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PurposeThis study assessed the safety and efficacy of transepithelial crosslinking (CXL) using femtosecond (FS) laser-machined epithelial microchannels (MCs) followed by UVA CXL compared to FS laser (NLO CXL) in rabbits.MethodsThe epithelium of 36 rabbits was machined to create 2- by 25-µm MCs at 400 MCs/mm2. Eyes were treated with 1% riboflavin (Rf) solution for 30 minutes, rinsed, and then crosslinked using UVA or NLO CXL. Rabbits were monitored by epithelial staining, optical coherence tomography (OCT) imaging, and esthesiometry. After sacrifice at 2, 4, or 8 weeks, corneas were examined for collagen autofluorescence and immunohistochemistry.ResultsNLO CXL showed no epithelial damage compared to UVA CXL, which produced on average 23.89 ± 5.6 mm2 epithelial defects that healed by day 3. UVA CXL also produced loss of corneal sensitivity averaging 0.83 ± 0.24 cm force to elicit a blink response that persisted for 28 days and remained significantly lower than control or NLO CXL. OCT imaging detected the presence of a demarcation line only following UVA CXL but not NLO CXL.ConclusionsEven with improved transepithelial Rf penetration, UVA CXL resulted in severe epithelial damage, loss of corneal sensitivity, and delayed wound healing persisting for a month. When MCs were paired with NLO CXL, however, these issues were mostly negated. This suggests that MC NLO CXL can achieve a faster visual recovery without postoperative pain or risk of infection.Translational relevanceUVA CXL is a successful procedure, but there is a need for a transepithelial protocol. The combination of MCs and NLO CXL is able to keep the benefits of UVA CXL without causing epithelial damage.

BackgroundDespite national testing guidelines, rates of testing for HIV, sexually transmitted infections, and hepatitis C remain lower than recommended for men who have sex with men (MSM) in the US. To help address this, the TakeMeHome (TMH) program was started in March 2020 by a consortium of public health organizations and dating apps - Building Healthy Online Communities - to work with health departments to increase access to HIV testing for MSM on dating apps.MethodsUsers of participating dating apps were sent messages about opportunities for testing with self-collected specimens through TMH. Program users were eligible to receive test kits if they lived in a participating zip code and were aged at least 18. Users who were interested in testing could order kits to be mailed to them for lab-based testing of HIV, hepatitis C, chlamydia, gonorrhea, and/or syphilis, depending on risk and availability in their zip code. Orders were sent via application programming interface (API) to Molecular Testing Labs (MTL) for fulfillment; kits were provided at no cost to the program user. Within approximately 24 hours of order receipt, MTL mailed program users a kit with required collection supplies, directions, and a link to a video instruction for self-collection. Program users received an automated email after testing was complete with a link to access results through their online account. Individuals with positive results on any of the relevant tests were directed to additional information and supported with linkage to additional testing or treatment, depending on local protocols.ResultsThe positivity rate of specimens processed through TMH was 1.4% for HIV, 0.6% for hepatitis C, and 2.9% for all STIs combined. The per-person positivity rate was 15.3% across all STIs.Conclusions: The TakeMeHome program demonstrates that self-collected lab-processed testing is feasible and effective at identifying new HIV and STI cases.

In this study, we developed composites with a poly(lactic acid) matrix and reinforced with basalt fiber, carbon-based nanoparticlcs (carbon nanotube [CNT] and expanded graphene [GNP]), and both basalt fiber and nanoparticles (hybrid composites). The composites were produced by extrusion, and then tensile specimens were injection molded from the composites. The hybrid composites exhibited enhanced mechanical properties. The reinforcing materials increased crystallinity; this was more pronounced for hybrid composites. We experienced significant increase in the glass transition temperature, which proves the better interaction between the reinforcing and the matrix phases. Dynamic mechanical thermal analysis showed that the nanoparticles increased the storage modulus both alone and in combination with basalt fibers. Furthermore, the basalt fiber-reinforced composites and hybrids exhibited significant modulus above the glass transition temperature. Based on scanning electron microscopy images of the fracture surfaces, we concluded that adding basalt fibers during compounding resulted in better dispersion of the nanoparticles. Highlights * Poly(lactic acid) (PLA) reinforced with basalt fiber has good strength properties. * Graphene hybrid exhibits notable tensile modulus improvement in hybrids. * Graphene and carbon nanotubes are crystalline nucleating agents for PLA. * Enhanced nanoparticle distribution was discovered for hybrid composites. * The glass transition temperature of PLA increases with reinforcement. KEYWORDS basalt fiber, carbon nanotube, graphene, hybrid composites, poly(lactic acid), 1 | INTRODUCTION Plastic waste is an important issue globally, encouraging more and more people and companies to use environmentally friendly materials. Therefore, many research groups focus on bio-based materials [...]

The literature on conceptual combination has thus far been limited to research at the aggregate level investigating adjective-noun and noun-noun combinations. One well-established phenomenon within this literature is that of concept dominance (Hampton, 1988), which is the finding that the relative contribution of constituent concepts (for example sport or game) to their conjunction (sport that is also a game) is often very unequal. This exploratory study investigated individual differences in how people understand adjective-adjective-noun combinations, such as long blue coat. Participants rated images of coats varying along the perceptual dimensions of length and color for typicality in two different conjunctions, namely long blue coat and long purple coat. We used multidimensional scaling (MDS) to construct an aggregate coat space from similarity data collected with the Spatial Arrangement Method (SpAM). Using external unfolding, we modeled participants' typicality judgements by representing their individual typicality data as vectors within the aggregate MDS space, such that orthogonal projections from the coats onto the vectors represent their perceived typicality in the conjunctions. We did not find strong evidence for concept dominance at the aggregate level; however, we did find evidence for concept dominance at the individual level, with marked individual differences in the extent of dominance and which dimension was dominant. The validation of external unfolding for research into conceptual combination comes with new research possibilities, several of which are proposed.

Healthcare access greatly impacts skin cancer diagnosis and mortality rates. Recognition of current disparities in Mohs micrographic surgery (MMS) access can assist future policy and clinical decisions to correct them. For the years 2014-2018, the CPT codes for MMS (17,311 and 17,313) were counted on a per county level across the United States per the Medicare Centers for Medicare & Medicaid Services (CMS) Medicare Prescriber Database. Any county with 0 MMS CPT codes recorded were classified as without MMS cases. MMS hotspots were identified as counties that possessed a high average number of MMS cases compared to the national average, while also being surrounded by counties that possessed a low average number of MMS cases compared to the national average. Three thousand eighty-four counties in the United States were analyzed; 785 (25%) counties were designated as with MMS cases and 2301 (75%) without MMS cases. There were no significant differences in age, ethnicity distribution, or cost per enrollee between the two designations. 74% of counties with MMS cases were considered urban, while only 25% of those without cases were urban (p

PurposePilot study to evaluate adverse events and intraocular pressure (IOP)-lowering of a novel, noninvasive glaucoma procedure, femtosecond laser, image-guided, high-precision trabeculotomy (FLIGHT).DesignProspective, nonrandomized, single-center, interventional, single-arm clinical trial.ParticipantsEighteen eyes from 12 patients with open-angle glaucoma.MethodsEighteen eyes from 12 patients underwent FLIGHT, creating a single channel measuring 500-μm wide by 200-μm high through the trabecular meshwork and into Schlemm's canal. Adverse events, IOP, and other parameters were evaluated out to 24 months.Main outcome measuresOutcomes were the rates and types of adverse events and the rate of postprocedure best-corrected visual acuity loss (≥ 2 lines) compared with baseline. Efficacy outcomes were reduction in mean intraocular pressure (IOP) with respect to baseline and the percentage of eyes with a ≥ 20% reduction in IOP.ResultsEighteen eyes from 12 patients were enrolled in the study; 11 patients (17 eyes) returned at 24 months. There were no serious adverse events related to the laser treatment. Well-defined channels were clearly visible at 24 months by gonioscopy and anterior segment OCT, with no evidence of closure. At 24 months, the mean IOP was reduced by 34.6% from 22.3 ± 5.5 to 14.5 ± 2.6 mmHg (P < 5e-5), with an average of 2.0 ± 1.2 hypotensive medications compared with 2.2 ± 1.1 at baseline (P = 0.22). Fourteen out of the 17 study eyes (82.3%) achieved a ≥ 20% reduction in IOP at 24 months when compared with baseline.ConclusionThe FLIGHT system demonstrated a favorable safety profile in this initial pilot study, with no device-related serious adverse events. The channels appeared patent at 24 months, indicating medium-term durability.Financial disclosuresProprietary or commercial disclosure may be found after the references.

Induced corneal collagen crosslinking and mechanical stiffening via ultraviolet-A photoactivation of riboflavin (UVA CXL) is now a common treatment for corneal ectasia and Keratoconus. Some effects of the procedure such as induced mechanical stiffening, corneal flattening, and cellular toxicity are well-known, but others remain more controversial. Authors report a variety of contradictory effects, and provide evidence based on individual results and observations. A full understanding of the effects of and mechanisms behind this procedure are essential to predicting its outcome. A growing interest in modifications to the standard UVA CXL protocol, such as transepithelial or accelerated UVA CXL, makes analyzing the literature as a whole more urgent. This review presents an analysis of both the agreed-upon and contradictory results reported and the various methods used to obtain them.

The purpose of this exploratory study was to examine the longitudinal, bidirectional relations between receptive and expressive Spanish and English language and internalizing and externalizing behavior problems in a sample of 97 preschool children from Spanish-speaking, homes who were enrolled in a U.S. Head Start program. Eight cross-lagged path models were conducted: four for each language. Models tested the autoregressive and cross-lagged paths between two dimensions of language (expressive and receptive) and behavior problems (internalizing and externalizing) over the preschool year. Findings highlight the critical importance of the home language for children who are dual language learners and suggest programs ensure adequate home language support is available in the classroom. Future directions are discussed.

Supported employment (SE) and customized employment (CE) are vocational rehabilitation services designed to assist job seekers with significant disabilities to find meaningful competitive integrated employment. We conducted an analysis of Rehabilitation Service Administration (RSA-911) data for fiscal years 2017-2020 to determine the outcomes at the exit for individuals receiving SE and CE services. Specifically, we examined (a) what occupations, according to the Standard Occupational Classification (SOC) system, are individuals obtaining after exiting from state vocational rehabilitation SE and CE services, (b) if there is a difference in occupational types at the exit for individuals who receive SE and CE services, (c) if there is a difference in hourly wages and hours worked at the exit for individuals who receive SE and CE services, and (d) if there are differences in wages, after controlling for sex and race at exit for SE and CE service recipients. Results indicated most individuals receiving SE and CE services exit into three broad SOC code categories: "Food preparation and servicing related," "office and administrative support," and "building grounds cleaning and maintenance" occupations. Proportional differences suggest that individuals receiving CE are exploring a wider range of occupations compared with SE. There was a significant difference in wages between SE and CE but no difference in hours worked between SE and CE service recipients.

Iridocorneal angle (ICA) details particularly the trabecular meshwork (TM), Schlemms canal (SC), and collector channels (CCs) play crucial roles in the regulation of the aqueous outflow in the eyes and are closely associated with glaucoma. Current clinical gonioscopy imaging provides no depth information, and studies of 3D high-resolution optical coherence tomography (OCT) imaging of these structures are limited. We developed a custom-built spectral-domain (SD-) OCT imaging system to fully characterize the angle details. Imaging of a human cadaver eye reveals the visibility of details in the TM/SC/CC region via a crossline scanning and a series of image processing. This shows that ICA imaging can be used for preoperative glaucoma inspections in the clinical setting with the proposed prototype.

Board-games constitute a tool that simultaneously develops children in many ways and motivates them to learn. The aim of this experiment is to examine the effectiveness of using board-games in Romanian lessons and how the attitudes of Hungarian children change towards the Romanian language. To this end, the author created a board-game for Hungarian speaking children. The aim of the game is to bring the children closer to the Romanian language, to make it possible for them to playfully master the key words in the topics present in the elementary classes, to increase their existing vocabulary, and to develop their sentence-forming skills. 21 children participated in the research. The children learned 14 topics during the experiments, of which 7 topics were learned using traditional methods and also 7 topics were learned using the board-game. To measure the level of knowledge, the children wrote a test at the beginning and at the end of each lesson. The results show that children were able to learn more words using board-games than using traditional methods. It also became clear that when using board games, more than half of the children (56.46%) managed to form a correct sentence, while when using traditional methods, far less than half (35.37%) were able to form a correct sentence. By the end of the experiment, the children liked the Romanian lessons and their learning motivation increased significantly.

BackgroundRadiofrequency (RF) devices are being increasingly used for cosmetic dermatology applications. Recent studies have reported an apparent dualistic nature of RF devices for hair, causing either removal or growth depending on the modality of RF.Materials and methodsPubMed/MEDLINE and Web of Science searches were conducted in July 2022 according to PRISMA guidelines for studies discussing RF technology in hair applications (n = 19).ResultsThe majority of studies describe the utility of RF devices in removal of unwanted hair (n = 15). Bipolar RF has been used in combination with intense pulsed light for effective long-term removal of body and facial hair. The chromophore-independent method of energy delivery in RF makes it a viable add-on therapy for treating lighter colored hair and darker Fitzpatrick skin types. Monopolar RF is used for eyelash removal in patients with trichiasis. In contrast, fractional RF has been used to stimulate hair growth in patients with alopecia areata and androgenetic alopecia.ConclusionsPreliminary evidence supports the use of bipolar and monopolar RF devices for hair removal, while fractional RF appears to be an emerging technology for hair growth. Additional studies are needed to investigate the efficacy, mechanisms, and parameters of radiofrequency devices for various hair applications.