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Two-dimensional (2D) semiconducting transition metal dichalcogenides could be used to build high-performance flexible electronics. However, flexible field-effect transistors (FETs) based on such materials are typically fabricated with channel lengths on the micrometre scale, not benefitting from the short-channel advantages of 2D materials. Here, we report flexible nanoscale FETs based on 2D semiconductors; these are fabricated by transferring chemical-vapour-deposited transition metal dichalcogenides from rigid growth substrates together with nano-patterned metal contacts, using a polyimide film, which becomes the flexible substrate after release. Transistors based on monolayer molybdenum disulfide (MoS2) are created with channel lengths down to 60 nm and on-state currents up to 470 μA μm−1 at a drain–source voltage of 1 V, which is comparable to the performance of flexible graphene and crystalline silicon FETs. Despite the low thermal conductivity of the flexible substrate, we find that heat spreading through the metal gate and contacts is essential to reach such high current densities. We also show that the approach can be used to create flexible FETs based on molybdenum diselenide (MoSe2) and tungsten diselenide (WSe2). By transferring two-dimensional semiconductors from rigid growth substrates together with nano-patterned metal contacts, flexible field-effect transistors can be fabricated with channel lengths down to 60 nm.

Female Genital Mutilation/Cutting (FGM/C) affects millions of girls and women globally each year despite widespread criminalization of the practice. Eradication efforts have focused on the health risks associated with FGM/C however, it is important to understand the sociocultural context in which this practice exists. We conducted a cross-sectional study using retrospective chart review and structured interviews with women recruited through the Bellevue/New York University Program for Survivors of Torture. Of the 43 participants enrolled in the study, 88.4% initially indicated there is no benefit of undergoing FGM/C but when prompted, agreed that social acceptance (16.3%), religious approval (11.6%), and better marriage prospects (9.3%) are possible benefits. More sexual pleasure for the women (46.5%), avoiding pain (30.2%), and fewer medical problems (16.3%) were stated as benefits of not undergoing FGM/C. Overall, 40 (93%) participants believed the practice should be discontinued. This study highlights that there may be a perception of social benefit of undergoing FGM/C. Although most participants believed the practice should be discontinued, the complex social milieu within which this practice exists must be addressed.

Purpose The purpose of this paper is to synthesize a dyadic theoretical model which takes social-oriented and individual-initiative drivers into account and illustrates a mechanism between social commerce intention and its antecedents in the hospitality industry. To understand tourist social commerce behaviors, the current study puts forward a comprehensive model and investigates the impact among social support, social capital, participant involvement and social identification on tourist propensity to engage in social commerce with behaviors such as to like, share, post reviews and make purchases. Design/methodology/approach The current research draws on social exchange theory and social penetration theory to study how social-oriented drivers (i.e., social support and social capital) and individual-initiated drivers (i.e., participant involvement and social identification) could better explain tourists’ social commerce intentions. Structural equation modeling was performed based on a sample of 569 hotel guests from 61 hotels in Macau. Findings Results reveal that social capital mediates the relationship between social support and social commerce behavioral intention. This chain of relationship is moderated by social identification in that the more a hotel guest identifies himself/herself as an in-group member of an online community, the more likely he/she would engage in social commerce behaviors. Practical implications The diffusion velocity of marketing effect is manifested through customers’ social commerce intentions and behaviors, which helps managers to identify the importance in maintaining a supportive atmosphere to nurture intimate member-to-member and member-to-provider relationships. Originality/value The present study enriches the social penetration theory and social exchange theory by showing how both individual and social perspectives could jointly influence hotel guest propensity to post likes and comments and to reserve hotel rooms, as means to build more intimate relationships with the members within a virtual community.

Changes in retinal blood flow may be involved in the pathogenesis of glaucoma and other ocular diseases. Erythrocyte mediated velocimetry (EMV) is a novel technique where indocyanine green (ICG) dye is sequestered in erythrocyte ghosts and autologously re-injected to allow direct visualization of erythrocytes for in vivo measurement of speed. The purpose of this study is to determine the mean erythrocyte speed in the retinal microvasculature, as well as the intravisit and intervisit variability of EMV. Data from 23 EMV sessions from control, glaucoma suspect, and glaucoma patients were included in this study. In arteries with an average diameter of 43.11 µm ± 6.62 µm, the mean speed was 7.17 mm/s ± 2.35 mm/s. In veins with an average diameter of 45.87 µm ± 12.04 µm, the mean speed was 6.05 mm/s ± 1.96 mm/s. Intravisit variability, as measured by the mean coefficient of variation, was 3.57% (range 0.44–9.68%). Intervisit variability was 4.85% (range 0.15–8.43%). EMV may represent reliable method for determination of retinal blood speed, potentially allowing insights into the effects of pharmacologic agents or pathogenesis of ocular diseases.

Objective To assess the repeatability of blood flow velocity index (BFVi) metrics obtained with a recently FDA-cleared laser speckle contrast imaging device, the XyCAM RI, and characterize differences in these metrics between control, glaucoma suspect, and glaucoma subjects. Design Prospective observational study Participants 46 subjects (20 control, 16 glaucoma suspect, and 10 glaucoma; one eye per subject) Methods Key dynamic BFVi metrics–mean, peak, dip, volumetric rise index (VRI), volumetric fall index (VFI), time to rise (TtR), time to fall (TtF), blow out time (BOT), skew, acceleration time index (ATI)–were measured in the optic disc, optic disc vessels, optic disc perfusion region, and macula in four imaging sessions on the same day. Intrasession and intersession variability were calculated using the coefficient of variation (CV) for each metric in each region of interest (ROI). Values for each dynamic BFVi variable were compared between glaucoma subjects, glaucoma suspects, and controls using bivariate and multivariable analysis. Pearson correlation coefficients were used to correlate each variable in each ROI with age, intraocular pressure, cup to disc ratio, mean deviation, pattern standard deviation, retinal nerve fiber layer thickness, and minimum rim width. Main outcome measures CV for the intrasession and intersession variability for each dynamic BFVi metric in each ROI, and differences in each metric in each ROI between each diagnostic group. Results The intersession CV for mean, peak, dip, as well as VRI, VFI, TtR, and TtF ranged from 3.2 ± 2.5% to 11.0 ± 3.8%. Age, cup-to-disc ratio, optical coherence tomography metrics, and visual field metrics showed significant correlations with dynamic BFVi variables. Peak, mean, dip, VRI, and VFI, were significantly lower in glaucoma subjects than in control subjects in all ROI except the fovea. These metrics were also significantly lower in glaucoma subjects than suspects in the disc vessels. Conclusions Dynamic blood flow metrics measured with the XyCAM RI are reliable, associated with structural and functional glaucoma metrics, and significantly different between glaucoma subjects, glaucoma suspects, and controls. The XyCAM RI may serve as an important tool in glaucoma management in the future.

High-density memory arrays require selector devices, which enable selection of a specific memory cell within a memory array by suppressing leakage current through unselected cells. Such selector devices must have highly nonlinear current-voltage characteristics and excellent endurance; thus selectors based on a tunneling mechanism present advantages over those based on the physical motion of atoms or ions. Here, we use two-dimensional (2D) materials to build an ultrathin (three-monolayer-thick) tunneling-based memory selector. Using a sandwich of h-BN, MoS2, and h-BN monolayers leads to an "H-shaped" energy barrier in the middle of the heterojunction, which nonlinearly modulates the tunneling current when the external voltage is varied. We experimentally demonstrate that tuning the MoS2 Fermi level can improve the device nonlinearity from 10 to 25. These results provide a fundamental understanding of the tunneling process through atomically thin 2D heterojunctions and lay the foundation for developing high endurance selectors with 2D heterojunctions, potentially enabling high-density non-volatile memory systems.

Introduction Emergency Department (ED)-based HIV counseling and testing (HCT) has had a significant impact on improving rates of HIV diagnosis and linkage to care. Unfortunately, expansion of this strategy to low- and middle-income countries has been limited. Successful implementation of ED-based HCT is dependent on patient and provider acceptance of the intervention, and their attitudes and pre-existing biases towards the disease. This study sought to develop validated survey instruments to assess attitudes towards ED-based HCT. Methods This cross-sectional study surveyed patients and providers in three EDs in the Eastern Cape province, South Africa. A convenience sample of patients and providers in the ED were surveyed. Exploratory factor analysis was conducted using questions on attitudes to HIV testing to develop validated survey instruments. An ANOVA test assessed variance in attitudes towards HCT based on demographic variables collected. Results A total of 104 patient and 132 provider surveys were completed. Exploratory factor analysis resulted in a 17- and 7-question attitudes survey for patients and providers, respectively. Overall, 92.3% of patients and 70.7% of providers supported ED-based HCT, however, both groups displayed only mildly positive attitudes. Questions representing ‘confidentiality’ and ‘stigma around HIV testing’ had the least positive influence on patients’ overall attitudes. Questions representing ‘comfort with HIV testing’ had the least positive influence on providers’ overall attitudes. Conclusion Our study demonstrated ED patients and providers are generally supportive of ED-based HCT. A validated survey instrument was able to provide a standardized approach to identify barriers to HCT implementation in an ED setting, across contexts. For successful implementation, behavioral interventions must focus on strengthening patient beliefs around confidentiality and the consent process, and providers’ comfort levels with providing HIV testing services in the ED.

Advanced data encryption requires the use of true random number generators (TRNGs) to produce unpredictable sequences of bits. TRNG circuits with high degree of randomness and low power consumption may be fabricated by using the random telegraph noise (RTN) current signals produced by polarized metal/insulator/metal (MIM) devices as entropy source. However, the RTN signals produced by MIM devices made of traditional insulators, i.e., transition metal oxides like HfO and AlO, are not stable enough due to the formation and lateral expansion of defect clusters, resulting in undesired current fluctuations and the disappearance of the RTN effect. Here, the fabrication of highly stable TRNG circuits with low power consumption, high degree of randomness (even for a long string of 2 − 1 bits), and high throughput of 1 Mbit s by using MIM devices made of multilayer hexagonal boron nitride (h-BN) is shown. Their application is also demonstrated to produce one-time passwords, which is ideal for the internet-of-everything. The superior stability of the h-BN-based TRNG is related to the presence of few-atoms-wide defects embedded within the layered and crystalline structure of the h-BN stack, which produces a confinement effect that avoids their lateral expansion and results in stable operation., M.L. acknowledges generous support from the King Abdullah University of Science and Technology. This work was supported by the Ministry of Science and Technology of China (grants no. 2018YFE0100800, 2019YFE0124200), the National Natural Science Foundation of China (grants no. 61874075), the Collaborative Innovation Centre of Suzhou Nano Science & Technology, the Priority Academic Program Development of Jiangsu Higher Education Institutions, and the 111 Project from the State Administration of Foreign Experts Affairs of China. A.A. and S.R. acknowledge the project: ModElling Charge and Heat trANsport in 2D-materIals based Composites—MECHANIC reference number: PCI2018-093120 funded by Ministerio de Ciencia, Innovación y Universidades. ICN2 is funded by the CERCA Programme/Generalitat de Catalunya and is supported by the Severo Ochoa program from Spanish MINECO (Grant No. SEV-2017-0706). Y.S. acknowledges support from the European Union (Marie Sklodowska-Curie actions (grant no. 894840). The authors acknowledge technical advice from H.-S. Philip Wong from Stanford University and Xiaoming Xie from Chinese Academy of Sciences.

Background: Emergency Departments (EDs) can serve as clinical sites for identification of new HIV infections and their entry into care. We examined if HIV-positive patients who present to EDs in South Africa are able to successfully link to care. Methods: We conducted a one-year longitudinal prospective cohort study in four hospitals across the Eastern Cape, South Africa between July 2016 and July 2018. All adult, non-critical patients presenting to the ED were systematically approached, asked about their HIV status, and, if unknown, offered a point-of-care (POC) HIV test. All HIV-positive patients were further consented to participate in a follow-up study to assess subsequent linkage to care and distance from “home” to ED. Linkage to care was defined as self-reported linkage (telephonic) or evidence of repeated CD4/viral load testing in the National Health Laboratory System (NHLS) at either 6- or 12-months post index ED visit. Findings: A total of 983 patients consented to participate in the study. In the 12 months following their ED visit, 34∙1% of patients demonstrated linkage to care (335/983), 23∙8% did not link to care (234/983), and 42∙1% (414/983) were lost to follow-up. Though not statistically significant, a higher percentage of young men and those presenting with a trauma-related complaint did not link to care. A considerable proportion of patients (105/454, 23∙2%,) resided 50 or more km from their index ED sites, though there was not a significant difference in linkage to care rate between those who lived closer or further from the ED. Interpretation: Innovative implementation strategies are required to overcome patient-level factors and structural barriers within the health system to improve HIV care linkage to care for both known HIV-positive and newly diagnosed HIV-positive ED patients. Strategies should consider the use of facilitated linkage using case management approaches and same day ART initiation, amongst others. Funding Information: This research was supported by the South African Medical Research Council, the Division of Intramural Research, the National Institute of Allergy and Infectious Diseases, National Institutes of Health, and the Johns Hopkins Center for Global Health. The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. Declaration of Interests: The authors have nothing to disclose. Ethics Approval Statement: The study was approved by the Johns Hopkins University School of Medicine Institutional Review Board (IRB00105801), the Human Research Ethics Committees (HREC) of University of Cape Town (Ref 856/2015), and the Walter Sisulu University HREC (Ref 069/15). Written consent was obtained from all participants for the collection of demographic data and POC HIV testing.

Transarterial embolization (TAE) is a standard-of-care treatment for tumors in which embolic particles are locally injected via a catheter to occlude blood flow and induce ischemia in the target tissue. Physicians currently rely on subjective visual cues from fluoroscopy in order to determine the procedural endpoint relative to the injection site. This contributes to highly variable treatment outcomes, including the accumulation of embolic particles in healthy tissue, called off-target embolization. To address this concern, we describe a novel, multilumen catheter that 1) measures real-time pressure upstream of the tumor site during TAE injection; and 2) associates that measurement with the volume of embolic particles injected. Using an in vitro silicon vascular model, we characterize the relationship between blood flow, intravascular pressure, and injection pressure. Furthermore, we identify a predictive pressure curve based on the volume of embolic particles injected. This approach has the potential to standardize and optimize TAE, reducing the likelihood of incomplete or off-target embolization, and improving patient outcomes.

Background Children with sickle cell disease (SCD) are at risk for neurocognitive deficits, which can lead to effects on academic performance and later job attainment. However, screening in children at high risk for poor academic performance (PAP) in a clinic setting has been limited. The goal was to identify young children with SCD at high risk for PAP via administration of a standardized screening tool at the clinic visit. Procedure Parents of 20 patients were asked to complete the Behavior Assessment System for Children, 3rd edition (BASC-3) Parent Rating Scale. Children ages six to nine years and all SCD genotypes were included. Those patients who scored at least 1 standard deviation below the mean were considered high risk. Statistics was used to associate demographic, academic, and laboratory data with risk status (RS). Results Four of 20 patients (20%) were found to be at risk by the BASC-3. A significant association was found between those with a history of PAP and RS (P = 0.001). A trend toward association was found between baseline hemoglobin, reticulocyte count, and RS. Children not at risk had a higher hemoglobin level and lower reticulocyte count (P = 0.37 and P = 0.20, respectively). Those on hydroxyurea were significantly less likely to score as at risk (P = 0.014), whereas those with siblings may be at greater risk (P = 0.037). Conclusion(s) A parent-directed screening tool may identify children with SCD in need of additional school support. Further prospective studies are necessary to understand correlations found between hemoglobin, reticulocyte count, and hydroxyurea treatment and risk for PAP.

Neuromorphic computing systems, which use electronic synapses and neurons, could overcome the energy and throughput limitations of today’s computing architectures. However, electronic devices that can accurately emulate the short- and long-term plasticity learning rules of biological synapses remain limited. Here, we show that multilayer hexagonal boron nitride (h-BN) can be used as a resistive switching medium to fabricate high-performance electronic synapses. The devices can operate in a volatile or non-volatile regime, enabling the emulation of a range of synaptic-like behaviour, including both short- and long-term plasticity. The behaviour results from a resistive switching mechanism in the h-BN stack, based on the generation of boron vacancies that can be filled by metallic ions from the adjacent electrodes. The power consumption in standby and per transition can reach as low as 0.1 fW and 600 pW, respectively, and with switching times reaching less than 10 ns, demonstrating their potential for use in energy-efficient brain-like computing. Vertically structured electronic synapses, which exhibit both short- and long-term plasticity, can be created using layered two-dimensional hexagonal boron nitride.

Background: Combining anti-VEGF/Ang2 and anti-PD-1 therapy promotes an immunopermissive state, supportive of T-cell-mediated tumour cell destruction. This phase Ib study is assessing BI 836880 plus ezabenlimab in patients (pts) with advanced solid tumours. In Part 1 (dose escalation in pts with advanced NSCLC), the recommended phase 2 dose (RP2D) was determined as BI 836880 720 mg + ezabenlimab 240 mg IV q3w. Here, we report updated results, including data from Part 2 (expansion cohorts). Methods: Part 2 has 7 cohorts: metastatic (m) NSCLC after checkpoint inhibitor (CPI) monotherapy (Cohort A);mNSCLC after chemotherapy (CT) + CPI (Cohort B);mSCLC after CT ± CPI (Cohort C);recurrent GBM (1st and 2nd recurrence;Cohort D);immunotherapy-resistant m-melanoma (Cohort E);HCC after prior sorafenib or lenvatinib (Cohort F);and previously untreated unresectable HCC (Cohort G). Primary endpoint is objective response rate (complete response [CR] + partial response [PR]). Results: As of March 2021, 215 pts have been treated (Part 1: 14, Part 2: 201 [Cohort A, 35;B, 32;C, 19;D, 31;E, 32;F, 29;G, 23];70% male, median age 62 yrs). Any and ≥G3 AEs (any-cause) were reported in 183 (85%) and 72 (33%) pts. 118 (55%) pts had drug-related AEs, most commonly asthenia (13%) and hypertension (12%). 7 pts had G4 AEs (non-related hyperkalaemia + cardiac arrest, laryngospasm, gastrointestinal perforation;drug-related anaphylactic reaction, cholestatic hepatitis, acute pancreatitis, increased transaminases);9 pts had G5 AEs (non-related COVID-19 pneumonia, epilepsy, intracranial haemorrhage, cardio-respiratory arrest, haemoptysis, hepatic failure, general physical health deterioration, Glasgow coma scale abnormal + shortness of breath;drug-related tracheal haemorrhage). 35 (16%) pts had immune-related AEs and 15 (7%) had AEs leading to discontinuation. 179 pts were evaluable for response: 1 had confirmed CR (Cohort F), 22 had PR (Part 1: 2;Part 2: 20 [Cohort A, 4;C, 5;D, 4;E, 3;F, 3;G, 1]) and 110 had stable disease. 106 pts remain on treatment. Conclusions: BI 836880 plus ezabenlimab had a manageable safety profile, with preliminary activity in a range of tumour types. Clinical trial identification: NCT03468426. Editorial acknowledgement: Medical writing support for the development of this manuscript, under the direction of the authors, was provided by Hannah Simmons MSc, of Ashfield MedComms, an Ashfield Health company, and funded by Boehringer Ingelheim. Legal entity responsible for the study: Boehringer Ingelheim. Funding: Boehringer Ingelheim. Disclosure: N. Girard: Financial Interests, Personal, Advisory Role: Roche, Eli Lilly, Boehringer Ingelheim, AstraZeneca, Novartis, Pfizer, BMS, MSD, Takeda, GSK, AbbVie, Pharmamar, Janssen, Sanofi;Financial Interests, Personal, Funding, Travel/accommodation/expenses: Roche, AstraZeneca, BMS MSD Oncology;Financial Interests, Institutional, Research Grant: Roche, AstraZeneca, Boehringer Ingelheim. M. Wermke: Financial Interests, Personal, Advisory Role: MSD, Novartis, Kite, Heidelberg Pharma, Roche, Boehringer Ingelheim;Financial Interests, Personal, Other, Honoraria: BMS, Merck, Roche, Novartis, Kite, Boehringer Ingelheim, AstraZeneca;Financial Interests, Personal, Funding, Travel/Accommodation/Expenses: Glenmark, BMS, AstraZeneca. E. Ledin: Financial Interests, Personal and Institutional, Research Grant: Boehringer Ingelheim. D. Kim: Financial Interests, Personal, Advisory Role: Health Insurance Review & Assessment Service, Korea;Financial Interests, Personal, Invited Speaker: Korean Association for Lung Cancer, Korean Cancer Association, Korean Society of Medical Oncology, Taiwan Lung Cancer Society;Financial Interests, Institutional, Principal Investigator, Clinical Trial Funding: Alpha Biopharma, Amgen, AstraZeneca/Medimmune, Boehringer-Ingelheim, Bridge BioTherapeutics, Chong Keun Dang, Daiich-Sankyo, GSK, Hanmi, Janssen, Merus, MIrati Therapeutics, MSD, Novartis, ONO Pharmaceutical, Pfizer, Roche/Genentech, Takeda, TP Therapeuti;Non-Financial Interests, Person l, Advisory Role: Amgen, AstraZeneca, BMS / ONO Pharmaceuticals, Daiich-Sankyo, GSK, Janssen, Pfizer, SK Biopharm, Takeda, Yuhan;Non-Financial Interests, Personal, Member of the Board of Directors: Asian Thoracic Oncology Research Group, Korean Association for Lung Cancer, Korean Cancer Association, Korean Society of Medical Oncology;Other, Personal, Funding, Travel support for advisory board meeting attendance: Amgen, Daiichi-Sankyo. J. Bennouna: Financial Interests, Personal, Other, Honoraria: Bristol Myers Squibb, MSD, AstraZeneca, Roche, Servier, Bayer, AMGEN;Financial Interests, Personal, Advisory Role: Bristol Myers Squibb, MSD, AstraZeneca, Roche;Financial Interests, Institutional, Research Grant: AstraZeneca. T. Lesimple: Financial Interests, Personal, Advisory Role: MSD, Novartis, BMS, Pierre Fabre;Financial Interests, Personal, Speaker’s Bureau: MSD, Novartis;Financial Interests, Institutional, Research Grant: Roche. E. Felip: Financial Interests, Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: BAYER;Financial Interests, Personal, Advisory Board: Beigene;Financial Interests, Personal, Advisory Board: Boehringer-Ingelheim;Financial Interests, Personal, Advisory Board: Bristol-Myers Squibb;Financial Interests, Personal, Advisory Board: Eli Lilly;Financial Interests, Personal, Advisory Board: F. Hoffman-La Roche;Financial Interests, Personal, Advisory Board: Glaxo Smith Kline;Financial Interests, Personal, Advisory Board: Janssen;Financial Interests, Personal, Advisory Board: Medical Trends;Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme;Financial Interests, Personal, Advisory Board: Merck Serono;Financial Interests, Personal, Advisory Board: Peptomyc;Financial Interests, Personal, Advisory Board: Pfizer;Financial Interests, Personal, Advisory Board: Puma;Financial Interests, Personal, Advisory Board: Regeneron;Financial Interests, Personal, Advisory Board: Sanofi;Financial Interests, Personal, Advisory Board: Syneos Health;Financial Interests, Personal, Advisory Board: Takeda;Financial Interests, Personal, Speaker’s Bureau: Amgen;Financial Interests, Personal, Speaker’s Bureau: AstraZeneca;Financial Interests, Personal, Speaker’s Bureau: Bristol-Myers Squibb;Financial Interests, Personal, Speaker’s Bureau: Eli Lilly;Financial Interests, Personal, Speaker’s Bureau: F. Hoffmann-La Roche;Financial Interests, Personal, Speaker’s Bureau: Janssen;Financial Interests, Personal, Speaker’s Bureau: Medscape;Financial Interests, Personal, Speaker’s Bureau: Merck Sharp & Dohme;Financial Interests, Personal, Speaker’s Bureau: Merck Serono;Financial Interests, Personal, Speaker’s Bureau: Peervoice;Financial Interests, Personal, Speaker’s Bureau: Pfizer;Financial Interests, Personal, Speaker’s Bureau: Springer;Financial Interests, Personal, Speaker’s Bureau: Touch Medical;Financial Interests, Personal, Member, Independent Member of the Board: Grifols. D. Berz: Financial Interests, Personal, Other, Honoraria: Oncocyte;Other, Personal, Other, Honoraria: Sun Pharma;Other, Personal, Other, Honoraria: Caris;Other, Personal, Other, Honoraria: Takeda;Other, Personal, Other, Honoraria: Natera;Other, Personal, Other, Honoraria: Jazz Pharma;Other, Personal, Other, Honoraria: Genentech;Financial Interests, Personal, Advisory Role: Oncocyte;Other, Personal, Advisory Role: Sun Pharma;Other, Personal, Advisory Role: Biocept;Other, Personal, Advisory Role: Prelude;Financial Interests, Personal, Speaker’s Bureau: Oncocyte;Other, Personal, Speaker’s Bureau: Caris;Other, Personal, Speaker’s Bureau: Sun Pharma;Other, Personal, Speaker’s Bureau: AstraZeneca;Other, Personal, Speaker’s Bureau: Takeda;Other, Personal, Speaker’s Bureau: Merck;Other, Personal, Speaker’s Bureau: Natera;Other, Personal, Speaker’s Bureau: Jazz Pharma. C. Mascaux: Financial Interests, Personal, Advisory Role: Roche;Financial Interests, Personal, Advisory Role: Astr Zeneca;Financial Interests, Personal, Advisory Role: Kephren;Financial Interests, Personal, Advisory Role: Bristol-Myers Squibb;Financial Interests, Personal, Advisory Role: MSD;Financial Interests, Personal, Advisory Role: Pfizer;Financial Interests, Personal, Other, Honoraria: Roche;Financial Interests, Personal, Other, Honoraria: AstraZeneca;Financial Interests, Personal, Other, Honoraria: Kephren;Financial Interests, Personal, Other, Honoraria: Bristol-Myers Squibb;Financial Interests, Personal, Other, Honoraria: MSD;Financial Interests, Personal, Other, Honoraria: Pfizer;Financial Interests, Personal, Other, travel, accommodations, expenses: Roche;Financial Interests, Personal, Other, travel, accommodations, expenses: AstraZeneca;Financial Interests, Personal, Other, travel, accommodations, expenses: Boehringer Ingelheim;Financial Interests, Personal, Other, travel, accommodations, expenses: Takeda. M. Voskoboynik: Financial Interests, Personal, Advisory Role: AstraZeneca. H.T. Landsteiner: Financial Interests, Personal, Full or part-time Employment: Boehringer Ingelheim. V. Chen: Financial Interests, Personal, Full or part-time Employment: Boehringer Ingelheim. G. Jayadeva: Financial Interests, Personal, Full or part-time Employment: Boehringer Ingelheim. J. Alt: Financial Interests, Personal, Other, Honoraria: AstraZeneca, Boehringer Ingelheim, BMS, Pfizer, Roche, Takeda;Financial Interests, Personal, Advisory Role: AstraZeneca, Boehringer Ingelheim, BMS, Roche;Financial Interests, Personal, Funding, Travel/accommodation/expenses: AstraZeneca, Boehringer Ingelheim, BMS. B. Hackanson: Financial Interests, Personal, Advisory Role: Boehringer Ingelheim, MSD, AstraZeneca, BMS. All other authors have declared no conflicts of interest.

In the design ecosystem, culture is often ignored or relegated to the periphery, perhaps because some see it as a concept that is hard to explain or completely capture. To contribute to a new direc...

The expected high performance of graphene-based electronics is often hindered by lack of adequate doping, which causes low carrier density and large sheet resistance. Many reported graphene doping schemes also suffer from instability or incompatibility with existing semiconductor processing. Here we report ultrahigh and stable p-type doping up to ~7x10^13 1/cm^2 (~2x10^21 1/cm^3}) of monolayer graphene grown by chemical vapor deposition. This is achieved by direct polycrystalline MoO3 growth on graphene using a rapid flame synthesis technique. With this approach, the metal-graphene contact resistance for holes is reduced to ~200 Ohm-um. We also demonstrate that flame-deposited MoO3 provides over 5x higher doping of graphene, as well as superior thermal and long-term stability, compared to electron-beam deposited MoO3., Comment: 4 pages, 3 figures

Background. Emergency medicine accounts for a large proportion of medical care in many low- and middle-income countries. A better understanding of the burden of disease will guide training and resource allocation priorities, but lack of electronic medical records and standardised data collection systems makes it difficult to obtain this information. Objectives. To draw attention to the proportionally large burden of trauma in emergency centres (ECs) throughout Eastern Cape Province, South Africa (SA), in the hope of influencing resource allocation and medical provider training protocols accordingly. Methods. A secondary data analysis was performed from information gathered in HIV testing studies in two large tertiary care centres and one regional hospital in the Eastern Cape region of SA. All patients presenting to the ECs during the 6-week study period who met the inclusion criteria were approached and requested to provide consent for point-of-care HIV testing and collection of demographic information. Information collected included patient demographics, presenting complaints and final diagnoses. Simple descriptive statistics were used to analyse the data. Results. Data were collected from 4 271 patients across three study sites: Frere Hospital ( n =2 391), Nelson Mandela Academic Hospital ( n =622) and Mthatha Regional Hospital ( n =1 258). At the two tertiary care centres, most patients were between the ages of 18 and 30 years (41.2% and 32.6%, respectively) and male (57.8% and 60.2%), and 70.4% and 41.5% had traumatic injuries. The most common complaints were stab/gunshot wounds (18.3% and 20.2%). At the district hospital, the majority of patients were female (57.2%), 40.1% were between 18 and 30 years old, and 27.3% presented with traumatic injuries. Stab/gunshot wounds were the second most common complaint (7.2%) after lower respiratory tract infections (8.7%). Conclusions. From the proportion of presenting individuals sampled, we can conclude that a large proportion of care delivered in ECs in the Eastern Cape is for trauma. Local clinical capacitation efforts must focus on trauma training.

Demonstration of metamaterials with ultrahigh thermal resistance by phonon-level engineering of heterogeneous 2D monolayers., Heterogeneous integration of nanomaterials has enabled advanced electronics and photonics applications. However, similar progress has been challenging for thermal applications, in part due to shorter wavelengths of heat carriers (phonons) compared to electrons and photons. Here, we demonstrate unusually high thermal isolation across ultrathin heterostructures, achieved by layering atomically thin two-dimensional (2D) materials. We realize artificial stacks of monolayer graphene, MoS2, and WSe2 with thermal resistance greater than 100 times thicker SiO2 and effective thermal conductivity lower than air at room temperature. Using Raman thermometry, we simultaneously identify the thermal resistance between any 2D monolayers in the stack. Ultrahigh thermal isolation is achieved through the mismatch in mass density and phonon density of states between the 2D layers. These thermal metamaterials are an example in the emerging field of phononics and could find applications where ultrathin thermal insulation is desired, in thermal energy harvesting, or for routing heat in ultracompact geometries.

Semiconducting MoTe2 is one of the few two-dimensional (2D) materials with a moderate band gap, similar to silicon. However, this material remains underexplored for 2D electronics due to ambient instability and predominantly p-type Fermi level pinning at contacts. Here, we demonstrate unipolar n-type MoTe2 transistors with the highest performance to date, including high saturation current (>400 μA/μm at 80 K and >200 μA/μm at 300 K) and relatively low contact resistance (1.2 to 2 kΩ·μm from 80 to 300 K), achieved with Ag contacts and AlOx encapsulation. We also investigate other contact metals (Sc, Ti, Cr, Au, Ni, Pt), extracting their Schottky barrier heights using an analytic subthreshold model. High-resolution X-ray photoelectron spectroscopy reveals that interfacial metal-Te compounds dominate the contact resistance. Among the metals studied, Sc has the lowest work function but is the most reactive, which we counter by inserting monolayer hexagonal boron nitride between MoTe2 and Sc. These metal-insulator-semiconductor (MIS) contacts partly depin the metal Fermi level and lead to the smallest Schottky barrier for electron injection. Overall, this work improves our understanding of n-type contacts to 2D materials, an important advance for low-power electronics.

3D coil structures through 2D processing, combined with ferrofluid core, achieve unprecedented high magnetic flux density., Monolithic strong magnetic induction at the mtesla to tesla level provides essential functionalities to physical, chemical, and medical systems. Current design options are constrained by existing capabilities in three-dimensional (3D) structure construction, current handling, and magnetic material integration. We report here geometric transformation of large-area and relatively thick (~100 to 250 nm) 2D nanomembranes into multiturn 3D air-core microtubes by a vapor-phase self-rolled-up membrane (S-RuM) nanotechnology, combined with postrolling integration of ferrofluid magnetic materials by capillary force. Hundreds of S-RuM power inductors on sapphire are designed and tested, with maximum operating frequency exceeding 500 MHz. An inductance of 1.24 μH at 10 kHz has been achieved for a single microtube inductor, with corresponding areal and volumetric inductance densities of 3 μH/mm2 and 23 μH/mm3, respectively. The simulated intensity of the magnetic induction reaches tens of mtesla in fabricated devices at 10 MHz.

OBJECTIVES: Current approved health claims in Canada, US and Europe recognize the ability of oat ß-glucan to lower blood cholesterol; however, its ability to improve glycemic control is less certain. We undertook a systematic review and meta-analysis of randomized controlled trials to update the evidence of the effect of oats and oat-fiber on markers of glycemic control in people with and without diabetes. Here we present data for the subgroup with diabetes. METHODS: MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched through September 23(rd), 2020. We included randomized controlled trials of ≥ 2-weeks of sources of oat ß-glucan and measures of glycemic control in diabetes. Two independent reviewers extracted relevant data and assessed the risk of bias (Cochrane Risk of Bias 2.0 Tool). The outcomes were fasting plasma glucose (FPG), 2h-plasma glucose (2h-PG) from a 75 g-oral glucose tolerance test, HbA1c and fasting plasma insulin (FPI). Data were pooled using the generic inverse variance method. Heterogeneity was assessed (Cochran Q statistic) and quantified (I(2) statistic). Pooled estimates were expressed as mean differences with 95% confidence intervals (CI). GRADE assessed the certainty of the evidence. RESULTS: Eligibility criteria were met by 5 trial comparisons (N = 359) in type 2 diabetes. No trials were identified in type 1 diabetes. Consumption of oat ß-glucan sources reduced FPG (MD = −0.37 mmol/L [95% CI: −0.70, −0.05 mmol/L], P = 0.03, I(2) = 0.00%, P(Q) = 0.76) and 2h-PG (MD = −1.24 mmol/L [95% CI: −1.97, −0.51 mmol/L], P = 0.00, I(2) = 0.00%, P(Q )= 0.56). There were non-significant reductions in HbA1c (MD = −0.12%, [95% CI: −0.26, 0.01%], P = 0.07, I(2) = 0.00%, P(Q) = 1.00) and FPI (MD = −4.59 pmol/L, [95% CI: −14.71, 5.52 pmol/L], P = 0.37, I(2) = 40.84%, P(Q) = 0.19). The certainty of evidence was high for 2h-PG and moderate for FPG, HbA1c and FPI (single downgrades for imprecision in each case). CONCLUSIONS: Current evidence provides a good indication that consumption of oat ß-glucan results in small improvements of glycemic control in type 2 diabetes. More high quality randomized trials are required to improve the precision of the pooled estimates. (ClinicalTrials.gov identifier, NCT04631913) FUNDING SOURCES: Quaker Oats Center of Excellence, Diabetes Canada, Banting & Best Diabetes Centre, Toronto 3D foundation

2579 Background: In preclinical studies, the combination of anti-VEGF/Ang2 and anti-PD-1 therapy has been shown to promote an immunopermissive state, which is supportive of T-cell-mediated tumor cell destruction. BI 836880 is a humanized bispecific nanobody that targets VEGF and Ang2, and ezabenlimab (BI 754091) is an anti-PD-1 antibody. Phase I studies investigating each as monotherapies have reported safety and preliminary antitumor activity. This ongoing Phase Ib study is evaluating the combination of BI 836880 and ezabenlimab in pts with advanced solid tumors. In Part 1 (dose escalation), the combination was feasible in pts with advanced NSCLC, with a recommended Phase II dose (RP2D) of BI 836880 720 mg + ezabenlimab 240 mg IV q3w. Here, we report updated results from Part 2 (expansion phase), which is assessing the antitumor activity and safety of the RP2D. Methods: Seven cohorts are currently recruiting pts in Part 2: metastatic (m) NSCLC after checkpoint inhibitor (CPI) monotherapy (Cohort A); mNSCLC after chemotherapy (CT) + CPI (Cohort B); mSCLC after CT ± CPI (Cohort C); 1st and 2nd recurrences of glioblastoma (GBM; Cohort D); immunotherapy-resistant m-melanoma (Cohort E); hepatocellular carcinoma (HCC) after prior sorafenib or lenvatinib ± CPI (Cohort F); and previously untreated/unresectable HCC (Cohort G). Primary endpoint is objective response rate (complete response + partial response [PR]). Results: As of January 2021, 196 pts have received BI 836880 plus ezabenlimab (14 in Part 1, 182 in Part 2 [Cohort A, 26; B, 30; C, 19; D, 31; E, 32; F, 28; G, 16]). 134 (68%) pts were male, median age was 63 years and 102 (52%) had prior CPI use. Any grade and ≥G3 adverse events (AEs; any cause) were reported by 160 (82%) and 62 (32%) pts, most commonly (all%/≥G3%) hypertension (20/8), asthenia (20/3), diarrhea, decreased appetite, and nausea (all 11/1). 95 (48%) pts had a drug-related AE, most commonly hypertension and asthenia (both 11%). 6 pts had a G4 AE (non-related: hyperkalemia + cardiac arrest, laryngospasm, gastrointestinal perforation; drug-related: anaphylactic reaction, acute pancreatitis, transaminases increased); 8 pts had a G5 AE (non-related: general physical health deterioration, epilepsy, hemoptysis, cardio-respiratory arrest, hepatic failure, intracranial hemorrhage, COVID-19 pneumonia; drug-related tracheal hemorrhage). 30 (15%) pts had immune-related AEs (3% ≥G3), including hypothyroidism (3%). 11 (6%) pts had an AE leading to discontinuation. Overall, 145 pts were evaluable for response: 9 pts achieved confirmed PR (2 pts in Part 1 and 7 in Part 2 [NSCLC, n = 3; SCLC, n = 1; GBM, n = 1; melanoma, n = 1; and 2nd-line HCC, n = 1]), 87 pts had stable disease and 49 pts had progressive disease. 111 pts remain on treatment. Conclusions: BI 836880 plus ezabenlimab had a manageable safety profile. The combination showed preliminary antitumor activity in a range of tumor types. Clinical trial information: NCT03468426.

We demonstrate 3D monolithically integrated two-level stacked 1-transistor/1-resistor (1T1R) memory cells, using monolayer MoS 2 transistors and few-layer hBN RRAMs, fabricated at temperatures below 150 °C. The stacking process is scalable to an arbitrarily large number of layers and on any substrate material without foreseeable physical limitations. The 1T1R cells can be switched with programming current $130\ \mu\mathrm{A}$ and voltage 2 transistor has low off-current due to the large band gap of monolayer MoS 2 $(\mathrm{E}_{\mathrm{g}} > 2\ \text{eV})$ . We also show that the linearity of RRAM resistance change is well-controlled by the gate voltage of the transistor.

Background There has been an exponential increase in the offering of short-term international field experiences in recent years in response to student demands for global health opportunities. Pre-departure preparation is an essential component to equip trainees with the adequate safety, wellness, and cultural competence needed to engage in a meaningful and mutually beneficial elective. This review seeks to quantify the plethora of pre-departure preparation training available to public health, clinical, and undergraduate trainees across the continuum of education for short-term experiences in low-and middle-income countries (LMICs). Methods We performed a systematic review of Pubmed, Embase, Web of Science, Scopus, and Ovid Global Health in February, 2018. A three-concept search was employed and included “global or international health”; “education or preparation of personnel/students”; and “field programs or travel.” The study teamed used PRISMA reporting guidelines to conduct title and full-text reviews and conduct data extraction and analysis. Results The search returned 2506 unique articles. Of these, 55 met inclusion criteria and were included in the final review. Ninety one percent (91%) of articles focused on pre-departure trainings for medical students and residents. Nine thematic domains for short-term international field experiences emerged; culture, safety, and project-specific knowledge were the most frequently covered domains while mentorship, professionalism, and emotional wellness and culture shock were least common. Approximately half (53.3%) of studies specifically evaluated the pre-departure component of the international experience using a survey or evaluation form. Recommendations emerged from these evaluations including early engagement with international partners, inclusion of self-reflection exercises and site-specific content, and utilization of interactive approaches in learning. Some institutions face barriers to conducting pre-departure preparation such as lack of dedicated faculty, finances, and institutional support. Conclusions Interest in pre-departure training for international experiences is growing but few programs conduct and publish evaluations of these trainings. Pre-departure trainings should be developed in partnership with receiving institutions and faculty and incorporate critical self- reflection throughout the experience. In addition to the experience itself, institutions need to evaluate these curricula to better understand how they influence trainees’ capacity to effectively engage in LMIC settings. Electronic supplementary material The online version of this article (10.1186/s12909-019-1586-y) contains supplementary material, which is available to authorized users.

Higher education can be seen as a “gateway” to entering professional careers (Rubenson, 2010), yet the teaching and learning practices used in the classroom may not always prepare students for their futures the way instructors intended, one example is the use of student participation to increase interaction and learning in the classroom. Although verbalizing thoughts can help students learn, students in this study felt they were more often rewarded for frequency of their contribution instead of quality of their contribution which challenges its intended use. They called it “verbal diarrhea” and explained how prominent it was in their university learning experiences making the learning environment not only disengaging and a practice they dreaded but also unrealistic to the real world setting. However, in the Active Learning Classroom (ALC), students noticed verbal diarrhea was significantly reduced and for the most of the time non-existent, and made their learning more authentic (Herrington, Reeves, & Oliver, 2014). This paper presents case studies of students’ lived experiences in their undergraduate degree, and their “prescriptions” and recommendations to instructors and other students on avoiding verbal diarrhea and encouraging meaningful discussions facilitated by the learning environment.

Objectives To determine at which ages providers choose to screen for mental, behavioral, and developmental disorder/delay (MBDD), and what they find; and which, if any, public and professional guidelines are most effective at identification. Study design Naturalistic retrospective cohort study of 215 general pediatric and family practice clinics within 24 US states involving 160 634 encounters during which MBDD screening tests were administered. Results Almost all clinicians (96%) administered screens at ages targeted by the American Academy of Pediatrics (AAP), that is, 9, 18, 24, and/or 30 months of age, but also at younger and older ages: 57% opted to screen at ≥5 years of age. Of the 8% of children at risk for probable MBDD, 27% were detected at American Academy of Pediatrics-targeted ages—71% across the birth to 5-year age range and an additional 29% at ≥5 years of age. Children >30 months of age were 3 times more likely to have probable MBDD than were younger children, and those >5 years of age were almost 4 times more likely to have probable MBDD. Older children were more likely to have psychosocial risk factors, but age itself was the most powerful predictor. Conclusions Most clinicians preferred to screen across the birth to 8-year age range and their findings revealed that most MBDDs cannot be detected in the earliest years of life. Policies regarding the timing of screening should be expanded to include all well visits and between visits if needed.

Category/Date Emerging Knowledge for Clinical Practice Podium Presentations focusing on the Research Agenda Priority of Pediatric Research: Professional Role & Health Promotion and Disease Prevention, Presented at NAPNAP's 40th National Conference on Pediatric Health Care, March 8, 2019, New Orleans, LA. Purpose A recent American Academy of Pediatrics (AAP) survey revealed that more than 80% of clinicians use a screen for autism spectrum disorders (ASD), with 74%, using the Modified Checklist of Autism in Toddlers (MCHAT)/MCHAT-Revised (MCHAT-R). The AAP recommends administering both broad-band (e.g., Parents’ Evaluation of Developmental Status (PEDS) & narrow-band (e.g., MCHAT-R) screens focused on detecting children at-risk for mental health, behavior, & developmental disorder/delay. Yet, use of broad-band mental health, behavior, & developmental disorder/delay screens is less common: only 50% of pediatric providers and fewer family practice providers report use of validated, accurate broad-band screens. Methods Sites were 197 primary care clinics using PEDS Online, a web-based service focused on identifying mental health, behavior, & developmental disorder/delay in children 0 to 8 years of age via: a) two broad-band validated mental health, behavior, & developmental disorder/delay screens– PEDS & PEDS: Developmental Milestones (PEDS:DM); and b) a narrow-band mental health, behavior, & developmental disorder/delay screen focused on ASD – either MCHAT or MCHAT-R. From the 231,789 encounters in 2014 through 2016, we selected only the 16% (N = 37,608) in which children were administered both broad- and narrow-band screens. We defined children at-risk for mental health, behavior, & developmental disorder/delay as children with at-risk screen results on one or more broad-band screens and/or on a narrow-band ASD screen. Results In 197 clinics representing 24 US States, 66% (N=24,992) of screening occurred in pediatric clinics and 34% (N=12,616) in family practices (including public health/community clinics). Compared to US Census Bureau data, the sample resided more in Southern and Northeast States (86% vs 55% nationally) and parents were less likely to be high school graduates (76% vs 87% nationally). Mean age of children was 24 months (SD = 6.02). Of the 37,608 encounters, 12% (N=4572) of children were identified at-risk for mental health, behavior, & developmental disorder/delay. Of the 4572 with probable mental health, behavior, & developmental disorder/delay, broad-band screens identified 73% (N=3332/4572). The MCHAT/MCHAT-R uniquely identified 27% (N= 1240/4572). There was agreement among broad- and narrow-band measures of 22% (N=984/4572). ASD screens, if used alone, identified only 49% of those with probable mental health, behavior, & developmental disorder/delay (N = 2224/4572). Although ASD screens contribute uniquely to early identification, such tools do not seem to adequately detect most children at-risk for mental health, behavior, & developmental disorder/delays. Conclusions Use of an ASD screen alone would miss about 51% of children at-risk for mental health, behavior, & developmental disorder/delay. Mental health, behavior, & developmental disorder/delay screening should embrace both broad-band and narrow-band measures to best identify children at-risk.

We present the first fabrication of electronic synapses using two dimensional (2D) hexagonal boron nitride (A-BN) as active switching layer. The main advantage of these devices compared to the transition metal oxide (TMO) based counterparts is that multilayer A-BN stacks show both volatile and non-volatile resistive switching (RS) depending on the programming stresses applied, which allows implementing short-term (STP) and long-term plasticity (LTP) rules using a single device and without the need of complex architectures.

This study was undertaken to examine whether marijuana use affects in vitro fertilization and gamete intrafallopian transfer (IVF/GIFT).Prospective study of 221 IVF/GIFT couples.Amount of lifetime heavy marijuana use adversely affected IVF/GIFT. Women smoking more than 90 times in their lifetime had 27% fewer oocytes retrieved (P = .03) and 1 fewer embryo transferred (P.05). Women smoking marijuana more than 10 times in their lifetime had infants 17% (P = .01) smaller at birth. If men smoked marijuana 11 to 90 times in their lifetime, there was a 15% decrease in infant birth weight (P = .03); if this increased to more than 90 times, there was a 23% decrease (P = .01). Timing also played a role. Women smoking marijuana 1 year before IVF/GIFT had 25% fewer oocytes retrieved (P = .03), whereas couples had 28% (P = .04) fewer oocytes fertilized. Women and men who smoked in the past 15 years, had 12% (P = .04) and 16% (P = .03) smaller infants, respectively.Both timing and amount of marijuana use negatively affected IVF/GIFT.

Background: Parent concerns (PC) about child development may be indicative of maternal depressive symptoms (DS), especially when child is found to have normal development. However, relationship between PC and DS has been understudied, especially in common screening tools like the Parents' Evaluation of Developmental Status (PEDS). Purpose: Determine whether maternal DS is associated with presence/#/type of PC elicited in PEDS screening. Methods: …

Purpose: Parent-child shared book reading has been shown to be related to a child’s language growth, emergent literacy, and reading achievement. Maternal depressive symptoms have been shown to be associated with less shared book reading. Though maternal self-efficacy is associated with both positive parenting practices and maternal depression, little is known about its relation to shared book reading. This study sought to determine if maternal …

In the weeks following birth, both the brain and the vascular network that supplies it undergo dramatic alteration. While studies of the postnatal evolution of the pial vasculature and blood flow through its vessels have been previously done histologically or acutely, here we describe a neonatal reinforced thin‐skull preparation for longitudinally imaging the development of the pial vasculature in mice using two‐photon laser scanning microscopy. Starting with mice as young as postnatal day 2 (P2), we are able to chronically image cortical areas >1 mm2, repeatedly for several consecutive days, allowing us to observe the remodeling of the pial arterial and venous networks. We used this method to measure blood velocity in individual vessels over multiple days, and show that blood flow through individual pial venules was correlated with subsequent diameter changes. This preparation allows the longitudinal imaging of the developing mammalian cerebral vascular network and its physiology., We developed a technique to longitudinally image blood vessels in the neonatal mouse cortex transcranially using two‐photon microscopy. The blood vessels on the surface of the brain undergo substantial pruning after birth. Blood flow through a vessel was correlated with the subsequent diameter change of the vessel.

Haemophilus parainfluenzae is an unusual cause of invasive bacterial disease and is particularly uncommon as a reported etiology of neonatal sepsis in current large published series. We describe a seriously ill, very low birth weight (VLBW) infant with documented early onset sepsis caused by H. parainfluenzae. We compare our case with those published previously and contrast the clinical presentation of infection in our patient to that of common bacterial pathogens causing neonatal sepsis. Our review suggests many common factors in the pathogenesis of early onset infection by H. parainfluenzae.

To demonstrate the capability of magnetic resonance (MR) imaging to assess alteration in regional pulmonary ventilation and perfusion with animal models of airway obstruction and pulmonary embolism.Airway obstruction was created by inflating a 5-F balloon catheter into a secondary bronchus. Pulmonary emboli were created by injecting thrombi into the inferior vena cava. Regional pulmonary ventilation was assessed with 100% oxygen as a T1 contrast agent. Regional pulmonary perfusion was assessed with a two-dimensional fast low-angle shot, or FLASH, sequence with short repetition and echo times after intravenous administration of gadopentetate dimeglumine.Matched ventilation and perfusion abnormalities were identified in all animals with airway obstruction. MR perfusion defects without ventilation abnormalities were seen in all animals with pulmonary emboli.Ventilation and perfusion MR imaging are able to provide regional pulmonary functional information with high spatial and temporal resolution. The ability of MR imaging to assess both the magnitude and regional distribution of pulmonary functional impairment could have an important effect on the evaluation of lung disease.