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Background; Effortful swallowing training (EST) is a remedial method for the training of swallowing-related muscles in the oropharyngeal phase. However, clinical evidence of its effectiveness is insufficient. Aims; To investigate the effects of EST on tongue strength and swallowing function in patients with stroke. Methods & Procedures; Stroke patients with dysphagia were randomly assigned to one of two groups: an experimental group (n = 12) and a control group (n = 12). The experimental group underwent EST, while the control group performed saliva swallowing. Training was conducted 5 days per week for 4 weeks. Both groups underwent conventional dysphagia treatment for 30 min/day, 5 days/week for 4 weeks. Outcomes & Results; Tongue strength was assessed using the Iowa Oral Performance Instrument. The Videofluoroscopic Dysphagia Scale (VDS), based on a videofluoroscopic swallowing study, was used to analyze oropharyngeal swallowing function. The experimental group showed greater improvements in anterior and posterior tongue strength compared with the control group (p = 0.046 and 0.042, respectively), and greater improvement in the oral phases of the VDS (p = 0.017). Conclusions & Implications; We recommend EST as a remedial strategy for improving tongue strength and oral swallowing function in patients with stroke.

We report a continuous-wave (CW) optical parametric oscillator (OPO) based on a MgO-doped periodically poled LiNb[O.sub.3] (MgO:PPLN) crystal. The 532 nm pump generates coherent radiation that is tunable from 800 to 920 nm for the signal and from 1250 to 1580 nm for the idler, respectively. The OPO output power exhibits a slowly varying instability that we attribute to a thermal effect induced by the pump. This instability is truncated by means of a low-pass servo that includes a single-mode fiber that filters the beam into a single spatial mode. The resulting output characteristics are promising for radiometric applications in the near infrared including most fiber-optic communication bands. OCIS codes: 190.0190, 190.4975.

We describe a novel optical acoustic detector based on a bias-controlled fiber Fabry-Perot interferometer. The detector has a broad bandwidth from 10 Mhz to a few gigahertz and higher sensitivity than conventional systems, which are useful for noncontact characterization of microsamples based on laser ultrasound. OCIS codes: 060.2370, 280.3420, 120.2230, 120.3180, 110.5120, 120.4290

1. Describe the spectrum of provider-reported pediatric palliative care domains discussed and managed during pediatric palliative care - oncology clinic visits and how these differ across initial and follow-up visits. 2. Compare the differences in palliative care domains addressed and managed in visits with pediatric patients with brain tumors versus solid tumors vs leukemia/lymphoma. This retrospective cohort study outlines the content and scope of PPC visits within pediatric oncology. Many domains are addressed in each visit, and significantly more domains were discussed near the end-of-life and in solid tumor visits where symptom management domains predominated compared to other cancer types. Introduction/Context: Pediatric palliative care (PPC) improves end-of-life outcomes for children with cancer. Though PPC visits are the 'intervention' in studies focused on end-of-life care, the content of PPC visits within pediatric oncology is poorly understood. Understand the scope of PPC practice that occurs during PPC outpatient visits for children with cancer. This was a retrospective cohort study of patients 0-27 years with cancer seen in PPC clinic within an academic pediatric oncology center between 2017-2022. During each PPC visit, documenting providers chose the domains discussed or managed (Goals of Care, Symptom Management, and Care Coordination with respective subdomains). Data was abstracted from the electronic health record, PPC clinic database and Cancer Registry. The differences in frequency and type of domains addressed were analyzed by visit type, diagnosis group, proximity to the end-of-life, and year of clinic (2017-2022). There were 1,919 outpatient PPC visits across 351 patients. The median domains discussed per visit (10) did not differ between initial visits (10) and follow-ups (10) or from 2017-2022. Median domains were higher in visits < 90 days compared to visits 91+ days from end-of-life (12 vs. 10, p< 0.0001). Compared to brain tumor or leukemia/lymphoma visits, solid tumor visits addressed more symptom management domains including pain (79.9%), fatigue (33.4%), appetite (28.5%), depression (18.5%, all p< 0.001). Certain Goals of care subdomains were more frequently discussed in follow-ups compared to initial visits, notably around accommodating to the disease (93.2% vs. 86.9; p< 0.0001), advance care planning (16.4% vs. 8.8%; p< 0.0001), and code status (5.8% vs. 2.6%; p=0.01). The scope of PPC practice is broad and each visit encompasses many domains with the most common being care coordination with oncology teams, and helping patients/families cope with the disease. More domains were addressed in solid tumor visits and at the end-of-life. Managing Suffering and Distress / Models of Palliative Care Delivery [ABSTRACT FROM AUTHOR]

Pediatric palliative care (PPC) improves end-of-life (EOL) outcomes for children with cancer. Though PPC visits are the 'intervention' in studies focused on EOL care, the content of PPC visits within pediatric oncology is poorly understood. This study aimed to understand the scope of PPC practice during visits for children with cancer and their families. This was a retrospective cohort study of patients 0–27 years with cancer seen in PPC clinic within an academic pediatric oncology center between 2017 and 2022. During each PPC visit, documenting providers chose the domains discussed or managed (goals of care, symptom management, and care coordination with respective subdomains). Data was abstracted from the electronic health record, PPC clinic database, and Cancer Registry. The differences in frequency and addressed domains were analyzed by demographics, visit type, diagnosis group, and proximity to EOL. Across 351 patients, 1919 outpatient PPC visits occurred. Median domains were higher in visits <90 days vs. 91+ days from EOL (12.0 vs. 10.0; p < 0.0001); pain and hospice collaboration were particularly discussed closer to EOL. Psychological symptoms like anxiety (30.7% vs. 21.1%; p < 0.001) were addressed more in follow-ups than initial visits. Compared to brain tumor or leukemia/lymphoma visits, solid tumor visits addressed more symptom management subdomains, especially pain (79.9%; p < 0.0001). The scope of PPC practice is broad and varied. Each visit encompasses many subdomains, the most common being care coordination with oncology teams and helping patients/families cope with the disease. More domains were addressed in solid tumor visits and near EOL. [ABSTRACT FROM AUTHOR]

Vaccines are one of the greatest public health achievements, protecting children and adults against numerous infectious diseases; however, the complex, rigorous process of vaccine development is unknown to many. A candidate vaccine undergoes extensive evaluation of safety and efficacy to meet licensure requirements before recommendations for use become policy. This time-consuming process involves an intricate collaboration among academia, public and private organizations, and federal agencies to ensure that safety is prioritized in every step. Vaccine safety continues to be monitored after licensure through a robust system. Yet, vaccine hesitancy remains a major challenge, especially now with the coronavirus disease 2019 (COVID-19) pandemic and concerns about the speed with which candidate vaccines are being developed. This article reviews the vaccine development process and the systems in place to ensure safety and effectiveness. A better understanding of these topics is necessary to address concerns and improve public acceptance of all vaccines, particularly COVID-19 vaccines. [Pediatr Ann. 2020;49(12):e509-e515.]. [ABSTRACT FROM AUTHOR]

Dynamic and coherent coupling between distant cores in a commercially available optical four-core fiber is demonstrated. Wavelength-selective excitation of cladding modes is experimentally realized by an acousto-optic mode coupler by which higher-order cladding modes are visualized and compared with simulations. By comparing the coupling conditions to a global cladding mode, the relative propagation constants of the local core modes are precisely measured at an accuracy level down to 10−6. Core-cladding-core three-mode coupling operation dynamically switches optical signals between two arbitrary distant cores in the four-core fiber and achieves an inter-core switching efficiency of 55.4%. [ABSTRACT FROM AUTHOR]

In this paper, we propose a deterministic secure quantum communication (DSQC) protocol based on the BB84 system. We developed this protocol to include quantum entity authentication in the DSQC procedure. By first performing quantum entity authentication, it was possible to prevent third-party intervention. We demonstrate the security of the proposed protocol against the intercept-and-re-send attack and the entanglement-and-measure attack. Implementation of this protocol was demonstrated for quantum channels of various lengths. Especially, we propose the use of the multiple generation and shuffling method to prevent a loss of message in the experiment. [ABSTRACT FROM AUTHOR]

Abstract Oxylipins are known to have several biological functions. The oxylipin 7,10-dihydroxy-8(E)-octadecenoic acid (DOD), produced from oleic acid by Pseudomonas aeruginosa , was reported to have strong antibacterial activities against broad range of food-borne and plant pathogenic bacteria. Among DOD producers, P. aeruginosa PR3 shows efficient production of DOD from oleic acid, triolein, and olive oil. In this study, we report the serendipitous isolation and characterization of a variant strain of PR3, which upon examination showed higher efficiency for DOD production from olive oil than the original PR3 strain. Compared with the PR3 strain, the variant strain displayed enhanced DOD production by 47.6% and different carbon requirements for maximum DOD production. Considering the advantageous differences seen in this study, we propose the further characterization of this new strain and optimization of culture conditions for efficient DOD production. [ABSTRACT FROM AUTHOR]

We propose a schematic setup of quantum key distribution (QKD) with an improved secret key rate based on high-dimensional quantum states. Two degrees-of-freedom of a single photon, orbital angular momentum modes, and multi-path modes, are used to encode secret key information. Its practical implementation consists of optical elements that are within the reach of current technologies such as a multiport interferometer. We show that the proposed feasible protocol has improved the secret key rate with much sophistication compared to the previous 2-dimensional protocol known as the detector-device-independent QKD. [ABSTRACT FROM AUTHOR]