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Quantum well nanolasers usually show single‐mode lasing, as gain saturation suppresses emissions in other modes. In contrast, for whispering gallery mode microdisk lasers with GaN quantum wells as active material, above threshold multimode laser emission is observed. This intriguing emission feature is manifested in the fact that several modes simultaneously show the characteristic kink in the input–output curve at the onset of lasing. A quantum theory for nanolasers is used to support the experimental finding and to analyze this behavior in the presence of gain saturation. Coupling effects between neighboring modes are identified as the origin of multimode lasing, which initiate photon exchange between modes via population pulsations similar to classical wave‐mixing effects. A reduction of this type of mode coupling with increasing mode spacing is demonstrated. The results can pave the way for multimode application of nanolasers in integrated photonic circuits. [ABSTRACT FROM AUTHOR]

BackgroundWith aging of the population, the search for alternative models of care adapted to older people with dependency is necessary. In this setting, foster families (1-3 older people per family) could be an alternative to nursing homes, residential care facilities, or community- and home-based care. ObjectiveThe KArukera Study of Ageing in Foster Families is a prospective cohort study designed to investigate the care pathways of older people with dependency in foster care over a year. The 1-year hospitalization rate (main objective), cost of hospitalization, incidence of mortality, prevalence of geriatric syndromes, and quality of life of residents will be assessed. Quality of life and burnout of their respective foster caregivers will also be studied. MethodsThis study cohort will include 250 older people living in foster families in Guadeloupe (French West Indies), as well as their respective foster caregivers. Both older people and caregivers will be interviewed concurrently on site at three time points: (1) at baseline, (2) at 6 months, and (3) at 12 months. For older people, we will collect anthropometric measures, cognitive impairment, depressive and anxiety symptoms, functional abilities, physical frailty, information on general health status, quality of life, and care pathways (hospitalization, mortality, and medical and paramedical consultations). We will also assess the quality of life and burnout symptoms of family caregivers at each follow-up. A phone update of vital status (alive or death) and care pathways of residents will be carried out at 3 and 9 months after the baseline examination. ResultsRecruitment opened in September 2020 and ended in May 2021, with 109 older people recruited and 56 respective foster caregivers. The 1-year follow-up was ended in June 2022. Data analyses are ongoing and the first results are expected to be published in May 2023. ConclusionsFoster families are a potentially innovative way to accommodate dependent older people. This study could help define the clinical profile of older people adapted to foster families in the transition from frailty to dependency. The effectiveness of foster families, in terms of hospitalizations and mortality, will be compared with other models of care, particularly nursing homes. In this setting, a twin study carried out in nursing homes in Guadeloupe with similar aims and outcomes will be conducted. Beyond mortality and morbidity, the numerous outcomes will allow us to assess the evolution of geriatric syndromes over time. Trial RegistrationClinicalTrials.gov NCT04545775; https://clinicaltrials.gov/ct2/show/NCT04545775 International Registered Report Identifier (IRRID)DERR1-10.2196/40604

Residential care facility may provide a transition between living at home and a nursing home for dependent older people or an alternative to nursing homes. The objective of this review was to compare mortality and hospitalizations of older adults living in residential care facilities with those living in nursing homes or in the community. We searched Medline, Scopus and Web of Science from inception to December 2022. Fifteen cohort studies with 6 months to 10 years of follow-up were included. The unadjusted relative risk (RR) of mortality was superior in nursing homes than in residential care facilities in 6 of 7 studies (from 1.3 to 1.68). Conversely, the unadjusted relative risk of hospitalizations was higher in residential care facilities in 6 studies (from 1.3 to 3.37). Studies conducted on persons with dementia found mixed results, the only study adjusted for co-morbidities observing no difference on these two endpoints. Compared with home, unadjusted relative risks were higher in residential care facilities for mortality in 4 studies (from 1.34 à 10.1) and hospitalizations in 3 studies (from 1.12 to 1.62). Conversely, the only study that followed older adults initially living at home over a 10-year period found a reduced risk of heavy hospital use (RR = 0.68) for those who temporarily resided in a residential care facilities. There is insufficient evidence to determine whether residential care facilities might be an alternative to nursing homes for older people with similar clinical characteristics (co-morbidities and dementia). Nevertheless, given the high rate of hospitalizations observed in residential care facilities, the medical needs of residents should be better explored.

The availability of crop type reference datasets for satellite image classification is very limited for complex agricultural systems as observed in developing and emerging countries. Indeed, agricultural land use is very dynamic, agricultural censuses are often poorly georeferenced and crop types are difficult to interpret directly from satellite imagery. In this paper, we present a database made of 24 datasets collected in a standardized manner over nine sites within the framework of the international JECAM (Joint Experiment for Crop Assessment and Monitoring) initiative; the sites were spread over seven countries of the tropical belt, and the number of data collection years depended on the site (from 1 to 7 years between 2013 and 2020). These quality-controlled datasets are distinguished by in situ data collected at the field scale by local experts, with precise geographic coordinates, and following a common protocol. Altogether, the datasets completed 27 074 polygons (20 257 crops and 6817 noncrops, ranging from 748 plots in 2013 (one site visited) to 5515 in 2015 (six sites visited)) documented by detailed keywords. These datasets can be used to produce and validate agricultural land use maps in the tropics. They can also be used to assess the performances and robustness of classification methods of cropland and crop types/practices in a large range of tropical farming systems. The dataset is available at https://doi.org/10.18167/DVN1/P7OLAP (Jolivot et al., 2021).

Abstract GeSn alloys are promising materials for CMOS-compatible mid-infrared lasers manufacturing. Indeed, Sn alloying and tensile strain can transform them into direct bandgap semiconductors. This growing laser technology however suffers from a number of limitations, such as poor optical confinement, lack of strain, thermal, and defects management, all of which are poorly discussed in the literature. Herein, a specific GeSn-on-insulator (GeSnOI) stack using stressor layers as dielectric optical claddings is demonstrated to be suitable for a monolithically integration of planar Group-IV semiconductor lasers on a versatile photonic platform for the near- and mid-infrared spectral range. Microdisk-shape resonators on mesa structures were fabricated from GeSnOI, after bonding a Ge0.9Sn0.1 alloy layer grown on a Ge strain-relaxed-buffer, itself on a Si(001) substrate. The GeSnOI microdisk mesas exhibited significantly improved optical gain as compared to that of conventional suspended microdisk resonators formed from the as-grown layer. We further show enhanced vertical out-coupling of the disk whispering gallery mode in-plane radiation, with up to 30% vertical out-coupling efficiency. As a result, the GeSnOI approach can be a valuable asset in the development of silicon-based mid-infrared photonics that combine integrated sources in a photonic platform with complex lightwave engineering.

Abstract Background Ureaplasma parvum is usually part of the normal genital flora. Rarely can it cause invasive infections such as genitourinary infections, septic arthritis, or meningitis. Case presentation Here we present the first description of chronic ureterocystitis in a 56-year-old immunocompromised patient, complicated first by reactive arthritis and secondarily by contralateral septic arthritis due to U. parvum infection. U. parvum was detected in synovial fluid and in a urine sample. Treatment consisted of double-J stenting and targeted antibiotic therapy. Evolution showed resolution of urinary symptoms and clinical improvement of arthritis despite functional sequelae. Conclusions Given the high prevalence of U. parvum colonisation, this diagnosis should remain a diagnosis of exclusion. However, because of the difficulty in detecting this microorganism, it should be considered in unexplained subacute urethritis or arthritis, including reactive arthritis, especially in immunosuppressed patients. Real-time PCR positivity in the absence of a differential diagnosis should not be overlooked.

MRI has been extensively used to identify anatomical and functional differences in Autism Spectrum Disorder (ASD). Yet, many of these findings have proven difficult to replicate because studies rely on small cohorts and are built on many complex, undisclosed, analytic choices. We conducted an international challenge to predict ASD diagnosis from MRI data, where we provided preprocessed anatomical and functional MRI data from > 2,000 individuals. Evaluation of the predictions was rigorously blinded. 146 challengers submitted prediction algorithms, which were evaluated at the end of the challenge using unseen data and an additional acquisition site. On the best algorithms, we studied the importance of MRI modalities, brain regions, and sample size. We found evidence that MRI could predict ASD diagnosis: the 10 best algorithms reliably predicted diagnosis with AUC∼0.80 – far superior to what can be currently obtained using genotyping data in cohorts 20-times larger. We observed that functional MRI was more important for prediction than anatomical MRI, and that increasing sample size steadily increased prediction accuracy, providing an efficient strategy to improve biomarkers. We also observed that despite a strong incentive to generalise to unseen data, model development on a given dataset faces the risk of overfitting: performing well in cross-validation on the data at hand, but not generalising. Finally, we were able to predict ASD diagnosis on an external sample added after the end of the challenge (EU-AIMS), although with a lower prediction accuracy (AUC=0.72). This indicates that despite being based on a large multisite cohort, our challenge still produced biomarkers fragile in the face of dataset shifts.

Introduction: Falls are a common geriatric syndrome in older people. Falls are associated with adverse health events such as dependency, unplanned emergency admissions and death. This study aimed to identify the factors associated with fall severity, such as diabetes, hypertension, heart disease, cognitive decline and polypharmacy, as well as sociodemographic characteristics in patients aged 70 years and over admitted to the emergency department in Guadeloupe. Method: A single-center, observational, retrospective study of patients aged 70 years and over admitted to the emergency department (ED) of the University Hospital of Guadeloupe for a fall between 1 May 2018 and 30 April 2019 was conducted. Fall severity was defined as the need for hospitalization. Bivariate analysis was used to determine the associations between fall severity and sociodemographic characteristics, comorbidities, history of falls and polypharmacy (defined as the daily use of at least five drugs). Polypharmacy was analyzed as a binary variable (>5 drugs daily; yes or no) in categories (0–3 (ref.), 4–6, 7–9 and ≥10 drugs). Results: During the study period, 625 patients who attended the ED for a fall were included. The mean age was 82.6 ± 7.6 years, and 51.2% were women. Of these, 277 patients (44.3%) were admitted to the hospital, and 3 patients (0.5%) died. In the bivariate analysis, only polypharmacy was associated with hospitalization for a fall (OR: 1.63 [95% CI: 1.33–2.02]). The odds ratios for the polypharmacy categories were 1.46 [95% CI 0.99–2.14], 1.65 [1.09–2.50] and 1.48 [0.76–2.85] for 4–6, 7–9 and ≥10 drugs, respectively. Conclusions: Polypharmacy was associated with hospitalization as a proxy for fall severity. A regular review of drug prescriptions is essential to reduce polypharmacy in older adults. [ABSTRACT FROM AUTHOR]

In this Letter, we propose an approach to improve the packaging of electro-optical transceivers based on silicon photonics through the development of a glass interposer. This assembly platform integrates polymer optical waveguides and an integrated turning mirror that vertically redirect the optical signal in the plane of the interposer to the grating coupler of a flip-chipped photonic integrated circuit (PIC). A distinctive feature of the proposed packaging scheme is to use a conventional flip-chip technique without active alignment. Functionalities are completed with a copper redistribution layer that supports the routing of DC to millimeter wave (mmW) signals to drive the PIC. The measured loss in polymer waveguides is 1.92 dB/cm at 1310 nm, and the coupling losses associated with light propagation through the turning mirror and the PIC grating coupler are 18.7 dB. Coplanar mmW waveguides are structured on the glass interposer by cold laser ablation, yielding an attenuation of 0.3 dB/mm at 58 GHz. The most important outcome of this work is that the coupling of the optical signal from the interposer to the PIC is experimentally established. We also assessed the mmW performance of coplanar waveguides through the validation of the interposer to PIC and PIC to the interposer transition. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the prevalence of malnutrition and its determinants in older adults living in French Caribbean nursing homes. Methods: This cross-sectional study was taken from the KASEHAD (Karukera Study of Ageing in EHPAD) study. Nutritional status was assessed with the Mini Nutritional Assessment Short-Form (MNA-SF). Clinical characteristics and scores on geriatric scales (Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), Short Physical Performance Battery (SPPB), Center for Epidemiologic Studies-Depression (CESD) and Questionnaire Quality of Life Alzheimer's Disease (QoL-AD)) were extracted. Bivariate analysis and logistic models adjusted were performed to test the association between nutritional status and both socio-demographic variables and geriatric scales. Results: A total of 332 older adults from six nursing homes were included in the KASEHPAD study. Among the participants, 319 had an MNA-SF score. The mean age was 81.3 ± 10.6 years, and half of the participants were men. The frequency of malnutrition (MNA-SF ≤ 7) was 27.6% (95% confidence interval (CI): 22.0–32.5) (n = 88). Based on the multivariable analysis, a low MMSE was associated with malnutrition (OR: 0.81 (0.68–0.92); p = 0.015) and there was a borderline significant link between a higher CESD score and malnutrition (OR: 1.05 (1.00–1.12); p = 0.07). Conclusions: Cognitive decline and a tendency toward depression were associated with malnutrition in nursing homes in the French West Indies. Although this study cannot establish causal relationships, the identification of these three geriatric syndromes in nursing homes is crucial for preventing adverse health events. [ABSTRACT FROM AUTHOR]

Background: Foster families may represent an alternative model for dependent older adults in many countries where nursing homes are insufficiently developed. This study aimed to assess the prevalence of malnutrition and its determinants in older adults living in foster families in Guadeloupe (French West Indies). Methods: This cross-sectional study was gathered from the KASAF (Karukera Study of Ageing in Foster families) study (n = 107, 41M/66F, Mdn 81.8 years). Nutritional status was assessed with the Mini Nutritional Assessment Short‐Form (MNA‐SF). Clinical characteristics and scores on geriatric scales (Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), Short Physical Performance Battery (SPPB), Center for Epidemiologic Studies- Depression (CESD) and Questionnaire Quality of Life Alzheimer's Disease (QoL-AD)) were extracted. Bivariate analysis and logistic models adjusted for age and gender were performed to test the association of nutritional status with socio-demographic variables and geriatric scales. Results: Thirty (28.0%) older adults were malnourished (MNA-SF score ≤7). In bivariate analysis, malnutrition was associated with an increased prevalence of cardiovascular diseases (46.7% versus 19.5%, p = 0.004), the presence of hemiplegia (30.0% versus 6.5%, p = 0.003), a poorer cognitive status (MMSE score 4.7 ± 7.1versus 9.7 ± 10.7; p = 0.031), higher risk of depression (CESD score 27.3 ± 23.0 versus 13.5 ± 14.4; p = 0.035) and dependency (ADL score 1.9 ± 1.9 versus 2.3 ± 2.1; p<0.001). Malnutrition was also associated with lower caregivers'rating of QoL (QoL-AD score 21.8 ± 6.4 versus 26.0 ± 5.7; p = 0.001) but not by older adult's rating (24.1 ± 11.2 versus 28.3 ± 7.7; p = 0.156). Similar associations were observed in logistic models adjusted for age and gender. Conclusion: Malnutrition was common among foster families for older adults. Special attention towards the prevention and treatment of malnutrition in older adults from cardiovascular diseases, cognitive impairment, dependency and depression is necessary in this model of dependency support. [ABSTRACT FROM AUTHOR]

Smallholder agriculture provides 90 % of primary food production in developing countries. Its mapping is thus a key element for national food security. Remote sensing is widely used for crop mapping, but it is underperforming for smallholder agriculture due to several constraints like small field size, fragmented landscape, highly variable cropping practices or cloudy conditions. In this study, we developed an original approach combining remote sensing and spatial modelling to improve crop type mapping in complex agricultural landscapes. The spatial dynamics are modelled using Ocelet, a domain-specific language based on interaction graphs. The method combines high spatial resolution satellite imagery (Spot 6/7, to characterize the landscape structure through image segmentation), high revisit frequency time series (Sentinel 2, Landsat 8, to monitor the land dynamic processes), and spatiotemporal rules (STrules, to express the strategies and practices of local farmers). The method includes three steps. First, each crop type is defined by a set of general STrules from which a model-based map of crop distribution probability is obtained. Second, a preliminary crop type map is produced using satellite image processing based on a combined Random Forest (RF) and Object Based Image Analysis (OBIA) classification scheme, after which each geographical object is labelled with the class membership probabilities. Finally, the STrules are applied in the model to identify objects with classes locally incompatible with known farming constraints and strategies. The result is a map of the spatial distribution of crop type mapping errors (omission or commission) that are subsequently corrected through the joint use of spatiotemporal rules and RF class membership probabilities. Combining remote sensing and spatial modelling thus provides a viable way to better characterize and monitor complex agricultural systems.

Buruli ulcer is a neglected tropical disease caused by M. ulcerans, an environmental mycobacterium. This cutaneous infectious disease affects populations with poor access to sanitation, safe water and healthcare living in rural areas of West and Central Africa. Stagnant open bodies of surface water and slow-running streams are the only risk factor identified in Africa, and there is no human-to-human transmission. Appropriate and effective prevention strategies are required for populations living in endemic areas. Based on a multidisciplinary approach in an area in which Buruli ulcer is endemic in South Benin, we investigated the link between all human-environment interactions relating to unprotected water and behaviors associated with Buruli ulcer risk likely to affect incidence rates. We characterised the sources of water as well as water bodies and streams used by communities, by conducting a prospective case-control study directly coupled with geographic field observations, spatial analysis, and the detection of M. ulcerans in the environment. A full list of the free surface waters used for domestic activities was generated for a set of 34 villages, and several types of human behaviour associated with a higher risk of transmission were identified: (i) prolonged walking in water to reach cultivated fields, (ii) collecting water, (iii) and swimming. Combining the results of the different analyses identified the risk factor most strongly associated with Buruli ulcer was the frequency of contact with unprotected and natural water, particularly in regularly flooded or irrigated lowlands. We confirm that the use of clean water from drilled wells confers protection against Buruli ulcer. These specific and refined results provide a broader scope for the design of an appropriate preventive strategy including certain practices or infrastructures observed during our field investigations. This strategy could be improved by the addition of knowledge about irrigation practices and agricultural work in low-lying areas.

In its 60 years of existence, the field of nonlinear optics has gained momentum especially over the past two decades thanks to major breakthroughs in material science and technology. In this article, we present a new set of data tables listing nonlinear-optical properties for different material categories as reported in the literature since 2000. The papers included in the data tables are representative experimental works on bulk materials, solvents, 0D–1D–2D materials, metamaterials, fiber waveguiding materials, on-chip waveguiding materials, hybrid waveguiding systems, and materials suitable for nonlinear optics at THz frequencies. In addition to the data tables, we also provide best practices for performing and reporting nonlinear-optical experiments. These best practices underpin the selection process that was used for including papers in the tables. While the tables indeed show strong advancements in the field over the past two decades, we encourage the nonlinear-optics community to implement the identified best practices in future works. This will allow a more adequate comparison, interpretation and use of the published parameters, and as such further stimulate the overall progress in nonlinear-optical science and applications.

We report the outcomes of a survey of underrepresented minorities (URMs) in life science academic (e.g., faculty) and nonacademic (e.g., research-related) positions seeking to ascertain variables that contribute to their success (e.g., favorable or desired outcome). Given that they had positions in research careers, all respondents were presumed to be successful, and we sought to identify shared factors that were associated with this success. As in previous studies, respondents reported that undergraduate research opportunities, performing research in small- to medium-sized laboratories, and access to mentors throughout all stages of training were important factors for success in their careers. Surprisingly, analysis of the survey results suggests that a record of publications in high-impact factor journals was not essential for their "success." There were fundamental differences in the experiences and needs of URMs in academic and nonacademic careers. For example, academic URMs ranked having mentorship as their first choice in order of importance compared with the nonacademic respondents, who ranked this category as their fifth selection. These findings suggest that taking diverse approaches toward these groups is critical for ensuring that all of the most creative minds have an equal opportunity to contribute to realizing our national research goals and diversified workforce.