An ultrafast and self-powered MoSxSe2-x/Si photodetector with high light-trapping structures and a SiOx interface layer.

MoSxSe2-x nanofilms, as a typical metal dichalcogenide, have attracted great interest, due to their adjustable bandgap and distinctive electronic and optical properties. However, the inherent bandgap of MoSxSe2-x and the strong interface recombination impede the actualization of a high-sensitivity photodetector (PD). Few-layer MoSxSe2-x nanofilms were prepared with vertically orientation at 450 °C, which would be a less restrictive choice of substrates. Herein, a self-powered MoSxSe2-x/SiOx/Si photodetector was fabricated which exhibits unprecedented performance with excellent reproducibility and stability from 405 nm to 980 nm, a high responsivity (0.450 A W-1), normalized detectivity (4.968 × 1012 Jones) and ultrafast photoresponse (τr = 1.20 µs, τf = 4.92 µs) at zero bias under 980 nm incident laser illumination with a density of 200 µW cm-2. Significantly, the self-powered PD is capable of detecting ultraweak IR signals below 200 µW cm-2 with high on-off ratios. More importantly, an oxidized atomic layer is generated through the wet oxidation in the Piranha solution. The PD can work well at high frequencies even at 100 kHz, which shows its potential application in high-frequency photoelectric devices and health monitors. Summing up, this work not only suggests that an ultrathin SiOx interface layer can reduce carrier recombination via simple interface engineering, but also proposes a novel strategy for the preparation of high-performance and low-cost optoelectronic devices.

Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-emergency patients with rectal cancer.

BACKGROUND: The routine establishment of a diverting stoma (DS) remains controversial in every patient undergoing Dixon operation. We aimed to establish a model for the risk assessment of rectal anastomotic leak (RAREAL) after Dixon in non-emergency patients with rectal cancer, using routinely available variables, by which surgeons could individualize their approach to DS. METHODS: 323 patients who underwent Dixon operation for rectal cancer from January 2015 to December 2018 were taken as the model group for retrospective study. Univariable and multivariable logistic regression analysis was used to determine the independent risk factors associated with anastomotic leakage. We constructed the RAREAL model. 150 patients who underwent Dixon operation due to rectal cancer from January 2019 to December 2020 were collected according to the uniform criteria as a validation group to validate the RAREAL model. RESULTS: In the model group, multivariable analysis identified the following variables as independent risk factors for AL: HbA1c (odds ratio (OR) = 4.107; P = 0.044), Left colic artery (LCA) non preservation (OR = 4.360; P = 0.026), Tumor distance from the anal margin (TD) (OR = 6.373; P = 0.002). In the model group, the area under the curve (AUC) of the receiver operating characteristic (ROC) for evaluating AL with RAREAL was 0.733, and when RAREAL score = 2.5, its sensitivity, specificity and Youden index were 0.385, 0.973, 0.358, respectively. The AUC was 0.722 in the validation group and its sensitivity and specificity were 0.333 and 0.985, respectively, when RAREAL score = 2.5. CONCLUSION: The RAREAL score can be used to assess the risk of AL after Dixon operation for rectal cancer, and prophylactic DS should be proactively done when the score is greater than 2.5.

Online High School Community Health Worker Curriculum: Key Strategies of Transforming, Engagement, and Implementation.

Background: Ample research evidence has demonstrated that Community Health Worker (CHW) programs are a cost-effective, culturally integrated, and impactful way to improve community health. Although most existing CHW programs recruit adults as CHWs, high school students, with their intellectual readiness and intimate community knowledge, also have great potential to be engaged as CHWs that impact community health. With this potential in mind, the High School Community Health Worker Curriculum (HSCHW), for face-to-face training, was created in 2016 at Morehouse School of Medicine (MSM) as an innovative solution to improve community health in underserved, urban neighborhoods. Sixteen Metro Atlanta high school students participated in the program's first cohort. The face-to-face HSCHW training program received very positive feedback from the students and community partners involved. Additionally, during the inaugural training, the program received more than 150 nationwide inquiries about an opportunity to either participate in the program or replicate its curriculum. Hence, in 2018, a corresponding online curriculum was created to meet these needs. The online HSCHW curriculum covers the roles and competencies described in the CHW Core Consensus (C3) Project and focuses on developing high school students' critical thinking, decision-making, and communication skills. As of February 2021, 346 high school community health workers have participated in this online curriculum. Purpose: This paper reports on the research study of the critical processes and strategies of transforming, engaging, and implementing the online HSCHW curriculum. Method: The project team conducted the research study to identify the key strategies to transform the face-to-face HSCHW curriculum, the engagement strategies embedded in the online curriculum's content development, and, ultimately, the curriculum's outcomes. Altogether, this mixed-method study analyzed and reported on the learning outcomes of 265 students', in tandem with 17 high school students' focused-group interviews and responses to online surveys. Results: The results showed that integrating instructional design processes is critical for the online curriculum's success. "Interestingness," the latent concept embedded in the online HSCHW curriculum, engages high school students in learning about complex CHW skills, through digital content and activities. Furthermore, the successful implementation of the program and its student learning outcomes was assured by integrating the online curriculum with local schools and community resources, training the local community and school "trainers" to facilitate the curriculum online, and providing ongoing coaching support from the program team. Impacts: This paper provides a research report on the key strategies and processes of creating and implementing an online CHW curriculum for high school students. Its findings will inform future endeavors to develop an online CHW curriculum for lifelong learners and increase training effectiveness. The online HSCHW curriculum increases the national capacity of community health workers, whose work will increase community engagement and health equity. The curriculum also empowers high school students to acquire health knowledge that can bridge the educational gap between health knowledge acquisition and health knowledge application. Additionally, the online HSCHW curriculum presents a concrete example of leveraging digital platforms to teach complex public health competencies to young adults who can positively impact community health.

Integrating High-Fidelity Simulation into a Medical Cardiovascular Physiology Curriculum.

INTRODUCTION: The challenges of transitioning from basic sciences to clerkships are well identified in medical education. High-fidelity simulations, which have established a track record of improving clinical reasoning and clinical skills, have been proposed as a viable approach to bridge the gap between basic sciences and clerkships. However, little is known about the results of using simulation to address the gap. METHODS: In 2018, Morehouse School of Medicine enhanced the first-year cardiovascular physiology curriculum by integrating the high-fidelity simulation iStan into the cardiovascular physiology curriculum, with the purpose of early clinical exposure, cardiovascular concept mastery, and increased clinical associations. The integration included three structural design elements: (a) simulated clinical case introduction; (b) simulated clinical case development; and (c) student-led clinical case study. RESULTS: The first-year medical (MD1) students' cardiovascular physiology learning outcomes have significantly improved compared to the last two cohorts of MD1 students, and the students' test-taking time was significantly reduced compared to the performance of the last two counterpart cohorts. Students reported increased engagement in the simulation-enhanced cardiovascular physiology curriculum. CONCLUSION: The findings provide preliminary evidence to suggest that the structural integration of high-fidelity simulation in the cardiovascular physiology curriculum proved successful in terms of students' learning experience and learning outcomes. The three central elements of high-fidelity simulation integration can inform future endeavor as a structural solution to effectively bridge the gaps between basic science concepts and clinical reasoning by using high-fidelity simulations.