Structural Determinants of Chirally Selective Transport of Amino Acids through the α-Hemolysin Protein Nanopores of Free-Standing Planar Lipid Membranes.

Despite the importance of the enantioselective transport of amino acids through transmembrane protein nanopores from fundamental and practical perspectives, little has been explored to date. Here, we study the transport of amino acids through α-hemolysin (αHL) protein pores incorporated into a free-standing lipid membrane. By measuring the transport of 13 different amino acids through the αHL pores, we discover that the molecular size of the amino acids and their capability to form hydrogen bonds with the pore surface determine the chiral selectivity. Molecular dynamics simulations corroborate our findings by revealing the enantioselective molecular-level interactions between the amino acid enantiomers and the αHL pore. Our work is the first to present the determinants for chiral selectivity using αHL protein as a molecular filter.

Analysis of forest cover change and its driving factors in Senan district, Amhara Region, Ethiopia.

Forests are pivotal in upholding and stabilizing ecosystem functions and services globally. Assessing changes in forest cover serves as a crucial indicator to comprehend the scope, scale, and dynamics of land use and land cover alterations on regional and global scales. This study evaluates the forest cover changes between 2005 and 2021, pinpointing the key drivers of forest land changes within the Senan district in Ethiopia's Amhara region. The analysis incorporated Landsat satellite images from 2005, 2011, and 2021, supplemented by field surveys using questionnaire data. Results reveal a shift: forest cover declined from 13.6% (2005) to 11.2% (2011) but rose to 15.4% by 2021, averaging a 12.9% annual change. Several crucial factors were identified as contributors to this forest cover change. These include expanding agricultural land, population growth, urbanization, and using wood as a fuel source. Poverty, exacerbated by population growth, climate change impacts, and a scarcity of food resources, directly linked to a shortage of farmlands, emerged as significant drivers of forest cover change. In light of these findings, an in-depth analysis of land use and land cover dynamics should be conducted, particularly at the expense of forest lands. Moreover, implementing sustainable management practices by developing strategies for intensive agriculture and fostering environmentally friendly non-farm income-generating activities is essential. This study provides reference material to policymakers and land-use planners setting sustainable development goals, advocating for balanced economic growth and environmental conservation to foster a harmonious relationship between humans and forests.

Dose-escalated radiotherapy for clinically localized and locally advanced prostate cancer.

BACKGROUND: Treatments for clinically localized prostate cancer include radical prostatectomy, external beam radiation therapy, brachytherapy, active surveillance, hormonal therapy, and watchful waiting. For external beam radiation therapy, oncological outcomes may be expected to improve as the dose of radiotherapy (RT) increases. However, radiation-mediated side effects on surrounding critical organs may also increase. OBJECTIVES: To assess the effects of dose-escalated RT in comparison with conventional dose RT for curative treatment of clinically localized and locally advanced prostate cancer. SEARCH METHODS: We performed a comprehensive search using multiple databases including trial registries and other sources of grey literature, up until 20 July 2022. We applied no restrictions on publication language or status. SELECTION CRITERIA: We included parallel-arm randomized controlled trials (RCTs) of definitive RT in men with clinically localized and locally advanced prostate adenocarcinoma. RT was dose-escalated RT (equivalent dose in 2 Gy [EQD2] ≥ 74 Gy, lesser than 2.5 Gy per fraction) versus conventional RT (EQD2 < 74 Gy, 1.8 Gy or 2.0 Gy per fraction). Two review authors independently classified studies for inclusion or exclusion. DATA COLLECTION AND ANALYSIS: Two review authors independently abstracted data from the included studies. We performed statistical analyses by using a random-effects model and interpreted them according to the Cochrane Handbook for Systematic Reviews of Interventions. We used GRADE guidance to rate the certainty of the evidence of RCTs. MAIN RESULTS: We included nine studies with 5437 men in an analysis comparing dose-escalated RT versus conventional dose RT for the treatment of prostate cancer. The mean participant age ranged from 67 to 71 years. Almost all men had localized prostate cancer (cT1-3N0M0). Primary outcomes Dose-escalated RT probably results in little to no difference in time to death from prostate cancer (hazard ratio [HR] 0.83, 95% CI 0.66 to 1.04; I2 = 0%; 8 studies; 5231 participants; moderate-certainty evidence). Assuming a risk of death from prostate cancer of 4 per 1000 at 10 years in the conventional dose RT group, this corresponds to 1 fewer men per 1000 (1 fewer to 0 more) dying of prostate cancer in the dose-escalated RT group. Dose-escalated RT probably results in little to no difference in severe RT toxicity of grade 3 or higher late gastrointestinal (GI) toxicity (RR 1.72, 95% CI 1.32 to 2.25; I2 = 0%; 8 studies; 4992 participants; moderate-certainty evidence); 23 more men per 1000 (10 more to 40 more) in the dose-escalated RT group assuming severe late GI toxicity as 32 per 1000 in the conventional dose RT group. Dose-escalated RT probably results in little to no difference in severe late genitourinary (GU) toxicity (RR 1.25, 95% CI 0.95 to 1.63; I2 = 0%; 8 studies; 4962 participants; moderate-certainty evidence); 9 more men per 1000 (2 fewer to 23 more) in the dose-escalated RT group assuming severe late GU toxicity as 37 per 1000 in the conventional dose RT group. Secondary outcomes Dose-escalated RT probably results in little to no difference in time to death from any cause (HR 0.98, 95% CI 0.89 to 1.09; I2 = 0%; 9 studies; 5437 participants; moderate-certainty evidence). Assuming a risk of death from any cause of 101 per 1000 at 10 years in the conventional dose RT group, this corresponds to 2 fewer men per 1000 (11 fewer to 9 more) in the dose-escalated RT group dying of any cause. Dose-escalated RT probably results in little to no difference in time to distant metastasis (HR 0.83, 95% CI 0.57 to 1.22; I2 = 45%; 7 studies; 3499 participants; moderate-certainty evidence). Assuming a risk of distant metastasis of 29 per 1000 in the conventional dose RT group at 10 years, this corresponds to 5 fewer men per 1000 (12 fewer to 6 more) in the dose-escalated RT group developing distant metastases. Dose-escalated RT may increase overall late GI toxicity (RR 1.27, 95% CI 1.04 to 1.55; I2 = 85%; 7 studies; 4328 participants; low-certainty evidence); 92 more men per 1000 (14 more to 188 more) in the dose-escalated RT group assuming overall late GI toxicity as 342 per 1000 in the conventional dose RT group. However, dose-escalated RT may result in little to no difference in overall late GU toxicity (RR 1.12, 95% CI 0.97 to 1.29; I2 = 51%; 7 studies; 4298 participants; low-certainty evidence); 34 more men per 1000 (9 fewer to 82 more) in the dose-escalated RT group assuming overall late GU toxicity as 283 per 1000 in the conventional dose RT group. Based on long-term follow-up (up to 36 months), dose-escalated RT may result or probably results in little to no difference in the quality of life using 36-Item Short Form Survey; physical health (MD -3.9, 95% CI -12.78 to 4.98; 1 study; 300 participants; moderate-certainty evidence) and mental health (MD -3.6, 95% CI -83.85 to 76.65; 1 study; 300 participants; low-certainty evidence), respectively. AUTHORS' CONCLUSIONS: Compared to conventional dose RT, dose-escalated RT probably results in little to no difference in time to death from prostate cancer, time to death from any cause, time to distant metastasis, and RT toxicities (except overall late GI toxicity). While dose-escalated RT may increase overall late GI toxicity, it may result, or probably results, in little to no difference in physical and mental quality of life, respectively.

Effect of telmisartan on an experimental model of periodontitis in mice.

OBJECTIVE: This study was performed to explore the impact of telmisartan on experimental periodontitis in mice, in terms of alveolar bone destruction, by using micro-computed tomography analysis. MATERIALS AND METHODS: Male BALB/c mice were divided into four groups of 7 to 9 mice each: control (C) group; experimental periodontitis (E) group; experimental periodontitis-plus-telmisartan 5 mg/kg (ET5) group; and experimental periodontitis-plus-telmisartan 10 mg/kg (ET10) group. The mice in Group C were not subjected to experimental periodontitis. The other mice from Groups E, ET5 and ET10 were exposed to periodontitis. Periodontitis was induced by inoculation with Porphyromonas gingivalis. RESULTS: Telmisartan significantly suppressed both the reduction in alveolar bone height and increase of root exposure caused by P. gingivalis infection. When mice were treated with telmisartan, the decrease in the bone volume fraction induced by the infection was notably recovered. In addition, telmisartan reversed P. gingivalis-induced alterations in the microstructural parameters of trabecular bone, except trabecular thickness.No significant difference was evident between Groups ET5 and ET10 in both the extent of alveolar bone loss and microstructural parameters assessed, except bone volume fraction and trabecular number. CONCLUSION: Telmisartan may have potential benefits as a host modulation agent for the therapy of periodontitis.

Korean vs. Western Exercise Capacity Nomograms for Korean Patients With Cardiovascular Disease.

BACKGROUND: Exercise capacity is known to be an independent predictor of cardiovascular events and mortality. However, most previous studies were based on Western populations. Further study is warranted for Asian patients according to ethnic or national standards. We aimed to compare prognostic values of Korean and Western nomograms for exercise capacity in Korean patients with cardiovascular disease (CVD). METHODS: In this retrospective cohort study, we enrolled 1,178 patients (62 ± 11 years; 78% male) between June 2015 and May 2020, who were referred for cardiopulmonary exercise testing in our cardiac rehabilitation program. The median follow-up period was 1.6 years. Exercise capacity was measured in metabolic equivalents by direct gas exchange method during the treadmill test. The nomogram for exercise capacity from healthy Korean individuals and a previous landmark Western study was used to determine the percentage of predicted exercise capacity. The primary endpoint was the composite of major adverse cardiovascular events (MACE; all-cause death, myocardial infarction, repeat revascularization, stroke and hospitalization for heart failure). RESULTS: A multivariate analysis showed that the risk of primary endpoint was more than double (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.10-4.40) in the patients with lower exercise capacity (< 85% of predicted) by Korean nomogram. The lower exercise capacity was one of the strong independent predictors along with left ventricular ejection fraction, age, and level of hemoglobin. However, the lower exercise capacity by Western nomogram could not predict the primary endpoint (HR, 1.33; 95% CI, 0.85-2.10). CONCLUSION: Korean patients with CVD with lower exercise capacity have higher risk of MACE. Considering inter-ethnic differences in cardiorespiratory fitness, the Korean nomogram provides more suitable reference values than the Western nomogram to determine lower exercise capacity and predict cardiovascular events in Korean patients with CVD.

Iatrogenic radial nerve palsy in the surgical treatment of humerus shaft fracture -anterolateral versus posterior approach: A systematic review and meta-analysis.

BACKGROUND: Although many studies have investigated iatrogenic radial nerve palsy (RNP) in humerus shaft fracture, there is inconsistent evidence on which approach leads to iatrogenic RNP. Moreover, no meta-analysis has directly compared the anterolateral and posterior approaches regarding iatrogenic RNP. METHODS: In this systematic review and meta-analysis, the MEDLINE, Embase, and Cochrane Library databases were searched systematically for studies published before March 30, 2021. We included studies that (1) assessed the RNP in the surgical treatment of humerus shaft fracture and (2) directly compared the anterolateral and posterior approaches regarding the RNP. We performed synthetic analyses of the incidence of iatrogenic RNP and the recovery rate of iatrogenic RNP in humerus shaft fracture between the anterolateral and posterior approaches. RESULTS: Our study enrolled nine studies, representing 1303 patients who underwent surgery for humerus shaft fracture. After exclusion of traumatic RNP, iatrogenic RNP was reported in 35 out of 678 patients in the anterolateral approach and in 69 out of 497 patients in the posterior approach. Pooled analysis revealed that the incidence of iatrogenic RNP was significantly higher in the posterior approach than in the anterolateral approach (OR = 2.72; 95% confidence interval (CI), 1.70-4.35; P < 0.0001, I2 = 0%), but there was no significant difference in the recovery rates of iatrogenic RNP between the two approaches (OR = 1.55; 95% CI, 0.26-9.18; P = 0.63, I2 = 0%). CONCLUSION: In this meta-analysis, the posterior approach showed a higher incidence of iatrogenic RNP than the anterolateral approach in the surgical treatment of humerus shaft fracture. With limited studies, it is difficult to anticipate if any particular approach favors the recovery of iatrogenic RNP.

Diagnosis of Neurogenic Thoracic Outlet Syndrome Based on the Clinical Status.

OBJECTIVES: At our institute, we devised a clinical algorithm for diagnosis of neurogenic thoracic outlet syndrome (TOS). Our approach assisted in the accurate diagnosis and in detection of patients likely to benefit from surgical treatment. The purposes of this study were to propose our diagnostic approach to neurogenic TOS, and to describe the outcomes of surgical and conservative treatment. METHODS: Patients (n = 91) who were suspected to have neurogenic TOS, and therefore, underwent a routine clinical protocol from January 2012 to January 2018 were reviewed. Through the clinical protocol, diagnosis of "true neurologic TOS", "symptomatic TOS", and "not likely TOS" was made. The visual analog scale (VAS) pain score and Disabilities of the Arm, Shoulder and Hand (DASH) score were used to assess the treatment outcomes. Satisfaction with surgery was assessed according to the Derkash classification as excellent, good, fair, or poor. RESULTS: Among 91 patients with presumed neurogenic TOS, 25 patients were "true neurologic TOS", 61 patients were "symptomatic TOS", and five patients were "not likely TOS". Nineteen patients underwent supraclavicular decompression of the brachial plexus whose mean age at the time of surgery was 36.4 years. The VAS average pain score improved from 3.6 to 0.8, and the DASH score improved from 38.4 to 17.1. According to the Derkash classification, ten patients (53%) rated their recovery as excellent, four (21%) as good, and five (26%) as fair. Sixty-seven patients underwent conservative treatment. At the last follow-up visit, their VAS and DASH score were 2.3 and 11.8, respectively. CONCLUSIONS: By using an algorithm, we diagnosed the patients suspected to have neurogenic TOS into three groups based on clinical status. We surgically treated 19 patients using supraclavicular approach, and achieved favorable outcomes.

Full-Color-Tunable Nanophotonic Device Using Electrochromic Tungsten Trioxide Thin Film.

Color generation based on strategically designed plasmonic nanostructures is a promising approach for display applications with unprecedented high-resolution. However, it is disadvantageous in that the optical response is fixed once the structure is determined. Therefore, obtaining high modulation depth with reversible optical properties while maintaining its fixed nanostructure is a great challenge in nanophotonics. In this work, dynamic color tuning and switching using tungsten trioxide (WO3), a representative electrochromic material, are demonstrated with reflection-type and transmission-type optical devices. Thin WO3 films incorporated in simple stacked configurations undergo dynamic color change by the adjustment of their dielectric constant through the electrochromic principle. A large resonance wavelength shift up to 107 nm under an electrochemical bias of 3.2 V could be achieved by the reflection-type device. For the transmission-type device, on/off switchable color pixels with improved purity are demonstrated of which transmittance is modulated by up to 4.04:1.

Ultra-Stable Freestanding Lipid Membrane Array: Direct Visualization of Dynamic Membrane Remodeling with Cholesterol Transport and Enzymatic Reactions.

Cell membranes actively change their local compositions, serving essential biological processes such as cellular signaling and endocytosis. Although membrane dynamics is vital in the cellular functions, the complexity of natural membranes has made its fundamental understanding and systematic assessment difficult. Here, a powerful artificial membrane system is developed for real-time visualization of the spatiotemporal dynamics of membrane remodeling. Through well-defined air/oil/water interfaces on grid holes, tens of planar lipid bilayer membranes are easily created, and their reproducibility, controllability, and generality are highlighted. The freestanding membranes are large but also highly stable, facilitating direct long-term monitoring of dynamic membrane reconstitution caused by external stimuli. As an example to demonstrate the superiority of this membrane system, the effect of cholesterol trafficking, which significantly affects biophysical properties of cell membranes, is investigated at different membrane compositions. Cholesterol transport into and out of the membranes at different rates causes anomalous lipid arrangements through cholesterol-mediated phase transitions and decomposition, which have never been witnessed before. Furthermore, enzyme-induced membrane dynamics is successfully shown in this platform; sphingomyelinases locally generate asymmetry between two membrane leaflets. This technique is broadly applicable for exploring the membrane heterogeneity under various membrane-based reactions, providing valuable insight into the membrane dynamics.

Influence of Competitive Inclusion of CO2 and N2 on sII Hydrate-Flue Gas Replacement for Energy Recovery and CO2 Sequestration.

This study investigated the structural transformation, guest distributions, and the extent of replacement in CH4 + C3H8-flue gas replacement occurring in sII hydrates via gas chromatography, NMR spectroscopy, and powder X-ray diffraction (PXRD). Simulated flue gas (CO2 (20%) + N2 (80%)) was injected into an sII CH4 (90%) + C3H8 (10%) hydrate for guest exchange. The extent of replacement occurring in CH4 + C3H8-flue gas replacement was much lower than that of CH4 + C3H8-CO2 replacement. Furthermore, 13C NMR spectra and PXRD patterns revealed that unlike CH4 + C3H8-CO2 replacement, CH4 + C3H8-flue gas replacement did not undergo any structural transformation during the replacement (i.e., iso-structural replacement in the sII hydrate). Rietveld refinement of PXRD patterns of gas hydrates after replacement using flue gas injection demonstrated that CO2 molecules occupied both the small (512) and large (51264) cages, whereas N2 molecules occupied only the small (512) cages. CO2 and N2 were not complementary but competitive in replacing CH4 in the small (512) cages, which contributed to the maintenance of the cage stability of the initial sII hydrate and thus, resulted in a lower extent of replacement. The experimental results obtained in this study provide valuable insights on the accurate replacement mechanism and cage-specific guest exchange behavior of sII hydrates using flue gas injection for energy recovery and CO2 sequestration.

Is Thumb Proprioception Decreased in Patients With Trapeziometacarpal Joint Osteoarthritis?

Proprioception is thought to be essential for normal joint homeostasis, and its decreased function has been associated with an increased risk of joint diseases. However, only a few studies have been performed on the association between proprioceptive function in the trapeziometacarpal joint (TMCJ) and osteoarthritis. The purpose of this study was to compare TMCJ proprioceptive function in elderly women with radiographic TMCJ osteoarthritis relative to age-matched control women without osteoarthritis. We enrolled 19 women (mean age, 66 years) with symptomatic, radiographic Eaton and Littler grade 2, 3, and 4 TMCJ osteoarthritis and 19 age-matched control women without osteoarthritis. We evaluated thumb proprioception by using a joint-position reproduction test and compared the reposition error (RE) between the groups. We carried out a multivariate analysis for factors potentially associated with increased RE, such as age, body mass index, hand dominance, the presence of diabetes, pain level, and the presence of osteoarthritis. Also, a logistic regression analysis was performed for factors associated with the occurrence of TMCJ osteoarthritis. Patients with TMCJ osteoarthritis had greater RE than did the control patients in the joint-position reproduction test at 20°, 30°, and 40° of thumb palmar abduction. The multivariate analysis indicated that increased RE was associated with the presence of osteoarthritis, but not with the other factors assessed. The occurrence of TMCJ osteoarthritis was associated with increased RE at 20°, 30°, and 40° of thumb palmar abduction. This study showed that decreased proprioceptive function was associated with the presence of osteoarthritis in the TMCJ, although the causality remains unknown. Further studies on the role of proprioception in the pathogenesis of TMCJ osteoarthritis and the potential role of its training for disease prevention or treatment are required.

Static and Dynamic Permeability Assay for Hydrophilic Small Molecules Using a Planar Droplet Interface Bilayer.

Because numerous drugs are administered through an oral route and primarily absorbed at the intestine, the prediction of drug permeability across an intestinal epithelial cell membrane has been a crucial issue in drug discovery. Thus, various in vitro permeability assays have been developed such as the Caco-2 assay, the parallel artificial membrane permeability assay (PAMPA), the phospholipid vesicle-based permeation assays (PVPA) and Permeapad. However, because of the time-consuming and quite expensive process for culturing cells in the Caco-2 assay and the unknown microscopic membrane structures of the other assays, a simpler yet more accurate and versatile technique is still required. Accordingly, we developed a new platform to measure the permeability of small molecules across a planar freestanding lipid bilayer with a well-defined area and structure. The lipid bilayer was constructed within a conventional UV spectrometer cell, and the transport of drug molecules across the bilayer was recorded by UV absorbance over time. We then computed the permeability from the time-dependent diffusion equation. We tested this assay for five exemplary hydrophilic drugs and compared their values with previously reported ones. We found that our assay has a much higher permeability compared to the other techniques, and this higher permeability is related to the thickness of the lipid bilayer. Also we were able to measure the dynamic permeability upon the addition of a membrane-disrupting surfactant demonstrating that our assay has the capability to detect real-time changes in permeability across the lipid bilayer.

Electrically tunable multifunctional metasurface for integrating phase and amplitude modulation based on hyperbolic metamaterial substrate.

Active metasurfaces, which are tunable and reconfigurable nanophotonic structures with active materials, have been in spotlight as a versatile platform to control the profiles of scattered light. These nanoscale structures show surpassing functionalities compared to the conventional metasurfaces. They also play an important role in a wide range of applications for imaging, sensing, and data storage. Hence, the expansion of functionalities has been highly desired, in order to overcome the limited space constraints and realize the integration of several optical devices on a single compact platform. In this context, an electrically tunable metasurface that enables respective modulation of the phase and amplitude of reflected light, depending on the angle of incidence at the targeted wavelength, is proposed. This resonance-based device with hyperbolic metamaterial substrate excites different kinds of highly confined modes, according to the incident angle. Indium tin oxide is employed to offer electrically tunable optical properties in the near-infrared regime. At the wavelength of 1450 nm, the proposed device modulates the phase of reflected light with ~207 degrees of modulation depth for normal incidence, whereas it shows ~86% of relative reflectance change for oblique incidence of 60 degrees. In principle, the proposed scheme might provide a path to applications for the next-generation ultracompact integrated systems.

Broadband efficient modulation of light transmission with high contrast using reconfigurable VO2 diffraction grating.

Ultra-compact dynamically reconfigurable modulation of optical transmission has been widely studied by using subwavelength-spaced resonant metasurface structures containing reconfigurable optical materials. However, it has been difficult to achieve high transmissivity, large modulation depth, and broad bandwidth simultaneously with the conventional resonance-based metasurface schemes. Here, we propose a reconfigurable phase-transition diffractive grating, made of thick VO2 ridge waveguides, for achieving the above-mentioned three goals simultaneously in the near-infrared range. Based on the large dielectric-to-plasmonic transition characteristic of VO2 in the near-infrared range, diffraction directivity of dual-VO2 ridge waveguide is designed to be tuned by thermally driven phase transition of VO2 for transverse electrically polarized illumination. Then, the diffractive VO2 ridge waveguide grating composed of the periodically arranged dual VO2 ridge waveguides is designed with on-state efficiency around 0.3 and minimum modulation depth about 0.35 over a broad bandwidth of 550 nm (1100-1650 nm). The working principle and excellent modulation performance are thoroughly verified through numerical and experimental studies.

Contribution of stress and coping strategies to problematic Internet use in patients with schizophrenia spectrum disorders.

INTRODUCTION: Internet use is already high and increasing rapidly among people with psychotic disorders, but there have been few studies on problematic Internet use (PIU) among patients with schizophrenia spectrum disorders. This study aimed to measure the prevalence of PIU and identify the factors associated with PIU among patients with schizophrenia spectrum disorders. METHODS: A cross-sectional survey was performed that included 368 outpatients with schizophrenia spectrum disorders: 317 with schizophrenia, 22 with schizoaffective disorder, 9 with schizophreniform disorder, and 20 with other schizophrenia spectrum and psychotic disorders. The severity of psychotic symptoms and levels of personal and social functioning were assessed by the Clinician-rated Dimensions of Psychosis Symptom Severity (CRDPSS) scale and the Personal and Social Performance (PSP) scale, respectively. PIU was evaluated using Young's Internet Addiction Test (IAT). Additionally, the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Rosenberg Selfesteem Scale (RSES), and Brief Coping Orientation to Problems Experienced (COPE) Inventory were administered. RESULTS: PIU was identified in 81 (22.0%) of the 368 patients with schizophrenia spectrum disorders. Subjects with PIU were significantly younger and more likely to be male. Scores on the HADS, PSS, and dysfunctional coping dimension of the Brief COPE Inventory were significantly higher, and RSES scores were significantly lower, in the PIU group. Logistic regression analysis indicated that PIU in patients was significantly associated with scores on the PSS and dysfunctional coping dimension of the Brief COPE Inventory. CONCLUSIONS: Patients with schizophrenia spectrum disorders and PIU were significantly more likely to have high levels of perceived stress and dysfunctional coping strategies. Patients with schizophrenia spectrum disorders who also engage in PIU may benefit from interventions that help them to develop appropriate skills for coping with stress.

Critical nanofocusing of magnetic dipole moment using a closed plasmonic tip.

Squeezing magnetic dipole (MD) moment into a deep subwavelegnth apex of a tapered tip has not been achieved so far owing to a specific mode volume of a MD resonance which is dependent on an operating wavelength and back reflection of nanofocused waves. We propose a novel strategy for efficient delivery and nanofocusing of optical MD at an apex of a closed resonant plasmonic tip. Due to the ultracompact area (~λ2/900) of the nanocavity and resonances assisted by partial mirrors in a plasmonic waveguide, the enhancement factor of magnetic energy density is improved over 5 times. We expect that our scheme can help to investigate strong magnetic phenomena, including enhanced magnetic transition, artificial optical magnetism, multipole nonlinear optics, biomolecular sensing, magnetic near-field imaging, and spectroscopy.

Broadband ultrathin circular polarizer at visible and near-infrared wavelengths using a non-resonant characteristic in helically stacked nano-gratings.

Modern imaging and spectroscopy systems require to implement diverse functionalities with thin thickness and wide wavelength ranges. In order to meet this demand, polarization-resolved imaging has been widely investigated with integrated circular polarizers. However, the circular polarizers which operate at the entire visible wavelengths and have a thickness of several tens of nanometers have not been developed yet. Here, a circular polarizer, operating at the entire visible wavelength range, is demonstrated using helically stacked aluminum nano-grating layers. High extinction ratio and broad operation bandwidth are simultaneously achieved by using non-resonant anisotropic characteristics of the nano-grating. It is theoretically verified that the averaged extinction ratio becomes up to 8 over the entire visible wavelength range while having a thickness of 390 nm. Also, the feasibility of the proposed structure and circular polarization selectivity at the visible wavelength range are experimentally verified. It is expected that the proposed structure will lead to extreme miniaturization of a circular polarizer and contribute greatly to the development of mobile/wearable imaging systems such as virtual reality and augmented reality displays.

Metallic Fresnel zone plate implemented on an optical fiber facet for super-variable focusing of light.

We propose and investigate a metallic Fresnel zone plate (FZP/MFZP) implemented on a silver-coated optical fiber facet for super-variable focusing of light, the focal point of which can be drastically relocated by varying the wavelength of the incident light. We numerically show that when its nominal focal length is set to 20 µm at 550 nm, its effective focal length can be tuned by ~13.7 µm for 300-nm change in the visible wavelength range. This tuning sensitivity is over 20 times higher than that of a conventional silica-based spherical lens. Even with such high tuning sensitivity with respect to the incident wavelength change, the effective beam radius at the focal point is preserved nearly unchanged, irrespective of the incident wavelength. Then, we fabricate the proposed device, exploiting electron- and focused-ion-beam processes, and experimentally verify its super-variable focusing functionality at typical red, green, and blue wavelengths in the visible wavelength range, which is in good agreement with the numerical prediction. Moreover, we propose a novel MFZP structure that primarily exploits the surface-plasmon-polariton-mediated, extra-ordinary transmission effect. For this we make all the openings of an MFZP, which are determined by the fundamental FZP design formula, be partitioned by multi-rings of all-sub-wavelength annular slits, so that the transmission of azimuthally polarized light is inherently prohibited, thereby leading to super-variable and selective focusing of radially polarized light. We design and fabricate a proof-of-principle structure implemented on a gold-coated fused-silica substrate, and verify its novel characteristics both numerically and experimentally, which are mutually in good agreement. We stress that both the MFZP structures proposed here will be very useful for micro-machining, optical trapping, and biomedical sensing, in particular, which invariably seek compact, high-precision, and flexible focusing schemes.

Vibration Anesthesia for Pain Reduction During Intralesional Steroid Injection for Keloid Treatment.

BACKGROUND: Patients suffer significant pain during intralesional steroid injection treatment for keloids and hypertrophic scars. Vibration anesthesia has been shown to effectively and safely alleviate pain sensations, likely by reducing pain transmission from peripheral receptors to the brain. OBJECTIVE: The objective was to evaluate the efficacy, safety, and patient satisfaction associated with vibration anesthesia for reducing pain during intralesional corticosteroid injection. METHODS: The authors recruited 40 patients with 58 keloids who were scheduled to undergo intralesional triamcinolone acetonide (TA) injections. Half of each keloid was injected with concomitant vibration anesthesia, whereas the other half was injected without vibration anesthesia. Pain experienced by patients during both procedures was assessed according to visual analog scale (VAS) score. The authors also assessed procedure safety. RESULTS: The mean VAS score during intralesional TA injection therapy without vibration was 5.88 ± 2.34. By contrast, the same patients yielded a mean VAS score during intralesional TA injection therapy with vibration of 3.28 ± 1.85; the difference between the mean scores was significant (p < .05). Thirty-nine (97.5%) patients tolerated this therapy well. CONCLUSION: Vibration anesthesia is a promising option for reducing pain during keloid treatment with intralesional steroid injection.