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Abstract 3-dB couplers, which are commonly used in photonic integrated circuits for on-chip information processing, precision measurement, and quantum computing, face challenges in achieving robust performance due to their limited 3-dB bandwidths and sensitivity to fabrication errors. To address this, we introduce topological physics to nanophotonics, developing a framework for topological 3-dB couplers. These couplers exhibit broad working wavelength range and robustness against fabrication dimensional errors. By leveraging valley-Hall topology and mirror symmetry, the photonic-crystal-slab couplers achieve ideal 3-dB splitting characterized by a wavelength-insensitive scattering matrix. Tolerance analysis confirms the superiority on broad bandwidth of 48 nm and robust splitting against dimensional errors of 20 nm. We further propose a topological interferometer for on-chip distance measurement, which also exhibits robustness against dimensional errors. This extension of topological principles to the fields of interferometers, may open up new possibilities for constructing robust wavelength division multiplexing, temperature-drift-insensitive sensing, and optical coherence tomography applications.

Objectives: The optimal treatment strategy for symptomatic young infants with tetralogy of Fallot (TOF) is unclear. We sought to compare the outcomes of staged repair (SR) (shunt palliation followed by second-stage complete repair) versus primary repair (PR) at 2 institutions that have exclusively adopted each strategy. Methods: We performed propensity score-matched comparison of 143 infants under 4 months of age who underwent shunt palliation at one institution between 1993 and 2021 with 122 infants who underwent PR between 2004 and 2018 at another institution. The primary outcome was mortality. Secondary outcomes were postoperative complications, durations of perioperative support and hospital stays, and reinterventions. Median follow-up was 8.3 years (interquartile range, 8.1-13.4 years). Results: After the initial procedure, hospital mortality (shunt, 2.8% vs PR, 2.5%; P = .86) and 10-year survival (shunt, 95%; 95% confidence interval [CI], 90%-98% vs PR, 90%; 95% CI, 81%-95%; P = .65) were similar. The SR group had a greater risk of early reinterventions but similar rates of late reinterventions. Propensity score matching yielded 57 well-balanced pairs. In the matched cohort, the SR group had similar freedom from reintervention (55%; 95% CI, 39%-68% vs 59%; 95% CI, 43%-71%; P = .85) and greater survival (98%; 95% CI, 88%-99.8% vs 85%; 95% CI, 69%-93%; P = .02) at 10 years, as the result of more noncardiac-related mortalities in the PR group. Conclusions: In symptomatic young infants with TOF operated at 2 institutions with exclusive treatment protocols, the SR strategy was associated with similar cardiac-related mortality and reinterventions as the PR strategy at medium-term follow-up.

Abstract Background The Grit scale (GS-12) is a widely used rating scale that assess passion and perseverance. The present study aimed to evaluate the reliability and validity of simple Chinese Version of Grit Scale (GS-SC) among Chinese adolescents. Methods Seven hundred one primary school students were recruited as Sample 1. Item analysis and exploratory factor analysis (EFA) were conducted on Sample 1 to preliminarily examine the structure of the scale. Sample 2 consisted of 5,384 primary school students. Confirmatory factor analysis (CFA) and verification of reliability and validity were conducted on Sample 2 to establish a formal scale and further verify the psychometric properties by applying item response theory (IRT). Results EFA and CFA revealed a clear two-factor structure. The results demonstrated that the Simplified Chinese Version of Grit Scale had adequate internal consistency and re-test reliability. GS-CS also showed good criterion-validity with personality, self-control, effort regulation and academic achievement. Furthermore, all the items show a acceptable fit to the GRM and have good discrimination (ranging from 2.13 to 3.45) and moderate difficulty(ranging from-1.58 to 0.95). Conclusions The reliability and validity of the GS-SC are good, indicating that the scale can be used as an effective tool for measuring the grit of primary school students in China.

Abstract Urban water bodies can effectively mitigate the urban heat island effect and thus enhance the climate resilience of urban areas. The cooling effect of different water bodies varies, however, the cooling heterogeneity of different sections of a single watercourse or river network is rarely considered. Based on various satellite images, geospatial approaches and statistical analyses, our study confirmed the cooling heterogeneity from spatial and seasonal perspectives of the Suzhou Outer-city River in detail in the urban area of Suzhou, China. The cooling effect of the river was observed in the daytime in four seasons, and it is strongest in summer, followed by spring and autumn, and weakest in winter. The combination of the width of the river reach, the width and the NDVI value of the adjacent green space can explain a significant part of the cooling heterogeneity of the different river sections in different seasons. Land surface temperature (LST) variations along the river are more related to the width of the river reach, but the variations of the cooling distance are more related to the adjacent green space. The cooling effect of a river reach could be enhanced if it is accompanied by green spaces. In addition, the cooling effect of a looping river is stronger on the inside area than on the outside. The methodology and results of this study could help orient scientific landscape strategies in urban planning for cooler cities.

Controllable design of the catalytic electrodes with hierarchical superstructures is expected to improve their electrochemical performance. Herein, a self-supported integrated electrode (NiCo-ZLDH/NF) with a unique hierarchical quaternary superstructure was fabricated through a self-sacrificing template strategy from the metal–organic framework (Co-ZIF-67) nanoplate arrays, which features an intriguing well-defined hierarchy when taking the unit cells of the NiCo-based layered double hydroxide (NiCo-LDH) as the primary structure, the ultrathin LDH nanoneedles as the secondary structure, the mesoscale hollow plates of the LDH nanoneedle arrays as the tertiary structure, and the macroscale three-dimensional frames of the plate arrays as the quaternary structure. Notably, the distinctive structure of NiCo-ZLDH/NF can not only accelerate both mass and charge transfer, but also expose plentiful accessible active sites with high intrinsic activity, endowing it with an excellent electrochemical performance for urea oxidation reaction (UOR). Specially, it only required the low potentials of 1.335, 1.368 and 1.388 V to deliver the current densities of 10, 100 and 200 mA cm−2, respectively, much superior to those for typical NiCo-LDH. Employing NiCo-ZLDH/NF as the bifunctional electrode for both anodic UOR and cathodic HER, an energy-saving electrolysis system was further explored which can greatly reduce the needed voltage of 213 mV to deliver the current density of 100 mA cm−2, as compared to the conventional water electrolysis system composed of OER. This work manifests that it is prospective to explore the hierarchically nanostructured electrodes and the innovative electrolytic technologies for high-efficiency electrocatalysis.

Sharp-bending waveguide is a key element for ultra-compact and densely integrated photonic devices, which is promising to enlarge the capability of modern information processing in a single chip. Topological photonics manifest the nature of robust propagation against sharp bending and such robustness has been experimentally demonstrated in topological integrated interfaces. It is important to quantify the bending loss of topological interface but has remained exclusive. In this work, we report on the characterization of sharp-bending robustness in the integrated topological interface of valley photonic crystals (VPCs) by experimentally quantifying the ultralow bending loss. The VPCs are designed on a standard silicon-on-insulator platform with the inversion-symmetry broken in honeycomb lattice, and four types of topological interfaces can be constructed by two topologically-distinct VPCs. As one of the representative cases, zigzag-AA interface is applied to demonstrate the robust propagation along sharp bending. In experiment, we fabricate a series of VPC interfaces with different turn number and the same transmission distance, which perform the ultralow bending loss less than 0.02 dB per 120-deg turning. Furthermore, we experimentally characterize the propagation loss in the integrated interfaces. Our approach not only shows the ability of VPC topological interfaces to suppress backscattering stemming from sharp bending, but also paves the way for topological nanophotonic dense integration.

Abstract Dental caries, a highly prevalent oral disease, impacts a significant portion of the global population. Conventional approaches that indiscriminately eradicate microbes disrupt the natural equilibrium of the oral microbiota. In contrast, biointervention strategies aim to restore this balance by introducing beneficial microorganisms or inhibiting cariogenic ones. Over the past three decades, microbial preparations have garnered considerable attention in dental research for the prevention and treatment of dental caries. However, unlike related pathologies in the gastrointestinal, vaginal, and respiratory tracts, dental caries occurs on hard tissues such as tooth enamel and is closely associated with localized acid overproduction facilitated by cariogenic biofilms. Therefore, it is insufficient to rely solely on previous mechanisms to delineate the role of microbial preparations in the oral cavity. A more comprehensive perspective should involve considering the concepts of cariogenic biofilms. This review elucidates the latest research progress, mechanisms of action, challenges, and future research directions regarding probiotics, prebiotics, synbiotics, and postbiotics for the prevention and treatment of dental caries, taking into account the unique pathogenic mechanisms of dental caries. With an enhanced understanding of oral microbiota, personalized microbial therapy will emerge as a critical future research trend.

Background As one of the most common diseases in the elderly, chronic insomnia is often accompanied by cognitive impairment and seriously affects the quality of life of the elderly. The biological mechanism of cognitive impairment in elderly patients with chronic insomnia still remains unclear. Objective To investigate the correlation of cognitive function with insomnia severity, serum 25-hydroxy vitamin D3 [25 (OH) D3], tumor necrosis factor-α (TNF-α) in elderly patients with chronic insomnia. Methods A total of 105 elderly patients with chronic insomnia in the 901th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from June 2020 to June 2022 were selected as the research subjects. Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS-15) and Generalized Anxiety Disorder Scale (GAD-7) were tested before enrollment. The patients were divided into 32 cases in the mild insomnia group, 38 cases in the moderate insomnia group and 35 cases in the severe insomnia group according to the PSQI score. Photoplethysmography (PPG) was used to assess the objective sleep quality of patients, monitor the total sleep time, sleep latency, sleep efficiency and arousal times; the cognitive function of patients was evaluated by Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Serum levels of 25 (OH) D3 and TNF-α were detected by enzyme-linked immunosorbent assay. Results The sleep latency, arousal times and the level of TNF-α in the severe insomnia group were higher than those in the mild and moderate insomnia groups, with lower total sleep time in the severe insomnia group compared to the mild insomnia group and lower sleep efficiency compared to the mild and moderate insomnia groups (P

Despite its existence for more than 80 years, the titanium industry is still challenged by massive carbon emissions, high production costs, and large resource waste. More than one hundred million tons of Ti−bearing blast furnace slag (TB−slag) has been discarded in China because of the difficulty of reutilization, which requires efficient titanium extraction and recovery technologies. This paper describes a low−cost, carbon−emission−free method for Ti extraction and oxygen evolution via molten oxide electrolysis (MOE) vacuum distillation. After a comprehensive analysis of the binding energies and activities of liquid metals, the highlights of our study are as follows. 1) Sb has the best preferential deposition of Ti among a series of high−Ti−affinitive liquid metal cathodes (Cu, Ni, Pb, Sn, and Sb). 2) The Ir anode was first used in TB−slag with IrO2 formed on its surface to protect it from further corrosion. 3) An alloy containing Ti and Ca can be obtained by MOE, and Ti and Ca metals can be refined by further vacuum distillation. 4) A closed loop is formed in the overall process owing to the recyclable Sb cathode and continuous feeding of TB−slag into the electrolyte. This simple, low−cost, and environmentally friendly method can realize the efficient utilization of Ti resources and achieve carbon neutrality.

Abstract Purpose To establish a multivariate linear equation to predict the diameter (outer diameter) of the acetabular prosthesis used in total hip arthroplasty. Methods A cohort of 258 individuals who underwent THA at our medical facility were included in this study. The independent variables encompassed the patients' height, weight, foot length, gender, age, and surgical access. The dependent variable in this study was the diameter of the acetabular prosthesis utilized during the surgical procedure. The entire cohort dataset was randomly partitioned into a training cohort and a validation cohort, with a ratio of 7:3, employing the SPSS 26.0 software. Pearson correlation analysis was conducted to examine the relationships between the patients' height, weight, foot length, gender, age, surgical access, and the diameter of the acetabular prosthesis in the training cohort. Additionally, a multiple linear regression equation was developed using the independent variables from the training cohort and the diameter of the acetabular prosthesis as the dependent variable. This equation aimed to predict the diameter of the acetabular prosthesis based on the patients' characteristics. The accuracy of the equation was evaluated by substituting the data of the validation cohort into the multiple linear equation. The predicted acetabular prosthesis diameters were then compared with the actual diameters used in the operation. Results The correlation analysis conducted on the training cohort revealed that surgical access (r = 0.054) and age (r = −0.120) exhibited no significant correlation with the diameter of the acetabular prosthesis utilized during the intraoperative procedure. Conversely, height (r = 0.687), weight (r = 0.654), foot length (r = 0.687), and sex (r = 0.354) demonstrated a significant correlation with the diameter of the acetabular prosthesis used intraoperatively. Furthermore, a predictive equation, denoted as Y (acetabular prosthesis diameter in mm) = 20.592 + 0.548 × foot length (cm) + 0.083 × height (cm) + 0.077 × weight (kg), was derived. This equation accurately predicted the diameter within one size with an accuracy rate of 64.94% and within two sizes with an accuracy rate of 94.81%. Conclusion Anthropometric data can accurately predict the diameter of acetabular prosthesis during total hip arthroplasty.

Cognitive diagnostic assessment based on Bayesian networks (BN) is developed in this paper to evaluate student understanding of the physical concept of buoyancy. we propose a three-order granular-hierarchy BN model which accounts for both fine-grained attributes and high-level proficiencies. Conditional independence in the BN structure is tested and utilized to validate the proposed model. The proficiency relationships are verified and the initial Q-matrix is refined. Then, an optimized granular hierarchy model is constructed based on the updated Q-matrix. All variants of the constructed models are evaluated on the basis of the prediction accuracy and the goodness-of-fit test. The experimental results demonstrate that the optimized granular-hierarchy model has the best prediction and model-fitting performance. In general, the BN method not only can provide more flexible modeling approach, but also can help validate or refine the proficiency model and the Q-matrix and this method has its unique advantage in cognitive diagnosis.

Missingness due to not-reached items and omitted items has received much attention in the recent psychometric literature. Such missingness, if not handled properly, would lead to biased parameter estimation, as well as inaccurate inference of examinees, and further erode the validity of the test. This paper reviews some commonly used IRT based models allowing missingness, followed by three popular examinee scoring methods, including maximum likelihood estimation, maximum a posteriori, and expected a posteriori. Simulation studies were conducted to compare these examinee scoring methods across these commonly used models in the presence of missingness. Results showed that all the methods could infer examinees' ability accurately when the missingness is ignorable. If the missingness is nonignorable, incorporating those missing responses would improve the precision in estimating abilities for examinees with missingness, especially when the test length is short. In terms of examinee scoring methods, expected a posteriori method performed better for evaluating latent traits under models allowing missingness. An empirical study based on the PISA 2015 Science Test was further performed.

Abstract The coupling electrosynthesis involving CO2 upgrade conversion is of great significance for the sustainable development of the environment and energy but is challenging. Herein, we exquisitely constructed the self‐supported bimetallic array superstructures from the Cu(OH)2 array architecture precursor, which can enable high‐performance coupling electrosynthesis of formate and adipate at the anode and the cathode, respectively. Concretely, the faradaic efficiencies (FEs) of CO2‐to‐formate and cyclohexanone‐to‐adipate conversion simultaneously exceed 90% at both electrodes with excellent stabilities. Such high‐performance coupling electrosynthesis is highly correlated with the porous nanosheet array superstructure of CuBi alloy as the cathode and the nanosheet‐on‐nanowire array superstructure of CuNi hydroxide as the anode. Moreover, compared to the conventional electrolysis process, the cell voltage is substantially reduced while maintaining the electrocatalytic performance for coupling electrosynthesis in the two‐electrode electrolyzer with the maximal FEformate and FEadipate up to 94.2% and 93.1%, respectively. The experimental results further demonstrate that the bimetal composition modulates the local electronic structures, promoting the reactions toward the target products. Prospectively, our work proposes an instructive strategy for constructing adaptive self‐supported superstructures to achieve efficient coupling electrosynthesis.

BackgroundPatient satisfaction survey serves as a pivotal tool in evaluating the quality of healthcare services. China’s nationwide standard patient satisfaction measurement tool was introduced in 2019. This study aimed to assess the model fit of the national standard outpatient satisfaction questionnaire in a tertiary hospital and evaluate the outpatient satisfaction levels using this tool.MethodA cross-sectional survey using the national outpatient satisfaction questionnaire was conducted via message links to all hospital outpatients who registered between April and July 2022. The data collected underwent descriptive analysis, comparative analysis, and confirmatory factor analysis (CFA).ResultsA total of 6,012 valid responses were received and analyzed during this period, with 52.9% of the participants being women. The confirmatory factor analysis (CFA) model showed a good fit and identified doctor communication as having a positive effect and environmental factors as having a negative effect on outpatients’ satisfaction, with standardized regression weights of 0.46 and 0.42, respectively. Despite the remarkably high satisfaction levels, patients’ recommendation for using the services of this hospital surpassed the overall evaluation and total satisfaction scores.ConclusionA disparity was identified between the expectations and real experiences of outpatients, leading to some extent of dissatisfaction. To enhance satisfaction levels, the hospital should improve the communication skills of all clinical staff, simplify the environment layout for first-time visitors, and manage patient overloads.