Advancing Concerns of Spanish-Speaking Physical Injury Survivors: Equitable Trauma Care System Service Delivery.

Objective: Few investigations have focused specifically on engaging Spanish-speaking patients in early post-injury comparative effectiveness trials. The goal of this study was to identify and categorize hospitalized Spanish-speaking injury survivors' posttraumatic concerns. Method: A secondary analysis of baseline data collected as part of a larger randomized comparative effectiveness trial was conducted. Participants were 22 male and female Spanish, non-English, speaking survivors of intentional and unintentional injuries, ages ≥ 18. At baseline, while hospitalized, each patient was asked to describe the nature and severity of their post-injury concerns. Patient concern narratives were audio-recorded and later transcribed. Raters coded patients' transcribed concerns into content domains. The associations between patient self-reported concern severity and posttraumatic stress disorder symptoms assessed with the PTSD Checklist and depressive symptoms assessed with the PHQ-9 were also ascertained. Results: The concerns of Spanish-speaking patients were reliably categorized into previously described content domains (i.e., work and finance, physical health, social, psychological, medical, and legal domains). The composite Kappa statistic across domains was 0.83 (95% Confidence Interval = 0.74, 0.92). Spanish-speaking patients also expressed novel concerns, including immigration, discriminatory experiences, and Coronavirus pandemic, related concerns. The number of severe patient concerns was highly correlated with PHQ-9 depressive symptom levels (r = 0.52, p < .05). Conclusions: The concerns of Spanish-speaking trauma survivors can be readily elicited and reliably interpreted. Future research could integrate concern narrative elicitation and amelioration into stepped care intervention procedures in order to engage diverse Spanish-speaking injury survivors and advance equitable trauma care system service delivery.

Initial coin offerings (ICOs): Why do they succeed?

Recent literature has addressed initial coin offering (ICO) projects, which are an innovative form of venture financing through cryptocurrencies using blockchain technology. Many features of ICOs remain unexplored, leaving much room for additional research, including the success factors of ICO projects. We investigate the success of ICO projects, with our main purpose being to identify factors that influence a project's outcome. Following a literature review, from which several potential variables were collected, we used a database comprising 428 ICO projects in the banking/financial sector to regress several econometric models. We confirmed the impacts of several variables and obtained particularly valuable results concerning project and campaign variables. We confirmed the importance of a well-structured and informative whitepaper. The proximity to certain markets with high availability of financial and human capital is also an important determinant of the success of an ICO. We also confirm the strong dependency on cryptocurrency and the impact of cryptocurrency valuations on the success of a project. Furthermore, we confirm the importance of social media in ICO projects, as well as the importance of human capital characteristics. Our research contributes to the ICO literature by capturing most of the success factors previously identified and testing their impacts based on a large database. The current research contributes to the building of systems theory and signaling theory by adapting their frameworks to the ICO environment. Our results are also important for regulators, as ICOs are mainly unregulated and have vast future potential, and for investors, who can benefit from our analysis and use it in their due diligence.

Alignment tolerant, low voltage, 0.23†V.cm, push-pull silicon photonic switches based on a vertical pn junction.

In this paper, we present the design, fabrication and characterization of a carrier depletion silicon-photonic switch based on a highly doped vertical pn junction. The vertical nature of the pn junction enables the device to exhibit a modulation efficiency as high as 0.23 V.cm. Fast switching times of 60ps are achieved in a lumped configuration. Moreover, the process flow is highly tolerant to fabrication deviations allowing a seamless transfer to the 350 nm process node of a commercial complementary-metal-oxide semiconductor (CMOS) foundry. Overall, this work showcases the possibility of fabricating highly efficient carrier depletion-based silicon photonic switches using medium resolution lithography.

Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review.

Background: Fibromyalgia (FM) is a chronic medical condition characterized by widespread pain, sleep disturbance, and cognitive dysfunction. Sleep disorders are thought to play a prominent role in the etiology and symptomatic management of FM, specifically obstructive sleep apnea (OSA). In order to provide collaborative care, we need a better understanding of any overlapping presentation of FM and OSA. We conducted a site-wide review of patients from 2012-2016 to identify FM patients diagnosed with OSA. Methods: Charts were reviewed in patients aged 18 and above from 2012-2016 using ICD codes from a clinical data repository. Intersection of patients with a diagnosis of FM and OSA in clinics of psychiatry, sleep, rheumatology, and other outpatient clinics was compared. Polysomnography order patterns for FM patients were investigated. Results: Co-morbidity was highest in the sleep clinic (85.8%) compared to psychiatry (42.0%), rheumatology (18.7%), and other outpatient clinics (3.6%) (p<0.001). In the rheumatology and other outpatient clinics, 93.5% and 96% of patients respectively, had no polysomnography ordered. Pairwise comparison of co-morbidity in clinics: sleep vs psychiatry, sleep vs rheumatology, sleep vs other clinics, psychiatry vs rheumatology, psychiatry vs other clinics, and rheumatology vs other clinics were statistically significant after applying a Sidak adjustment to the p-values (all p<0.001). Conclusion: Our analysis suggests that there could be a correlation between FM and OSA, and referral to sleep studies is recommended in the management of patients with FM. The varying prevalence of FM patients with co-morbid OSA in sleep clinics when compared to other outpatient clinics suggests a discrepancy in the identification of FM patients with OSA. When properly screened, OSA co-morbidity has the potential to be higher in other outpatient clinics.

Large Pockels effect in micro- and nanostructured barium titanate integrated on silicon.

The electro-optical Pockels effect is an essential nonlinear effect used in many applications. The ultrafast modulation of the refractive index is, for example, crucial to optical modulators in photonic circuits. Silicon has emerged as a platform for integrating such compact circuits, but a strong Pockels effect is not available on silicon platforms. Here, we demonstrate a large electro-optical response in silicon photonic devices using barium titanate. We verify the Pockels effect to be the physical origin of the response, with r42 = 923 pm V-1, by confirming key signatures of the Pockels effect in ferroelectrics: the electro-optic response exhibits a crystalline anisotropy, remains strong at high frequencies, and shows hysteresis on changing the electric field. We prove that the Pockels effect remains strong even in nanoscale devices, and show as a practical example data modulation up to 50 Gbit s-1. We foresee that our work will enable novel device concepts with an application area largely extending beyond communication technologies.

Microwave index engineering for slow-wave coplanar waveguides.

Microwave index engineering has been investigated in order to properly design slow-wave coplanar waveguides suitable for a wide range of applications in microwave, photonics, plasmonics and metamaterials. The introduction and optimization of novel capacitive and inductive elements is proposed as a design approach to increase the microwave index while keeping the impedance close to 50 Ω to ensure the compatibility with external electronic devices. The contribution of inductive and capacitive elements and their influence on the performance of the slow-wave coplanar waveguide has been systematically analyzed. As a result, a microwave index as high as 11.6 has been experimentally demonstrated in a frequency range up to 40 GHz which is, to the best of our knowledge, the largest microwave index obtained so far in coplanar waveguides.

High performace silicon 2x2 optical switch based on a thermo-optically tunable multimode interference coupler and efficient electrodes.

Optical switches based on tunable multimode interference (MMI) couplers can simultaneously reduce the footprint and increase the tolerance against fabrication deviations. Here, a compact 2x2 silicon switch based on a thermo-optically tunable MMI structure with a footprint of only 0.005 mm(2) is proposed and demonstrated. The MMI structure has been optimized using a silica trench acting as a thermal isolator without introducing any substantial loss penalty or crosstalk degradation. Furthermore, the electrodes performance have significantly been improved via engineering the heater geometry and using two metallization steps. Thereby, a drastic power consumption reduction of around 90% has been demonstrated yielding to values as low as 24.9 mW. Furthermore, very fast switching times of only 1.19 µs have also been achieved.