$22,566 per life saved at hospital discharge and $11,690 per QALY gained. The maximum, cost-effective, per patient investment in a hypothetical program to improve LPV adherence from 50 to 90$9,482. Results were robust to a wide range of economic and patient parameter assumptions. Conclusions: Even a costly intervention to improve adherence with low-tidal volume ventilation in patients with ALI reduces death and is cost-effective by current societal standards.NIH F32HL090220.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/84154/1/Cooke - CEA LPV.pd

A Prospective Study of the Association of Metacognitive Beliefs and Processes with Persistent Emotional Distress After Diagnosis of Cancer

Two hundred and six patients, diagnosed with primary breast or prostate cancer completed self-report questionnaires on two occasions: before treatment (T1) and 12 months later (T2). The questionnaires included: the Hospital Anxiety and Depression Scale; Impact of Events Scale; the Metacognitions Questionnaire-30 (MCQ-30) and the Illness Perceptions Questionnaire-revised. A series of regression analyses indicated that metacognitive beliefs at T1 predicted between 14 and 19 % of the variance in symptoms of anxiety, depression and trauma at T2 after controlling for age and gender. For all three outcomes, the MCQ-30 subscale ‘negative beliefs about worry’ made the largest individual contribution with ‘cognitive confidence’ also contributing in each case. For anxiety, a third metacognitive variable, ‘positive beliefs about worry’ also predicted variance in T2 symptoms. In addition, hierarchical analyses indicated that metacognitive beliefs explained a small but significant amount of variance in T2 anxiety (2 %) and T2 depression (4 %) over and above that explained by demographic variables, T1 symptoms and T1 illness perceptions. The findings suggest that modifying metacognitive beliefs and processes has the potential to alleviate distress associated with cancer

An international examination of the economic effectiveness of banking recapitalization

While the literature on capital adequacy and bank recapitalization agrees on the importance of a minimum capital requirement, recurring financial crises across the world do little to suggest that capital adequacy is enough protection for banks, even when they fully comply. By examining the case of regulation compelled banking recapitalizations in a cross-country context (during the period 1990Q1–2016Q2), we scrutinize the effectiveness of banking recapitalization on the economies of recently recapitalized countries. We provide implications for international business research, practice and policy by highlighting the need for countries adopting the Basel capital adequacy framework to pay attention to the peculiarities of their economies, the supporting regulatory mechanisms and their comparative spare capacities

Advancing our understanding of the EU sports policy: the socio-cultural model of sports regulation and players’ agents

This paper explains the development of the socio-cultural dimension of the European Union (EU) sports policy over the course of the decade from 2005 to 2015. By adopting the theoretical lenses of the Advocacy Coalition Framework (ACF), the paper firstly offers a novel perspective on the belief systems of the members of the socio-cultural advocacy coalition that operates within the EU sports policy subsystem. A set of empirical policy core beliefs of the coalition actors reflecting their concerns regarding to sport’s integrity and economic welfare that affect its healthy development is presented and explained as the basic causes of the policy problem, i.e., threats that undermine sport’s specific characteristics. In this light, the paper then illustrates that the coalition members have perceived the issue of players’ agents, in particular problems in the activities of agents in European football, to be detrimental to the integrity of sport. As a result, the issue has been the subject of a considerable policy activity by the coalition actors with a view to establishing an alternative regulatory framework to effectively govern players’ agents. Consequently, the paper elucidates the evolving nature of the socio-cultural model of sports regulation that not only promotes the social role of sport in Europe but now also addresses the problems that affect its well-being and clear image. The paper’s principal method of investigation is based on the content analysis of official policy documents and statements of the coalition actors

Predicting eating disorder and anxiety symptoms using disorder-specific and transdiagnostic polygenic scores for anorexia nervosa and obsessive-compulsive disorder

BACKGROUND: Clinical, epidemiological, and genetic findings support an overlap between eating disorders, obsessive-compulsive disorder (OCD), and anxiety symptoms. However, little research has examined the role of genetics in the expression of underlying phenotypes. We investigated whether the anorexia nervosa (AN), OCD, or AN/OCD transdiagnostic polygenic scores (PGS) predict eating disorder, OCD, and anxiety symptoms in a large developmental cohort in a sex-specific manner. METHODS: Using summary statistics from Psychiatric Genomics Consortium AN and OCD genome-wide association studies, we conducted an AN/OCD transdiagnostic genome-wide association meta-analysis. We then calculated AN, OCD, and AN/OCD PGS in participants from the Avon Longitudinal Study of Parents and Children to predict eating disorder, OCD, and anxiety symptoms, stratified by sex (combined N = 3212-5369 per phenotype). RESULTS: The PGS prediction of eating disorder, OCD, and anxiety phenotypes differed between sexes, although effect sizes were small. AN and AN/OCD PGS played a more prominent role in predicting eating disorder and anxiety risk than OCD PGS, especially in girls. AN/OCD PGS provided a small boost over AN PGS in the prediction of some anxiety symptoms. All three PGS predicted higher compulsive exercise across different developmental timepoints [β = 0.03 (s.e. = 0.01) for AN and AN/OCD PGS at age 14; β = 0.05 (s.e. = 0.02) for OCD PGS at age 16] in girls. CONCLUSIONS: Compulsive exercise may have a transdiagnostic genetic etiology, and AN genetic risk may play a role in the presence of anxiety symptoms. Converging with prior twin literature, our results also suggest that some of the contribution of genetic risk may be sex-specific

Usefulness of multimodal MR imaging in the differential diagnosis of HaNDL and acute ischemic stroke

<p>Abstract</p> <p>Background</p> <p>Syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocitosis (HaNDL) is a rare disease which can present with focal neurological deficits and mimic stroke. A neurologist-on-duty faced with a HaNDL patient in the first hours might erroneously decide to use thrombolytic drugs, a non-innocuous treatment which has no therapeutic effect on this syndrome.</p> <p>Case Presentation</p> <p>We present a case where neuroimaging, together with the clinical picture, led to a presumed diagnosis of HaNDL avoiding intravenous thrombolysis.</p> <p>Conclusions</p> <p>This report shows the usefulness of multimodal MR imaging in achieving early diagnosis during an acute neurological attack of HaNDL. Our experience, along with that of others, demonstrates that neuroimaging tests reveal the presence of cerebral hypoperfusion in HaNDL syndrome</p