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The technological requirements of low-power and high-fidelity color displays have been instrumental in driving research into advanced coloration technologies. At the forefront of these developments is the implementation of dye-free approaches, which overcome previous constraints related to color resolution and fading. Resonant dielectric nanostructures have emerged as a promising paradigm, showing great potential for high efficiency, high color saturation, wide gamut palette, and image reproduction. However, they still face limitations related to color accuracy, purity, and simultaneous brightness tunability. Here, we demonstrate an all-dielectric metasurface empowered by photonic bound states in the continuum (BICs), which supports sharp resonances throughout the visible spectral range, ideally suited for producing a wide range of structural colors. The metasurface design consists of TiO2 ellipses with carefully controlled sizes and geometrical asymmetry, allowing versatile and on-demand variation of the brightness and hue of the output colors, respectively.

This article examines request for confirmation (RfC) sequences in Low German (LoG) conversation, a dialect variety of German. The study is based on both a quantitative analysis of 200 RfC instances and a qualitative analysis of selected excerpts in the framework of conversation analysis (CA). As for the question design of RfCs, declarative and phrasal formats, as well as modulations and tags prevail in the LoG data. Concerning the response design, LoG is characterized as a polarity system in which language contact with the high variety plays a decisive role in the answer possibility space. In particular, High German response tokens are predominantly used as unmarked response types, while LoG response tokens are deployed as marked types. Moreover, LoG seems to be a language between the poles of token- and repeat-type languages. Full repeats index different degrees of ‘markedness’ in LoG interaction. Contrary to previous studies on polar answers, repeats in LoG are frequently deployed as unmarked responses in subordinate lines of actions. Repeats are also used as more marked answers after understanding displays. This article attempts to stress the importance of investigating non-standard languages and variety contact in CA, thereby addressing the monolingual bias in research on polar questions.

Julia Elisabeth Lenz,1 Dominik Szymski,1 Jonas Krueckel,1 Johannes Weber,1 Felix Krieger,2 Thomas Karius,3 Rainer Meffert,4 Volker Alt,1 Kai Fehske3,4 1Department of Trauma Surgery, University Hospital Regensburg, Regensburg, Germany; 2Department of Diagnostic and Interventional Radiology, Passau Hospital, Passau, Germany; 3Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus, Bonn, Germany; 4Department of Trauma-, Hand-, Plastic- and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, GermanyCorrespondence: Julia Elisabeth Lenz, Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg, 93053, Germany, Tel +0049 941 944 6805, Email julia1.lenz@ukr.dePurpose: This study aims to conduct an epidemiological investigation into the types and causes of injuries during CrossFit® training in Germany.Patients and Methods: Voluntary athletes from various German CrossFit® gyms participated, providing personal information, training habits, and details on injuries through a standardized questionnaire.Results: The study involved 308 participants, with an equal sex split, a peak age of 20– 40, and a BMI of 24.3 ± 3.3 kg/m2. Most participants trained for over two years (49.4%), primarily in supervised groups. Motivations for engaging in CrossFit® included health prevention (33.1%), athletic training (32.8%), and work-life balance support (17%). Injuries were reported by 28.6% of participants, with 61.4% experiencing single injuries. The majority of injuries (55.3%) occurred during the middle of workouts. Injury types included wounds (23.3%), contusions, sprains, or strains (cumulative 30.8%), and fractures (2.9%). Almost all injured individuals (96.5%) had a time-loss injury, with a return to sport ranging from a day to over three months. Treatments varied, with 50.6% not requiring medical intervention, 34.1% undergoing physiotherapy, 21.2% receiving medication and 8.2% needing surgery. Barbell exercises, notably Snatch and Clean, were main exercises with association to injuries, accounting for 36.3%. The Box Jump stood out as the exercise with the highest isolated injury prevalence (14.3%). Notable injury causes included falls during Pull-Ups and lumbar disc herniation linked to Deadlifts. Following injuries, 45.8% of participants made training adjustments.Conclusion: This study provides an epidemiological investigation into the types and causes of injuries during CrossFit® training in Germany. The shoulder and knee joint exhibited the highest injury prevalence. Barbell exercises, box jumps, and bar pull-ups were identified as major exercises with association to injuries. Prevention through technical training and the incorporation of soft boxes could reduce the risk of injuries in CrossFit®.Plain language summary: This study looks at the types and causes of injuries during CrossFit® training in Germany. A total of 308 CrossFit® athletes took part, with an equal number of men and women, mostly aged 20-40, and an average BMI of 24.3 ± 3.3 kg/m². Most had trained for over two years, often in supervised groups, and were motivated by health, fitness, and balancing work and life.About 28.6% of participants reported injuries, mostly single injuries happening in the middle of workouts. The types of injuries included cuts, bruises, sprains, strains, and fractures, with the shoulder and knee being the most commonly affected areas. Notably, exercises involving barbells like the Snatch and Clean caused a significant number (36.3%) of injuries, followed by Box Jumps (14.3%) and bar pull-ups. Causes of injuries included falls during pull-ups and back injuries from Deadlifts.After getting injured, nearly half of the participants changed their training routines. Treatments varied, with some not needing medical help and others undergoing physiotherapy, taking medication, or having surgery.The findings suggest that focusing on proper technique and using softer equipment, like softer landing surfaces for Box Jumps, could help reduce the risk of injuries in CrossFit® training.Keywords: fitness, weightlifting, bodyweight, barbell, sport injury, gymnastics

Matthew E Sprong,1,2 Heaven Hollender,3 Bob Blankenberger,2 Stuart Rumrill,4 Yu-Sheng Lee,5 Travis Bland,2 Jeremiah Bailey,6 Kenneth Weber,1 James Gilbert,1 Ken Kriz,2 Frank D Buono7 1Edward Hines Jr. VA Medical Center, Hines, IL, USA; 2University of Illinois Springfield, School of Public Management and Policy, Springfield, IL, USA; 3Indiana University - Indianapolis, School of Health & Human Services, Indianapolis, IN, USA; 4Univerity of Illinois Urbana-Champaign, Department of Kinesiology and Community Health, Champaign, IL, USA; 5University of Illinois Springfield, School of Integrated Sciences, Sustainability, and Public Health, Springfield, IL, USA; 6Florida Agricultural and Mechanical University, Department of Sociology and Criminal Justice, Tallahassee, FL, USA; 7Yale School of Medicine, New Haven, CT, USACorrespondence: Matthew E Sprong, Email mspro2@uis.eduIntroduction: Veterans diagnosed with mental health and/or substance use disorders (SUD) often face significant barriers to employment and reintegration into civilian society. In the current study, we investigated whether how the VA healthcare system for mental health and/or SUD treatment predicted program enrollment into vocational rehabilitation, simultaneous mental health and/or SUD treatment while enrolled in vocational rehabilitation predicted employment at discharge, and mental health and/or SUD treatment continues and employment remain 60-days-post-vocational-rehabilitation discharge.Methods: An outcome-based, summative program evaluation design to measure quality assurance of vocational rehabilitation services provided to 402 veteran patients enrolled in a VA healthcare located within the Great Lakes Health Care System – Veterans Integrated Services Network.Results: Multivariable logistic regression analyses showed psychological empowerment (confidence in one’s ability to work or find work) is a significant factor determining whether a veteran is enrolled in the vocational rehabilitation program, prior mental health treatment (yes/no) and frequency of mental health treatment did not predict program enrollment, and frequency of SUD VA system treatment 60 days prior did not predict program enrollment. Other findings showed that simultaneous mental health and/or SUD treatment while enrolled in vocational rehabilitation did not predict employment at discharge, and employment at discharge did not predict continued mental health and/or SUD treatment post-discharge from vocational rehabilitation. However, veterans with both SUD and mental health and continued mental health treatment were less likely to be employed.Conclusion: Utilization of real-world program evaluation data from an actual VHA vocational rehabilitation program enhances the study’s ecological validity, offering practical implications for policymakers and practitioners in the field. The findings support the importance of veterans enrolling in mental health and/or SUD treatment simultaneously while enrolled in vocational rehabilitation services, as integrating vocational rehabilitation with mental health and SUD treatment services can lead to improved vocational and health outcomes for veterans (eg, development of targeted interventions to support veterans’ successful reintegration into the workforce and society).Keywords: substance use disorders, mental health, veterans affairs, health administration, veterans, vocational rehabilitation, treatment access

Anselm Jorda,1 Sabine Eberl,1 Alina Nussbaumer-Pröll,1 Maysa Sarhan,2 Maria Weber,1 Lara Elisabeth Tegrovsky,1 Markus Wahrmann,2 Valentin al Jalali,1 Felix Bergmann,1,3 Lena Pracher,1 Amelie Leutzendorff,1 Matthias Farlik,4 Bernd Jilma,1 Markus Zeitlinger1 1Medical University of Vienna, Department of Clinical Pharmacology, Vienna, Austria; 2Medical University of Vienna, Department of Internal Medicine III, Division of Nephrology and Dialysis, Vienna, Austria; 3Medical University of Vienna, Department of Plastic, Reconstructive and Aesthetic Surgery, Vienna, Austria; 4Medical University of Vienna, Department of Dermatology, Vienna, AustriaCorrespondence: Markus Zeitlinger, Department of Clinical Pharmacology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria, Tel +43 1 40400 29810, Email markus.zeitlinger@meduniwien.ac.atIntroduction: Lipopolysaccharide (LPS) stimulation of human whole blood ex vivo has been widely used to investigate human innate immune responses. However, there are uncertainties regarding the reproducibility and reliability of this assay.Methods: In this prospective, single-center study, cytokine responses (interleukin 8, interferon-α, interferon-γ, interleukin 10, interleukin 1-β, interleukin 6, and tumor necrosis factor-α) to ex vivo whole blood LPS stimulation were assessed in 12 healthy volunteers. Cytokine levels were measured at 0, 2, and 4 h using a multiplex immunoassay (Luminex ®). Stimulation was repeated after six weeks. We examined reproducibility across technical and biological replicates at baseline and between repeated experiments after 6 weeks based on the area under the curve (AUC) of the individual cytokines using Pearson’s correlation coefficient and the mean coefficient of variation.Results: The lowest mean coefficients of variation were observed for the technical replicates (5.4 to 9.2%), followed by the biological replicates (8.1 to 24.8%), and the repeated experiments after 6 weeks (17 to 31.2%). Between the baseline and 6-week AUCs, the following Pearson correlation coefficients R were observed: interleukin 10, 0.97; interferon-α, 0.84; interleukin 1-β, 0.83; interleukin 8, 0.79; interleukin 6, 0.73; interferon-γ, 0.73; and tumor necrosis factor-α, 0.63.Discussion: The level of agreement between the baseline and week-6 cytokine response to ex vivo LPS stimulation was high across the seven cytokines analyzed. While interleukin 10 exhibited the lowest level of variability over time, tumor necrosis factor-α showed the highest variability in repeated experiments, which should be considered in the design and interpretation of future studies.Keywords: LPS, lipopolysaccharide, inflammation, endotoxin

Jonas Krueckel,1 Dominik Szymski,1 Julia Lenz,1 Julian Fluegel,2 Johannes Weber,1 Leonard Achenbach,3 Rainer Meffert,4 Volker Alt,1 Kai Fehske4,5 1Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany; 2Department of Orthopaedic Surgery, Arcus Clinics Pforzheim, Pforzheim, Germany; 3Department of Orthopaedic Surgery, Koenig Ludwig Haus Wuerzburg, Wuerzburg, Germany; 4Department of Trauma Surgery, University Hosptial Wuerzburg, Wuerzburg, Germany; 5Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus Bonn, Bonn, GermanyCorrespondence: Kai Fehske, Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus Bonn, Waldstraße 73, Bonn, 53177, Germany, Email Fehske_k@ukw.de Jonas Krueckel, Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany, Email jonas.krueckel@ukr.dePurpose: While injuries among elite tennis athletes are extensively documented, a notable research gap exists regarding tennis injuries among club-level players. This study examines tennis injuries in German league players, with a particular emphasis on the impact of racquet properties and court surfaces, distinguishing between chronic and acute injuries.Patients and Methods: Retrospectively analyzing data from 600 tennis players over a 1.5-year period, a standardized questionnaire covered anthropometrics, injury characteristics, equipment usage, and court surface conditions.Results: The study identified 1012 tennis-related injuries, averaging 1.7 per player. Acute injuries predominantly affected the lower extremity (56%), with ankle injuries being the most prevalent, and ligaments were the most commonly affected structures (36.4%). Chronic complaints (reported by 364 athletes) focused on the upper extremity (63.2%), primarily tendon injuries (56.8%). Racket properties exhibited no significant impact on chronic upper extremity injuries.Conclusion: This study highlights a high incidence of acute lower extremity injuries, especially ankle ligament injuries, among German league tennis players. It offers crucial insights for devising targeted injury prevention strategies applicable to amateur, semi-professional, and professional tennis players, despite finding no significant link between racquet material and chronic upper extremity injuries.Keywords: tennis, injury, epidemiology, court surface, racquet material, ankle, ligament

Dielectric metasurfaces supporting quasi-bound states in the continuum (qBICs) enable high field enhancement with narrow-linewidth resonances in the visible and near-infrared ranges. The resonance emerges when distorting the meta-atom’s geometry away from a symmetry-protected BIC condition and, usually, a given design can sustain one or two of these states. In this work, we introduce a silicon-on-silica metasurface that simultaneously supports up to four qBIC resonances in the near-infrared region. This is achieved by combining multiple symmetry-breaking distortions on an elliptical cylinder array. By pumping two of these resonances, the nonlinear process of degenerate four-wave mixing is experimentally realized. By comparing the nonlinear response with that of an unpatterned silicon film, the near-field enhancement inside the nanostructured dielectric is revealed. The presented results demonstrate independent geometric control of multiple qBICs and their interaction through wave mixing processes, opening new research pathways in nanophotonics, with potential applications in information multiplexing, multi-wavelength sensing and nonlinear imaging.

Aims: Comprehensive provision of general healthcare (i.e. primary care) within the populace is contingent on there being enough general practitioners (GPs) in proximity to patients. It is no longer the case that vacated allocated positions for primary-care physicians are being filled in all regions. Support for specialist training in general medical practice is one of the measures intended to ensure provision of GP services. This analytical project aims to make a data-driven contribution to gauging the impact of such support on primary care in Germany, while also delivering pointers for further research. Methods: On the basis of routinely collected data, the history of such support was examined in detail for all practice-based, statutory health insurance (SHI)-accredited GPs during the period 2016–2022. In the analysis, GPs were broken down by whether they took up full-time or part-time roles, self-employed or salaried roles, and roles in a practice or in an ambulatory healthcare centre (MVZ).Results: During the period under review, the proportion of those who have both recently commenced work as SHI-accredited GPs and had previously used support for their specialist training, increased from 57% to 81%. The total number of new GPs (headcount) rose from 1,590 to 1,955. Results indicate that those who had availed themselves of this support take up self-employed and full-time roles more often than those who had not. Conclusions: Both take-up of support for specialist training, and the number of new GPs, increased markedly during the period under review. The data does not indicate any causal links. However, these results could form a jumping-off point for further research (in general) into support for specialist training, and (in particular) into how this may impact these individuals’ subsequent work roles.

Background: Contrast-induced nephropathy is a prevalent cause of hospital-acquired renal insufficiency and increases adverse events in older patients undergoing angiography and percutaneous coronary intervention. The Mehran risk score has been widely used in Vietnam to assess contrast-induced nephropathy risk in patients before coronary angiography and percutaneous coronary intervention. Recently, there has been a shift toward the adoption of simpler risk prediction models, such as the contrast volume-to-glomerular filtration rate ratio. This study aimed to (1) determine the incidence of contrast-induced nephropathy in older patients undergoing coronary angiography and/or percutaneous coronary intervention, and (2) compare the validity of the contrast volume-to-glomerular filtration rate ratio and the Mehran score in predicting contrast-induced nephropathy. Method: This is a prospective cohort study conducted at a hospital in Vietnam from September 2019 to May 2020. Consecutive patients aged ⩾60 years who underwent coronary angiography and/or percutaneous coronary intervention were recruited. The contrast volume-to-glomerular filtration rate ratio and the Mehran score were evaluated for their predictive utility regarding contrast-induced nephropathy risk. The receiver operator characteristic was employed to calculate the area under the curve for both the contrast volume-to-glomerular filtration rate ratio and the Mehran score in predicting contrast-induced nephropathy. Results: The study included 170 participants with a mean age of 70 years and 33.1% were female. Contrast-induced nephropathy was diagnosed in 9.4% of the participants. Participants with contrast-induced nephropathy exhibited a higher prevalence of chronic kidney disease, anemia, and heart failure. There was no significant difference between the area under the curves of the contrast volume-to-glomerular filtration rate ratio (0.79, 95% CI: 0.65–0.92), and the Mehran score (0.65, 95% CI: 0.51–0.82) in predicting contrast-induced nephropathy. Conclusion: Our findings indicate that contrast-induced nephropathy was prevalent among older patients following percutaneous coronary intervention. The contrast volume-to-glomerular filtration rate ratio demonstrated a good prognostic value for predicting contrast-induced nephropathy comparable to that of the Mehran score. Further research is needed to identify optimal cutoff values for the contrast volume-to-glomerular filtration rate ratio in older patients.

Accessibility research has matured over the last three decades and developed a better understanding of accessibility technologies, design and evaluation methods, systems and tools as well as empirical studies in accessibility. We envision how progress in new contexts over the next decade can be made to develop stronger links to other areas in Human-Centered Computing and address the research communities. A human-centered perspective on disability needs to develop from a medical model to a social model. New methods will utilize generative AI in design and development processes that address accessibility from the start of system design. We build on AI embedded into future design processes to address participation of small numbers of users better, and new technologies to allow for personalization of multi-modal interaction to improve verbal and non-verbal communication, making body-centric computing and natural interaction truly accessible.

Andrea Nicole Weber,1 Joshua Trebach,2 Marielle A Brenner,2 Mary Margaret Thomas,3 Nicholas L Bormann4 1Department of Psychiatry, University of Iowa, Iowa City, IA, USA; 2Department of Emergency Medicine, University of Iowa, Iowa City, IA, USA; 3Hardin Library for the Health Sciences, University of Iowa, Iowa City, IA, USA; 4Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USACorrespondence: Andrea Nicole Weber, Department of Psychiatry, University of Iowa, 500 Newton Road, 1-308 MEB, Iowa City, IA, 52242, USA, Tel +1-319-335-6980, Fax +1-319-384-7467, Email andrea-n-weber@uiowa.eduAbstract: Illicitly manufactured fentanyl (IMF) is a significant contributor to the increasing rates of overdose-related deaths. Its high potency and lipophilicity can complicate opioid withdrawal syndromes (OWS) and the subsequent management of opioid use disorder (OUD). This scoping review aimed to collate the current OWS management of study populations seeking treatment for OWS and/or OUD directly from an unregulated opioid supply, such as IMF. Therefore, the focus was on therapeutic interventions published between January 2010 and November 2023, overlapping with the period of increasing IMF exposure. A health science librarian conducted a systematic search on November 13, 2023. A total of 426 studies were screened, and 173 studies were reviewed at the full-text level. Forty-nine studies met the inclusion criteria. Buprenorphine and naltrexone were included in most studies with the goal of transitioning to a long-acting injectable version. Various augmenting agents were tested (buspirone, memantine, suvorexant, gabapentin, and pregabalin); however, the liberal use of adjunctive medication and shortened timelines to initiation had the most consistently positive results. Outside of FDA-approved medications for OUD, lofexidine, gabapentin, and suvorexant have limited evidence for augmenting opioid agonist initiation. Trials often have low retention rates, particularly when opioid agonist washout is required. Neurostimulation strategies were promising; however, they were developed and studied early. Precipitated withdrawal is a concern; however, the rates were low and adequately mitigated or managed with low- or high-dose buprenorphine induction. Maintenance treatment continues to be superior to detoxification without continued management. Shorter induction protocols allow patients to initiate evidence-based treatment more quickly, reducing the use of illicit or non-prescribed substances.Keywords: synthetic opioids, treatment, diagnosis, prevention, addiction medicine