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Implementation fidelity is a critical component of intervention science, which aims to understand how interventions unfold in practice to improve outcomes. A key element of fidelity is facilitator competent adherence—the extent to which a program is delivered as prescribed with the specified level of quality. We conducted a two-part systematic review examining these aspects in parenting programs aiming to reduce child behavior problems and maltreatment. Part One reviews measures of facilitator competent adherence and Part Two examines the psychometric properties of the observational measures found. Searches identified 9153 articles from electronic databases, citation tracking, and expert input. After screening using pre-specified criteria, 156 (Part One) and 41 (Part Two) articles remained. In Part One, measure, facilitator, and intervention characteristics were extracted and synthesized from 65 measures. Most measures were observational, used by facilitators and researchers, and employed Likert-scale ratings. In Part Two, evidence on the reliability (internal consistency, inter-rater, intra-rater, test–retest) and validity (content, construct, convergent/divergent, criterion) of 30 observational measures identified from Part One was synthesized and evaluated. An adapted COSMIN checklist was used to assess study and measure quality. We found most studies to be of reasonably high quality. This is the first review to summarize and critically appraise measures of facilitator competent adherence used in the parenting program literature and establish their psychometric properties. The findings underscore the need to advance research on measures of facilitator competent adherence; reliable, valid, and high-quality implementation measures allow for evidence-based decisions regarding the delivery and scale-up of parenting programs. PROSPERO Registration Number: CRD42020167872. Supplementary Information The online version contains supplementary material available at 10.1007/s10567-021-00350-8.

A patient with severe mitral regurgitation and chronic systolic heart failure taking inotropic support at home presents for transcatheter edge-to-edge mitral valve repair, complicated by torrential mitral regurgitation from damaged mitral leaflets requiring escalating mechanical circulatory support and ultimately expedited orthotopic heart transplantation. (Level of Difficulty: Intermediate.), Graphical abstract

Item does not contain fulltext Introduction: In the two-process model of sleep regulation, slow-wave activity (SWA, EEG power in the 0.5–4 Hz band) is a direct indicator of sleep need. SWA builds up during NREM sleep, declines before the onset of REM sleep, remains low during REM and the level of increase in successive NREM episodes gets progressively lower. The sleep regulation model of Borbely et al, 1999, states that the rate of decrease in sleep need S(t) is proportional to SWA, i.e. dS(t)/dt =-γSWA(t) where γ is the decay rate. The sleep need after T minutes of sleep is: S(T)=S0-γCSWA(T), where S0 is the sleep need at sleep-onset and CSWA(T) is the integral of SWA from sleep onset to time T. The goal in this research is to assess the effect of age on the dynamics of sleep need dissipation. Methods: Sleep EEG and EOG data were collected from 25 subjects (10M and 15F; 37.1 ± 6.5 years old) for 3 nights at home. The data was manually scored into sleep stages according to AASM rules. SWA was calculated for each 6-second epoch of NREM sleep. In this model, sleep need dissipation is completely determined by S0 and γ. To estimate these, two boundary conditions were used: 1) the final value of S(t) is 0, and 2) S(t*) coincides with SWA(t*) at time t* where SWA is maximum in the first sleep cycle. Results: Two age groups were defined using as threshold the median age (38) of subjects in the study. S0 did not significantly differ between groups while γ was significantly different (γ group1=2.82 and γ group2=2.12; p=0.006). These results suggest that the efficiency of sleep need dissipation significantly decreases in the older group by 25%. Conclusion: The rate of sleep need dissipation is proportional to slow wave activity. The proportionality coefficient γ (decay rate) can be estimated using a differential model. It was found that γ is significantly lower, by 25%, in the age group 38 to 47 as compared to the age group 22 to 38. The initial sleep need did not differ between groups. 1 p.

Journal URL: http://www.znaturforsch.com/b.htm

Satellite communications systems are a vitally important component of our Defense infrastructure for both tactical and strategic missions. In particular, satellite communications (whether military or commercial) have become increasingly important to support tactical operations, as was clearly demonstrated during Operations Desert Shield and Desert Storm. In the emerging doctrinal shift to a CONUS-based force structure with capabilities for rapidly responsive lethal power projection to meet global crises, the vital necessity for SATCOM to provide an omnipresent communications infrastructure for immediate support of the developing theater will become a key element in the successful realization of our new warfighting strategy. This infrastructure must provide RF bandwidth on demand and access to ATM switches and B-ISDN or SONET services as required from any worldwide location for any type of terminal. DARPA is developing the enabling technologies to give future systems the ability to realize their potential for becoming more affordable, more capable and more accessible by a theater commander. Advanced technologies are facilitating microminiaturization of key subsystems for communications satellite payloads, their host satellite buses, terminals and interfaces with terrestrial systems. These technologies can enhance the "capability density" of large spacecraft, as well as facilitate small, highly capable space and terrestrial assets, which can be labeled "microMILSATCOM" systems.

Spermatozoa in the ejaculate of a man with antispermatozoal antibodies in the serum (gelatin agglutination technique (GAT) titre, 640) and the seminal plasma (GAT titre, 80) were shown to have IgG and IgA bound to them. In preparation for intrauterine artificial insemination, the ejaculate was collected in Tyrode's medium. Then spermatozoa were washed, resuspended in Tyrode's medium, and 0.2 mL of the suspension was injected in the uterus. A successful pregnancy resulted. Reasons are given for considering that the successful pregnancy resulted from the manipulation of the semen.

Journal URL: http://pubs.acs.org/organometallics/