Search

At the 2023 International Society for Traumatic Stress Studies annual meeting, a panel of three distinguished investigators and clinicians convened to reflect on their careers, their contributions to the field of traumatic stress disorders, and the lessons learned over the years. Dr. Terence M. Keane has guided the development and deployment of evidence‐based care, shaping evaluation guidelines and best treatment practices for traumatic stress pathology. Dr. Sheila Rauch, a pioneer in the development of prolonged exposure therapy, has significantly contributed to the treatment of posttraumatic stress disorder (PTSD) and other traumatic stress disorders. Dr. Richard Bryant has developed targeted psychological treatments for traumatic stress and prolonged grief, adapting to the diverse needs, mechanisms, and cultural contexts of patients. These individuals’ collective experiences span from the establishment of the PTSD diagnosis to the current proliferation of scientific knowledge on its epidemiology, assessment, and treatment. Their unique yet overlapping contributions have provided invaluable guidelines for the next generation of clinicians and investigators. This panel discussion offers a retrospective look at their careers and a forward‐looking perspective on the future of traumatic stress treatment. [ABSTRACT FROM AUTHOR]

Segmental tunnel linings have a complex structural behavior that is difficult to predict. Full-scale in situ structural monitoring allows us to gain access to these structures, observe the acting mechanisms, and better understand the actual structural behavior under realistic boundary conditions. In a recent structural monitoring project in Frankfurt, Germany, strains, deformations, and temperatures were measured at the segmental lining of a twin-tube tunnel boring machine (TBM) tunnel. Hereby, internal forces were back-calculated from the strain measurements. The results of the monitoring are presented and discussed in this paper. The measurements began immediately after the assembly of the segments and have been performed continuously over several years. Because of that, it was possible to observe that the internal forces differ significantly between the construction stage and the final state. During the construction stage, the internal forces develop quickly within hours after ring assembly, showing a distribution along the lining's circumference that is hard to predict. Almost all radial deformations occur during this period and remain unchanged afterward. After this first early phase, a period of stress redistribution follows, including significant changes in the internal forces. At its end, the stable, final state is reached. In this state, the internal forces match better with expectations. In the monitored areas, the stresses during the construction stage slightly exceeded those of the final state, which should be avoided for economic reasons. Additional investigations regard the temperature development within the lining, the influence of the second tube construction on the already built tube, and the development of longitudinal ring interaction over time. The latter significantly influences the structural behavior, but its development is often subject to uncertainties. In this case, it was observed that the longitudinal interaction decreases considerably over time. Practical Applications: In the structural design of segmental tunnel linings, structural or geotechnical engineers have various options regarding the available calculation methods and modeling strategies. All of these options are part of the state of the art, and the selection is up to the engineer. However, the results can be quite different depending on the chosen option. Consequently, uncertainties remain regarding the real linings' internal forces and structural reliability. The actual mechanisms can be identified by investigating the real structural behavior of segmental tunnel linings with in situ structural monitoring. Then, with back-analyses, on the one hand, it can be tested to determine how well different calculation methods and modeling strategies correspond to reality. On the other hand, the monitoring data can contribute to improving existing calculation methods, developing new modeling approaches, and establishing more detailed recommendations or optimizations regarding the design and construction of segmental tunnel linings. This paper presents findings derived from a structural monitoring project on a segmental lining. Different mechanisms and aspects, sometimes uncertain or debatable in tunnel design, are discussed regarding their real in situ appearance. The gained data will also be used for further back-analyses and investigations. [ABSTRACT FROM AUTHOR]

Load‐bearing and fatigue behaviour of butt welds in plates of different thicknesses The cross‐section of long‐span steel structures is usually adapted to the bending moment distribution. For this purpose, a thickness transition is applied in the area of butt‐welded joints in flanges of I‐shaped beam members. The fatigue behaviour of these constructional details is complex and differs from a butt‐welded joint in steel plates of the same thickness. This paper presents the results of 30 notch detail tests and compares the behaviour of butt‐welded joints in plates with a thickness transition with those of the same thickness. The statistical analysis of the experimental studies shows a higher fatigue resistance for butt‐welded joints with a thickness transition compared to butt welds of plates of the same thickness. The classification of the latter constructional detail in detail category 90 acc. to FprEN1993‐1‐9:2024 can be confirmed. The prognosis of the notch detail tests with the Two‐Stage‐Model confirms its applicability for the analytical‐numerical prediction of the service life of complex welded constructional details. In addition, the application of the model proves the influence of the thickness ratio and stress ratio on the service life of butt‐welded joints with thickness transition. [ABSTRACT FROM AUTHOR]

The article focuses on the limitations of the New York Times v. Sullivan decision in protecting democratic efficacy, arguing that the defamation tort primarily addresses the harm of democratic disempowerment rather than merely personal dignity. Topics include the inherent flaws in Sullivan's balance between free speech and defamation, the current impact of these flaws on democratic participation, and potential reforms to better protect both free expression and democratic engagement.

This article aims to contribute to the analysis of the processes of school attachment and disengagement of young people in secondary schools in the context of the pandemic, highlighting the family socioeconomic level in which the young people in this study are embedded. School connection is the subject of extensive debates in our country, mainly since the expansion of the Right to Education where compulsory schooling extends to the secondary level. The pandemic has impacted education in multiple ways, making school engagement one of the main focuses of attention when looking at school trajectories. Preliminary findings from an ongoing investigation are presented below: "School dropout in secondary school: an investigation into the networks of events and experiences in the processes of school interruptions with secondary school youth"; which aims to contribute to knowledge about educational problems in secondary schools in the context of the pandemic. [ABSTRACT FROM AUTHOR]

Background: Although macrophages are now recognized as an essential part of the HIV latent reservoir, whether and how viral latency is established and reactivated in these cell types is poorly understood. To understand the fundamental mechanisms of viral latency in macrophages, there is an urgent need to develop latency models amenable to genetic manipulations and screening for appropriate latency-reversing agents (LRAs). Given that differentiated THP-1 cells resemble monocyte-derived macrophages in HIV replication mechanisms, we set out to establish a macrophage cell model for HIV latency using THP-1 cells. Methods: We created single-cell clones of THP-1 cells infected with a single copy of the dual-labeled HIVGKO in which a codon switched eGFP (csGFP) is under the control of the HIV-1 5' LTR promoter, and a monomeric Kusabira orange 2 (mKO2) under the control of cellular elongation factor one alpha promoter (EF1α). Latently infected cells are csGFP−, mKO2+, while cells with actively replicating HIV (or reactivated virus) are csGFP+,mKO2+. After sorting for latently infected cells, each of the THP-1 clones with unique integration sites for HIV was differentiated into macrophage-like cells with phorbol 12-myristate 13-acetate (PMA) and treated with established LRAs to stimulate HIV reactivation. Monocyte-derived macrophages (MDMs) harboring single copies of HIVGKO were used to confirm our findings. Results: We obtained clones of THP-1 cells with latently infected HIV with unique integration sites. When the differentiated THP-1 or primary MDMs cells were treated with various LRAs, the bromodomain inhibitors JQ1 and I-BET151 were the most potent compounds. Knockdown of BRD4, the target of JQ1, resulted in increased reactivation, thus confirming the pharmacological effect. The DYRK1A inhibitor Harmine and lipopolysaccharide (LPS) also showed significant reactivation across all three MDM donors. Remarkably, LRAs like PMA/ionomycin, bryostatin-1, and histone deacetylase inhibitors known to potently reactivate latent HIV in CD4 + T cells showed little activity in macrophages. Conclusions: Our results indicate that this model could be used to screen for appropriate LRAs for macrophages and show that HIV latency and reactivation mechanisms in macrophages may be distinct from those of CD4 + T cells. [ABSTRACT FROM AUTHOR]

The article "Health Data Utilization Act: The Conflict between Data Protection and Data Usage" deals with the conflict between data protection and the use of health data. The law on improved use of health data in Germany aims to improve digital healthcare and research and create legal certainty. However, there are still challenges due to different nationwide regulations on health data usage in hospitals. Collaboration with data protection authorities and strengthening health data protection are also important factors. The article discusses the Health Data Utilization Act (GDNG) and the associated challenges in dealing with hospital data. It argues that the regulations for hospitals should be clearer, as the legal uncertainty is multiplied by the responsibility of around 100 institutions for data protection. It also addresses the differences between pseudonymization and anonymization of data and emphasizes the importance of a clear definition of legitimate interests for anonymization. The article also mentions the criminal prosecution of re-identification attempts and the need for further criminal procedural regulations to protect health data. It argues that the new regulation of § 25b SGB V exceeds medical competencies and could lead to discrimination. The possibility of objecting to data processing is also mentioned. It is suggested to conduct a pilot project with medical self-administration to verify the reliability of the data. The need for clear regulations for particularly sensitive data is emphasized. Overall, it is argued that data protection has been insufficiently considered in the implementation of the law. The article also addresses the risks to the protection goal of confidentiality in connection with criminal energy and artificial intelligence. It emphasizes that transparent and open collaboration with all stakeholders, as well as careful consideration of these risks, are necessary to achieve the desired health policy goal. The opt-out solution is proposed as a possible compromise to involve patients. Furthermore, the joinder of parties in medical liability proceedings is discussed as a means of securing subsequent claims. [Extracted from the article]

In this paper we study the role of within‐city roads layout in fostering city growth. Within‐city roads networks have not been studied extensively in economics although they are essential to facilitate human interactions, which are at the core of agglomeration economies. We build and compute several simple measures of roads network and construct a sample of over 1800 cities and towns from Sub‐Saharan Africa. Using a simple econometric model and two instrumental variable strategies based on the history of African cities, we then estimate the causal impact of within‐city roads layout on urban growth. We find that over the recent decades, cities with greater road density and road evenness in the centre grew faster. [ABSTRACT FROM AUTHOR]

Hydrogen is a versatile energy vector for a plethora of applications; nevertheless, its production from waste/residues is often overlooked. Gasification and subsequent conversion of the raw synthesis gas to hydrogen are an attractive alternative to produce renewable hydrogen. In this paper, recent developments in R&D on waste gasification (municipal solid waste, tires, plastic waste) are summarised, and an overview about suitable gasification processes is given. A literature survey indicated that a broad span of hydrogen relates to productivity depending on the feedstock, ranging from 15 to 300 g H2/kg of feedstock. Suitable gas treatment (upgrading and separation) is also covered, presenting both direct and indirect (chemical looping) concepts. Hydrogen production via gasification offers a high productivity potential. However, regulations, like frame conditions or subsidies, are necessary to bring the technology into the market. [ABSTRACT FROM AUTHOR]

Dealing with a mass casualty incident presents many challenges in the clinical and preclinical situation. There are various systems and structures to address this problem. In the present work, the management of the train accident near Garmisch-Partenkirchen on 3 June 2022 is evaluated with the aid of the recommendations of the Federal Office for Civil Protection and Disaster Relief for hospital alarm and deployment planning as well as the recommendations from the terror and disaster surgical care training of the German Academy of Trauma Surgery and the findings are presented from the perspective of a regional trauma center. It also discusses which key factors in the present case have proved to be successful and in which areas there is still a need for improvement. [ABSTRACT FROM AUTHOR]

One therapeutical alternative in the treatment of functional disorders is the use of printed oral splints. The mechanical properties of these materials are highly essential to their clinical effectiveness, and their performance may vary depending on factors such as cleaning, post-polymerization, or their orientation during construction. The objective of this in vitro investigation is to evaluate the effectiveness of the selected materials in terms of their biaxial flexural strength in relation to the criteria listed above. Splint materials were used in the printing of 720 discs. The printing process was carried out in different orientations in relation to the building platform. Either an automatic or manual cleaning process was performed on the samples. For post-polymerization, either an LED or Xenon light was utilized. A piston-on-three-ball test was used to measure the biaxial flexural strength (BFS) of the materials after they were stored in water for either 24 h or 60 days. The homogeneity of the data was controlled by employing the Levene method, and the differences between the groups were analyzed using the ANOVA and Bonferroni methods. After being stored for twenty-four hours, the mean BFS ranged anywhere from 79 MPa to 157 MPa. Following a period of sixty hours, the BFS exhibited a substantial drop and revealed values that ranged from 72 to 127 MPa. There was no significant difference that could be identified between the materials or between the various cleaning processes. The results of post-polymerization showed that the LED light produced higher means than the Xenon light did. In terms of position, the mean values varied greatly, with 0°'s mean value being 101 MPa, 45°'s mean value being 102 MPa, and 90°'s mean value being 115 MPa. The use of a build orientation of 90° and post-polymerization with LED light resulted in significantly increased biaxial flexural strength. According to this study, this design should be implemented in order to ensure that splint materials have the highest possible strength. [ABSTRACT FROM AUTHOR]

The stability of Reissner–Nördstrom black holes with an extremal mass–charge relation was determined by calculating the propagation speed of gravitational waves on this background in an effective field theory (EFT) of gravity. New results for metric components are shown, along with the corresponding new extremal relation, part of which differs by a global factor of 2 from the past published work. This new relation further develops the existing constraints on EFT parameters. The radial propagation speed for gravitational waves in the Regge–Wheeler gauge was calculated linearly for all perturbations, yielding exact luminality for all dimension-4 operators. The dimension-6 radial speed modifications introduce no constraints on the sign of the modified theory parameters from causality arguments, while the deviation from classical theories vanishes at both horizons. The angular speed was found to be altered for the dimension-4 operators, with possible new constraints on the modified theory being suggested from causality arguments. Results are consistent with existing literature on Schwarzschild black hole backgrounds, with some EFT terms becoming active only in non-vacuum spacetimes such as Reissner–Nördstrom black holes. [ABSTRACT FROM AUTHOR]

Background: Sample size calculation is a central aspect in planning of clinical trials. The sample size is calculated based on parameter assumptions, like the treatment effect and the endpoint's variance. A fundamental problem of this approach is that the true distribution parameters are not known before the trial. Hence, sample size calculation always contains a certain degree of uncertainty, leading to the risk of underpowering or oversizing a trial. One way to cope with this uncertainty are adaptive designs. Adaptive designs allow to adjust the sample size during an interim analysis. There is a large number of such recalculation rules to choose from. To guide the choice of a suitable adaptive design with sample size recalculation, previous literature suggests a conditional performance score for studies with a normally distributed endpoint. However, binary endpoints are also frequently applied in clinical trials and the application of the conditional performance score to binary endpoints is not yet investigated. Methods: We extend the theory of the conditional performance score to binary endpoints by suggesting a related one-dimensional score parametrization. We moreover perform a simulation study to evaluate the operational characteristics and to illustrate application. Results: We find that the score definition can be extended without modification to the case of binary endpoints. We represent the score results by a single distribution parameter, and therefore derive a single effect measure, which contains the difference in proportions p I - p C between the intervention and the control group, as well as the endpoint proportion p C in the control group. Conclusions: This research extends the theory of the conditional performance score to binary endpoints and demonstrates its application in practice. [ABSTRACT FROM AUTHOR]

Automated fiber placement is a state-of-the-art manufacturing method which allows for precise control over layup design. However, AFP results in irregular morphology due to fiber tow deposition induced features such as tow gaps and overlaps. Factors such as the squeeze flow and resin bleed out, combined with large non-linear deformation, lead to morphological variability. To understand these complex interacting phenomena, a coupled multiphysics finite element framework was developed to simulate the compaction behavior around fiber tow gap regions, which consists of coupled chemo-rheological and flow-compaction analysis. The compaction analysis incorporated a visco-hyperelastic constitutive model with anisotropic tensorial prepreg viscosity, which depends on the resin degree of cure and local fiber orientation and volume fraction. The proposed methodology was validated using the compaction of unidirectional tows and layup with a fiber tow gap. The proposed approach considered the effect of resin bleed out into the gap region, leading to the formation of a resin-rich pocket with a complex non-uniform morphology. [ABSTRACT FROM AUTHOR]

Maxwell or concomitant fields imprint additional phases on the transverse magnetization. This concomitant phase may cause severe image artifacts like signal voids or distort the quantitative parameters due to the induced intravoxel dephasing. In particular, double diffusion encoding (DDE) schemes with two pairs of bipolar diffusion-weighting gradients separated by a refocusing radiofrequency (RF) pulse are prone to concomitant field-induced artifacts. In this work, a method for reducing concomitant field effects in these DDE sequences based on additional oscillating gradients is presented. These oscillating gradient pulses obtained by constrained optimization were added to the original gradient waveforms. The modified sequences reduced the accumulated concomitant phase without significant changes in the original sequence characteristics. The proposed method was applied to a DDE acquisition scheme consisting of 60 pairs of diffusion wave vectors. For phantom as well as for in vivo experiments, a considerable increase in the signal-to-noise ratio (SNR) was obtained. For phantom measurements with a diffusion weighting of b = 2000 s/mm2 for each of the gradient pairs, an SNR increase of up to 40% was observed for a transversal slice that had a distance of 5 cm from the isocenter. For equivalent slice parameters, in vivo measurements in the brain of a healthy volunteer exhibited an increase in SNR of up to 35% for b = 750 s/mm2 for each weighting. These findings are supported by corresponding simulations, which also predict a positive effect on the SNR. In summary, the presented method leads to an SNR gain without additional RF refocusing pulses. • Proposes a novel method for concomitant field effect reduction for double diffusion encoding. • Demonstrates a positive effect on the SNR in phantom and in vivo. • Reveals importance for clinical high-amplitude gradient systems. [ABSTRACT FROM AUTHOR]

BACKGROUND Patient-reported outcome measures (PROMs) are valuable in understanding patient motivations, setting expectations, and ensuring satisfaction. As the aesthetic industry expands globally, factors that motivate the treatment goals of the aesthetic patient reflect evolving social, cultural, and commercial influences. OBJECTIVE This article will assess the applicability of current PROMs used in aesthetic medicine to an increasingly diverse patient population and consider their ability to measure the underlying motives that drive different types of patients to pursue their specific goals. METHODS PubMed database was searched for studies using PROMs to evaluate the motivations and expectations of aesthetic patients. RESULTS Seven validated aesthetic PROM tools were reviewed against a backdrop of different patient segments as represented by the 4 patient archetypes: Positive Aging, Beautification, Correction, and Transformation. None of the tools could universally represent the individual motivations and expectations of all 4 patient archetypes. CONCLUSION There is a need for updated PROMs in aesthetics that are applicable to patients with different motivations or expected outcomes than the traditional rejuvenation patient. PROMs that help decode patient motivations and that are developed with more diverse patient involvement will help aesthetic clinicians better understand the goals and expectations of new patient segments. [ABSTRACT FROM AUTHOR]

Cancer cells often adapt to targeted therapies, yet the molecular mechanisms underlying adaptive resistance remain only partially understood. Here, we explore a mechanism of RAS/RAF/MEK/ERK (MAPK) pathway reactivation through the upregulation of RAF isoform (RAFs) abundance. Using computational modeling and in vitro experiments, we show that the upregulation of RAFs changes the concentration range of paradoxical pathway activation upon treatment with conformation-specific RAF inhibitors. Additionally, our data indicate that the signaling output upon loss or downregulation of one RAF isoform can be compensated by overexpression of other RAF isoforms. We furthermore demonstrate that, while single RAF inhibitors cannot efficiently inhibit ERK reactivation caused by RAF overexpression, a combination of two structurally distinct RAF inhibitors synergizes to robustly suppress pathway reactivation. [ABSTRACT FROM AUTHOR]

Inclusion of urea in dairy cattle diets is often limited by negative effects of high levels of feed urea on dry matter intake (DMI) and efficiency of rumen N utilization. We hypothesized that supplying urea postruminally would mitigate these limitations and allow greater inclusion of urea in dairy cattle diets. Four rumen-fistulated Holstein-Friesian dairy cows (7 ± 2.1 lactations, 110 ± 30.8 d in milk; mean ± standard deviation) were randomly assigned to a 4 × 4 Latin square design to examine DMI, milk production and composition, digestibility, rumen fermentation, N balance, and plasma constituents in response to 4 levels of urea continuously infused into the abomasum (0, 163, 325, and 488 g/d). Urea doses were targeted to linearly increase the crude protein (CP) content of total DMI (diet plus infusion) by 0%, 2%, 4%, and 6% and equated to 0%, 0.7%, 1.4%, and 2.1% of expected DMI, respectively. Each 28-d infusion period consisted of a 7-d dose step-up period, 14 d of adaptation, and a 7-d measurement period. The diet was fed ad libitum as a total mixed ration [10.9% CP, 42.5% corn silage, 3.5% grass hay, 3.5% wheat straw, and 50.5% concentrate (dry matter basis)] and was formulated to meet 100%, 82%, and 53% of net energy, metabolizable protein, and rumen-degradable protein requirements, respectively. Linear, quadratic, and cubic effects of urea dose were assessed using polynomial regression assuming the fixed effect of treatment and random effects of period and cow. Dry matter intake and energy-corrected milk yield responded quadratically to urea dose, and milk urea content increased linearly with increasing urea dose. Apparent total-tract digestibility of CP increased linearly with increasing urea dose and ruminal NH 3 -N concentration responded quadratically to urea dose. Mean total VFA concentration was not affected by urea dose. The proportion of N intake excreted in feces decreased linearly and that excreted in urine increased linearly in response to increasing urea dose. The proportion of N intake excreted in milk increased linearly with increasing urea dose. Urinary urea excretion increased linearly with increasing urea dose. Microbial N flow responded cubically to urea dose, but the efficiency of microbial protein synthesis was not affected. Plasma urea concentration increased linearly with increasing urea dose. Regression analysis estimated that when supplemented on top of a low-CP diet, 179 g/d of postruminal urea would maximize DMI at 23.4 kg/d, corresponding to a dietary urea inclusion level of 0.8% of DMI, which is in line with the current recommendations for urea inclusion in dairy cattle diets. Overall, these results indicate that postruminal delivery of urea does not mitigate DMI depression as urea dose increases. [ABSTRACT FROM AUTHOR]

The prediction of the structural behavior and the internal forces acting in segmental tunnel linings is a difficult task and contains uncertainties. In situ measurements within structural monitoring are the only possibility to assess the results under realistic boundary conditions. However, no standardized structural monitoring method for segmented lining exists and consequentially setting up a new monitoring project requires an increased effort. Therefore, in this paper, first, an analysis of experiences in reported monitoring projects is done. Then, a report on a current monitoring project carried out by the authors and the experiences made are presented. Based on these, suggestions are given to facilitate future applications of structural monitoring on segmental tunnel linings regarding conceptualization, instrumentation, installation, operation, and data evaluation. [ABSTRACT FROM AUTHOR]

Fexofenadine hydrochloride (HCl) is a second‐generation, nonsedating, histamine H1‐receptor antagonist used to manage seasonal allergic rhinitis and chronic idiopathic urticaria. A new oral pediatric suspension of fexofenadine HCl has been developed, with the preservative potassium sorbate replacing parabens. The objective of this phase 1 single‐center, open‐label, randomized, 2‐treatment, full‐replicated, 4‐period, 2‐sequence crossover study in healthy adult volunteers was to assess the bioequivalence of 30 mg of the new oral suspension of fexofenadine HCl (test) versus 30 mg of the marketed pediatric oral suspension of fexofenadine HCl (reference). The replicate design was based on the high intra‐individual variability of fexofenadine (>30% on Cmax). The study comprised 68 randomized and treated volunteers. Plasma concentrations of fexofenadine were similar following the administration of a single dose of each formulation. Cmax, AUClast, AUC, median tmax, and mean t1/2z were similar between administrations of the same fexofenadine formulation and between formulations. A high intra‐individual variability was confirmed with both formulations. Bioequivalence of the test and reference fexofenadine HCl formulations was demonstrated as the 90% confidence intervals of the geometric least squares mean ratio for Cmax, AUClast, and AUC of fexofenadine were all within the bioequivalence range of 0.80‐1.25. There were no serious adverse events (AEs) or study discontinuations due to treatment‐emergent AEs with either fexofenadine HCl formulation. The new paraben‐free fexofenadine HCl 30‐mg oral suspension and marketed fexofenadine HCl 30‐mg pediatric oral suspension are bioequivalent under fasting conditions, with no safety concerns and a safety profile consistent with the known profile of fexofenadine. [ABSTRACT FROM AUTHOR]

Though bullying is a near universal experience for middle school students at some point, LGBTQ + students experience additional stress and poorer academic outcomes than their peers do. This qualitative study interviewed six middle school principals from rural, suburban and urban schools. Data collection for this study included two semi-structured interviews over a four-month period. Data analysis included a constant comparative method using minority stress prior-research themes. Principals noted that many of the LGBTQ + students experienced prejudice and stigma. They also stated, that some of the LGBTQ + concealed their identity and at times internalized their phobias. [ABSTRACT FROM AUTHOR]

Structural monitoring strategies contributing to a realistic assessment and surveillance of engineering structures – experiences from research and practice Structural monitoring allows for capturing the actual load‐bearing behavior of engineering structures and their realistic assessment and surveillance. Various technical and organizational aspects must be considered for a successful application of structural monitoring. These include the preparation and conceptual design of the monitoring, the calibration and validation of the measurements, the installation and operation of the measurement system, as well as the data evaluation and analysis. These aspects will be discussed based on experiences from research and practice, and consequential recommendations will be given. The application possibilities of structural monitoring are presented with four examples. [ABSTRACT FROM AUTHOR]

To develop a clinical model to predict the risk of an individual patient developing delirium during inpatient rehabilitation, based on patient characteristics and clinical data available on admission. Retrospective observational study based on electronic health record data. We studied a previously validated data set of inpatients including incident delirium episodes during rehabilitation. These patients were admitted to ZURZACH Care, Rehaklinik Bad Zurzach, a Swiss inpatient rehabilitation clinic, between January 1, 2015, and December 31, 2018. We performed logistic regression analysis using backward and forward selection with alpha = 0.01 to remove any noninformative potential predictor. We subsequentially used the Akaike information criterion (AIC) to select the final model among the resulting "intermediate" models. Discrimination of the final prediction model was evaluated using the C-statistic. Of the 20 candidate predictor variables, 6 were included in the final prediction model: a linear spline of age with 1 knot at 60 years and a linear spline of the functional independence measure (FIM), a measure of the functional degree of patients independency, with 1 knot at 64 points, diagnosis of disorders of fluid, electrolyte, and acid-base balance (E87), use of other analgesic and antipyretics (N02B), use of anti-parkinson drugs (N04B), and an anticholinergic burden score (ACB) of ≥3 points. Our clinical prediction model could, upon validation, identify patients at risk of incident delirium at admission to inpatient rehabilitation, and thus enable targeted prevention strategies. [ABSTRACT FROM AUTHOR]

We investigate the state complexity of languages resulting from the cascade product of two minimal deterministic finite automata with  n and  m states, respectively. More precisely we study the magic number problem of the cascade product operation and show what range of complexities can be produced in case the left automaton is unary, that is, has only a singleton letter alphabet. Here we distinguish the cases when the involved automata are reset automata, permutation automata, permutation-reset automata, or do not have any restriction on their structure. It turns out that the picture on the obtained state complexities of the cascade product is diverse, and for all cases, except where the left automaton is a unary permutation(-reset) or a deterministic finite automaton without structural restrictions, and the right one is a reset automaton or a deterministic finite automaton without structural restrictions, we are able to identify state sizes that cannot be reached — these numbers are called "magic." [ABSTRACT FROM AUTHOR]

Introduction: Despite high cost and wide prevalence of posttraumatic stress disorder (PTSD) in veteran populations, and Veterans Health Administration (VA)-wide mental health provider training in evidence-based treatments for PTSD, most veterans with PTSD do not receive best practices interventions. This may be because virtually all evidence-based PTSD treatment is offered through specialty clinics, which require multiple steps and referrals to access. One solution is to offer PTSD treatment in VA primary care settings, which are often the first and only contact point for veterans. Method: The present study, Improving Function Through Primary Care Treatment of PTSD (IMPACT), used a randomized controlled design to compare an adaptation of prolonged exposure for PTSD to primary care (PE-PC) versus best practices Primary Care Mental Health Integration (PCMHI) clinic treatment as usual (TAU) in terms of both functioning and psychological symptoms in 120 veterans recruited between April 2019 and September 2021. Results: Participants were mostly males (81.7%) with a mean age of 43.6 years (SD = 12.8), and more than half were non-White veterans (50.8%). Both conditions evinced significant improvement over baseline across functioning, PTSD, and depression measures, with no differences observed between groups. As observed in prior studies, PTSD symptoms continued to improve over time in both conditions, as measured by structured clinical interview. Discussion: Both PE-PC and best-practices TAU are effective in improving function and reducing PTSD severity and depression severity. Although we did not observe differences between the two treatments, note that this study site and two PCMHI clinics employ primarily cognitive behavioral therapies (e.g., exposure and behavioral activation). Public Significance Statement: Veterans with posttraumatic stress disorder (PTSD) can be effectively treated in the primary care setting. Specifically, veterans who received either prolonged exposure for primary care or usual Veterans Health Administration-integrated primary care showed reductions in PTSD and improvement in PTSD function. [ABSTRACT FROM AUTHOR]

Development of the fast model of phase transformations in the Pyrowear 53 steel was the objective of the paper. An upgrade of the JMAK (Johnson–Mehl–Avrami–Kolmogorov) was proposed. Coefficients in the model were introduced as modified Gauss functions of the temperature. Changes in the carbon and molybdenum concentrations due to precipitation were accounted for. Dilatometric tests were carried out across a wide range of cooling rates. Identification of the model was performed using inverse analysis for the results of these tests. Three austenitization cycles prior to transformations were applied and an influence of the grain size on the nucleation and kinetics of phase transformations was accounted for in the model. All the tests were carried out on the core samples with the nominal chemical composition and on the carburized samples. Numerical tests confirmed the good accuracy of the model for both compositions in the whole investigated range of the grain size. [ABSTRACT FROM AUTHOR]

The author explores the associations among science, women and the idea of translating scientific thinking for 19th century readers. Topics discussed include the recognition of women translators who translate complex ideas in science and culture, the success of writer and poet Elizabeth Carter as a translating pioneer, and the role of women translators as mediator of scientific thought including scientist and writer Mary Somerville, poet and author Helen Maria Williams and Thomasina Ross.

Simple Summary: Quantitative image analysis of cancers requires accurate tumor segmentation that is often performed manually. In this study, we developed a deep learning model with a self-configurable nnU-Net for fully automated tumor segmentation on serially acquired dynamic contrast-enhanced MRI images of triple-negative breast cancer. In an independent testing dataset, our nnU-Net-based deep learning model performed automated tumor segmentation with a Dice similarity coefficient of 93% and a sensitivity of 96%. Accurate tumor segmentation is required for quantitative image analyses, which are increasingly used for evaluation of tumors. We developed a fully automated and high-performance segmentation model of triple-negative breast cancer using a self-configurable deep learning framework and a large set of dynamic contrast-enhanced MRI images acquired serially over the patients' treatment course. Among all models, the top-performing one that was trained with the images across different time points of a treatment course yielded a Dice similarity coefficient of 93% and a sensitivity of 96% on baseline images. The top-performing model also produced accurate tumor size measurements, which is valuable for practical clinical applications. [ABSTRACT FROM AUTHOR]

Chipping of implant-supported molar crowns (iSCs) is a frequently reported complication. This study aimed to investigate the in-vitro aging and fracture resistance of iSCs with a CAD/CAM resin composite veneer structure fabricated with the Rapid Layer Technology (RLT) approach. Eight iSCs per group were fabricated by using two different CAD/CAM resin composites (Shofu Block HC: SH; Grandio blocs: GB) for veneer structures, and zirconia (ZrO2), polyetheretherketone (PEEK), and cobalt–chromium (CoCr; control) as framework materials. The surfaces to be bonded were sandblasted, cleaned in an ultrasonic bath, and a coupling agent was applied. A self-adhesive resin luting composite was used to adhesively lute the veneer structures to the frameworks. The crowns were semi-permanently cemented to the abutments. After storage in deionized water, iSCs were loaded in a chewing simulator (TCML, 10,000 thermal cycles 5 °C to 55 °C for 20 s, 1.2 million, loading force 50 N). Four ZrO2 and one CoCr crown did not survive the TCML. The fracture force was determined after 24 h storage in deionized water and yielded values of ≥974 N. Lowest fracture forces were yielded in the PEEK-SH group in comparison to CoCr or ZrO2 groups (p ≤ 0.031). For identical framework materials, no significant influence of the veneering material was observed. All PEEK-GB frameworks fractured, and chipping occurred for ZrO2-SH and all CoCr frameworks. PEEK-SH and ZrO2-GB presented both chipping and framework fractures. Within the limitations of this in-vitro study, the RLT with a CAD/CAM resin composite veneer structure might be a promising approach to veneer iSCs. Yet, the choice of the CAD/CAM resin composite and of the framework material determine the fracture resistance. [ABSTRACT FROM AUTHOR]

The role and method of image-based staging of anal cancer has evolved with the rapid development of newer imaging modalities and the need to address the rising incidence of this rare cancer. In 2014, the European Society of Medical Oncology mandated pelvic magnetic resonance imaging (MRI) for anal cancer and subsequently other societies such as the National Comprehensive Cancer Network followed suit with similar recommendations. Nevertheless, great variability exists from center to center and even within individual centers. Notably, this is in stark contrast to the imaging of the anatomically nearby rectal cancer. As participating team members for this malignancy, we embarked on a comprehensive literature review of anal cancer imaging to understand the relative merits of these new technologies which developed after computed tomography (CT), e.g., MRI and positron emission tomography/computed tomography (PET/CT). The results of this literature review helped to inform our next stage: questionnaire development regarding the imaging of anal cancer. Next, we distributed the questionnaire to members of the Society of Abdominal Radiology (SAR) Rectal and Anal Disease-Focused Panel, a group of abdominal radiologists with special interest, experience, and expertise in rectal and anal cancer, to provide expert radiologist opinion on the appropriate anal cancer imaging strategy. In our expert opinion survey, experts advocated the use of MRI in general (65% overall and 91–100% for primary staging clinical scenarios) and acknowledged the superiority of PET/CT for nodal assessment (52–56% agreement for using PET/CT in primary staging clinical scenarios compared to 30% for using MRI). We therefore support the use of MRI and PET and suggest further exploration of PET/MRI as an optimal combined evaluation. Our questionnaire responses emphasized the heterogeneity in imaging practice as performed at numerous academic cancer centers across the United States and underscore the need for further reconciliation and establishment of best imaging practice guidelines for optimized patient care in anal cancer. [ABSTRACT FROM AUTHOR]

The article focuses on the case presentation of an 18-year-old man with Dravet syndrome who was admitted to the hospital due to fever and increased seizures. It mentions the patient had a history of developmental delay and experienced swelling in his left foot, which was later diagnosed as multifocal bone marrow edema, and he also exhibited cerebral volume loss on MRI scans.

Objectives: The aim of this study was to investigate the in vitro fatigue and fracture force of temporary implant-supported anterior crowns made of different materials with different abutment total occlusal convergence (TOC), with/without a screw channel, and with different types of fabrication. Materials and methods: One hundred ninety-two implant-supported crowns were manufactured (4° or 8° TOC; with/without screw channel) form 6 materials (n = 8; 2 × additive, 3 × subtractive, 1 × automix; reference). Crowns were temporarily cemented, screw channels were closed (polytetrafluoroethylene, resin composite), and crowns were stored in water (37 °C; 10 days) before thermal cycling and mechanical loading (TCML). Fracture force was determined. Statistics: Kolmogorov–Smirnov, ANOVA; Bonferroni; Kaplan–Meier; log-rank; α = 0.05. Results: Failure during TCML varied between 0 failures and total failure. Mean survival was between 1.8 × 105 and 4.8 × 105 cycles. The highest impact on survival presented the material (η2 = 0.072, p <.001). Fracture forces varied between 265.7 and 628.6 N. The highest impact on force was found for the material (η2 = 0.084, p <.001). Conclusion: Additively and subtractively manufactured crowns provided similar or higher survival rates and fracture forces compared to automix crowns. The choice of material is decisive for the survival and fracture force. The fabrication is not crucial. A smaller TOC led to higher fracture force. Manually inserted screw channels had negative effects on fatigue testing. Clinical relevance: The highest stability has been shown for crowns with a low TOC, which are manufactured additively and subtractively. In automix-fabricated crowns, manually inserted screw channels have negative effects. [ABSTRACT FROM AUTHOR]

South Africa has a colonial and apartheid past of social injustice, epistemological oppression, and exclusion. These mechanisms are historically inscribed in the designs, practices, and content of higher education—including in occupational therapy curriculum. If these historical markers are not consciously interrogated, patterns of reproduction are reified along the fault lines that already exist in society. The focus of this article is to demonstrate how an archaeological Foucauldian method was crafted from foundational Foucauldian archaeology analytics and existing approaches of Foucauldian discourse analysis to unearth the rules of the formation of the occupational therapy profession. These rules pertain to the formation of (a) the 'ideal occupational therapist'; (b) who had a say about the profession; (c) the ways of preferred reasoning; and (d) underlying theoretical themes and perspectives about the future. Data sources for this archaeology analytics included commemorative documents of universities on the origin of their programmes; historical regulatory documents; and the South African Journal of Occupational Therapy archive from the period 1953–1994. The analysis rendered two subthemes for each of the rules of formation including 'white exceptionalism', white male national, and international, regulatory bodies, the profession's know-how practical knowledge, and its need for recognition within a bio-medical paradigm. Unearthing the historical markers of a curriculum and viewing it as discourse may enable a conscious reconfiguration thereof. [ABSTRACT FROM AUTHOR]

Laser-driven x-ray backlighting can be used to image fast dynamic processes like the propagation of laser-driven shock waves in matter. We demonstrate and evaluate the feasibility of operating the JUNGFRAU detector designed by PSI, a direct detecting x-ray detector, in environments with extreme electromagnetic pulses. The electromagnetic pulse-protective housing is specifically designed for this detector and optimized for pump-probe experiments at the Petawatt High-Energy Laser for Heavy Ion EXperiments (PHELIX) facility at the GSI Helmholtzzentrum für Schwerionenforschung GmbH. The beryllium x-ray entrance window of the protective housing has a high x-ray transmission of 94% at 8 keV. Measurements have shown that the housing simultaneously provides a relative damping of the electromagnetic field on average higher than 1000 in the frequency range of 100 MHz to 5 GHz. The results demonstrate the feasibility of operating digital detectors in experiments where strong electromagnetic pulses are present. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the clinical performance of chairside fabricated tooth-supported posterior single crowns from lithium disilicate ceramic. Materials and methods: Thirty-four crowns (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein) were inserted between 2006 and 2007 and again evaluated after 15 years. Survival and success rates were calculated according to Kaplan–Meier, and the quality of the crowns was evaluated by using modified United States Public Health (USPHS) criteria. Results: Twenty-two crowns were available for recall; six patients were defined as dropouts. The mean observation period was 15.2 years (± 0.2). Six failures occurred (1 technical/5 biological) resulting in a survival rate of 80.1%. The success rate was 64.2%. The roughness of the crowns increased (p = 0.021) and the majority of adhesive gaps were discolored (p = 0.001) in comparison to baseline. The color, tooth, and crown integrity remained stable over the follow-up period (p ≥ 0.317). Conclusion: The fabrication of tooth-supported lithium disilicate crowns using a chairside approach yielded acceptable long-term survival and success rates. Due to discoloration, the long-term use of dual-cure self-adhesive resin cements might result in unpleasing esthetic results. Clinical relevance: The performance of posterior lithium disilicate single crowns revealed excellent to good clinical quality and an acceptable number of events after 15 years of clinical service. [ABSTRACT FROM AUTHOR]

Background: Information on the prevalence of temporomandibular disorders (TMD) or possible/probable bruxism in seniors is heterogeneous and sparse. Objectives: To elucidate the prevalence of TMD and possible/probable bruxism in German adults aged 60 years and older. Methods: Participants of the Interdisciplinary Longitudinal Study of Adult Development and Aging (ILSE) born between 1950–1952 (C1) and 1930–1932 (C2) were examined in 2014–2016 (fourth wave). The participants were surveyed and clinically examined by one calibrated examiner. Two questions of the Patient Health Questionnaire (PHQ) were utilised to evaluate self‐reported bruxism. The clinical examination included signs of probable bruxism and the RDC/TMD examination protocol. Results: Data from 191 participants were available. No RDC/TMD diagnosis was made in 83.2%. Of the participants, 15.2% received a single diagnosis and 1.6% multiple diagnoses that included disc displacements (9.4%) and degenerative joint diseases (8.9%). A total of 24.7% reported bruxism that included self‐reported awake bruxism in 11.9% and sleep bruxism in 16.2%. Wear was clinically identified in 27.2% of the participants. No sex‐related differences were observed. Significant differences were detected for probable bruxism between C1 (14.1%) and C2 (54.3%). Conclusion: In the German population aged 60 years and older, the prevalence of TMD is 16.8%. TMD is characterised by temporomandibular joint disorders, including disc displacements and degenerative joint disorders. Bruxism was observed in a quarter of the old population. [ABSTRACT FROM AUTHOR]

Zirconia-based ceramics exhibit shape memory and superelastic effects based on the reversible martensitic transformation between tetragonal and monoclinic crystal structures. In the form of granular packings, these shape memory ceramics can be scaled up for bulk applications despite their intrinsic brittleness, while displaying drastically different transformation characteristics than the monolithic counterparts. Here, we present a comparative study to understand the thermally induced reverse martensitic transformation in granular packings and the influence of mechanical constraints. This study employs ZrO2–CeO2 shape memory ceramics of the same composition but with different degrees of mechanical constraints. The explored material forms include loose and jammed granular packings, themselves consisting of polycrystalline or single crystal particles, as well as sintered bulk polycrystals. Except for the latter, no endothermic peak is observed in the heat flow measurement of the reverse transformation process. This unusual behavior is shown to stem from the weak inter-particle mechanical constraint and the transformation heterogeneity among individual particles, rather than stress relaxation or particle rearrangement. To compare, conspicuous endothermic peaks only appear in bursting-type transformations under a strong mechanical constraint. For granular packings, the intra-particle mechanical constraint does not affect the presence of any endothermic peaks in thermal reversion but can influence the austenite start temperature. [ABSTRACT FROM AUTHOR]

The article discusses the significant contributions of the military research community to advancements in medical care in both military and civilian settings. It emphasizes the importance of medical research in maintaining force readiness and addresses the future challenges that the military health system may face. These challenges include the need for medical care to be delivered closer to the field of battle, the importance of addressing mental health challenges, and the necessity of innovative approaches to improve the overall physical health of the warfighter. The article also highlights the role of the Military Health System Research Symposium in fostering collaboration and generating ideas to address these challenges. [Extracted from the article]

Bear bile-farming is common in East and Southeast Asia and this farming practice often results in irreversible health outcomes for the animals. We studied long-term effects of chronic bacterial and sterile hepatobiliary inflammation in 42 Asiatic black bears (Ursus thibetanus) rescued from Vietnamese bile farms. The bears were examined under anesthesia at least twice as part of essential medical interventions. All bears were diagnosed with chronic low-grade sterile or bacterial hepatobiliary inflammation along with pathologies from other systems. Our main finding was that the chronic low-grade inflammatory environment associated with bile extraction in conjunction with the suboptimal living conditions on the farms promoted and accelerated the development of age-related pathologies such as chronic kidney disease, obese sarcopenia, cardiovascular remodeling, and degenerative joint disease. Through a biomimetic approach, we identified similarities with inflammation related to premature aging in humans and found significant deviations from the healthy ursid phenotype. The pathological parallels with inflammageing and immuno-senescence induced conditions in humans suggest that bile-farmed bears may serve as animal models to investigate pathophysiology and deleterious effects of lifestyle-related diseases. [ABSTRACT FROM AUTHOR]

Determining the optimal course of treatment for low grade glioma (LGG) patients is challenging and frequently reliant on subjective judgment and limited scientific evidence. Our objective was to develop a comprehensive deep learning assisted radiomics model for assessing not only overall survival in LGG, but also the likelihood of future malignancy and glioma growth velocity. Thus, we retrospectively included 349 LGG patients to develop a prediction model using clinical, anatomical, and preoperative MRI data. Before performing radiomics analysis, a U2-model for glioma segmentation was utilized to prevent bias, yielding a mean whole tumor Dice score of 0.837. Overall survival and time to malignancy were estimated using Cox proportional hazard models. In a postoperative model, we derived a C-index of 0.82 (CI 0.79–0.86) for the training cohort over 10 years and 0.74 (Cl 0.64–0.84) for the test cohort. Preoperative models showed a C-index of 0.77 (Cl 0.73–0.82) for training and 0.67 (Cl 0.57–0.80) test sets. Our findings suggest that we can reliably predict the survival of a heterogeneous population of glioma patients in both preoperative and postoperative scenarios. Further, we demonstrate the utility of radiomics in predicting biological tumor activity, such as the time to malignancy and the LGG growth rate. [ABSTRACT FROM AUTHOR]

Ultraviolet (UV) disinfection has been incorporated into both drinking water and wastewater treatment processes for several decades; however, it comes with negative environmental consequences such as high energy demands and the use of mercury. Understanding how to scale and build climate responsive technologies is key in fulfilling the intersection of UN Sustainable Development Goals 6 and 13. One technology that addresses the drawbacks of conventional wastewater UV disinfection systems, while providing a climate responsive solution, is UV light emitting diodes (LEDs). The objective of this study was to compare performance of bench-scale 280 nm UV LEDs to bench-scale low pressure (LP) lamps and full-scale UV treated wastewater samples. Results from the study demonstrated that the UV LED system provides a robust treatment that outperformed LP systems at the bench-scale. A comparison of relative energy consumptions of the UV LED system at 20 mJ cm−2 and LP system at 30 and 40 mJ cm−2 was completed. Based on current projections for wall plug efficiencies (WPE) of UV LED it is expected that the energy consumption of LED reactors will be on par or lower compared to the LP systems by 2025. This study determined that, at a WPE of 20%, the equivalent UV LED system would lead to a 24.6% and 43.4% reduction in power consumption for the 30 and 40 mJ cm−2 scenarios, respectively. [ABSTRACT FROM AUTHOR]

Narrow‐band emission is essential for applicable circularly polarized luminescence (CPL) active materials in ultrahigh‐definition CP‐OLEDs. One of the most promising classes of CPL active molecules, helicenes, however, typically exhibit broad emission with a large Stokes shift. We present, herein, a design strategy capitalizing on intramolecular donor‐acceptor interactions between nitrogen and boron atoms to address this issue. 1,4‐B,N‐embedded configurationally stable single‐ and double helicenes were synthesized straightforwardly. Both helicenes show unprecedentedly narrow fluorescence and CPL bands (full width at half maximum between 17–28 nm, 0.07–0.13 eV) along with high fluorescence quantum yields (72–85 %). Quantum chemical calculations revealed that the relative localization of the natural transition orbitals, mainly on the rigid core of the molecule, and small values of root‐mean‐square displacements between S0 and S1 state geometries, contribute to the narrower emission. [ABSTRACT FROM AUTHOR]

Narrow‐band emission is essential for applicable circularly polarized luminescence (CPL) active materials in ultrahigh‐definition CP‐OLEDs. One of the most promising classes of CPL active molecules, helicenes, however, typically exhibit broad emission with a large Stokes shift. We present, herein, a design strategy capitalizing on intramolecular donor‐acceptor interactions between nitrogen and boron atoms to address this issue. 1,4‐B,N‐embedded configurationally stable single‐ and double helicenes were synthesized straightforwardly. Both helicenes show unprecedentedly narrow fluorescence and CPL bands (full width at half maximum between 17–28 nm, 0.07–0.13 eV) along with high fluorescence quantum yields (72–85 %). Quantum chemical calculations revealed that the relative localization of the natural transition orbitals, mainly on the rigid core of the molecule, and small values of root‐mean‐square displacements between S0 and S1 state geometries, contribute to the narrower emission. [ABSTRACT FROM AUTHOR]

Objective: To conduct a quality improvement evaluation of the Empower Veterans Program (EVP), an interdisciplinary pain rehabilitation/functional restoration program option for functional restoration for high‐impact chronic pain, offered in a large metro‐area Veterans Health Administration (VHA) system. Data Sources: VHA Corporate Data Warehouse electronic medical record data for patients treated by EVP between 2015 and 2019. Evaluation Design: This retrospective design first compared EVP patients considered engaged or not engaged in completing treatment in terms of demographic characteristics and post‐treatment changes in clinical measures related to opioid use and mental health. We then compared mortality risk between matched groups of treated and untreated patients with chronic pain and concurrent opioid prescriptions using propensity score matching and Cox proportional hazards methods. "Treated" in the matched groups was defined as any level of EVP participation (i.e., both engaged and not engaged). Data Collection/Extraction Methods: We first identified 1053 EVP patients with 1 year of pre‐and post‐treatment follow‐time and determined their engagement level. From those with chronic pain and prescription opioids, we matched 237 EVP patients to 375 untreated patients. Principal Findings: Engaged patients (57.4% of treated patients), were somewhat older than the non‐engaged (mean age 57.1 vs. 53.7, Cohen's D = 0.30), and achieved lower mean PHQ9 depression scores in the post‐treatment year (9.2 vs. 10.6, Cohen's D = 0.20). Participation in EVP was associated with a 65% lower mortality risk among Veterans with chronic pain and opioid use when compared to the untreated patients: (HR: 0.35, 95% CI: 0.17, 0.75). Conclusions: EVP was associated with a large reduction in mortality risk for Veterans with both chronic pain and opioid use. This result could inform the decision process in a VA station or region when considering providing or expanding access to an interdisciplinary rehabilitation/functional restoration program for chronic pain. [ABSTRACT FROM AUTHOR]

An introduction is presented in which author discusses articles on topics including focuses on review of Action Research for Student Teachers by Colin Forster and Rachel Eperjesi based on experiences of using book to support novice teachers through their first teacher action research projects.

During several decades, patients with haemophilia have been treated using FVIII and FIX concentrates by haematologists working in specialized comprehensive haemophilia care centres. In the last fifteen years haemophilia treatments have been tremendously improved and novel treatment options have been developed. Gene therapy is one of these innovative approaches and will soon be available on the market. The European Association for Haemophilia and Allied Disorders and the European Haemophilia Consortium recently described a new healthcare setting for the management of patients who will receive gene therapy. This hub-and-spoke model aims to ensure the safe administration and monitoring of gene therapy by expert comprehensive haemophilia care centres, in close collaboration with the proximity haemophilia treatment centres where the patient is followed up. Any adverse events should be managed by both the expert "hubs" in collaboration with the spoke centre to provide the timeliest state-of-the-art treatment and management options to patients receiving gene therapy. All adverse events and efficacy data should be reported lifelong to a centralised registry. French reference centre for haemophilia and the patient's organization AFH worked together to adapt the European Hub and spoke model to the existing infrastructures and organization for rare bleeding disorders in France. This review describes the haemophilia patient's journey for gene therapy in France. [ABSTRACT FROM AUTHOR]

Bone turnover markers (BTMs) have been developed many years ago to study, in combination with imaging techniques, bone remodeling in adults. In children and adolescents, bone metabolism differs from adults since it implies both growth and bone remodeling, suggesting an age- and gender-dependent BTM concentration. Therefore, specific studies have evaluated BTMs in not only physiological but also pathological conditions. However, in pediatrics, the use of BTMs in clinical practice is still limited due to these many children-related specificities. This review will discuss about physiological levels of BTMs as well as their modifications under pathological conditions in children and adolescents. A focus is also given on analytical and clinical challenges that restrain BTM usefulness in pediatrics. [ABSTRACT FROM AUTHOR]