Research Foundation for the State University of New York

The authors discuss the historical and contemporary connection to social justice issues in the fields of counseling and counseling psychology via the multicultural counseling movement. In addition, the authors present ways in which social justice issues can be addressed in counselors' and counseling psychologists' work with clients from diverse cultural backgrounds and in graduate training programs.

Background: Recurrent vulvovaginal candidiasis (RVVC) is a problematic form of mucosal Candida infection, characterized by repeated episodes per year. Candida albicans is the most common cause of RVVC. Currently, there are no immunotherapeutic treatments for RVVC. Methods: This exploratory randomized, double-blind, placebo-controlled trial evaluated an immunotherapeutic vaccine (NDV-3A) containing a recombinant C. albicans adhesin/invasin protein for prevention of RVVC. Results: The study in 188 women with RVVC (n = 178 evaluable) showed that 1 intramuscular dose of NDV-3A was safe and generated rapid and robust B- and T-cell immune responses. Post hoc exploratory analyses revealed a statistically significant increase in the percentage of symptom-free patients at 12 months after vaccination (42% vaccinated vs 22% placebo; P = .03) and a doubling in median time to first symptomatic episode (210 days vaccinated vs 105 days placebo) for the subset of patients aged <40 years (n = 137). The analysis of evaluable patients, which combined patients aged <40 years (77%) and ≥40 years (23%), trended toward a positive impact of NDV-3A versus placebo (P = .099). Conclusions: In this unprecedented study of the effectiveness of a fungal vaccine in humans, NDV-3A administered to women with RVVC was safe and highly immunogenic and reduced the frequency of symptomatic episodes of vulvovaginal candidiasis for up to 12 months in women aged <40 years. These results support further development of NDV-3A vaccine and provide guidance for meaningful clinical endpoints for immunotherapeutic management of RVVC. Clinical Trials Registration: NCT01926028.

Monolithic integration of quantum dot (QD) gain materials onto Si photonic platforms via direct epitaxial growth is a promising solution for on-chip light sources. Recent developments have demonstrated superior device reliability in blanket hetero-epitaxy of III-V devices on Si at elevated temperatures. Yet, thick, defect management epi designs prevent vertical light coupling from the gain region to the Si-on-Insulator waveguides. Here, we demonstrate the first electrically pumped QD lasers grown by molecular beam epitaxy on a 300 mm patterned (001) Si wafer with a butt-coupled configuration. Unique growth and fabrication challenges imposed by the template architecture have been resolved, contributing to continuous wave lasing to 60 °C and a maximum double-side output power of 126.6 mW at 20 °C with a double-side wall-plug efficiency of 8.6%. The potential for robust on-chip laser operation and efficient low-loss light coupling to Si photonic circuits makes this heteroepitaxial integration platform on Si promising for scalable and low-cost mass production.

This paper addresses the impact of back-gate biasing to DC, RF/millimeter-Wave (mmWave) and high frequency (HF) noise in 22nm FD-SOI technology (GLOBALFOUNDRIES’ 22FDX® technology). The front-gate and the back-gate cut-off frequency fT, together with the maximum oscillation frequency fMAX, were extracted from the four-port S-parameters data. The maximum achieved front-gate/back-gate fT and fMAX for the NFET is 350/85 GHz and 370/23 GHz respectively. In addition, 22FDX® technology demonstrated a tuneable HF noise parameter by using the back-gate biasing to achieve best-in-class low noise level. Two front-end (FE) modules were presented, which exploit the unique feature of back-gate. This unique feature allows superior designs with excellent combination of performance, power consumption and development cost, for emerging applications such as IoT, Telecommunication UE, RF and mmWave circuits with high speed connectivity and networking.

Summary This article includes an overview of the history and rationale of service learning in elder care, a description of the varied service learning in elder care programs initiated by the Foundation for Long Term Care and other entities, the empirical and qualitative impacts of service learning in elder care projects on students, elders and the host agency staff. It concludes with recommendations and resource materials for implementation, expansion and incorporation into effective collegiate pedagogy and gerontological social work practice, with an emphasis on how social work faculty can collaborate with Other disciplines in service learning. Key Words: Service learningcommunity serviceeducationelder careinformal support

OBJECTIVE: We performed a study of tumor necrosis factor inhibitors (TNFi) compared to non-TNFi biologic therapies in rheumatoid arthritis to test whether body mass index (BMI) modified the effect of each therapy. METHODS: We utilized data from CorEvitas. We studied 3 clinical outcomes based on the Clinical Disease Activity Index (CDAI) at 6 months from therapy initiation: 1) achievement of low disease activity (LDA); 2) a change as large as the minimum clinically important difference (MCID); and 3) the absolute change. We categorized BMI and utilized restricted cubic splines to consider nonlinear associations. We used linear and logistic regression to evaluate associations with response, adjusting for confounders. To determine if comparative effectiveness of therapy varied by BMI, we tested for interactions between BMI and class of therapy. RESULTS: The sample included 2,891 TNFi and 3,010 non-TNFi initiators. Among all initiators, those with severe obesity experienced lower odds of achieving LDA or MCID and less improvement in CDAI score, although associations were attenuated with adjustment. Low BMI was associated with reduced response rates in adjusted models including lower odds of LDA (odds ratio 0.32 [95% confidence interval (95% CI) 0.15, 0.71], P = 0.005). Analyses stratified by TNFi and non-TNFi therapies demonstrated no differences in clinical response rates for TNFi versus non-TNFi across BMI categories (all P for interaction >0.05). Estimates for non-TNFi biologics fit within the 95% CI for TNFi. CONCLUSION: This study observed lower response rates among obese and underweight patients and no evidence of a superior effect of non-TNFi therapy over TNFi therapy in particular BMI categories.

We report for the first time the direct growth of quantum dot (QD) lasers with electrical pumping on 300 mm Si wafers on both a planar template and in-pocket template for in-plane photonic integration. O-band lasers with five QD layers were grown with molecular beam epitaxy (MBE) in a 300 mm reactor and then fabricated into standard Fabry–Perot ridge waveguide cavities. Edge-emitting lasers are demonstrated with high yield and reliable results ready for commercialization and scaled production, and efforts to make monolithically integrated lasing cavities grown on silicon-on-insulator (SOI) wafers vertically aligned and coupled to SiN waveguides on the same chip show the potential for 300 mm-scale Si photonic integration with in-pocket direct MBE growth.

Decongestive lymphatic therapy (DLT) has gained wide acceptance as an effective treatment for patients with lymphedema resulting from breast cancer treatment. It is unclear whether DLT is effective for patients with lymphedema who have received lymphedema treatment previously. Our purpose was to compare the effectiveness of DLT in patients who had received lymphedema treatment previously with those who had never received treatment. We retrospectively reviewed the medical records of 98 patients who received outpatient lymphedema therapy for upper extremity lymphedema following surgery. Seventy-two eligible patients with a breast cancer diagnosis and complete medical records were divided into two groups: group 1; previously treated (PT) patients (n = 38, 53%) had previously received lymphedema treatment, while group 2 (no PT, n = 34, 47%) had never received lymphedema treatment. The primary outcome was the percent change in volume in the lymphedematous arm, measured by perometer, after DLT treatment. The two groups did not differ significantly in age, comorbidities, body mass index, and median time from surgery to current treatment, surgical procedure, previous radiation treatment, or history of cellulitis/lymphangitis. DLT significantly reduced arm volume in both groups (group 1, p < 0.001; group 2, p = 0.003). The mean percent volume reduction did not differ significantly between the groups (p = 0.619). This study is the first to show that, DLT reduce limb volume significantly with post-mastectomy lymphedema, regardless of previous lymphedema therapy.

OBJECTIVE: The classic conception of pain etiology in rheumatologic disease is nociceptive pain-tissue injury and inflammation signaling through peripheral and central nerve fibers. But this can be mixed with other pain etiologies, including nociplastic, which is augmented pain experience due to central sensitization. The pain of fibromyalgia (FM) is nociplastic, occurs in 10% to 30% of patients with rheumatologic disease, and its presence can influence disease severity assessment. The objective of our study was to (1) ascertain the prevalence of FM and widespread pain (WP) in the CorEvitas psoriatic arthritis (PsA) registry as assessed by the Widespread Pain Index (WPI) and Symptom Severity Scale (SSS) questionnaires; (2) characterize the demographic and clinical factors associated with FM and WP; and (3) ascertain the association of FM and WP on the Clinical Disease Activity in Psoriatic Arthritis (cDAPSA) score and other disease activity measures. METHODS: PsA registry patients completing the WPI/SSS questionnaires since May 2020, at their most recent visit recorded in the registry, were analyzed. RESULTS: The analysis included 1,823 patients with PsA; 11.1% fulfilled the FM definition and 20.6% fulfilled the WP definition. Several factors were associated with the FM definition, including female sex, depression and/or anxiety, impaired function, increased body mass index, and increased number of comorbidities. cDAPSA, patient pain and global assessment, and tender joint count were twice as severe in patients with FM compared to those without. CONCLUSION: FM prevalence is elevated in PsA and is associated with elevated disease measures, confounding reliable disease assessment for treat-to-target goals. Identification of FM as an influential contextual factor in disease assessment is recommended.

OBJECTIVE: Though randomized controlled trials have demonstrated relatively comparable clinical outcomes with triple therapy (methotrexate [MTX], sulfasalazine [SSZ], and hydroxychloroquine [HCQ]) compared to combination therapy (tumor necrosis factor inhibitor [TNFi] and MTX), real-world experiences comparing these strategies have not been well studied. METHODS: We evaluated the clinical effectiveness and effects of medication discontinuation of triple therapy with MTX/SSZ/HCQ versus combination therapy with TNFi/MTX in rheumatoid arthritis (RA) patients enrolled in the Corrona RA Drug Safety & Effectiveness Registry. Propensity score matching was used to match patients up to a ratio of 1:3 to adjust for imbalances between treatment groups, with stratification performed according to biologics-naive or biologics-exposed status of study participants. RESULTS: Patients eligible for analysis in this study included biologics-naive RA patients (3,926 who received combination therapy with TNFi/MTX and 262 who received triple therapy with MTX/SSZ/HCQ) and biologics-exposed RA patients (3,365 who received combination therapy with TNFi/MTX and 130 patients who received triple therapy with MTX/SSZ/HCQ). Before propensity score matching, numerous factors were imbalanced between the treatment groups, with triple therapy patients generally being older, having a longer disease duration of RA and lower RA disease activity, and more likely having a history of malignancy and other comorbidities. After matching, almost all (93-98%) triple therapy patients could be matched to TNFi/MTX therapy patients, and cohort characteristics were generally well balanced. Discontinuation of medication was greater in triple therapy patients referent to TNFi/MTX therapy patients (adjusted hazard ratio [HR] of 2.17 [95% confidence interval 1.63-2.88] in the biologics-naive group; adjusted HR of 1.51 [95% confidence interval 1.06-2.15] in the biologics-exposed group). At 6 months, the proportion of biologics-naive patients attaining low disease activity was significantly greater in the TNFi/MTX treatment group (49.2% in TNFi/MTX therapy patients versus 33.3% in triple therapy patients), as was the mean change in Clinical Disease Activity Index scores (-9.3 units versus -5.5 [95% confidence interval -1.5, -6.1]). Corresponding results in the biologics-exposed patients numerically favored TNFi/MTX therapy compared to triple therapy but did not reach statistical significance. CONCLUSION: Few patients receive triple therapy with MTX/SSZ/HCQ in the US. In the present study, drug persistence and clinical effectiveness outcomes were less favorable in triple therapy patients compared to TNFi/MTX therapy patients.

GM1-gangliosidosis is a rare autosomal recessive lysosomal storage disease caused by deficiency of β-galactosidase (GLB1). Newborn screening (NBS) may be warranted in the near future given the initiation of a number of gene therapy clinical trials. Here, we report a tandem mass spectrometry (MS/MS) enzymatic assay of GLB1 using dried blood spots (DBS), and the demonstration that GLB1 activities in newborn DBS from seven GM1-gangliosidosis patients are well below those measured in random newborn DBS. MS/MS analysis of two glycan biomarkers, dp5 and A2G2, shows high elevation in newborn DBS from GM1-gangliosidosis compared to the levels in the nonaffected reference range.

Moisture, microbial and in particular mold related indoor exposure and health problems in homes, offices, and public buildings (Kindergartens, schools, library, and hospitals) have been gaining recognition as one of the most common indoor environmental health issues. Proper recognition of microbial related health problems and the differential diagnosis of sick building syndrome (SBS) or building related illness (BRI) are important for early and effective exposure intervention, treatment, referral and prevention of more serious illness.

BACKGROUND: Intestinal failure (IF) is defined as an ultrarare disease, with an estimated prevalence of ∼25,000 cases in the US. There is a suspicion of disparities in outcomes in IF care, likely related to widespread lack of expertise. The Extension for Community Healthcare Outcomes (ECHO) model originally described by Dr Sanjeev Arora has been used to disseminate knowledge and best practices in many chronic diseases to improve outcomes. We examined our initial experience with using the ECHO model to disseminate learning in IF. METHOD: This is a retrospective review of the launch, growth, and geographic reach of the Learn Intestinal Failure TeleECHO (LIFT-ECHO) program using prospectively collected data. RESULTS: The LIFT-ECHO program has achieved significant geographic reach and clinician engagement. The program has reached close to two-thirds of the states in the US and several countries outside. Clinician engagement in the learning program appears to be growing exponentially. CONCLUSION: It is feasible to use the ECHO model to disseminate knowledge in managing a rare disease like IF while maintaining fidelity to the proven model. Studies are underway to demonstrate direct benefit to patients.

This paper reports the high frequency (HF) noise characterized performance and modeling on 22nm FD-SOI technology transistor (GLOBALFOUNDRIES’ 22FDX <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">®</sup> technology) from 2 GHz to the maximum E-band millimetre-Wave (mmWave) frequency of 90 GHz. The measurement was performed using the Focus Microwaves noise system with different customised setups and optimised for each discrete frequency bands. The data measured from each frequency bands were subsequently combined to produce the noise spectrum covering from 2 GHz to 90 GHz, with high accuracy, good continuity and excellent correlation to the compact model. The 22FDX <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">®</sup> technology transistor demonstrated very low mmWave noise figure, which is favourable for RF and mmWave applications such as LNA.

Abstract Integrating quantum dot (QD) gain elements onto Si photonic platforms via direct epitaxial growth is the ultimate solution for realizing on‐chip light sources. Tremendous improvements in device performance and reliability have been demonstrated in devices grown on planar Si substrates in the last few years. Recently, electrically pumped QD lasers deposited in narrow oxide pockets in a butt‐coupled configuration and on‐chip coupling have been realized on patterned Si photonic wafers. However, the device yield and reliability, which ultimately determines the scalability of such technology, are limited by material uniformity. Here, detailed analysis is performed, both experimentally and theoretically, on the material asymmetry induced by the pocket geometry and provides unambiguous evidence suggesting that all pockets should be aligned to the [1 ] direction of the III‐V crystal for high yield, high performance, and scalable on‐chip light sources at 300 mm scale.

The precise quantification of a dielectric waveguide core thickness, core width, core refractive index, and cladding refractive index across a wafer is critical for greater consistency and accuracy in photonic circuit fabrication. However, accurate wafer-scale measurements of these parameters have not yet been demonstrated. We have previously described a method for extracting these four parameters simultaneously from silicon nitride waveguides using unbalanced Mach–Zehnder interferometers on a single die. In this work, we show that this technique can be scaled to characterize these photonic parameters across an entire 300 mm wafer. The refractive indices of the core and cladding materials are found with relative standard deviations of the mean of 0.07% and 0.03%, respectively. The core width offset (bias) and thickness are found with relative standard deviations of 0.3% (2.6 nm) and 0.5% (1.1 nm), respectively. The extracted parameter maps suggest a radial variation of material indices and a planar variation of geometric parameters. We verify the extracted parameters by accurately predicting the performance of an unbalanced Mach–Zehnder interferometer and the degeneracy between different modes in straight waveguides.

GM1-gangliosidosis (GM1) is a rare neurodegenerative disorder leading to early mortality and causing progressive decline of physical skills and cerebral functioning. No approved treatment for GM1 exists. In this study-the first to explore priorities of parents of subjects with pediatric onset forms of GM1-we address a crucial gap by characterizing symptoms most critical to caregivers of children with GM1 to treat. Our two-part, mixed-methods approach began with focus groups, followed by interviews with a distinct set of parents. Interviews included a prioritization activity that used best-worst scaling. Quantitative data were analyzed descriptively. Qualitative data were analyzed using thematic analysis and rapid analysis process. Parents prioritized the symptoms they believed would increase their child's lifespan and improve their perceived quality of life (QoL); these symptoms focused on communicating wants/needs, preventing pain/discomfort, getting around and moving one's body, and enhancing eating/feeding. Although lifespan was highly valued, almost all parents would not desire a longer lifespan without acceptable child QoL. Parents indicated high caregiver burden and progressive reduction in QoL for children with GM1. This novel study of caregiver priorities identified important symptoms for endpoints' selection in patient-focused drug development in the context of high disease impact and unmet treatment needs.

The use of social media by members of college campuses, including students, staff, and administrators, is on the rise and a growing body of research is examining such use.  In this study, two graduate level courses that incorporated Facebook’s closed group feature into the course logistics are explored.  It was found that using Facebook could promote a virtual student learning community.  The students involved used the groups for sharing ideas and support, asking questions, and participating in discussions.  This article provides a framework for using Facebook to develop a virtual student learning community.

The ability to deliver sensations of human-like touch within virtual reality remains an important challenge to immersive, realistic experiences. Since conventional haptic actuators impart distinctively unnatural effects, we instead tackle this challenge through the design of a rendering mechanism using soft pneumatic actuators (SPA), embedded within a wearable jacket. The resulting system is then evaluated for its ability to mimic realistic touch gesture sensations of grab, touch, tap, and tickle as performed by human fingertips. The results of our experiments indicate that the stimuli produced by our design were reasonably effective in presenting realistic human-generated sensations.

Polarization management, and in particular polarization rotation, is becoming increasingly important for photonic integrated circuits (PICs). While fiber-optic networks are generally polarization insensitive, the large aspect ratio of high-index-contrast PIC waveguides leads to a large polarization-dependent response of integrated components such as waveguides, optical cavities, couplers, etc. Although foundry-processed polarization rotators operating at telecom and datacom wavelengths (C- and O-band) have been demonstrated, to date, there have been few reports of devices operating at shorter wavelengths. This work demonstrates silicon nitride (SiN) polarization rotators operating from λ=700-1000 nm (the I/Z-band) that take advantage of optical coupling between two waveguiding layers in a standard foundry process. We demonstrate a broadband white-light polarization measurement setup that enables precise characterization of the polarization-dependent transmission of photonic waveguide devices. Measurements on foundry-processed devices confirm full TE-to-TM rotation exhibiting a maximum polarization extinction ratio (PER) approaching 20 dB (limited by our measurement setup), and an exceptionally large bandwidth of up to 160 nm with an insertion loss less than 0.2 dB. Beam propagation method (3D-BPM) simulations show good agreement with experimental data and enable the device parameters to be adjusted to accommodate different operating wavelengths and geometries with no changes to the existing foundry process. This work opens up opportunities for applications in quantum information and bio-sensing where operation at λ<1000nm is needed.