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Two western Pacific states — the Solomon Islands and Papua New Guinea (PNG) — experimented with unusual and ambitious reforms aimed at strengthening political parties in the new millennium. In this paper, we look at what those laws entailed and how they worked in practice. In both cases, we find that unforeseen repercussions dominated. In PNG, the new laws encouraged candidates who formerly contested as independents to now nominate as members of microscopic one‐ or two‐member parties whereas in the Solomon Islands many formerly party‐affiliated candidates adjusted by contesting as independents. In PNG, the law was one of a range of devices aimed at strengthening incumbent governments, but money politics and manipulation of parliamentary procedure proved more significant. Core anti‐defection provisions in the new law were ruled unconstitutional in 2010, but other still valid clauses preserved an advantage for the "largest party" in government formation. In the Solomon Islands, the law created a shadow world of free‐floating individuals able to switch at liberty between formally constrained hermit crab shell parties. In neither country did these laws succeed in strengthening party systems. [ABSTRACT FROM AUTHOR]

This special issue of the Journal of Pacific History brings together several scholars, who were close to Professor Brij Lal, to write on the contemporary politics of Fiji. Brij died on 25 December 2021. [ABSTRACT FROM AUTHOR]

Fiji's 14 December 2022 election saw the defeat of 2006 coup leader turned civilian prime minister Frank Bainimarama's FijiFirst Party, and victory for an opposition coalition led by Sitiveni Rabuka, the 1987 coup leader and 1992–9 prime minister. This article examines the polling venue-level data to investigate whether regional, class, ethnic, or urban–rural differences determined that outcome, as well as exploring the influence of variations in the personal vote over the three open list proportional representation elections of 2014, 2018, and 2022. [ABSTRACT FROM AUTHOR]

The article presents the discussion on numerous treatment guidelines from the American College of Rheumatology and EULAR encourage shared decision. Topics include low health and numeric literacy are prevalent barriers to effectively informing patients and may disproportionately affect vulnerable populations; and heuristics illustrating the impact risk communication using data from the Oral Rheumatoid Arthritis Trial (ORAL) Surveillance trial.

Background. Airborne SARS-CoV-2 plays a prominent role in COVID-19 transmission. Numerous studies have sampled air from patient rooms, but airborne spread to other hospital areas such as corridors is less investigated. Methods. Size-fractionated aerosol particles were collected weekly, with 12 hours of sampling time daily, in corridors at two infectious disease wards in southern Sweden between March 2020 and May 2021. Samples were analysed with real-time reverse transcription polymerase chain reaction (RT-qPCR) for detection of SARS-CoV-2 RNA. Indoor temperature, relative humidity, and CO2 concentration were monitored during the sampling period. Results. 20 of the 784 collected samples contained SARS-CoV-2 RNA, although in low concentrations. Positive air samples were found in sizes between 0.14 and 8.1 μm, but none >8.1 μm. 45% were found in submicron particles. No clear seasonal pattern was observed among the positive samples. There was no significant difference in the positivity rate of the samples between the two wards. Conclusions. SARS-CoV-2 was only detected in 2.6% of the aerosol samples, which indicates that the spread of airborne virus from patient rooms to the corridor was limited. [ABSTRACT FROM AUTHOR]

We show how to extend the Laakso-Taagepera measure of the effective number of parties so as to incorporate both party and ethnicity in a way that allows both ethnic-specific, party-specific, and composite measures that we refer to as extended L-T indices. While the aim of this article is methodological, we also illustrate our approach with U.S. two-party data from presidential elections, using two-group, three-group, and five-group categorizations of ethnicities to show how party ethnicization in that country has grown since 1952. For comparison, and to show the generality of our approach to situations with more than two parties, we present data from the Federation of Bosnia and Herzegovina (Federacija Bosne i Hercegovine), where we have three ethnic groups but also more than two parties. [ABSTRACT FROM AUTHOR]

This article analyzes the talmudic story of the first encounter between Rav and Shmuel (b. Shabbat 108a). It focuses on the structural difficulties of the plot, particularly the relationship between Rav's interview at the beginning of the story and the aggressive medical treatment he undergoes at the end. A new interpretation of Shmuel's request of his student Karna to "sniff Rav's jar" can solve these problems. The request is here understood as a play on words, which concretizes the metaphorical idiom. This interpretation enables a new reading of the entire story, as one that centers on the relationship between metaphor and reality and, by extension, between the Torah and the body of the immigrant sage. [ABSTRACT FROM AUTHOR]

The April 2021 election triggered Sāmoa's most severe constitutional crisis since independence, an unusual development for a country long known for stability. Extensive litigation occurred over a 2013 constitutional amendment which required that a minimum of 10 per cent of parliamentarians be women and over the powers of the head of state. The outgoing government refused to concede defeat until late July. In the Introduction to this special issue, we take the opportunity to examine the debates about stability and instability in Sāmoa in a historical and theoretical context. [ABSTRACT FROM AUTHOR]

In 2021, Sāmoa witnessed its first change of government since the 1980s. The April election result entailed a narrow defeat for the governing Human Rights Protection Party (HRPP). This triggered a major constitutional crisis and a succession of legal battles over the 10 per cent quota for women in parliament and over the powers of the head of state, who had attempted to cancel the election. This paper examines the election outcome, how this was influenced by changing electoral laws, and why the newly formed Fa'atuatua I Le Atua Samoa ua Tasi (FAST) party was able to mount such a strong challenge to the HRPP. The paper argues that the central issue during the campaign – the HRPP's reforms to reconfigure the Land and Titles Court – was not (as widely depicted) a dispute over 'communal' versus 'individual rights' but rather one over two conflicting visions of centralized control. [ABSTRACT FROM AUTHOR]

A security deal struck between the Solomon Islands and China in April 2022 has been depicted as the precursor to the establishment of a Chinese naval base in the Pacific. Fed by the proximity of an Australian federal election, these fears have stimulated lurid images in the Australian press of Beijing's aircraft carriers being stationed off Brisbane's coast creating a Pacific version of the 1962 Cuban missile crisis. In this paper, we examine the provisions of the 'framework agreement', explore its rationale and consider the likelihood that the predicted naval base eventuates. We also investigate Chinese extraterritoriality on the global stage and Chinese commercial activity in the Solomons since the switch in diplomatic recognition from Taipei to Beijing in 2019. We argue that Solomon Islands Prime Minister Manasseh Sogavare signed the deal primarily in response to domestic pressures, in particular the danger of a repeat of major riots that took place in the capital in November 2021. The most pressing risk is not Chinese warships or nuclear missiles stationed in Honiara, but repression to handle urban unrest without the restraint required of Australian, Papua New Guinean, Fijian or New Zealand police officers. [ABSTRACT FROM AUTHOR]

We demonstrate the use of three diagnostic tools which simultaneously view the target from nearly the same direction, and their results are combined to provide temporally, spectrally, and spatially resolved absolutely calibrated target emission information. To demonstrate this capability, Au targets were irradiated by 1.8 kJ, 3 ns laser pulses to produce broadband soft x-ray emission in the 0.1–3.5 keV spectral range. Target diagnostics included a time-resolved x-ray diode array, each measured a partial spectral band, time-integrated spectrally resolved absolutely calibrated transmission grating spectrometer, and static and time-resolved soft x-ray imagers coupled to a charge-coupled device camera and to a streak camera, respectively, measuring spatially and temporally resolved radiation at the main Au target emission bands. The combined temporally, spectrally, and spatially resolved absolutely calibrated target emission result can be compared to simulations and be used to design and analyze experiments in which the source emission is used as a drive for various physical processes. [ABSTRACT FROM AUTHOR]

Background Transmission of coronavirus disease 2019 (COVID-19) can occur through inhalation of fine droplets or aerosols containing infectious virus. The objective of this study was to identify situations, patient characteristics, environmental parameters, and aerosol-generating procedures (AGPs) associated with airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Methods Air samples were collected near hospitalized COVID-19 patients and analyzed by RT-qPCR. Results were related to distance to the patient, most recent patient diagnostic PCR cycle threshold (Ct) value, room ventilation, and ongoing potential AGPs. Results In total, 310 air samples were collected; of these, 26 (8%) were positive for SARS-CoV-2. Of the 231 samples from patient rooms, 22 (10%) were positive for SARS-CoV-2. Positive air samples were associated with a low patient Ct value (OR, 5.0 for Ct <25 vs >25; P  = .01; 95% CI: 1.18–29.5) and a shorter physical distance to the patient (OR, 2.0 for every meter closer to the patient; P  = .05; 95% CI: 1.0–3.8). A mobile HEPA-filtration unit in the room decreased the proportion of positive samples (OR,.3; P  = .02; 95% CI:.12–.98). No association was observed between SARS-CoV-2–positive air samples and mechanical ventilation, high-flow nasal cannula, nebulizer treatment, or noninvasive ventilation. An association was found with positive expiratory pressure training (P  < .01) and a trend towards an association for airway manipulation, including bronchoscopies and in- and extubations. Conclusions Our results show that major risk factors for airborne SARS-CoV-2 include short physical distance, high patient viral load, and poor room ventilation. AGPs, as traditionally defined, seem to be of secondary importance. [ABSTRACT FROM AUTHOR]

The objectives of this article are to describe and analyze the perceptions and experiences of Ultra-Orthodox men working in the high-tech industry: the identity conflict that they might experience and how they live with, or resolve, this conflict. In-depth interviews were conducted with 20 self-identified Jewish Ultra-Orthodox men. The study shows that employees from segregated religious backgrounds face four specific challenges, relating to their faith, spirituality, and emotions, the meaning attributed to work, their cultural identity, and their social identity. These challenges may be experienced as sources of identity conflict. The study also explored the various ways in which employees interpret and or justify their positions in relation to these challenges and, accordingly, their workplace integration. [ABSTRACT FROM AUTHOR]

The obituary honors Dr. Evan Imber-Black, a respected professor, therapist, and author who made significant contributions to the field of family therapy. Throughout her career, she authored multiple books and articles, mentored students, and led innovative training programs. Dr. Imber-Black's work focused on family rituals, secrets, and larger systems, and she was known for her clear and concise writing style. Her impact on the field of family therapy was profound, and she was a vocal advocate for social justice and systemic change. Her legacy continues to inspire colleagues and students worldwide. [Extracted from the article]

Objective: To develop updated guidelines for the pharmacologic management of rheumatoid arthritis. Methods: We developed clinically relevant population, intervention, comparator, and outcomes (PICO) questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the certainty of evidence. A voting panel comprising clinicians and patients achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. Results: The guideline addresses treatment with disease‐modifying antirheumatic drugs (DMARDs), including conventional synthetic DMARDs, biologic DMARDs, and targeted synthetic DMARDs, use of glucocorticoids, and use of DMARDs in certain high‐risk populations (i.e., those with liver disease, heart failure, lymphoproliferative disorders, previous serious infections, and nontuberculous mycobacterial lung disease). The guideline includes 44 recommendations (7 strong and 37 conditional). Conclusion: This clinical practice guideline is intended to serve as a tool to support clinician and patient decision‐making. Recommendations are not prescriptive, and individual treatment decisions should be made through a shared decision‐making process based on patients' values, goals, preferences, and comorbidities. [ABSTRACT FROM AUTHOR]

The variation of the activity coefficient of aqueous sulfuric acid with acid concentration, solution's temperature, and solvent's (water) dielectric constant, clearly fits a typical strong 1–3 electrolyte behaviour [Fraenkel, J. Phys. Chem. B. 116, 11662 (2012)]. Therefore, the aqueous acid was proposed to have the molecular formula H4SO5, and to dissociate to 3H+ (3H3O+) and 1HSO53−. When the above study was reported, electric conductivity data of the aqueous acid could not be theoretically interpreted to prove or disprove the 1–3 electrolyte behaviour, due to the lack of an appropriate conductance theory. The improved Debye–Hückel–Onsager (DHO) theory, DHO–SiS, recently reported [Fraenkel, Phys. Chem. Chem. Phys. 20, 29896 (2018)], allows, unlike its parent theory, a quantitative analysis of strong 1–1, 1–2 and 1–3 electrolytes. A good-to-excellent theory–experiment agreement is achieved for dilute aqueous H2SO4 at 0–50°C, but only if the acid is considered, as before, as a strong 1–3 electrolyte; the new analysis thus corroborates the previous activity-based findings. In contrast, the conductance of dilute sulfuric acid in pure methanol follows the conventional H2SO4 dissociation pattern, exhibiting a 'mixed 1–1/1–2' electrolyte behaviour. [ABSTRACT FROM AUTHOR]

In spite of the great importance of mixed electrolytes in science and technology, no compelling theoretical explanation has been offered yet for the thermodynamic behavior of such systems, such as their deviation from ideality and the variation of their excess functions with ionic composition and concentration. Using the newly introduced Smaller-ion Shell treatment - an extension of the Debye- Hückel theory to ions of dissimilar size (hence DH-SiS) - simple analytic mathematical expressions can be derived for the mean and single-ion activity coefficients of binary electrolyte components of ternary ionic systems. Such expressions are based on modifying the parallel DH-SiS equations for pure binary ionic systems, by adding to the three ion-size parameters - a (of counterions), b+ (of positive coions), and b- (of negative coions) - a fourth parameter. For the (+ + -) system, this is "b++," the contact distance between non-coion cations. b++ is derived from fits with experiment and, like the other b's, is constant at varying ion concentration and combination. Four case studies are presented: (1) HCl-NaCl-H2O, (2) HCl-NH4Cl-H2O, (3) (0.01 M HX)-MX-H2O with X = Cl, Br, and with M = Li, Na, K, Cs, and (4) HCl-MCln-H2O with n = 2, M = Sr, Ba; and n = 3, M = Al, Ce. In all cases, theory is fully consistent with experiment when using a of the measured binary electrolyte as the sole fitting parameter. DH-SiS is thus shown to explain known "mysteries" in the behavior of ternary electrolytes, including Harned rule, and to adequately predict the pH of acid solutions in which ionized salts are present at different concentrations. [ABSTRACT FROM AUTHOR]

Purpose: To point out the biomechanical changes of the topographically and tomographically normal partner eye (NPE) in patients with very asymmetrical corneal ectasia. Setting: Department of Ophthalmology, Saarland University Medical Center in Homburg/Saar, Germany. Design: Retrospective study. Methods: The topographical and tomographical results of the NPE were assessed using the Pentacam HR and the biomechanical corneal properties using the Ocular Response Analyzer (keratoconus match index [KMI], corneal hysteresis [CH], and corneal resistance factor [CRF]) and the Corvis ST (topographic biomechanical index [TBI] and Corvis biomechanical index) and compared those results with a normal control group (CG). Results: The clinical records of 26 patients recruited from the Homburg Keratoconus Center diagnosed with a very asymmetrical corneal ectasia were reviewed. The NPE (8.5 +/- 1.5 mm Hg) showed a significantly more pathological CH (P <.001) compared with the CG. The CRF was also significantly more pathological (P =.04) for the NPE (8.3 +/- 1.5 mm Hg) compared with the CG. The NPE (0.62 +/- 0.32) showed a nonsignificant (P =.08) more pathological KMI compared with the CG. Nineteen (73.1%) of 26 NPE had a KMI less than 0.72 and were considered pathological. Compared with the CG, the TBI of the NPE (0.19 +/- 0.25) did not differ significantly overall (P =.57). However, 5 (19.2%) of 26 eyes had a TBI more than 0.29 and were considered pathological. Conclusions: Topographically and tomographically NPEs in very asymmetrical corneal ectasia frequently showed biomechanical changes. This should be considered before planning any type of refractive corneal surgery in such patients. [ABSTRACT FROM AUTHOR]

In this work, we present the measurement of L-band emission from buried Sc/V targets in experiments performed at the OMEGA laser facility. The goal of these experiments was to study non-local thermodynamic equilibrium plasmas and benchmark atomic physics codes. The L-band emission was measured simultaneously by the time resolved DANTE power diagnostic and the recently fielded time integrated Soreq-Transmission Grating Spectrometer (TGS) diagnostic. The TGS measurement was used to support the spectral reconstruction process needed for the unfolding of the DANTE data. The Soreq-TGS diagnostic allows for broadband spectral measurement in the 120 eV–2000 eV spectral band, covering L- and M-shell emission of mid- and high-Z elements, with spectral resolution λ/Δλ = 8–30 and accuracy better than 25%. The Soreq-TGS diagnostic is compatible with ten-inch-manipulator platforms and can be used for a wide variety of high energy density physics, laboratory astrophysics, and inertial confinement fusion experiments. [ABSTRACT FROM AUTHOR]

Objectives: A measure that encompasses both benefits and harms at the individual patient level may facilitate comparisons between treatment options and improve shared decision-making. The objective of this study was to develop a patient reported measure to capture overall experience (including both benefits and harms) of treatment using rheumatoid arthritis (RA) as a case example. Methods: Hierarchies for treatment benefits are known. Therefore, we developed a hierarchy of adverse events (AEs) using a series of trajectory mapping and paired comparison surveys. We subsequently used these data to construct a paired comparison survey, asking patients to compare options including both a specified level of benefit and an AE. These data were used to generate a hierarchy of overall experience on treatment. Results: 782 participants completed a series of three surveys. The trajectory mapping procedure and a paired comparison survey led to the generation of a hierarchy of AEs with nine levels ranging from No AEs to irreversible serious complications. In a third survey, in which AEs were paired with benefits, participants' ratings generated a 6-level hierarchy of overall experiences ranging from Major improvement + No, mild or manageable AEs (Level 1) to No improvement + Irreversible AEs (Level 6). Conclusions: Using a trajectory mapping approach, we developed a patient reported measure representing the distribution of patients' overall experiences on treatment. The intent of this measure is to enable patients and their physicians to compare the percentage of patients experiencing each level of outcome, from most to least desirable, across treatments. [ABSTRACT FROM AUTHOR]

Over the past three decades, the theory and practice of couple therapy has moved towards integrative approaches. Typically, two or more couple therapy theories and their associated practices are blended into a more comprehensive, flexible approach to conceptualizing and intervening with couples' problems. Emerging findings from social and affective neuroscience are also increasingly incorporated. This article argues for broadening integrative efforts to include the perspectives and products of the arts and humanities into couple therapy, with a focus on music. The article presents the rationale for this broadened scope of integration by discussing E. O. Wilson's consilience theory and its bearing on the distinctions and convergence among the science, craft, and art of therapy. The research on the neuroscience of music and the role of music in affective experience, expression, and intimate relationships strongly supports use of music in transformative work with couples. Music theory and arts provide a useful framework for creating novel theories about couple relationships, for observing and understanding distressed couples' problematic patterns, and for formulating interventions. Sensitivity to the musical aspects of therapists' communicative behavior can increase the impact of interventions. The article provides a practical framework for utilizing music in couple therapy, and includes several illustrative case examples. [ABSTRACT FROM AUTHOR]

The worldwide coronavirus (COVID‐19) has had profound effects on all aspects of life: physical health, the ability to travel locally or to more distant destinations, material and financial resources, and psychosocial wellbeing. Couples, families, and communities and individual persons in those relationships have struggled to cope with emerging depression, anxiety, and trauma, and the rise of relational conflict. In this article, we suggest that the existential nature of the pandemic's challenges requires more than just the usual psychosocial interventions. We propose a taxonomy of responses to foster coping and resilience—"Reaching Up, Down, In, and Around." "Reaching Up" includes accessing spiritual, religious, and ethical values. "Reaching Down" includes ideas and practices that foster a revised relationship with the Earth and its resources, and that engage families to participate in activities that aid the Earth's recovery from decades of human‐caused damage. "Reaching In" represents a turn towards experiences available in the mind and in shared minds in relationships that provide pleasure, excitement, joy, and peace, given that external sources of these emotions are of limited availability due to quarantine. "Reaching Around" involves reframing the mandate for "social distancing" as fostering social connection and support while maintaining physical distancing. The challenges for family therapists, whose practices are confined largely to online therapy, and who are struggling with the same fears and constraints as those persons they are attempting to help, are also discussed. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has convulsed human communities across the globe like no previous event in history. Family therapists, paradoxically, given the core of their work is with systems, are also experiencing upheaval in professional and personal lives, trying to work amidst a society in chaos. This paper offers a collection of reflections by systemic and family therapists from diverse cultures and contexts penned in the midst of the pandemic. The main intention in distilling these narratives is to preserve the 'cultural diversity' and 'ecological position' of the contributors, guided by phenomenology, cultural ecology, and systemic worldviews of 'experiencing.' The second intention is to 'unite' promoting solidarity in this isolating situation by bringing each story together, creating its own metaphor of a family: united, connected, stronger. As a cross‐cultural family practitioner, with a strong mission for collaboration, the lead author acknowledges the importance of Context – the nation and location of the experience; Culture – the manner in which culture impacts on experience; Collaboration – enhancing partnership, enriching knowledge, and mapping the journey's direction; and Connectedness – combating isolation while enhancing unity. Since the key transmission of culture is through language, raw reflections were sought initially in the practitioners' own language, which were translated for an English‐speaking readership. These narratives are honest and rich descriptions of the authors' lived experiences, diverse and distinctive. The contributors trust colleagues will find these reflections helpful, validating and acknowledging the challenges of this unique period in history. [ABSTRACT FROM AUTHOR]

Background Noroviruses are the major cause of viral gastroenteritis. Disease transmission is difficult to prevent and outbreaks in health-care facilities commonly occur. Contact with infected persons and contaminated environments are believed to be the main routes of transmission. However, noroviruses have recently been found in aerosols and airborne transmission has been suggested. The aim of our study was to investigate associations between symptoms of gastroenteritis and the presence of airborne norovirus, and to investigate the size of norovirus-carrying particles. Methods Air sampling was repeatedly performed close to 26 patients with norovirus infections. Samples were analyzed for norovirus RNA by reverse transcription quantitative polymerase chain reaction. The times since each patient's last episodes of vomiting and diarrhea were recorded. Size-separating aerosol particle collection was performed. Results Norovirus RNA was found in 21 (24%) of 86 air samples from 10 different patients. Only air samples during outbreaks, or before a succeeding outbreak, tested positive for norovirus RNA. Airborne norovirus RNA was also strongly associated with a shorter time period since the last vomiting episode (odds ratio 8.1; P =.04 within 3 hours since the last vomiting episode). The concentrations of airborne norovirus ranged from 5–215 copies/m3, and detectable amounts of norovirus RNA were found in particles <0.95 µm and >4.51 µm. Conclusions The results suggest that recent vomiting is the major source of airborne norovirus and imply a connection between airborne norovirus and outbreaks. The presence of norovirus RNA in submicrometre particles indicates that airborne transmission can be an important transmission route. [ABSTRACT FROM AUTHOR]

A common myth about families living in homeless shelters is that they are laconically and contentedly waiting around for housing, financial support through welfare or jobs, and other resources and services. Nothing could be further from the truth. Single parents in shelters dealing with inequities incurred by poverty are busy trying to procure housing, jobs, and other resources while managing children's behavior and homework, and while attempting to maintain the family's sense of relational and emotional integrity. Thirty-six African American, Afro-Caribbean, and Latinx families living in a New York City shelter were interviewed about the time challenges they face and their means of coping with those challenges. Six themes emerged: (1) franticness, time pressure, and sense of having not enough time; (2) the temporal unpredictability of daily life; (3) the unpredictability of time to live in shelter; (4) anxious waiting for next steps toward employment and housing; (5) the shelter's control of time; and (6) the importance of family time and strategies used to sustain it. These findings are discussed using theoretical perspectives about the elements of temporal behavior, as well as research on time and personal agency, and recommendations are made for professionals working to support homeless families, especially around their temporal challenges. [ABSTRACT FROM AUTHOR]

Fiji's 2018 election was the first test of prime minister and coup leader Frank Bainimarama's FijiFirst government after a period in elected office and the second election since the military coup of 2006. It was an election the incumbents confidently expected easily to win, but one which signalled some reinvigoration of a previously divided and demoralized opposition. This article examines the major political parties and their social bases, the key issues in the campaign and the polling venue data. It uses Sitiveni Rabuka's accession to the leadership of the main opposition party as a window on important events in Fiji's postcolonial history, which themselves became a key focus of the 2018 campaign. The paper finds unusual forms of orchestrated ethnic polarization disguised as its inverse, concerted use of incumbency to consolidate a reformist electoral base and some limited easing of previous constraints on the courts, the media and public protest. Despite the 12 years since the 2006 coup, Fiji remains a highly precarious democracy. [ABSTRACT FROM AUTHOR]

This article presents an integrative approach to the special challenges of therapy with couples on the brink of dissolution or divorce—who often describe this therapy as their "last chance." In some, one partner is considering ending the relationship, and in others, both partners are considering ending it. Often, these couples have had prior dissatisfying experiences in couple therapy. Four types of last chance couples are described: high‐conflict couples; couples in which partners have differing goals for their lives or different timelines for reaching shared goals; couples in which one or both partners have acted in a manner that violates the values, expectations, emotional comfort, or safety of the other; and couples in which there has been a gradual loss of intimacy. The Therapeutic Palette, a multiperspectival, theoretically eclectic integrative approach, is enlisted as a general framework for selecting and sequencing use of particular theories and their associated practices, based on the three "primary colors" of couple therapy: time frame/focus, level of directiveness, and change entry point. An additional complementary framework, the creative relational movement approach, is proposed to provide an integrative frame encompassing both language‐based and action‐based practices, suggesting that meaning is held and expressed as much through interaction or "relational motion" as it is through language. Principles of change are described. Due to the couple's level of crisis and desire for immediate evidence of possible improvement, priority is given to action‐based interventions in early stages of therapy, by engaging couples in "experiments in possibility." Typical action approaches are described. An extended vignette follows. [ABSTRACT FROM AUTHOR]

Objective  Previous studies suggested maternal hypothyroidism during pregnancy to be associated with cognitive impairment of the offspring. Scarce data exist regarding long-term endocrine health of the offspring. This study was aimed to assess whether children born to mothers with hypothyroidism during pregnancy are at an increased risk for long-term endocrine morbidity. Study Design  A retrospective population-based cohort study compared long-term endocrine morbidity of children born between the years 1991 and 2014 to mothers with and without hypothyroidism. Multiple gestations, fetuses with congenital malformations, and women lacking prenatal care were excluded. Hospitalizations of the offspring up to the age of 18 years involving endocrine morbidity were evaluated according to a predefined set of ICD-9 codes. Kaplan–Meier's survival curves were used to compare the cumulative risk and a Cox multivariable model was used to adjust for confounders. Results  During the study period, 217,910 deliveries met the inclusion criteria; 1.1% of which were with maternal hypothyroidism (n  = 2,403). During the follow-up period, the cumulative incidence of endocrine morbidity among children born to mothers with hypothyroidism was 27 per 1,000 person-years and 0.47 per 1,000 person-years in the comparison group (relative risk: 2.14; 95% confidence interval [CI]: 1.21–3.79). The Kaplan–Meier's survival curve demonstrated a significantly higher cumulative endocrine morbidity in children born to mothers with hypothyroidism (log-rank test, p  = 0.007). In the Cox regression model controlled for maternal age, birth weight, preterm birth, maternal diabetes, hypertensive disorders of pregnancy, induction of labor, and mode of delivery, maternal hypothyroidism was found to be independently associated with pediatric endocrine morbidity in the offspring (adjusted hazard ratio = 1.92, 95% CI: 1.08–3.4, p  = 0.025). Conclusion  Maternal hypothyroidism appears to be independently associated with long-term pediatric endocrine morbidity of the offspring. [ABSTRACT FROM AUTHOR]

Background: Treatment decision-making regarding immunosuppressive therapy is challenging for individuals with lupus. We assessed the effectiveness of a decision aid for immunosuppressive therapy in lupus nephritis.Methods and Findings: In a United States multicenter, open-label, randomized controlled trial (RCT), adult women with lupus nephritis, mostly from racial/ethnic minority backgrounds with low socioeconomic status (SES), seen in in- or outpatient settings, were randomized to an individualized, culturally tailored, computerized decision aid versus American College of Rheumatology (ACR) lupus pamphlet (1:1 ratio), using computer-generated randomization. We hypothesized that the co-primary outcomes of decisional conflict and informed choice regarding immunosuppressive medications would improve more in the decision aid group. Of 301 randomized women, 298 were analyzed; 47% were African-American, 26% Hispanic, and 15% white. Mean age (standard deviation [SD]) was 37 (12) years, 57% had annual income of <$40,000, and 36% had a high school education or less. Compared with the provision of the ACR lupus pamphlet (n = 147), participants randomized to the decision aid (n = 151) had (1) a clinically meaningful and statistically significant reduction in decisional conflict, 21.8 (standard error [SE], 2.5) versus 12.7 (SE, 2.0; p = 0.005) and (2) no difference in informed choice in the main analysis, 41% versus 31% (p = 0.08), but clinically meaningful and statistically significant difference in sensitivity analysis (net values for immunosuppressives positive [in favor] versus negative [against]), 50% versus 35% (p = 0.006). Unresolved decisional conflict was lower in the decision aid versus pamphlet groups, 22% versus 44% (p < 0.001). Significantly more patients in the decision aid versus pamphlet group rated information to be excellent for understanding lupus nephritis (49% versus 33%), risk factors (43% versus 27%), medication options (50% versus 33%; p ≤ 0.003 for all); and the ease of use of materials was higher in the decision aid versus pamphlet groups (51% versus 38%; p = 0.006). Key study limitations were the exclusion of men, short follow-up, and the lack of clinical outcomes, including medication adherence.Conclusions: An individualized decision aid was more effective than usual care in reducing decisional conflict for choice of immunosuppressive medications in women with lupus nephritis.Trial Registration: Clinicaltrials.gov, NCT02319525. [ABSTRACT FROM AUTHOR]

Presents a study that investigated the lifetime and carrier-concentration profile of boron-implanted p-type mercury compound photodiodes. Common technique for producing the p-type junctions; Details on the carrier profile measurement; Discussion on the results of the study.

A molecular dynamics simulation of the trapping of a guest molecule in a rare gas matrix deposition is presented. Using Lennard-Jones pairwise potentials, the shape and size of trapping sites are seen to depend on the preparation conditions, particularly the temperature and the cooling rate. The proper way to obtain a defect-free matrix is by depositing at temperatures that are somewhat lower than the annealing temperature. [ABSTRACT FROM AUTHOR]

Presents a study which aimed to find the optimal conditions for generating a few nanoseconds x-ray pulse source in the wavelength range 4-14 Å. Characterization of laser produced plasmas; Instruments that detected x-ray emission; Results and discussion.

Presents a study that measured the reflectivity of tungsten-carbon multilayer lasers. Methodology; Reasons for the increase in reflectivity in the multilayer structures; Details on a thermal model of laser absorption and heat transport.

Presents a study that determined measurements of the vertical mobility of photo-excited carriers in quantum well infrared detectors. Details on photo geometrical magnetoresistance measurement technique; Schematic structure geometry for geometrical magnetoresistance measurement technique; Device parameters and experimental details.

The lack of access to gender-affirming surgery represents a significant unmet health care need within the transgender community, frequently resulting in depression and self-destructive behavior. While some transgender people may have access to gender reassignment surgery (GRS), an overwhelming majority cannot afford facial feminization surgery (FFS). The former may be covered as a "medical necessity," but FFS is considered "cosmetic" and excluded from insurance coverage. This demarcation between "necessity" and "cosmetic" in transgender health care based on specific body parts is in direct opposition to the scientific community's understanding of gender dysphoria and professional guidelines for transgender health. GRS affects one's ability to function in an intimate relationship, while FFS has the same impact on social interactions an, therefore may have a far greater implication for one's quality of life. FFS is a cost-effective intervention that needs to be covered by insurance policies. The benefits of such coverage far exceed the insignificant costs. [ABSTRACT FROM AUTHOR]

We tested predictions of fuzzy‐trace theory that qualitative health status and gist representations (ordinal and categorical) of risks contribute to willingness to start medications, beyond effects of objective risk, emotion (worry), and numeracy. Adults in two experiments were given hypothetical scenarios based on actual medications, varying health status quo (acceptable or unacceptable), adverse event (pneumonia or cancer), and four levels of quantitative risk (from 1/100,000 to 1/100) between subjects. In both experiments, cancer and higher quantitative risk elicited greater worry and risk perceptions and reduced willingness to start a new medication. Willingness to start was also influenced by health status quo. After controlling for other variables, only status quo and gist representations consistently predicted willingness to start in both experiments. Results support an integrated approach to understanding and predicting perceptions of the risks of medications that encompasses numerical cognition, emotions (such as worry), and qualitative gist representations of medical information. [ABSTRACT FROM AUTHOR]

Objective: To examine whether visual aids (a graphic representation and/or conceptual illustrations) influence patients' risk perceptions for rare and very rare risks.Methods: Participants were randomized to a scenario which varied by probability of infection (2% or 0.2%) and visual aid: numbers only, numbers + graphic representation, numbers + conceptual illustrations, or numbers + graphic representation + conceptual illustrations. Risk perceptions and likelihood of starting the medication were examined across the four formats, separately, in participants with and without a college education.Results: Adding a graphic representation and/or conceptual illustrations did not affect risk perceptions among those with a higher level of education. Adding both a graphic representation + conceptual illustrations decreased risk perceptions and increased likelihood of starting the medication among participants randomized to the 2%, but not 0.2% scenario, among participants with lower levels of education.Conclusion: Adding a graphic representation + conceptual illustrations to numbers may influence perceptions for rare, but not very rare, risks among patients with lower education.Practice Implications: Clinicians should be aware of the differential effects of visual aids developed to facilitate risk communication. Patients with higher levels of education may be less responsive to visual aids than those with lower education. [ABSTRACT FROM AUTHOR]

Highlights • Omics technologies allow evaluation of entire layers of molecular activity at once. • Omics data can be used to answer a variety of questions in translational research. • Integrating multiple layers of omics data leads to novel, important results. • Tools for pathway-based and comparative studies will advance the field. Omics technologies have made it easier and cheaper to evaluate thousands of biological molecules at once. These advances have led to novel therapies approved for use in the clinic, elucidated the mechanisms behind disease-associated mutations, led to increased accuracy in disease subtyping and personalized medicine, and revealed novel uses and treatment regimes for existing drugs through drug repurposing and pharmacology studies. In this review, we summarize some of these milestones and discuss the potential of integrative analyses that combine multiple data types for further advances. [ABSTRACT FROM AUTHOR]

The physical interpretation of the limiting equivalent conductivity of binary electrolytes in solution, Λ0 (=Σi =+,- λ0 i), has been a challenge for almost a century. Here, as a follow-up on a preliminary communication [D. Fraenkel, Mol. Phys. 115, 2944 (2017)], a quantitative theoretical treatment is offered and fully developed for the limiting ionic equivalent conductivity, λ0 i, based on assuming that around any singled-out ion i in solution, there is an electrostatic atmosphere that includes oriented solvent dipoles and the counterion as 'charge density'. This leads to a simple mathematical expression for λ0 i as the result of the tandem operation of the dipole viscosity and dipole relaxation forces on the drifting ion. Contrary to literature teaching, λ0 i is found proportional to the effective ionic radius, ri. An 'electric ion-radius scale' derived from experimental λ0 i's for aqueous solutions, compares reasonably well with known ion-size scales. A newly defined solvent-specific dipole random-walk correction factor, ξ, is used for nonaqueous solvents as an adjustable parameter, to attain a parallel electric ion-size scale. The new theory provides overall a comprehensive view of the limiting ion mobility in solution, based on the ionic properties, solvent variables and universal constants. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate predictors of low thyroid‐stimulating hormone (TSH) persisting beyond the first trimester and associated pregnancy outcomes. Methods: We retrospectively assessed the association between low first‐trimester TSH and obstetric outcomes of singleton pregnancies in southern Israel between 2001 and 2011. We included women with first‐trimester TSH and at least one other THS measurement. Clinical data were from maternity and community medical records. Results: Among 3761 women, 185 (4.9%) had a TSH of 0.10 mIU/L or less in the first trimester. Multiple of the median human chorionic gonadotropin was higher in women with TSH of 0.40 mIU/L or less versus 0.41–4.0 mIU/L, but was not associated with higher rates of persistent low TSH. Maternal age (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.00–1.16; per yearly increment), free thyroxine (FT4; OR 1.11, 95% CI 1.03–1.20; per ng/dL increment), and TSH of 0.10 mIU/L or less (OR 3.06, 95% CI 1.38–6.80 vs 0.21–0.40 mIU/L) were independent predictors of persistent low TSH. No adverse pregnancy outcomes occurred in women with low first‐trimester TSH. Conclusions: Low TSH persisting beyond the first trimester was more common with increasing maternal age, elevated FT4, and TSH below 0.10 mIU/L, but was not associated with obstetric complications. [ABSTRACT FROM AUTHOR]

We analyze a natural generalization, W , of the infinite Fibonacci word over the alphabet Σ = { a , b } . We provide tools to represent explicitly the set { s ∈ Z ≥ 0 : W ( s ) = b , W ( s + x ) = a } for any fixed positive integer x . We show how this representation can be used to analyze the preservation of P -positions of any game whose P -positions are a pair of complementary Beatty sequences, in particular a certain generalization of Wythoff Nim (Holladay, 1968; Fraenkel, 1982). [ABSTRACT FROM AUTHOR]

We describe a ruleset for a 2-pile subtraction game with P-positions {(⌊αn⌋,⌊βn⌋):n∈Z≥0} for any irrational 1<α<2, and β such that 1/α+1/β=1. We determine the α’s for which the game can be represented as a finite modification of t-Wythoff (Holladay, Math Mag 41:7-13, 1968; Fraenkel, Am Math Mon 89(6):353-361, 1982) and describe this modification. [ABSTRACT FROM AUTHOR]

Introduction/Aims: Amyotrophic lateral sclerosis (ALS), a motor neuron disease, remains a clinical diagnosis with an average time from onset of symptoms to diagnosis of about 1 year. Herein we examine the possibility that interactions with an internet search engine can identify people with ALS. Methods: We identified 285 anonymous Bing users whose queries indicated that they had been diagnosed with ALS and matched them to: (1) 3276 control users; and (2) 1814 users whose searches indicated they had ALS disease mimics. We tested whether the ALS group could be distinguished from controls and disease mimics based on search engine query data. Finally, we conducted a prospective validation from participants who provided access to their Bing search data. Results: The model distinguished between the ALS group and controls with an area under the curve (AUC) of 0.81. Model scores for the ALS group differed from the disease mimics group (rank sum test, p <.05 with Bonferroni correction). Mild cognitive impairment could not be distinguished from ALS (p >.05). In the prospective analysis, the model reached an AUC of 0.74. Discussion: Our results suggest that interactions with search engines should be further studied to understand the potential to act as a tool to assist in screening for ALS and to reduce diagnostic delay. [ABSTRACT FROM AUTHOR]

The physical essence of the limiting equivalent ionic conductivity in solution, λ0i, has been a continuing challenge over almost a century. Here I briefly present anab initiotheoretical treatment providing (1) a new insight into the nature of λ0i, and (2) a mathematical formula for computing λ0i. In the new treatment, one assumes that any chosen ioniis surrounded by a spherical body of oriented solvent dipoles carrying the charge of the counterion, and the bulk solvent is a continuum with no molecular detail. λ0iis thus the result of the tandem operation, at hydrodynamic equilibrium, of the dipole body's electrophoretic and relaxation forces exerted on the drifting ion. λ0iis found to be proportional to the radius of ioni, and independent of the ionic charge. From experimental λ0i's, the ion radius can be computed as ‘electric radius.’ An electric ion-radius scale so derived compares well with other ion-size scales. The current theory expresses λ0iusing only universal constants and unitary factors of the ionic solution, and it sheds new light on the fundamental nature of ion and charge transport in a polar liquid medium. [ABSTRACT FROM PUBLISHER]

Around the turn of the century, political developments in Northern Ireland, Fiji and Papua New Guinea encouraged claims that preferential voting systems could steer polities in the direction of ‘moderate’ multi-ethnic government. Sixteen years later, we have a longer time period and larger volume of data to reassess these verdicts. This article investigates ballot transfer and party vote–seat share patterns in the seven deeply divided polities with some experience of preferential voting for legislative elections or direct presidential elections (Northern Ireland, Fiji, Papua New Guinea, Estonia, Sri Lanka, Bosnia-Herzegovina and Southern Rhodesia). We find little support for centripetalist claims that such systems encourage ‘moderate’ parties. We argue that where district magnitude is low, where voters are required to rank preferences and where ticket voting prevails, departures from vote–seat proportionality may favour ‘moderate’ parties, but such heavily engineered systems may simply advantage the larger parties or yield erratic outcomes. [ABSTRACT FROM PUBLISHER]