2,369 research outputs found

    High-Power Directional Emission from Microlasers with Chaotic Resonators

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    High-power and highly directional semiconductor cylinder-lasers based on an optical resonator with deformed cross section are reported. In the favorable directions of the far-field, a power increase of up to three orders of magnitude over the conventional circularly symmetric lasers was obtained. A "bow-tie"-shaped resonance is responsible for the improved performance of the lasers in the higher range of deformations, in contrast to "whispering-gallery"-type modes of circular and weakly deformed lasers. This resonator design, although demonstrated here in midinfrared quantum-cascade lasers, should be applicable to any laser based on semiconductors or other high-refractive index materials.Comment: Removed minor discrepancies with published version in the text and in Fig.

    LETā€™s CONNECT community mentorship program for youths with peer social problems: Preliminary findings from a randomized effectiveness trial

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    This study examined the effectiveness of LETā€™s CONNECT (LC), a community mentorship program for youths who report peer social problems, which is based on a positive youth development framework. Participants were 218 youths (66.5% girls), aged 12 to 15 years, who were recruited from an urban medical emergency department and screened positive for bullying victimization, bullying perpetration, and/or low social connectedness. Youths were randomized to LC (nĀ =Ā 106) or the control condition (nĀ =Ā 112). Sixā€month outcomes were assessed with selfā€report measures of youth social connectedness, community connectedness, thwarted belongingness, depression, selfā€esteem, and suicidal ideation. LC was associated with a significant increase in only one of these outcomes, social connectedness (effect sizeĀ =Ā 0.4). It was associated consistently with trendā€level positive changes for thwarted belongingness (decreased), depression (decreased), community connectedness, and selfā€esteem (effect sizesĀ =Ā 0.2). There was no effect on suicidal ideation (effect sizeĀ =Ā 0.0), and although not a primary outcome, eight youths in the LC condition and seven youths in the control condition engaged in suicidal behavior between baseline and followā€up. Although LC effect sizes are consistent with those from previous studies of community mentorship, there were multiple challenges to LC implementation that affected dosage and intervention fidelity, and that may account for the lack of stronger positive effects.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145529/1/jcop21979.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145529/2/jcop21979_am.pd

    Paper 3: Workforce Readiness Alignment: The Relationship Between Job Preferences, Retention, and Earnings

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    This paper focuses on testing propositions related to workforce readiness by examining the relationship between job preferences, military conferred skills, and a variety of outcome measures including retention, income, and perceptions about transition

    Comprehensive quality assessment for aphasia rehabilitation after stroke: Protocol for a multicentre, mixed-methods study

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    INTRODUCTION: People with aphasia following stroke experience disproportionally poor outcomes, yet there is no comprehensive approach to measuring the quality of aphasia services. The Meaningful Evaluation of Aphasia SeRvicES (MEASuRES) minimum dataset was developed in partnership with people with lived experience of aphasia, clinicians and researchers to address this gap. It comprises sociodemographic characteristics, quality indicators, treatment descriptors and outcome measurement instruments. We present a protocol to pilot the MEASuRES minimum dataset in clinical practice, describe the factors that hinder or support implementation and determine meaningful thresholds of clinical change for core outcome measurement instruments. METHODS AND ANALYSIS: This research aims to deliver a comprehensive quality assessment toolkit for poststroke aphasia services in four studies. A multicentre pilot study (study 1) will test the administration of the MEASuRES minimum dataset within five Australian health services. An embedded mixed-methods process evaluation (study 2) will evaluate the performance of the minimum dataset and explore its clinical applicability. A consensus study (study 3) will establish consumer-informed thresholds of meaningful change on core aphasia outcome constructs, which will then be used to establish minimal important change values for corresponding core outcome measurement instruments (study 4). ETHICS AND DISSEMINATION: Studies 1 and 2 have been registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12623001313628). Ethics approval has been obtained from the Royal Brisbane and Women\u27s Hospital (HREC/2023/MNHB/95293) and The University of Queensland (2022/HE001946 and 2023/HE001175). Study findings will be disseminated through peer-reviewed publications, conference presentations and engagement with relevant stakeholders including healthcare providers, policy-makers, stroke and rehabilitation audit and clinical quality registry custodians, consumer support organisations, and individuals with aphasia and their families

    A Hypermorphic Missense Mutation in PLCG2, Encoding Phospholipase CĪ³2, Causes a Dominantly Inherited Autoinflammatory Disease with Immunodeficiency

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    Whole-exome sequencing was performed in a family affected by dominantly inherited inflammatory disease characterized by recurrent blistering skin lesions, bronchiolitis, arthralgia, ocular inflammation, enterocolitis, absence of autoantibodies, and mild immunodeficiency. Exome data from three samples, including the affected father and daughter and unaffected mother, were filtered for the exclusion of reported variants, along with benign variants, as determined by PolyPhen-2. A total of eight transcripts were identified as possible candidate genes. We confirmed a variant, c.2120C>A (p.Ser707Tyr), within PLCG2 as the only de novo variant that was present in two affected family members and not present in four unaffected members. PLCG2 encodes phospholipase CĪ³2 (PLCĪ³2), an enzyme with a critical regulatory role in various immune and inflammatory pathways. The p.Ser707Tyr substitution is located in an autoinhibitory SH2 domain that is crucial for PLCĪ³2 activation. Overexpression of the altered p.Ser707Tyr protein and exĀ vivo experiments using affected individualsā€™ leukocytes showed clearly enhanced PLCĪ³2 activity, suggesting increased intracellular signaling in the PLCĪ³2-mediated pathway. Recently, our laboratory identified in individuals with cold-induced urticaria and immune dysregulation PLCG2 exon-skipping mutations resulting in protein products with constitutive phospholipase activity but with reduced intracellular signaling at physiological temperatures. In contrast, the p.Ser707Tyr substitution in PLCĪ³2 causes a distinct inflammatory phenotype that is not provoked by cold temperatures and that has different end-organ involvement and increased intracellular signaling at physiological temperatures. Our results highlight the utility of exome-sequencing technology in finding causal mutations in nuclear families with dominantly inherited traits otherwise intractable by linkage analysis

    Examination of Englandā€™s New Medicine Service (NMS) of complex health care interventions in community pharmacy

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    Background: Community pharmacies are increasingly commissioned to deliver new, complex health interventions in response to the growing demands on family doctors and secondary health care services. Little is known about how these complex interventions are being accommodated and translated into the community pharmacy setting and whether their aims and objectives are realized in practice. The New Medicine Service (NMS) is a complex medicine management intervention that aims to support patientsā€™ adherence to newly prescribed medicines for a long-term condition. Objective: This study explores the recent implementation of the NMS in community pharmacies across England. It also seeks to understand how the service is becoming manifest in practice and what lessons can be learned for future service implementation. Methods: Structured, organizational ethnographic observations and in situ workplace interviews with pharmacists and support staff were undertaken within 23 English community pharmacies. Additionally, one-toone, semi-structured interviews were carried out with 47 community pharmacists and 11 general practitioners (GPs). Observational and interview data were transcribed and analysed thematically and guided by Damschroderā€™s consolidated framework for implementation research. Results: The NMS workload had been implemented and absorbed into pharmacistsā€™ daily routines alongside existing responsibilities with no extra resources and little evidence of reduction in other responsibilities. Pharmacists were pragmatic, simplifying, and adapting the NMS to facilitate its delivery and using discretion to circumvent perceived non-essential paperwork. Pharmacist understanding of the NMS was found to impact on what they believed should be achieved from the service. Despite pharmacists holding positive views about the value of the NMS, not all were convinced of its perceived benefits and necessity, with reports that many consultations did not identify any problems with the patientsā€™ medicines. GPs were generally supportive of the initiative but were unaware of the service or potential benefits. Poorly developed existing pharmacist-GP relationships impeded implementation. Conclusions: This study identifies the multifaceted and complex processes involved in implementing a new community pharmacy service in England. Community pharmacy workflow, infrastructure, and public and professional relationships all affect NMS implementation. Greater prior engagement with the pharmacy workforce and GPs, robust piloting and a phased rollout together with ongoing support and updates, are potentials strategies to ensure future implementation of pharmacy services meet their intended aims in practice

    Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in New England Seals, United States

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    We report the spillover of highly pathogenic avian influenza A(H5N1) into marine mammals in the northeastern United States, coincident with H5N1 in sympatric wild birds. Our data indicate monitoring both wild coastal birds and marine mammals will be critical to determine pandemic potential of influenza A viruses
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