Silicon-tapered waveguide for mode conversion in metal-insulator-metal waveguide-based plasmonic sensor for refractive index sensing.

In this study, we have undertaken a comprehensive numerical investigation of a refractive index sensor designed around a metal-insulator-metal (MIM) plasmonic waveguide. Our approach utilizes the finite element method to thoroughly analyze the sensor's performance. The sensor's configuration utilizes a ring resonator design, which has been slightly modified at the coupling segment. This modification enhances the efficiency of light coupling between a bus waveguide and the ring resonator, particularly at the resonance wavelength. This strategic adjustment significantly improves the device's extinction ratio, a critical factor in its functionality. Remarkably, the sensitivity of this sensor is determined to be approximately 1155.71 nm/RIU, while it possesses a figure of merit of 25.9. Furthermore, our study delves into the intricate mechanism governing the injection of light into the nanoscale MIM waveguide. We achieve this through the incorporation of silicon-tapered waveguides, which play a pivotal role in facilitating the transformation of a dielectric mode into a plasmonic mode, and vice versa. Ultimately, the findings of this research hold significant promise for advancing the field of plasmonic sensing systems based on MIM waveguide technology. The insights gained here pave the way for the practical realization and optimization of highly efficient and precise plasmonic sensors.

Interconnected principles of ocean governance through science-policy integration under the judgements of the international dispute settlement bodies.

International Dispute Settlement Bodies (IDSBs), through their judgements, have consistently urged the States to take scientific approaches in ocean governance for marine environmental protection. There has been the development of significant jurisprudence which undertake policy principles with scientific prescription in ocean governance. The jurisprudence relating to maritime dispute resolution has primarily relied on the interpretative criteria of 'integration' for science and policy as specified in the Vienna Convention. Indeed, this principle of 'integration' integrated 'science-policy' through various concepts, and IDSBs applied and endorsed the 'rule of law', 'cooperation', 'precaution' and 'ecosystem-based approach' to lay stress on the progressive ocean governance. This also reflects that the scientific basis in jurisprudence demonstrates a change in the international organisations' interests (of environmental protection and global sustainability). Moreover, it is also suggested at the end how the provisions related to Marine Scientific Research can be purposefully developed and maintained to protect the marine environment and ecosystems in light of the decisions of the IDSBs. This research article analysed the relevant jurisprudence to explain the principles for science-policy integration, which operates in ocean governance for marine environmental protection.

Outcome of a Simple Novel Technique to Reduce Soft Tissue Complications in Open Tendoachilles Injury: A Series of 20 Patients.

Introduction: Open tendoachilles injuries are rare and associated with significant soft tissues complications. The objective of the present study was to assess the clinical outcome and safety of a simple and minimally invasive technique, with a goal to assess if it may help minimise flap and wound related complications in open tendoachilles injuries. Materials and methods: This prospective study of four years duration included 20 patients with open tendoachilles injuries managed with a simple minimally invasive tunnel technique. The primary outcome variable was occurrence of a major soft tissue complication. The secondary outcome variables included functional outcome measured using AOFAS Ankle hind foot score, re-rupture of tendoachilles and need for revision surgery. Results: None of the patients in the present series developed a serious soft tissue complication. Based upon the AOFAS hind foot scoring system, good to excellent outcome was achieved in 19 (95%) patients. All the patients were able to perform tip toe walking at six months post-surgery. None of the patients had a re-rupture of the tendoachilles and no patient needed a revision surgery. The complications encountered include thickening of the tendon at the repair site (15%), superficial wound infection (5%), stitch granuloma (5%) and hypertrophic scar (5%). Conclusion: This technique seems to be promising in reducing the soft tissue complications associated with the surgical management of open tendoachilles injuries. Most patients had a good final clinical outcome. The technique is safe, simple and reproducible. However, further randomised control studies with a larger sample size assessing the technique are recommended.

China's belt and road initiative (BRI) under the vision of 'maritime community with a shared future' and its impacts on global fisheries governance.

'Maritime Community with a Shared Future' is the broad vision through which China aims to lead the global fisheries governance. This research has been motivated by China's ambition of equating its maritime development goals with sustainable development goal - 14 (Life Below Water). Through this research, the influential role of China in 'global fisheries governance' has been put through an 'ocean governance mechanism at various levels (national, regional, and international). Therefore, China's role in 'global ocean and fisheries' are discussed side-by-side, focusing on and supporting a better understanding of China's potential challenges and opportunities in world fisheries. The role of China in global and regional fisheries governance has been critically analysed throughout the discussion. It is also discussed how China plays its part in Regional Fisheries Management Organisations (RFMOs) and how this role-playing can be utilised through the Belt and Road initiative (BRI) for effective governance, conservation and preservation of marine fisheries. The scope of China's national ocean and fisheries legislation is framed to support China's stance in leading global fisheries governance. The conclusion followed the discussion in descending order suggesting ocean and fisheries governance improvement and appropriate advocacy options available to China.

Genetic variation between hybrid (Labeo rohita ♂, Cirrhinus mrigala ♀ and Labeo rohita) by RAPD marker.

The present work was to study the genetic variability between the major carps Labeo rohita and Cirrhinus mrigala and their hybrids of L. rohita (male♂) and C. mrigala (female♀). Genetic variability was studied by employing RAPD molecular markers. 25 samples of each target species having different sizes with the same age group for the determination of interspecific variation were collected. The morphometric parameters such as body weight, total length, tail length, and lengths of dorsal and anal fins of each individual were recorded and results showed that wet body weight, total length, dorsal fin, anal fin, and tail fin length are positively correlated and then the DNA was extracted using the inorganic salt-based method and conformed by Gel electrophoresis. Twenty-four arbitrary decamer primers were used to get species-specific RAPD analysis Distinct and highly reproducible RAPD profiles with significant genetic variability was detected among species. Only five primers showed amplification. The RAPAD primer OPB-05 produced a total of seven bands out of these 5 monomorphic and 2 polymorphic, so in this case, the percentage polymorphism was 28.57%. The Hybrid show more than a 50% difference from the Labeo rohita. This shows that the Hybrid more resembles C.mrigala. Phylogenetic analysis demonstrated that hybrid (L. rohita ♂ X Cirrhinus mrigala ♀) is the closest to C. mrigala and the farthest from L. rohita. Overall data are presented concerning the applications of RAPD markers for hybrid identification, genetic diversity assessment, and studying taxonomic relationships at a molecular level.

Does simulation training result in improved on-call outcomes among newly appointed radiology registrars?

AIM: To quantify the impact of a marked increase in radiology trainee numbers and the compensatory introduction of formal simulation on-call training by investigating the discrepancy rates among on-call radiologists in training before and after the introduction of structured simulation training. MATERIALS AND METHODS: The first 100 cases reported by a cohort of Specialty Trainee Year 2 doctors (ST2), having commenced on-call reporting, were analysed. This included registrars working in two major tertiary centres. Two groups of registrars were compared directly: those who undertook the simulation training and those who did not. Discrepancies were divided by severity into minor, moderate, and major categories. The criteria for each category were based on previously published literature. RESULTS: Twelve registrars from 2017 were compared with 12 from previous years (two in 2013, four in 2014, and six in 2015); 2,320 cases were analysed. There was a statistically significant reduction in the total number of discrepancies (p=0.01) made by registrars who underwent simulation training. A similar improvement was observed in the number of major discrepancies; however, this was not statistically significant. CONCLUSION: The present study shows that simulation training successfully increases competency in on-call work. Despite doubling the number of doctors in training, discrepancy rates did not worsen and in fact improved.

Numerical scrutiny of a silica-titania-based reverse rib waveguide with vertical and rounded sidewalls.

In this work, a modal analysis of reverse rib waveguide (RRW) structures based on a silica-titania platform is carried out. The silica-titania waveguide films can be deposited via the sol-gel method and dip-coating technique. To combine this low-cost deposition technique with the economical fabrication method, we propose to structure the samples via wet-chemical etching. Due to the isotropic nature of wet etching, the waveguide architecture with rounded sidewalls is considered to model the RRW. Additionally, the modal conditions and bending loss are compared with the RRW with vertical sidewalls. It is assumed that this study will be beneficial for comprehending the modal conditions of waveguide structures with perfectly vertical and rounded sidewalls.

Development of a low-cost silica-titania optical platform for integrated photonics applications.

This paper investigates a highly attractive platform for an optical waveguide system based on silica-titania material. The paper is organized into two parts. In the first part, an experimental study on the development of an optical waveguide system is conducted via the sol-gel dip-coating method, and the optical characterization of the waveguide system is performed at a visible wavelength. This system is capable of operating from visible to near-IR wavelength ranges. The experimental results prove the dominance of this waveguide platform due to its low-cost, low loss, and easy to develop integrated optics systems. The numerical analysis of a one-dimensional Photonic crystal waveguide optical filter based on the silica-titania platform is considered in the second part of the paper by utilizing the 2D-finite element method (2D-FEM). A Fabry-Perot structure is also analyzed for refractive index sensing applications. We believe that the results presented in this work will be valuable in the realization of low-cost photonic integrated circuits based on the silica-titania platform.

Internalized skin bias: validation study to explore the impact of the internalization of social stigma on those with hidradenitis suppurativa.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic auto-inflammatory disease that is highly associated with adverse psychopathology and impaired body image. Previous studies show that patients with HS are also impacted by social stigma associated with their skin disease. Over time, these experiences can influence the way in which patients feel about themselves, leading to internalized skin bias (ISB). OBJECTIVES: To evaluate the validity and reliability of the Internalized Skin Bias Questionnaire (ISBQ) in an HS population and to determine the association of this instrument with markers of HS severity. METHODS: A cross-sectional survey with 72-h retest was sent to adult patients with HS from March to November 2021. Reliability for the ISBQ was evaluated using Cronbach's alpha and the Concordance Correlation Coefficient (CCC). Construct validity was evaluated using Pearson Correlation Coefficients with similar measures. RESULTS: Internal consistency for the ISBQ instrument was 0.89 with a CCC of 0.88. The ISBQ had moderate correlation (r = 0.63) with the experienced skin stigma questionnaire as well as the BDI-II (r = 0.66) and the psychosocial subscale of the HiSQOL (r = 0.65). ISBQ scores differed significantly across different stages of disease severity (P = 0.04). There was no significant difference between those with different durations of disease (P = 0.47). CONCLUSIONS: This study shows that the ISBQ is a valid and reliable instrument that can be used to assess the psychosocial construct of ISB especially in a population of HS patients. Further, ISB places a prevalent negative impact on the psychopathology of patients with HS.

Global law, policy, and governance for effective prevention and control of COVID-19: A comparative analysis of the law and policy of Pakistan, China, and Russia.

Global health governance is a developing system in this complex institutional regime. The local and regional health policies sometimes challenge global health governance due to diverse discourse in various countries. In the wake of COVID-19, global health governance was reaffirmed as indifferent modules to control and eliminate the pandemic; however, the global agencies later dissected their own opinion and said that "countries must learn to live with a pandemic." Given the controversial statement, this research focuses on the strong and effective policies of the Russian Federation, Pakistan, and China. The research uses the law and governance results and newly developed policies of the three countries formed under the global health policies. The conclusion is based on the statement that in order to live with the pandemic, strong health measures are required at each level.

Plasmonic sensor based on metal-insulator-metal waveguide square ring cavity filled with functional material for the detection of CO2 gas.

In this work, a straightforward and highly sensitive design of a CO2 gas sensor is numerically investigated using the finite element method. The sensor is based on a plasmonic metal-insulator-metal (MIM) waveguide side coupled to a square ring cavity filled with polyhexamethylene biguanide (PHMB) functional material. The refractive index of the functional material changes when exposed to the CO2 and that change is linearly proportional to the concentration of the gas. The sensors based on surface plasmon polariton (SPP) waves are highly sensitive due to the strong interaction of the electromagnetic wave with the matter. By utilizing PHMB polymer in the MIM waveguide plasmonic sensor provides a platform that offers the highest sensitivity of 135.95 pm/ppm which cannot be obtained via optical sensors based on silicon photonics. The sensitivity reported in this work is ∼7 times higher than reported in the previous works. Therefore, we believe that the results presented in this paper are exceedingly beneficial for the realization of the sensors for the detection of toxic gases by employing different functional materials.

Concern about malignancy contributes to the psychosocial toll of dermatomyositis.

Objective: Dermatomyositis (DM) is associated with increased morbidity and mortality, decreased quality of life, and an increased incidence of psychiatric illness. We performed a pilot study to investigate whether concern about malignancy contributes to the psychosocial toll of DM.Method: Patients with a recent DM diagnosis at our institution between 2013 and 2018 and no history of DM-associated malignancy completed standardized questionnaires and a novel survey generated by our group, and participated in focus groups.Results: Seventeen patients (14 females and three males) completed the surveys. The mean Dermatology Life Quality Index (DLQI) score was 2.75. The mean score on the Patient Health Questionnaire-9 (PHQ-9) was 5.35, with a range of 0-20. Our independent DM-specific questionnaire revealed a mean of 17.41 (range 2-40).Conclusion: Concern about the increased risk of malignancy contributes to the psychosocial toll of DM. Individual impacts are highly variable and patient specific. Clinicians should assess for depression and anxiety in patients with DM, understanding that concern for malignancy adds to the total psychosocial burden in some patients.

Brain MR Image Classification for Glioma Tumor detection using Deep Convolutional Neural Network Features.

BACKGROUND: Detection of brain tumor is a complicated task, which requires specialized skills and interpretation techniques. Accurate brain tumor classification and segmentation from MR images provide an essential choice for medical treatments. Different objects within an MR image have similar size, shape, and density, which makes the tumor classification and segmentation even more complex. OBJECTIVE: Classification of the brain MR images into tumorous and non-tumorous using deep features and different classifiers to get higher accuracy. METHODS: In this study, a novel four-step process is proposed; pre-processing for image enhancement and compression, feature extraction using convolutional neural networks (CNN), classification using the multilayer perceptron and finally, tumor segmentation using enhanced fuzzy cmeans method. RESULTS: The system is tested on 65 cases in four modalities consisting of 40,300 MR Images obtained from the BRATS-2015 dataset. These include images of 26 Low-Grade Glioma (LGG) tumor cases and 39 High-Grade Glioma (HGG) tumor cases. The proposed CNN feature-based classification technique outperforms the existing methods by achieving an average accuracy of 98.77% and a noticeable improvement in the segmentation results are measured. CONCLUSION: The proposed method for brain MR image classification to detect Glioma Tumor detection can be adopted as it gives better results with high accuracies.

Hidradenitis Suppurativa Area and Severity Index Revised (HASI-R): psychometric property assessment.

BACKGROUND: Validated, reliable, globally accepted outcome measurement instruments for hidradenitis suppurativa (HS) are needed. Current tools to measure the physical signs domain for HS rely on lesion counts, which are time-consuming and unreliable. OBJECTIVES: To assess the reliability and validity of the Hidradenitis suppurativa Area and Severity Index Revised (HASI-R) tool, a novel method for assessing HS severity, incorporating signs of inflammation and body surface area involved. METHODS: The measurement properties of the HASI-R tool were evaluated. The tool was created by combining the previously published HASI and Severity and Area Score for Hidradenitis instruments. Twenty raters evaluated 15 patients with HS in a hospital-based ambulatory dermatology clinic. The objectives of the study were to assess inter- and intra-rater reliability of the HASI-R and its components, as well as its construct and known-groups validity. Existing lesion count-based clinician-reported measures of HS and their components were also assessed. Raters were also asked their preferences regarding the various HS severity assessment tools. RESULTS: The HASI-R had moderate inter-rater reliability [intra-class correlation coefficients (ICC) 0·60]. This was better than all other HS physical sign outcome measures evaluated, which had poor inter-rater reliability (ICC < 0·5). HASI-R had the highest intra-rater reliability (ICC 0·91). The HASI-R had good construct validity and demonstrated known-groups validity. The HASI-R was also the most preferred tool by all raters. CONCLUSIONS: Results from the clinometric assessment of the HASI-R are encouraging, and support continued evaluation of this clinician-reported outcome measure.

Validation of global item for assessing impact on quality of life of patients with hidradenitis suppurativa.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease. The HS core outcome set calls for a patient global assessment (PtGA). OBJECTIVES: To assess the validity, reliability and responsiveness of a candidate single-item PtGA for HS-specific health-related quality of life (HRQoL). METHODS: Cognitive debriefing interviews were conducted with patients with HS in Denmark and the USA. A cross-sectional observational study was done with adults with HS in the USA and Denmark. Candidate PtGA item, demographic items and multiple patient-reported scales - the Hidradenitis Suppurativa Quality of Life (HiSQOL), Dermatology Life Quality Index (DLQI) and numerical rating scale (NRS) for pain - were concurrently administered to evaluate convergent and known-groups validity. Scales with a single-item assessment of change were readministered 24-72 h later, to evaluate reliability and responsiveness. RESULTS: After cognitive debriefing, the candidate PtGA for HS-specific HRQoL was finalized with five response levels. Convergent validity of the PtGA was supported by significant correlations with HiSQOL score [r = 0·79, 95% confidence interval (CI) 0·75-0·82] and DLQI (r = 0·78, 95% CI 0·74-0·82). The PtGA displayed known-groups validity with DLQI score bands based on significance of an anova (P < 0·001). Good test-retest reliability was supported by the intraclass correlation coefficient (0·82, 95% CI 0·78-0·85) for those who reported stable HS. Responsiveness was assessed by differences in PtGA score against a patient-reported assessment of change, which showed significant differences towards improvement. CONCLUSIONS: The single-item PtGA exhibits reliability, validity and responsiveness in assessing HS-specific HRQoL in HS, making it a good provisional tool for HS clinical research.

Internalized weight bias in patients presenting for bariatric surgery.

INTRODUCTION: Internalized weight bias (IWB) is significantly related to poor psychosocial health outcomes in patients with increased body mass index (BMI). The objective of this study was to evaluate the psychometric properties and correlates of the Weight-Bias Internalization Scale in a pre-surgical bariatric population. METHODS: Self-report measures were administered to patients prior to surgery. Measures assessed internalized weight bias, body dissatisfaction, depression, anxiety, quality of life, and eating behaviors. Statistical methods included confirmatory factor analysis to examine the factor structure [of the WBIS] in this population, descriptive statistics, correlations, and hierarchical linear regression between continuous variables to determine patterns of associations, and t-tests to compare levels of IWB between the current sample and previously documented samples. RESULTS: Confirmatory factor analysis indicated an acceptable fit using a one-factor structure for the WBIS, with one item removed. Mean WBIS in the current sample was comparable to that documented in a community sample of adults with overweight and obesity, as well as a sample of adolescents seeking bariatric surgery. Additionally, IWB was positively associated with body dissatisfaction, restrained, emotional, and external eating, depression, and anxiety, and negatively associated with quality of life. Further, individuals endorsing episodes of loss of control over eating had significantly higher WBIS scores. CONCLUSIONS: This study highlights the strong pattern of associations with measures of body image, disordered eating, and quality of life point toward the relevance of IWB to bariatric patients' experiences. Future studies to explore the longitudinal effects of IWB in a post-bariatric population are needed particularly to understand psychosocial and surgical health outcomes.

Ultrashort inverted tapered silicon ridge-to-slot waveguide coupler at 1.55 µm and 3.392 µm wavelength.

Herein, a compact and efficient inverted tapered ridge-to-slot waveguide coupler design based on the silicon-on-insulator platform is presented. The proposed device consists of three segments such as ridge waveguide, inverted taper segment, and slot waveguide. The coupling segment resembles a V shape, which provides good mode-matching between the ridge and slot waveguide. Two significant aspects of the proposed coupler design are discussed. In the first part of the paper, the coupler design optimized at 1.55 µm is suggested for optical interconnect. The propagation loss and coupling efficiency of 1.69 dB/µm and 91% are obtained for the 100 nm long tapered segment introduced between the ridge waveguide and slot waveguide, respectively. This propagation loss of the device includes the loss suffered by the ridge waveguide, tapered segment, and slot waveguide. Our proposed device design can be used in integrated optical platforms, where the efficient coupling of light to slot waveguides is required. Whereas, in the second part, the coupler design is optimized at the mid-infrared of 3.392 µm for an evanescent field absorption methane gas sensor. Slot waveguide offers excessive light-matter interaction due to its strong mode confinement in the low index material. The evanescent field ratio of ∼0.73 is obtained for the optimized waveguide geometry. As a result, 3 dB decay in the transmitted power can be obtained at 60% of gas concentration present in the ambient medium.

Severity and Area Score for Hidradenitis (SASH): a novel outcome measurement for hidradenitis suppurativa.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease with a large impact on patients' health-related quality of life. However, reliable and consistent outcome measures to assess body surface area (BSA) of HS have not been established. OBJECTIVES: To develop and assess the reliability and validity of a novel outcome instrument for assessment of HS BSA in a clinical trial setting. METHODS: Qualitative interviews and focus groups were conducted from July to August 2015 and October 2017 to January 2018. Evaluation of the measurement was assessed during a single-day grading session with patients in April 2018. Participants, who included clinicians or patients, were recruited from academic medical centres in the U.S. mid-Atlantic region. RESULTS: Concept elicitation included input from 10 providers, of which 60% (n = 6) were female, 80% (n = 8) dermatology specialists and 20% (n = 2) gynaecology specialists. Cognitive debriefing was conducted with 11 providers, of which 82% (n = 9) were dermatologists and 18% (n = 2) gynaecologists. The evaluation stage included 10 clinicians and 23 patients. The intraclass correlation coefficient (ICC) for inter-rater reliability was 0·60 [95% confidence interval (CI) 0·44-0·74]. The ICC for intrarater reliability was 0·98 (95% CI 0·94-1·00). Transformation of the BSA score resulted in an increase in inter-rater reliability to 0·75 (95% CI 0·62-0·85) or 0·76 (95% CI 0·62-0·85). Scores all demonstrated concurrent validity, with statistically significant correlations with extant scoring methods. CONCLUSIONS: This novel scale is a reliable and valid HS outcome instrument and may capture a wide range of patients by assessing BSA. Future research is necessary to demonstrate its responsiveness. What's already known about this topic? The major HS disease activity scales rely on lesions counts and have moderate-to-good reliability. Body surface area (BSA) is one of the physical signs included in the Core Outcome Set for HS, but is not a part of existing HS disease activity scales. What does this study add? A novel disease severity scale, the Severity and Area Score for Hidradenitis (SASH), was developed and the psychometric properties assessed. There was high inter-rater reliability of 0·75 and 0·76 when BSA was scored on an ordinal scale, and an excellent intrarater reliability of 0·98. The SASH score also demonstrated convergent validity with extant instruments. What are the clinical implications of this work? The ability of clinicians to accurately assess disease status will be improved. Implementation of the SASH score will help guide and assess the effectiveness of appropriate treatment choice.