Reedmagnusson3412

he utilization of BMP-2 for the entire United States over an 11-year period, further research is needed to the determine the factors affecting these trends.Topical imiquimod could be an alternative, noninvasive, treatment modality for high-grade cervical intraepithelial neoplasia (CIN). However, evidence is limited, and there are no studies that compared treatment effectiveness and side effects of topical imiquimod cream to standard large loop excision of the transformation zone (LLETZ) treatment. A multi-center, nonrandomized controlled trial was performed among women with a histologic diagnosis of CIN 2/3. Women were treated with either vaginal imiquimod (6.25 mg 3 times weekly for 8 to 16 wk) or LLETZ according to their own preference. Successful treatment was defined as the absence of high-grade dysplasia at the first follow-up interval after treatment (at 20 wk for the imiquimod group and at 26 wk for the LLETZ group). Secondary outcome measures were high-risk human papillomavirus (hrHPV) clearance, side effects, and predictive factors for successful imiquimod treatment. Imiquimod treatment was successful in 60% of women who completed imiquimod treatment and 95% of women treated with LLETZ. hrHPV clearance occurred in 69% and 67% in the imiquimod group and LLETZ group, respectively. This study provides further evidence on topical imiquimod cream as a feasible and safe treatment modality for high-grade CIN. Although the effectiveness is considerably lower than LLETZ treatment, imiquimod treatment could prevent initial surgical treatment in over 40% of women and should be offered to a selected population of women who wish to avoid (repeated) surgical treatment of high-grade CIN.

Effective patient-provider communication (PPC) can improve clinical outcomes and therapeutic alliance. While PPC may have improved over time due to the implementation of various policies for patient-centered care, its nationwide trend remains unclear.

The objective of this study was to examine trends in PPC quality among US adults and whether trends vary with race-ethnicity.

A repeated cross-sectional study.

We examine noninstitutionalized civilian adults who made 1 or more health care visits in the last 12 months and self-completed the mail-back questionnaire in the Medical Expenditure Panel Survey, 2002-2016.

Outcomes include 4 top-box measures, each representing the odds of patients reporting that their providers always (vs. never, sometimes, usually) used a given communication behavior in the past 12 months regarding listening carefully, explaining things understandably, showing respect, and spending enough time. A linear mean composite score (the average of ordinal responses for the behaviors a warranting future research.

Our findings suggest that providers are increasingly likely to use patient-centered communication strategies. While racial differences have narrowed, Asians report the lowest quality throughout the study period, warranting future research.

Little is known about how health insurance payer types differ between transgender and gender diverse (TGD) people and cisgender people. Much of what is known about insurance coverage among TGD adults has been based on research from claims and electronic health record data, which excludes individuals who have not accessed gender-affirming care. Research designed to understand how TGD populations pay for health care to best inform care interventions and public insurance policies is lacking.

The objective of this study was to examine differences in the prevalence of public and private health insurance between transgender and cisgender adults.

Using data from the Behavioral Risk Factor Surveillance System, this study estimated prevalence of health insurance coverage among TGD and cisgender adults residing in 22 states that administered the Sexual Orientation and Gender Identity module and the Healthcare Access module from 2014 to 2019. This study estimated the odds of health insurance coverage (no insurance, private insurance, public insurance) among cisgender adults compared with TGD adults.

TGD people had greater odds of being uninsured compared with cisgender women. Among nondisabled, nonelderly respondents, TGD adults had lower odds of having private insurance and higher odds of public insurance compared with cisgender men. Among respondents who were likely Medicaid-eligible, TGD respondents had lower odds of having public insurance and higher odds of being uninsured compared with cisgender women.

These findings provide foundational information about the payer mix among TGD people and provide insight into barriers to health insurance that TGD adults may face.

These findings provide foundational information about the payer mix among TGD people and provide insight into barriers to health insurance that TGD adults may face.Radiotherapy is a common treatment modality for the treatment of cancer, where treatments must be carefully designed to deliver appropriate dose to targets while avoiding healthy organs. The comprehensive multi-disciplinary quality assurance (QA) process in radiotherapy is designed to ensure safe and effective treatment plans are delivered to patients. However, the plan QA process is expensive, often time-intensive, and requires review of large quantities of complex data, potentially leading to human error in QA assessment. We therefore develop an automated machine learning algorithm to identify 'acceptable' plans (plans that are similar to historically approved plans) and 'unacceptable' plans (plans that are dissimilar to historically approved plans). This algorithm is a supervised extension of projective adaptive resonance theory, called SuPART, that learns a set of distinctive features, and considers deviations from them indications of unacceptable plans. We test SuPART on breast and prostate radiotherapy datasets from our institution, and find that SuPART outperforms common classification algorithms in several measures of accuracy. When no falsely approved plans are allowed, SuPART can correctly auto-approve 34% of the acceptable breast and 32% of the acceptable prostate plans, and can also correctly reject 53% of the unacceptable breast and 56% of the unacceptable prostate plans. Thus, usage of SuPART to aid in QA could potentially yield significant time savings.Two-dimensional boron (i.e. borophene) holds promise for a variety of emerging nanoelectronic and quantum technologies. Since borophene is synthesized under ultrahigh vacuum (UHV) conditions, it is critical that the chemical stability and structural integrity of borophene in oxidizing environments are understood for practical borophene-based applications. In this work, we assess the mechanism of borophene oxidation upon controlled exposure to air and molecular oxygen in UHV via scanning tunneling microscopy andspectroscopy, x-ray photoelectron spectroscopy, and density functional theory calculations. While borophene catastrophically degrades almost instantaneously upon exposure to air, borophene undergoes considerably more controlled oxidation when exposed to molecular oxygen in UHV. In particular, UHV molecular oxygen dosing results in single-atom covalent modification of the borophene basal plane in addition to disordered borophene edge oxidation that shows altered electronic characteristics. By comparing these experimental observations with density functional theory calculations, further atomistic insight is gained including pathways for molecular oxygen dissociation, surface diffusion, and chemisorption to borophene. Overall, this study provides an atomic-scale perspective of borophene oxidation that will inform ongoing efforts to passivate and utilize borophene in ambient conditions.In this letter, a tunneling field effect transistor based on quasi-broken gap energy band alignment (QB-TFET) is proposed and investigated by simulation method. To offering high on-state current, InGaAs/GaAsSb heterojunction with quasi-broken gap energy band alignment is applied to QB-TFET to improve the band-to-band tunneling rate. Trench gate structure and InGaAs pocket layer are applied to further increase the tunneling efficiency. To suppress the leakage current caused by the off-state tunneling path from source to drain, an intrinsic InGaAs spacer is inserted between n+ InGaAs drain and p+ GaAsSb source. In order to further improve the control ability of gate voltage on channel, TiO2is used as the gate dielectric of the proposed QB-TFET. Moreover, the effect ofxandyfraction of InxGa1-xAs and GaAsySb1-yon quasi-broken gap tunneling junction are studied in this work. The electrical characteristic change of QB-TFET with differentxandyfraction is analyzed. The proposed QB-TFET is compared with other works and shows an obvious advantage on performance. As a result, a large on-state current (Ion) of 921μAμm-1can be obtained. Moreover, steep average subthreshold swing (SSavg) of 4.9 mV/dec can be achieved whenIon = 1μAμm-1.Coincidence timing resolution (CTR) is an important parameter in clinical positron emission tomography (PET) scanners to increase the signal-to-noise ratio of PET images by using time-of-flight (TOF) information. Lutetium (Lu) based scintillators are often used for TOF-PET systems. However, the self-radiation of Lu-based scintillators may influence the image quality for ultra-low activity PET imaging. Recently, a gadolinium fine aluminum gallate (CeGFAG) scintillation crystal that features a fast decay time (∼55 ns) and no self-radiation was developed. The present study aimed at optimizing the GFAG crystal surface treatment to enhance both CTR and energy resolution (ER). The TOF-PET detector consisted of a GFAG crystal (3.0 × 3.0 × 20 mm3) and a SiPM with an effective area of 3.0 × 3.0 mm2. The timing and energy signals were extracted using a high-frequency SiPM readout circuit and then were digitized using a CAMAC DAQ system. The CTR and ER were evaluated with nine different crystal surface treatments such as partial saw-cut and chemical polishing and the 1-side saw-cut was the best choice among the treatments. The respective CTR and ER of 202 ± 2 ps and 9.5 ± 0.1% were obtained with the 1-side saw-cut; the other 5-side mechanically polished GFAG crystals had respective values which were 18 ps (9.0%) and 1.3% better than those of the all-side mechanically polished GFAG crystal. The chemically polished GFAG crystals also offered enhanced CTR and ER of about 17 ps (8.2%) and 2.1%, respectively, over the mechanically polished GFAG crystals.Nonlinear optical response could be greatly enhanced when metasurfaces support plasmonic resonances at both fundamental and harmonic wavelengths. However, it is still challenging to fulfill the doubly resonant condition. Here, we propose a dielectric-loading method, which simply coats a conformal thin dielectric layer onto the plasmonic metasurfaces, to introduce an additional degree of freedom and make the doubly resonant condition easily fulfilled. We demonstrate that by simultaneously tuning the thickness of the coated dielectric layer and the geometrical parameters of the gold complementary split-ring resonators (CSRRs), the doubly resonant enhancement of third harmonic generation (THG) could be achieved for any given fundamental wavelengths. Y-27632 We also experimentally verify this concept and show that the THG intensity in the dielectric-loaded CSRRs under the doubly resonant condition could be further increased about 3 times as compared with the case of the conventional CSRRs.