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Humankind has been living ‘online’ for more than twenty years now, under the pressure of extending its real-life existence into the virtual world. The increasingly complex virtual life has also brought forth a paradigm shift in identity. Our daily lives seem caught in a digital web with profound ramifications at individual, organisational, and societal levels. The analysis of identity construction, performance, and development, and the 'rules' to be followed for successful integration in specific environments (acting, television, education, etc.) have become central topics of identity studies over the past few decades. Online identities have got very little attention so far, despite a long legacy of critical management and organisation studies literature on identity. The assumption of online gender identity, love affairs, or reality shows routinely exposed on different platforms to form communities and ultimately earn money, influencers, and the ethics of almost uncontrolled advertising are topics fiercely debated by specialists. In this context, the massive evolution of digital tools is changing perceptions, businesses, and even lives, which makes us pay special attention to digital identity, as an emerging concept. The article thus traces a potential online identity path that leads (if we know how) to what we want to be perceived as “I” and co-exists with us, sometimes even after our physical disappearance.

This research is an attempt to present a complete explanation of Edward Albee's Me, Myself and I through applying the deconstructive theory in order to generate a better understanding of its text and thoughtful themes. According to this theory, language as a significant means of interaction does not embrace merely one meaning. This multiplicity of meanings strengthens the importance of language in Albee's theater of the absurd. For Jacques Derrida as a French deconstructionist, the concept of "différance" plays an imperative role in the language's multiple explanations and implications. Also, binary opposition is proven to be a significant concept, which regards such differences as central to the language, human attitude, and culture. It is shown in this study that language of Albee's play does not have a fixed meaning. In fact, it is found that language in Albee’s Me, Myself and I is a highly significant feature which assists the readers to comprehend the absurd, vague, and formless lives of his American characters. Thus, benefitting from différance discloses the absurdities, roughness, and messiness of American society. [ABSTRACT FROM AUTHOR]

The contribution deals with the question of the constitution and persistence of the "self," linking psychological and sociological approaches. The central interface of this linkage is derived from the process character of the self. It is argued that transdisciplinary work aiming at this common conceptual core will prove particularly fruitful. After discussing the status of the term "the self" in both science and everyday usage, conceptual arguments and definitions (in contrast to related terms such as ego, individual, person, or subject) are examined. A third step provides a synopsis of established approaches and arguments both from psychological and sociological perspectives, offering points of convergence for a metadisciplinary concept of the self. The proposed process character of the self is discussed with respect to language pragmatics, memory performance, and body boundedness. The final section sums up the lines of argumentation and emphasizes intended inspiration for interdisciplinary discussion. [ABSTRACT FROM AUTHOR]

Purpose: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic condition with a constellation of symptoms presenting as severe and profound fatigue of ≥ 6 months not relieved by rest. ME/CFS affects health-related quality of life (HRQoL), which can be measured using multi-attribute health state utility (HSU) instruments. The aims of this study were to quantify HSUs for people living with ME/CFS, and to identify an instrument that is preferentially sensitive for ME/CFS. Methods: Cross-sectional national survey of people with ME/CFS using the AQoL-8D and EQ-5D-5L. Additional questions from the AQoL-8D were used as 'bolt-ons' to the EQ-5D-5L (i.e., EQ-5D-5L-Psychosocial). Disability and fatigue severity were assessed using the De Paul Symptom Questionnaire-Short Form (DSQ-SF). HSUs were generated using Australian tariffs. Mean HSUs were stratified for sociodemographic and clinical factors. Bland–Altman plots were used to compare the three HSU instruments. Results: For the 198 participants, mean HSUs (95% confidence intervals) were EQ-5D-5L: 0.46 (0.42–0.50); AQoL-8D: 0.43 (0.41–0.45); EQ-5D-5L-Psychosocial: 0.44 (0.42–0.46). HSUs were substantially lower than population norms: EQ-5D-5L: 0.89; AQoL-8D: 0.77. As disability and fatigue severity increased, HSUs decreased in all three instruments. Bland–Altman plots revealed interchangeability between the AQoL-8D and EQ-5D-5LPsychosocial. Floor and ceiling effects of 13.5% and 2.5% respectively were observed for the EQ-5D-5L instrument only. Conclusions: ME/CFS has a profound impact on HRQoL. The AQoL-8D and EQ-5D-5L-Psychosocial can be used interchangeably: the latter represents a reduced participant burden. [ABSTRACT FROM AUTHOR]

The Sumerian concept of "me" represents a complicated and multifaceted group of cultural and religious norms that were paramount to the Sumerian worldview. The term "me" contains a range of meanings, including divine orders and divine regulations, which governed Sumerian life. These "me" were believed to be granted by the gods and were important for preserving order and harmony in the universe. Comprehending the "me" reveals how the Sumerians sensed the complex relations between the divine and human existence. This paper focuses on carefully chosen examples taken from Sumerian myths, hymns, and royal inscriptions. These examples represent only a fraction of the total existing examples, as the entire collection is a challenge for this brief study. Therefore, this paper discusses the term from the literary and religious perspective, as its linguistic aspect has been well-established by Sumerologist. [ABSTRACT FROM AUTHOR]

This article, which reports on a didactic experiment carried out to verify whether student-student collaboration helps to remedy the writing difficulties of FLE learners, sheds light on the relationship between the Self and the Other in this type of verbal interaction. Our contribution questions not the student writings collected as part of this research but the relationship of the Self to the Other in collaboration. Indeed, we emphasize that in a collaborative context, the quality of the psychosocial relationship is decisive in the acquisition of help from the Other, taking into account the dysfunctions linked to insufficient knowledge in FLE which can hinder collaboration. The results obtained indicate that the psychosocial and socio-cognitive relationship between students is built in a double congruence : social underpinned by affect, then cognitive.

Myalgic encephalomyelitis, or chronic fatigue syndrome (ME/CFS) is a serious disease whose cause has yet to be identified. Objective markers of the disease are also not well understood and would serve as important tools in diagnosis and management. One potential biomarker or transmitter of immune signals in ME/CFS is the extracellular vesicle (EV) compartment. These small, membrane bound particles have been shown to play a key role in intercellular signaling. Our laboratory has focused on methods of detection of EVS in clinical samples. In this study we explored whether the prevalence of EVs in the plasma of participants with mild or severe ME/CFS differed from the plasma of healthy control participants. By staining for multiple cell surface molecules, plasma EVs could be fingerprinted as to their cell of origin. Our study revealed a significant correlation between severe ME/CSF and levels of EVs bearing the B cell marker CD19 and the platelet marker CD41a, though these changes were not significant after correction for multiple comparisons. These findings point to potential dysregulation of B cell and platelet activation or homeostasis in ME/CFS, which warrants validation in a replication cohort and further exploration of potential mechanisms underlying the association.

El artículo se centra en el estudio del arte de acción avant la lettre realizado durante los inicios de Luis Buñuel en España, y en relación con el proceso de los filmes Un chien andalou (Un perro andaluz, 1929), efectuado en París y Los olvidados (1950), producido en la Ciudad de México DF. De hecho, unas actuaciones extraordinarias relacionadas con la etnografía e ideología.

Copyright of Polymer Materials Science & Engineering is the property of Sichuan University, Polymer Research Institute and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rhipicephalus microplus, hard tick causes babesiosis and anaplasmosis in cattle. For decades, ticks control has been depending on synthetic acaricide use, however, acaricide-resistant ticks led to alternative effective and eco-friendly tick control approach such as vaccination. Currently, vaccine design using immuno-informatics is a promising method in the vaccination field. Here, we proposed a multi-epitope-based (ME) vaccine against R. microplus tick, comprising potential immunodominant Bcells, Helper-T Lymphocytes and Cytotoxic-T Lymphocytes epitopes. Then, designing of ME vaccine construct, containing sequences of Bm86, Subolesin and Bm95, was cloned into pET28a a prokaryotic expression vector. The recombinant ME protein was expressed in the Escherichia coli BL21 strain. After that protein purification was done by Nickle-NTA affinity chromatography. Evaluation of expression of recombinant ME based protein by SDS-PAGE analysis showed that optimal expression in LB medium for 8 h at 37 °C post-induction by 0.7 mM IPTG. The quality of purified recombinant protein was validated by Western blot analysis. 100 µg/2ml of purified ME protein with adjuvant Montanide ISA 50V was used in rabbits to evaluate the antigenicity of ME protein. Our study finding revealed that the expressed recombinant ME protein's molecular weight was 42kDa. The antirecombinant protein antibodies raised in immunized rabbit's sera was detected through western blotting and ELISA. This study results showed that recombinant ME protein is a potential vaccine candidate against Rhipicephalus microplus tick infestations. [ABSTRACT FROM AUTHOR]

This article is based on an interview study of 24 Swedish veterans who experienced deteriorating mental health and increased suffering without meeting the criteria for a PTSD diagnosis. With no clinical answers as to the cause of their deteriorating mental health, they have been thrown into a veteran’s health limbo. The analysis was based on an inductive logic. A key finding of the analysis was a kind of deep-seated permanent moral conflict that could be conceptualized as moral injury. Such an injury can give rise to intense guilt, shame, anxiety, anger, dejection, bitterness, identity issues and more. The results section of the article details five different yet for the sample representative cases of moral injury and their implications. The notion of moral injury is linked to Mead’s division of the self into an I and me, where me is the socially constructed part of the self that is charged with the morality of a group. Thus, a moral me played a key role in the development of moral injury. The conceptual apparatus illustrates a new way of understanding experiences that can create suffering and negatively impact a veteran’s mental health. Future research is encouraged that examines this topic, national designs for addressing moral injury, screening for moral injury, and methods for healing included.

Simple Summary: Epidemiological research indicates that low blood plasma levels of high-density lipoprotein (HDL) and increased levels of low-density lipoprotein (LDL) are associated with an increased risk of cardiovascular diseases in humans. Yet, the impact of blood lipids on the health and wellbeing of poultry is not fully understood. This research provides information that feeding black peppercorn (BP) increases HDL and feeding xylanase (XYL) reduces LDL in the blood plasma of broiler chickens. For XYL-fed birds, this coincided with increased hepatic antioxidant capacity. Although the life span of commercial poultry is much shorter than that of humans, further understanding of the need to manipulate blood lipids for the improvement of the health and wellbeing of poultry is important. This study offers a nutritional approach to influence the production performance and health of poultry. This study aimed to determine the impact of dietary black peppercorn (BP) and xylanase (XYL) alone or in combination on growth performance, dietary energy, nutrient digestibility and blood lipid profile when fed to male Ross 308 broiler chickens from the ages of 7 to 21 d. A wheat-soy-based basal feed that was formulated to be 0.42 MJ lower in metabolizable energy (ME) was mixed. The basal feed was then split into four batches, with the first batch set aside as the basal control; the second batch was supplemented with freshly milled BP; the third batch was supplemented with XYL; the fourth batch was supplemented with both BP and XYL, as in the previous two batches. Each diet was fed to eight pens, with two birds in a pen, following randomization. Feeding BP reduced bird growth and most of the digestibility coefficients but increased blood high-density lipoprotein (p < 0.05). Dietary XYL increased bird growth, dietary ME and nutrient digestibility (p < 0.05). In addition, XYL increased hepatic carotenoids and coenzyme Q10, but reduced blood low-density lipoprotein (p < 0.05). There were no BP by XYL interactions (p > 0.05) observed. Further research is needed to identify the optimum level of BP in broiler diets. [ABSTRACT FROM AUTHOR]

Research into humour in Indigenous Australian fiction is strikingly rare, even when compared to studies on humour in traditional Indigenous societies. As a consequence, when channelled through fictional prose, Indigenous humour rarely "receives any echo" (Bergson). One case in point is Gayle Kennedy's novel Me, Antman & Fleabag (2007). Kennedy's text, despite being marketed as humorous and winning the prestigious 2006 David Unaipon Award, has attracted a handful of minuscule reviews. The paper discusses distinctive "elastic polarity" of humour (Boskin) in Kennedy's text, which simultaneously denies and affirms. By analysing the way in which her narrative debunks social and racial stereotypes of Indigenous and non-Indigenous Australia, the paper argues that her double-edged humour produces a site of cultural negotiations necessary for understanding complexities of contemporary Indigeneities and contemporary Australia. [ABSTRACT FROM AUTHOR]

Additive manufacturing techniques are widely used in the present manufacturing era because of their ability to manufacture intricate products. Fused filament fabrication (FFF) is one of the most commonly adopted additive manufacturing technology, which involves the extrusion of the semi-solid polymer through the nozzle to be deposited in layers to form the part. In FFF, the polymer melt being deposited, forms the bonds with the neighboring pre-deposited melt during the part fabrication. The pre-deposited melt is at the low temperature compared to the polymer melt extruding out of the nozzle; hence the heat transfer occurs due to temperature gradient by the mode of conduction and convection. The commercialization of the FFF technology in a wide range of industrial applications still seems to be constrained due to several drawbacks such as insufficient mechanical properties, poor surface quality, and low dimensional accuracy. The grade of FFF-produced products is affected by various process parameters, for example, layer thickness, build orientation, raster width, or print speed. In FFF, process parameters are optimized to improve the quality of the final printed part. The cost of post-processing is also reduced as a result of parameter optimization. In this study, the influence of the convection coefficient on bond formation was investigated, and a model for predicting bond size in terms of convection coefficient is discussed for a given set of parameters. This work also aims to study the effects of thermal properties on neck formation and the effects of neck formation on strength, surface finish, and dimensional accuracy of the printed parts. In addition, this study reveals the problems and difficulties found in previous works, potential future scope in this area has been analyzed, and new research approaches are suggested. [ABSTRACT FROM AUTHOR]

Mohamed Hany Shehata,1,2 Archana Prabu Kumar,3 Ahmed Mohammed Al Ansari,3 Abdelhalim Deifalla,4,5 Hani Salem Atwa3,5 1Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 2Helwan University Faculty of Medicine, Cairo, Egypt; 3Medical Education Unit, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 4Department of Anatomy, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 5Faculty of Medicine, Suez Canal, University, Ismailia, EgyptCorrespondence: Archana Prabu Kumar, Medical Education Unit, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain, Tel +973 33854782 ; +919962006869, Email archanaprabukumar@gmail.com; archanak@agu.edu.bhBackground: World Health Organization Collaborating Centres (WHOCCs) cooperate with the WHO on a range of strategic areas such as nursing, nutrition, mental health, chronic diseases, education, and health technologies, depending on their speciality areas. As of 2021, WHO has 47 CCs in the Eastern Mediterranean Region (EMR) collaborating on diverse areas. Four CCs in the EMR located in Egypt, Kingdom of Bahrain, Sudan, and Pakistan focus primarily on medical education (ME).Objective: The objective of this review of the literature is to describe the best practices in ME based on published research from the four WHOCCs in EMR. The secondary objective is to classify them based on the level of Kirkpatrick’s model (KM) of educational outcomes.Methods: The contributions of WHOCCs are categorised in to five domains namely “Curriculum Development and Course Design”, “Student Assessment”, “Quality, Accreditation, and Program Evaluation”, “Teaching and Learning” and “Innovation in Medical Education”. Initial extraction yielded 96 articles for review, while the second level of analysis reduced the number of publications to 37 based on the date of publication within the last 5 years. Numerous best practices in ME emerged from the recently published works of these WHOCCs in the areas of learning and teaching, curriculum development, innovations in medical education, quality, and assessments in medical education. Literature from the WHOCCs on assessment and curriculum design are limited, possibly indicating opportunities for additional research.Conclusion: The researchers conclude that the WHOCCs in the EMR show transformational impact on all principal areas of research and at multiple levels.Keywords: WHOCC, ME, EMR, best practice, research domains, educational outcomes

In French, it is the same signifier that refers to the two different signifieds, namely the organs of sensoriality (the senses) and signification (the meaning), which emphasises that access to meaning depends fundamentally on sensoriality. From there, the article addresses the question of foetal sensoriality, and in particular auditory sensoriality, from the perspective of Suzanne Maiello's work on the first prenatal sound object. The question of polysensoriality is then raised, with reference to intersubjectivity, presymbolic representations and the language of the body and of the act. The article concludes with some reflections on the dialectic between being and existence and on autistic functioning between autosensuality and autoeroticism. [ABSTRACT FROM AUTHOR]

The heights determined by Global Positioning System (GPS) refer to the ellipsoid called the World Geodetic System 1984 (WGS84). Global Geopotential Models (GGMs) that are available on GNSS commercial software are generally used to transform ellipsoidal heights to orthometric heights. In this study, the geoid heights of GPS/Levelling were computed to evaluate the accuracy of the geoid heights obtained from two GGMs, namely, the Earth Gravitational Model 96 (EGM96) and the Earth Gravitational Model 08 (EGM08). Seventeen (17) GPS/Levelling stations of the High Accuracy Reference Network (HARN) over Egypt were used for this purpose. The standard deviations for the differences between the geoid heights obtained through GPS/Levelling and those obtained from EGM96 and EGM08 were determined as ± 1.212 m and ± 0.543 m, respectively. This research confirms that the geoid heights obtained from EGM08 are closer to the geoid heights determined using GPS/Levelling over Egypt. [ABSTRACT FROM AUTHOR]

The new NICE guideline for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), published in October 2021, makes significant changes in treatment recommendations. It acknowledges the complexity of this chronic medical condition, which always impacts quality of life and can be profoundly disabling, recognising the prejudice and stigma that people with ME/CFS often experience in the absence of any specific diagnostic test. The guideline outlines steps for accurate diagnosis, recognising post-exertional malaise as a core symptom; importantly, ME/CFS can now be diagnosed after just 3 months in a bid to improve long-term health outcomes. It recommends the need for individual, tailored management by a multi-disciplinary team, ensuring that the wellbeing of the individual is paramount. The guideline makes clear that any programme based on fixed incremental increases in physical activity or exercise, for example, graded exercise therapy (GET), should not be offered as a treatment for ME/CFS and emphasises that cognitive behavioural therapy (CBT) should only be offered as a supportive intervention. Because of the rigorous methodology required by NICE Committee review and the inclusion of the testimony of people with lived experience as committee members, this guideline will influence the future diagnosis and management of ME/CFS in the UK and beyond. [ABSTRACT FROM AUTHOR]

Minimizing airborne molecular contamination (AMC) and moisture significantly decreases the defect rate of semiconductor products during manufacturing. Humid air originating from the fan filter unit (FFU) that is located at the top of a mini-environment (ME) might be transferred into a front opening unified pod (FOUP). Different moisture removal techniques such as diffuser purge and air curtain were applied to minimize the humidity level inside the FOUP. This computational fluid dynamics (CFD) numerical study evaluates the relative humidity (RH) level inside the FOUP subjected to different moisture removal techniques when the door is open. Different practical purge and air curtain flow rates were simulated. The large eddy simulation (LES) model was performed to simulate eddies inside the FOUP and ME. The relative humidity contours were also simulated inside the FOUP and ME. The results of the simulations were verified by experimental RH measurements. The findings show that combining the methods of diffuser purge and air curtain with flow rates of 130 and 360 LPM respectively has the highest moisture removal efficiency. This method can significantly decrease the humidity level inside the FOUP, resulting in a decrease in the defect rate on silicon wafers during manufacturing and storage. [ABSTRACT FROM AUTHOR]

AbstractIdentity is a mental state for recognition, which can be found in the characteristics distinguishing each individual. The study of women's identity has been the subject of research through various means in the literature. The Shahnameh or the long epic poem book, written by the Persian Poet Ferdowsi, is continually playing a crucial role in the cultural and social heritage of Iranians. The book is an acceptable source to study women’s identity in Persian territory. The research version of the text is edited by Dr. Khaleghi Motlaq and the research methodology, itself, is qualitative. Content analysis is the technique, used in the present study. The research framework is a conceptual model where two fundamental concepts of “I” and “me” are used to analyze women’s actions in Shahnameh. This analysis shows that their identity is the result of the superiority of the word "I" in nature. In the actions of all the characters, except Sindokht, the "I" is more obvious than the word "Me". When it comes to choose or decide, the women do actions, which are subliminal to their consciousness. However, when they act contrary to the traditional norms and expectations, the "I" becomes apparent. It is the occurrence of these different and norm-breaking actions that cause their individualities. Boldness in love, courage, warfare, wisdom, and politics can be considered as the identifying features of women in the heroic part of the Shahnameh..

This study aimed to determine the impact of dietary black peppercorn (BP) and xylanase (XYL) alone or in combination on growth performance, dietary energy, nutrient digestibility and blood lipid profile when fed to male Ross 308 broiler chickens from the ages of 7 to 21 d. A wheat-soy-based basal feed that was formulated to be 0.42 MJ lower in metabolizable energy (ME) was mixed. The basal feed was then split into four batches, with the first batch set aside as the basal control; the second batch was supplemented with freshly milled BP; the third batch was supplemented with XYL; the fourth batch was supplemented with both BP and XYL, as in the previous two batches. Each diet was fed to eight pens, with two birds in a pen, following randomization. Feeding BP reduced bird growth and most of the digestibility coefficients but increased blood high-density lipoprotein (p < 0.05). Dietary XYL increased bird growth, dietary ME and nutrient digestibility (p < 0.05). In addition, XYL increased hepatic carotenoids and coenzyme Q10, but reduced blood low-density lipoprotein (p < 0.05). There were no BP by XYL interactions (p > 0.05) observed. Further research is needed to identify the optimum level of BP in broiler diets.

Acadia National Park (ANP) is located on Mt. Desert Island, ME on the U.S. Atlantic coast. ANP is routinely a top-ten most popular National Park with over four million visits in 2022. The overall contribution and negative effects of long-range atmospheric transport and local sources of dioxin-like contaminants endangering natural and wildlife resources is unknown. Dioxin-like (DL) contaminants polychlorinated dibenzo-p-dioxins (∑PCDD) and polychlorinated dibenzofurans (∑PCDF), non-ortho coplanar PCBs (∑CP4), and polychlorinated naphthalenes (∑PCNs) were measured at the McFarland Hill air monitoring station (44.37⁰N, 68.26⁰W). On a mass/volume basis, total PCNs averaged 90.9 % (788 fg/m3) of DL contaminants measured annually, with 92.9 % of the collected total in the vapor-phase. Alternatively, total dioxin/furans (∑PCDD/Fs) represented 71.6 % of the total toxic equivalence (∑TEQ) (1.018 fg-TEQ/m3), with 69.7 % in the particulate-phase. Maximum concentrations measured for individual sampling events for ∑PCDD/F, ∑CP4, and ∑PCN were 159 (winter), 139 (summer), and 2100 (autumn), fg/m3 respectively. Whereas the maximum ∑TEQ concentrations for individual sampling events for ∑PCDD/F, ∑CP4, and ∑PCN were 2.8 (autumn), 0.38 (summer), and 0.71 (autumn), fg-TEQ/m3 respectively. Pearson correlations were calculated for ∑PCDD/Fs and ∑PCN particulate/vapor-phase air concentrations and PM 2.5 wood smoke "indicator" species. The most significant correlations were observed in autumn for particulate-phase ∑PCDD/Fs suggesting a relationship between visitation-generated combustion sources (campfires and/or waste burning) or climate-change mediated forest fires. Significant Clausius-Clapeyron (C–C) correlations observed for particulate-phase ∑PCDDs (r2 = 0.567) as ambient temperatures decreased suggests a connection between localized domestic heating sources or visitor-based burning of wood/trash resources. Alternatively, highly significant C–C vapor-phase ∑CP4-PCBs correlations (r2 = 0.815) implies that the majority of ∑CP4-PCB loading to ANP is from long-range atmospheric transport processes. Based on these findings, Acadia National Park should be classified as a remote site with minor depositional impacts from ∑PCDD/Fs, ∑CP4-PCBs, and ∑PCN atmospheric transport or local diffuse sources. [Display omitted] • Thermal combustion sources are important contributors to contaminant deposition. • Depositional pathways are due to both air-surface exchange and combustion byproducts. • Wood smoke indicator particulates, PCDD/Fs, and PCNs were seasonally correlated. • Forest fires and visitor biomass combustion likely contribute to contaminant deposition. [ABSTRACT FROM AUTHOR]

The British National Institute for Health and Care Excellence (NICE) recently published its updated guidelines for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). NICE concluded, after an extensive review of the literature, that graded exercise therapy (GET) is harmful and should not be used, and that cognitive behavioural therapy (CBT) is only an adjunctive and not a curative treatment. Leading proponents of the cognitive behavioural model (CBmodel) find it difficult to accept this paradigm shift. In, for example, an article in The Lancet, they try to argue that the new NICE guideline is based on ideology instead of science. In this article we reviewed the evidence they used to support their claims. Our analysis shows that the trials they used in support suffered from serious flaws which included badly designed control groups, relying on subjective primary outcomes in non-blinded studies, including patients in their trials who didn't have the disease under investigation or had a self-limiting disease, selective reporting, outcome switching and making extensive endpoint changes, which created an overlap in entry and recovery criteria, using a post-hoc definition of recovery which included the severely ill, not publishing results that contradict their own conclusion, ignoring their own (objective) null effect, etc. The flaws in these trials all created a bias in favour of the interventions. Despite all these flaws, treatments that are said to lead to recovery in reality do not lead to objective improvement. Therefore, these studies do not support the claim that CBT and GET are effective treatments. Moreover, the arguments that are used to claim that NICE was wrong, in reality, highlight the absence of evidence for the safety and efficacy of CBT and GET and strengthen the decision by NICE to drop CBT and GET as curative treatments for ME/CFS. [ABSTRACT FROM AUTHOR]

This article is based on an interview study of 24 Swedish veterans who experienced deteriorating mental health and increased suffering without meeting the criteria for a PTSD diagnosis. With no clinical answers as to the cause of their deteriorating mental health, they have been thrown into a veteran's health limbo. The analysis was based on an inductive logic. A key finding of the analysis was a kind of deep-seated permanent moral conflict that could be conceptualized as moral injury. Such an injury can give rise to intense guilt, shame, anxiety, anger, dejection, bitterness, identity issues and more. The results section of the article details five different yet for the sample representative cases of moral injury and their implications. The notion of moral injury is linked to Mead's division of the self into an I and me , where me is the socially constructed part of the self that is charged with the morality of a group. Thus, a moral me played a key role in the development of moral injury. The conceptual apparatus illustrates a new way of understanding experiences that can create suffering and negatively impact a veteran's mental health. Future research is encouraged that examines this topic, national designs for addressing moral injury, screening for moral injury, and methods for healing included., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Grimell.)