An in-depth understanding of stakeholders' experiences about their participation in the co-production of 'Maze Out': a serious game for the treatment of eating disorders.

Background: Co-production is increasingly used in mental health research and clinical settings. Maze Out is a digital game co-produced by clinicians, patients with eating disorders (EDs), an art director with lived experience in EDs, and a game-developing company. Maze Out is based on everyday challenges when suffering from EDs and is currently being evaluated as a supplement tool in EDs treatment.

Patient Perspectives on Blended Internet-Based and Face-to-Face Cognitive Behavioral Therapy for Alcohol Use Disorder: Qualitative Study.

Background: Harmful alcohol consumption has been identified as a major contributor to disease, mortality, and social harm, accounting for 5.3% of worldwide deaths annually. In Denmark, an estimated 150,000 people suffer from alcohol use disorder (AUD), but a low proportion seek treatment due to person- and treatment-related barriers.

Evaluating the effect of BCG vaccination for non-specific protection from infection in senior citizens during the COVID-19 pandemic: A randomised clinical trial.

Objectives: The Bacillus Calmette-Guérin (BCG) vaccine may induce non-specific protection against unrelated infections. We tested the effect of BCG on the risk of infections among Danish senior citizens.

Methods: Single-blinded randomised controlled trial including 1676 volunteers >65 years.

Video consultation and treatment in the community smoking cessation therapy success rates in patients with mental illness: a randomized controlled trial.

Purpose: Smoking is the single factor with the highest impact on reducing life expectancy of patients with mental illness. Patients experience difficulty in participating in smoking cessation programs but are concerned about the impact of tobacco on their health and finances. Smoking cessation advice videoconferencing might be an alternative to an ordinary in-person consultation.

Nonuse of Blended Web-Based and Face-To-Face Cognitive Behavioral Therapy for Alcohol Use Disorder: Qualitative Study.

Background: The use of digital technologies for health care has been the focus of social studies, which have concentrated on the digital divide between individuals who use technology and those who do not-with the latter often being considered as individuals with shortcomings. In Denmark, 91% of the population have computers and 97 out of 100 families have internet access, indicating that lack of access to technology is not the primary reason for nonuse. Although previous studies have primarily focused on participants' perspectives of using internet-based treatment for alcohol use disorder (AUD), no study has investigated individuals' reasons to prefer face-to-face treatment over blended face-to-face and internet-based cognitive behavioral therapy (bCBT) for AUD among treatment-seeking populations.

Characterization of an iPSC-based barrier model for blood-brain barrier investigations using the SBAD0201 stem cell line.

Background: Blood-brain barrier (BBB) models based on primary murine, bovine, and porcine brain capillary endothelial cell cultures have long been regarded as robust models with appropriate properties to examine the functional transport of small molecules. However, species differences sometimes complicate translating results from these models to human settings. During the last decade, brain capillary endothelial-like cells (BCECs) have been generated from stem cell sources to model the human BBB in vitro.

An open-source nnU-net algorithm for automatic segmentation of MRI scans in the male pelvis for adaptive radiotherapy.

Background: Adaptive MRI-guided radiotherapy (MRIgRT) requires accurate and efficient segmentation of organs and targets on MRI scans. Manual segmentation is time-consuming and variable, while deformable image registration (DIR)-based contour propagation may not account for large anatomical changes. Therefore, we developed and evaluated an automatic segmentation method using the nnU-net framework.

Efficient low-reflection fully etched vertical free-space grating couplers for suspended silicon photonics.

We design and fabricate a grating coupler for interfacing suspended silicon photonic membranes with free-space optics while being compatible with single-step lithography and etching in 220 nm silicon device layers. The grating coupler design simultaneously and explicitly targets both high transmission into a silicon waveguide and low reflection back into the waveguide by means of a combination of a two-dimensional shape-optimization step followed by a three-dimensional parameterized extrusion. The designed coupler has a transmission of -6.

Hybrid achromatic microlenses with high numerical apertures and focusing efficiencies across the visible.

Compact visible wavelength achromats are essential for miniaturized and lightweight optics. However, fabrication of such achromats has proved to be exceptionally challenging. Here, using subsurface 3D printing inside mesoporous hosts we densely integrate aligned refractive and diffractive elements, forming thin high performance hybrid achromatic imaging micro-optics.

Dosimetric validation of the couch and coil model for high-field MR-linac treatment planning.

Purpose: The precision of the dose delivery in radiation therapy with high-field MR-linacs is challenging due to the substantial variation in the beam attenuation of the patient positioning system (PPS) (the couch and coils) as a function of the gantry angle. This work aimed to compare the attenuation of two PPSs located at two different MR-linac sites through measurements and calculations in the treatment planning system (TPS).

Methods: Attenuation measurements were performed at every 1° gantry angle at the two sites with a cylindrical water phantom with a Farmer chamber inserted along the rotational axis of the phantom.

Impact of figures of merit in photonic inverse design.

The rates of optical processes, such as two-photon absorption and spontaneous photon emission, are strongly dependent on the environment in which they take place, easily varying by orders of magnitude between different settings. Using topology optimization, we design a set of compact wavelength-sized devices, to study the effect of optimizing geometries for enhancing processes that depend differently on the field in the device volume, characterized by different figures of merit. We find that significantly different field distributions lead to maximization of the different processes, and - by extension - that the optimal device geometry is highly dependent on the targeted process, with more than an order of magnitude performance difference between optimized devices.

Designing structures that maximize spatially averaged surface-enhanced Raman spectra.

We present a general framework for inverse design of nanopatterned surfaces that maximize spatially averaged surface-enhanced Raman (SERS) spectra from molecules distributed randomly throughout a material or fluid, building upon a recently proposed trace formulation for optimizing incoherent emission. This leads to radically different designs than optimizing SERS emission at a single known location, as we illustrate using several 2D design problems addressing effects of hot-spot density, angular selectivity, and nonlinear damage. We obtain optimized structures that perform about 4 × better than coating with optimized spheres or bowtie structures and about 20 × better when the nonlinear damage effects are included.

Prophylactic Splenectomy and Hyposplenism in Spaceflight.

There is debate whether astronauts traveling to space should undergo a prophylactic splenectomy prior to long duration spaceflight. Risks to the spleen during flight include radiation and trauma. However, splenectomy also carries significant risks.

The magnetic properties of MAl(OH)SO·3HO with M = Co, Ni, and Cu determined by a combined experimental and computational approach.

The magnetic properties of the nickelalumite-type layered double hydroxides (LDH), MAl(OH)(SO)·3HO (MAl-LDH) with M = Co ( = 3/2), Ni ( = 1), or Cu ( = 1/2) were determined by a combined experimental and computational approach. They represent three new inorganic, low-dimensional magnetic systems with a defect-free, structurally ordered magnetic lattice. They exhibit no sign of magnetic ordering down to 2 K in contrast to conventional hydrotalcite LDH.

On the trade-off between mode volume and quality factor in dielectric nanocavities optimized for Purcell enhancement.

This study explores the effect of geometric limitations on the achievable Purcell factor for single emitters in dielectric structures by employing topology optimization as an inverse design tool to maximize the local density of states. Nanobeams of different lengths with varying fixed central bridge widths are considered to investigate the impact of footprint and geometric length-scale. In single-mode photonic cavities, the Purcell factor is known to be proportional to the ratio of the quality factor Q to the effective mode volume V.

Nanometer-scale photon confinement in topology-optimized dielectric cavities.

Nanotechnology enables in principle a precise mapping from design to device but relied so far on human intuition and simple optimizations. In nanophotonics, a central question is how to make devices in which the light-matter interaction strength is limited only by materials and nanofabrication. Here, we integrate measured fabrication constraints into topology optimization, aiming for the strongest possible light-matter interaction in a compact silicon membrane, demonstrating an unprecedented photonic nanocavity with a mode volume of V ~ 3 × 10 λ, quality factor Q ~ 1100, and footprint 4 λ for telecom photons with a λ ~ 1550 nm wavelength.

Bring me my alcohol!-On the continuum of pleasure and pain.

Alcohol use has been recognized as a challenge in eldercare and social care, and some anticipate that problems related to alcohol use will increase in the future as the current adult generation has high alcohol consumption rates. Accordingly, it is suggested that care workers are at risk of becoming passive bystanders to the destructive lifestyles of vulnerable older adults and even facilitating these lifestyles. In the present paper, we suggest that alcohol exacerbates and underscores inherent difficulties in eldercare, such as finding an appropriate balance between the personal freedom of the older adult and the responsibility of the care worker to provide care.

Filial Piety, Generativity and Older Adults' Wellbeing and Loneliness in Denmark and China.

The article considers the potential of intergenerational encounters and family and social ties for alleviating loneliness and promoting older adults' wellbeing. Loneliness has been widely recognized as one of the factors that are most deeply and pervasively detrimental to older adults' wellbeing. We combine theoretical reflections with a comparative study of older adults in Denmark and China.

Alcohol in long-term care homes: A qualitative investigation with residents, relatives, care workers and managers.

Introduction: Western societies are aging rapidly, and habitual use of alcohol is changing among older adults. Hence, care facilities are facing novel challenges regarding alcohol use. This pioneering qualitative study seeks to investigate the role of alcohol in care homes, as seen from the perspectives of residents, care workers, relatives, and institution management simultaneously.

Online adaptive radiotherapy potentially reduces toxicity for high-risk prostate cancer treatment.

Background And Purpose: With daily, MR-guided online adapted radiotherapy (MRgART) it may be possible to reduce the PTV in pelvic RT. This study investigated the potential reduction in normal tissue complication probability (NTCP) of MRgART compared to standard radiotherapy for high-risk prostate cancer.

Materials And Methods: Twenty patients treated with 78 Gy to the prostate and 56 Gy to elective pelvic lymph nodes were included.

The three major axes of terrestrial ecosystem function.

The leaf economics spectrum and the global spectrum of plant forms and functions revealed fundamental axes of variation in plant traits, which represent different ecological strategies that are shaped by the evolutionary development of plant species. Ecosystem functions depend on environmental conditions and the traits of species that comprise the ecological communities. However, the axes of variation of ecosystem functions are largely unknown, which limits our understanding of how ecosystems respond as a whole to anthropogenic drivers, climate and environmental variability.

Attitudes of Patients and Health Professionals Regarding Screening Algorithms: Qualitative Study.

Background: As a preamble to an attempt to develop a tool that can aid health professionals at hospitals in identifying whether the patient may have an alcohol abuse problem, this study investigates opinions and attitudes among both health professionals and patients about using patient data from electronic health records (EHRs) in an algorithm screening for alcohol problems.

Objective: The aim of this study was to investigate the attitudes and opinions of patients and health professionals at hospitals regarding the use of previously collected data in developing and implementing an algorithmic helping tool in EHR for screening inexpedient alcohol habits; in addition, the study aims to analyze how patients would feel about asking and being asked about alcohol by staff, based on a notification in the EHR from such a tool.

Methods: Using semistructured interviews, we interviewed 9 health professionals and 5 patients to explore their opinions and attitudes about an algorithm-based helping tool and about asking and being asked about alcohol usage when being given a reminder from this type of tool.

A Causal Framework for Distribution Generalization.

We consider the problem of predicting a response Y from a set of covariates X when test- and training distributions differ. Since such differences may have causal explanations, we consider test distributions that emerge from interventions in a structural causal model, and focus on minimizing the worst-case risk. Causal regression models, which regress the response on its direct causes, remain unchanged under arbitrary interventions on the covariates, but they are not always optimal in the above sense.

Evaluation of a High Stakes Physician Competency Assessment: Lessons for Assessor Training, Program Accountability, and Continuous Improvement.

Introduction: There is a dearth of evidence evaluating postlicensure high-stakes physician competency assessment programs. Our purpose was to contribute to this evidence by evaluating a high-stakes assessment for assessor inter-rater reliability and the relationship between performance on individual assessment components and overall performance. We did so to determine if the assessment tools identify specific competency needs of the assessed physicians and contribute to our understanding of physician dyscompetence more broadly.