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We explored use of Recurrence Quantification Analysis (RQA) of speech rhythm data from mental-health counseling sessions for prediction of quality of psychotherapy. Time-series of inter-syllable intervals (ISIs) were extracted from 239 counseling sessions conducted by 12 therapists who repeatedly interacted with 30 clients. We found a negative association between recurrence metrics and client-rated session quality and a negative link between percent of laminarity and therapist-rated session quality, after controlling for self-reported client depression and distress measures and duration of speech sound within a session. Placing value on reduced recurrence in patterns of ISIs, and especially reduced degree of a dyadic system remaining in the same speech-rhythm pattern may be indicative of a desire for variation in content and strategies of client-therapist interaction. These exploratory findings point to the possibility of RQA-based automated systems to capture the ‘footprint’ of the non-verbal dynamic that is indicative of successful mental-health counseling.

Abstract Objectives Evaluating effectiveness of speech/phrase recognition software in critically ill patients with speech impairments. Design Prospective study. Setting Tertiary hospital critical care unit in the northwest of England. Participants 14 patients with tracheostomies, 3 female and 11 male. Main outcome measures Evaluation of dynamic time warping (DTW) and deep neural networks (DNN) methods in a speech/phrase recognition application. Using speech/phrase recognition app for voice impaired (SRAVI), patients attempted mouthing various supported phrases with recordings evaluated by both DNN and DTW processing methods. Then, a trio of potential recognition phrases was displayed on the screen, ranked from first to third in order of likelihood. Results A total of 616 patient recordings were taken with 516 phrase identifiable recordings. The overall results revealed a total recognition accuracy across all three ranks of 86% using the DNN method. The rank 1 recognition accuracy of the DNN method was 75%. The DTW method had a total recognition accuracy of 74%, with a rank 1 accuracy of 48%. Conclusion This feasibility evaluation of a novel speech/phrase recognition app using SRAVI demonstrated a good correlation between spoken phrases and app recognition. This suggests that speech/phrase recognition technology could be a therapeutic option to bridge the gap in communication in critically ill patients. What is already known about this topic Communication can be attempted using visual charts, eye gaze boards, alphabet boards, speech/phrase reading, gestures and speaking valves in critically ill patients with speech impairments. What this study adds Deep neural networks and dynamic time warping methods can be used to analyse lip movements and identify intended phrases. How this study might affect research, practice and policy Our study shows that speech/phrase recognition software has a role to play in bridging the communication gap in speech impairment.

Abstract In the manufacturing of photovoltaic (PV) modules, the lamination process can take up to 20 min to complete. In this work, new lamination processes are being developed, and have been prototyped, which hope to be able to cut this time down to as little as 30 s. This could provide significant savings in the cost of lamination equipment, floor space, and energy. PV modules are expected to have a lifespan exceeding 20 to 30 years. For moisture‐sensitive PV technologies, the edge seal between the two layers of glass can be the weakest point of its reliability. There is an inherent challenge when evaluating edge seal materials due to their low permeation rates. As part of Colorado State University's Photovoltaic Research and Development 2, work at the National Renewable Energy Laboratory has developed models to evaluate edge seal configurations in glass‐glass PV modules. Here, this new manufacturing process is evaluated for long‐term moisture durability. Different edge seal design options within glass–glass PV modules are explored. Most of these designs are targeting a superstrate on glass configuration, e.g CdTe, but some designs could be used on conventional crystalline Si cells. Using COMSOL finite element simulation software, we investigated the edge seal and interlayer design configurations containing silicone perimeter edge adhesive, desiccated polyisobutylene‐based edge seal, air, and polyolefin while integrating climate conditions equivalent to a hot and humid environment such as Miami, Florida. We found optimized configurations that will allow the module to prevent moisture ingress over 50 years minimizing the amount of time and material used while utilizing polymers that are easily dispensed.

Background A positive child-caregiver relationship is one of the strongest determinants of child health and development, yet many caregivers report challenges in establishing a positive relationship with their child. For over 20 years, Make the Connection ® (MTC), an evidence-based parenting program, has been delivered in-person by child-caring professionals to over 120,000 parents to improve positive parenting behaviours and attitudes. Recently, MTC has been adapted into a ‘direct to caregiver’ online platform to increase scalability and accessibility. The purpose of this study is to evaluate the effectiveness of the online modality of MTC in increasing parenting knowledge, attitudes, and the perceived relationship with their child, and to understand barriers and facilitators to its access. Methods Two hundred caregivers with children aged 0-3 years old will be recruited through Public Health agencies in Ontario, Canada. Participants will be randomly placed in the intervention or waitlist control group. Both groups will complete a battery of questionnaires at study enrolment and 8 weeks later. The intervention group will receive the MTC online program during the 8-week period, while the waitlist group will receive the program after an 8-week wait. The study questionnaires will address demographic information, caregivers’ relational attitudes towards their infant, self-competence in their caregiver role, depression, and caregiver stress, as well as caregivers’ and infants’ emotion regulation. Discussion Results from this study will add critical knowledge to the development, scaling, and roll out of the MTC online program, thus increasing its capacity to reach a greater number of families. Trial registration The study was registered with ClinicalTrials.gov on 15 March 2023 (NCT05770414).

Objective: The purpose of the current study was to understand what families identify as necessary information to guide decision-making in the treatment of their child with UPJO. Methods: We conducted semi-structured interviews with parents of children with UPJO using phenomenological methodology. Data were systematically analyzed according to principles of thematic analysis, using a team-based inductive approach. Results: 32 parents were interviewed. Findings are organized by three major themes including barriers to meaningful participation in decision making, logistical aspects of the decision, and psychosocial aspects of the decision. Conclusion: These findings suggest the need to increase parent education and understanding around medical and surgical decision-making, and the need to enhance psychosocial support for more meaningful parental engagement in the surgical decision-making process. Practice implications: The findings from the interviews highlight the importance of caregivers needing clear and accurate information in order to engage in meaningful discussions related to surgical decision-making for decisions around surgery for UPJO treatment.

Abstract Background Children with medical complexity (CMC) often rely upon the use of multiple medications to sustain quality of life and control substantial symptom burden. Pediatric polypharmacy (≥ 5 concurrent medications) is prevalent and increases the risk of medication-related problems (MRPs). Although MRPs are associated with pediatric morbidity and healthcare utilization, polypharmacy is infrequently assessed during routine clinical care for CMC. The aim of this randomized controlled trial is to determine if a structured pharmacist-led Pediatric Medication Therapy Management (pMTM) intervention reduces MRP counts, as well as the secondary outcomes of symptom burden and acute healthcare utilization. Methods This is a hybrid type 2 randomized controlled trial assessing the effectiveness of pMTM compared to usual care in a large, patient-centered medical home for CMC. Eligible patients include all children ages 2–18 years old, with ≥ 1 complex chronic condition, and with ≥ 5 active medications, as well as their English-speaking primary caregivers. Child participants and their primary parental caregivers will be randomized to pMTM or usual care before a non-acute primary care visit and followed for 90 days. Using generalized linear models, the overall effectiveness of the intervention will be evaluated using total MRP counts at 90 days following pMTM intervention or usual care visit. Following attrition, a total of 296 CMC will contribute measurements at 90 days, which provides > 90% power to detect a clinically significant 1.0 reduction in total MRPs with an alpha level of 0.05. Secondary outcomes include Parent-Reported Outcomes of Symptoms (PRO-Sx) symptom burden scores and acute healthcare visit counts. Program replication costs will be assessed using time-driven activity-based scoring. Discussion This pMTM trial aims to test hypotheses that a patient-centered medication optimization intervention delivered by pediatric pharmacists will result in lower MRP counts, stable or improved symptom burdens, and fewer cumulative acute healthcare encounters at 90 days following pMTM compared to usual care. The results of this trial will be used to quantify medication-related outcomes, safety, and value for a high-utilization group of CMC, and outcomes may elucidate the role of integrated pharmacist services as a key component of outpatient complex care programs for this priority pediatric population. Trial Registration This trial was prospectively registered at clinicaltrials.gov (NCT05761847) on Feb 25, 2023.

Background: Clinical case illustrations of patients with an impairment of personality functioning (IPF) have repeatedly reported that progress during psychotherapy is reflected by alterations in dream content. However, quantitative studies based on samples of psychotherapy patients are scarce. As a core component of both personality functioning and contemporary psychodynamic dream theory, the construct of affect regulation is of specific significance in this context. Aims: To test if improvement in personality functioning in the course of psychotherapy is associated with an increasing ability to regulate affects in dreams. Method: In a longitudinal design, affect regulation was compared in N = 94 unsolicited dream reports from the first vs. last third of long term psychotherapy of ten patients with initial IPF. Dream reports were transcribed from recordings of the sessions. Expert ratings of the level of personality functioning were obtained using the Scales of Psychological Capacities. The capacity for affect regulation was assessed using the Zurich Dream Process Coding System. Group differences were assessed using linear mixed models, controlling for dream length as well as the nested structure of this data set. Results: Patients demonstrated an increased capacity for affect regulation in dreams that was primarily evident in three core features: the complexity of dream elements (cf., e.g., parameter attributes, p = 0.024); the extent of affective involvement in the dream ego (cf., e.g., parameter subject feeling, p = 0.014); and the flexibility to regulate the dynamics of safety/involvement processes (p ≤ 0.001). This pattern was especially prominent in a subgroup (n = 7) of patients with more pronounced improvements in personality functioning. Conclusion: These findings support the hypotheses that decreasing IPF during psychotherapy is associated with increases in the capacity for affect regulation in dreams. Thus, researchers and therapists can utilize dream reports to illuminate the important aspects of treatment progress in clinical practice.

Background: Pannexin1 (Panx1) is a membrane channel expressed in different cells of the nervous system and is involved in several pathological conditions, including pain and inflammation. At the central nervous system, the role of Panx1 is already well-established. However, in the periphery, there is a lack of information regarding the participation of Panx1 in neuronal sensitization. The dorsal root ganglion (DRG) is a critical structure for pain processing and modulation. For this reason, understanding the molecular mechanism in the DRG associated with neuronal hypersensitivity has become highly relevant to discovering new possibilities for pain treatment. Here, we aimed to investigate the role of Panx1 in acute nociception and peripheral inflammatory and neuropathic pain by using two different approaches. Methods: Rats were treated with a selective Panx1 blocker peptide (10Panx) into L5-DRG, followed by ipsilateral intraplantar injection of carrageenan, formalin, or capsaicin. DRG neuronal cells were pre-treated with 10Panx and stimulated by capsaicin to evaluate calcium influx. Panx1 knockout mice (Panx1-KO) received carrageenan or capsaicin into the paw and paclitaxel intraperitoneally. The von Frey test was performed to measure the mechanical threshold of rats’ and mice’s paws before and after each treatment. Results: Pharmacological blockade of Panx1 in the DRG of rats resulted in a dose-dependent decrease of mechanical allodynia triggered by carrageenan, and nociception decreased in the second phase of formalin. Nociceptive behavior response induced by capsaicin was significantly lower in rats treated with Panx1 blockade into DRG. Neuronal cells with Panx1 blockage showed lower intracellular calcium response than untreated cells after capsaicin administration. Accordingly, Panx1-KO mice showed a robust reduction in mechanical allodynia after carrageenan and a lower nociceptive response to capsaicin. A single dose of paclitaxel promoted acute mechanical pain in wildtype (WT) but not in Panx1-KO mice. Four doses of chemotherapy promoted chronic mechanical allodynia in both genotypes, although Panx1-KO mice had significant ablation in the first eight days. Conclusion: Our findings suggest that Panx1 is critical for developing peripheral inflammatory pain and acute nociception involving transient receptor potential vanilloid subtype 1 (TRPV1) but is not essential for neuropathic pain chronicity.

Syftet med denna artikel är att beskriva och diskutera vilka, för lärare, användbara och relevanta kunskapsprodukter som har genererats i 11 forskningsprojekt, finansierade av Skolforskningsinstitutet och beviljade år 2016 och 2017. Forskningsfrågorna är: Vad i resultaten kan ses som kunskapsprodukter och vilken karaktär har dessa? På vilka sätt har lärare medverkat i processen att ta fram dessa kunskapsprodukter? Sammantaget har 55 öppet tillgängliga granskade publikationer analyserats. Sex kvalitativt skilda kategorier av kunskapsprodukter har identifierats: 1) Kunnanden och förmågor, 2) Undervisnings- och lektionsdesign, 3) Didaktiska exempel, 4) Redskap, 5) Processer och metaperspektiv och 6) Generella eller kontextuella förutsättningar. Graden av medverkan från lärares sida har varierat avsevärt; från en aktiv medverkan, där lärare och forskare samarbetar på likvärdiga villkor, till en låg grad, där lärare primärt fungerar som bollplank eller forskningsobjekt. ENGLISH: Knowledge products for the teaching profession – Projects 2016 and 2017 funded by the Swedish Institute for Educational Research This article examines the knowledge products of relevance to the teaching profession from eleven research projects funded by the Swedish Institute for Educational Research. A total of 55 openly accessible reviewed publications have been analysed. The aim is to describe and discuss which, for teachers, useful and relevant knowledge products that the research projects (granted 2016 and 2017) have yielded. The research questions are: What in the results can be interpreted as knowledge products and what is the characteristic of these? In what ways have teachers participated in the process of producing these knowledge products? Six qualitatively different categories of knowledge products have been identified as descriptions of: 1) Knowings and capabilities, 2) Teaching/lesson design, 3) Didactical examples, 4) Tools, 5) Processes and meta-perspectives, and 6) General or contextual preconditions. The degree of involvement of teachers has varied considerably, ranging from a high degree of active involvement, where teachers and researchers collaborate on equal terms, to a low degree of involvement where teachers primarily act as informants. Keywords: Knowledge products, Swedish Institute for Educational Research, practice-based research, teacher profession, teaching development

ObjectiveTo evaluate the effect of different modalities of centralized reminder/recall (autodialer, text, mailed reminders) on increasing childhood influenza vaccination.Study designTwo simultaneous randomized clinical trials conducted from October 2017 to April 1, 2018, in New York State and Colorado. There were 61 931 children in New York (136 practices) and 23 845 children in Colorado (42 practices) who were randomized to different centralized reminder/recall modalities-4 arms in New York (autodialer, text, mailed, and no reminder control) and 3 arms in Colorado (autodialer, mailed, and no reminder control). The message content was similar across modalities. Up to 3 reminders were sent for intervention arms. The main outcome measure was receipt of ≥1 influenza vaccine.ResultsIn New York, compared with the control arm (26.6%), postintervention influenza vaccination rates in the autodialer arm (28.0%) were 1.4 percentage points higher (adjusted risk ratio, 1.06; 95% CI, 1.02-1.10), but the rates for text (27.6%) and mail (26.8%) arms were not different from controls. In Colorado, compared with the control arm (29.9%), postintervention influenza vaccination rates for the autodialer (32.9%) and mail (31.5%) arms were 3.0 percentage points (adjusted risk ratio, 1.08; 95% CI, 1.03-1.12) and 1.6 percentage points (adjusted risk ratio, 1.06; 95% CI, 1.02-1.10) higher, respectively. Compared with the control arm, the incremental cost per additional vaccine delivered was $20 (New York) and $16 (Colorado) for autodialer messages.ConclusionsCentralized reminder/recall for childhood influenza vaccine was most effective via autodialer, less effective via mail, and not effective via text messages. The impact of each modality was modest. Compared with no reminders, the incremental cost per additional vaccine delivered was also modest for autodialer messages.Trial registrationClinicalTrials.gov: NCT03294473 and NCT03246100.

Although autodialer centralized reminder and recall (C-R/R) from state immunization information systems (IISs) has been shown to raise childhood vaccination rates, its impact on human papillomavirus (HPV) vaccination rates is unclear. In a 4-arm pragmatic randomized controlled trial across 2 states, we randomly selected practices representative of the specialty (pediatrics, family medicine, and health center) where children received care. Within each practice, patients 11 to 17.9 years old who had not completed their HPV vaccine series (NY: N = 30 616 in 123 practices; CO: N = 31 502 in 80 practices) were randomly assigned to receive 0, 1, 2, or 3 IIS C-R/R autodialer messages per vaccine dose. We assessed HPV vaccine receipt via the IIS, calculated intervention costs, and compared HPV vaccine series initiation and completion rates across study arms. In New York, HPV vaccine initiation rates ranged from 37.0% to 37.4%, and completion rates were between 29.1% and 30.1%, with no significant differences across study arms. In Colorado, HPV vaccine initiation rates ranged from 31.2% to 33.5% and were slightly higher for 1 reminder compared with none, but vaccine completion rates, ranging from 27.0% to 27.8%, were similar. On adjusted analyses in Colorado, vaccine initiation rates were slightly higher for 1 and 3 C-R/R messages (adjusted risk ratios 1.07 and 1.04, respectively); completion rates were slightly higher for 1 and 3 C-R/R messages (adjusted risk ratios 1.02 and 1.03, respectively). IIS-based C-R/R for HPV vaccination did not improve HPV vaccination rates in New York and increased vaccination rates slightly in Colorado.

Introducing unknown compound classes is the key to extent the chemical space qualitatively. Here the authors report on a concept to design heterocyclic compound classes rationally and the synthesis of unknown classes of N-heterocyclic compounds

Iterated language learning experiments that explore the emergence of linguistic structure in the laboratory vary considerably in methodological implementation, limiting the generalizability of findings. Most studies also restrict themselves to exploring the emergence of combinatorial and compositional structure in isolation. Here, we use a novel signal space comprising binary auditory and visual sequences and manipulate the amount of learning and temporal stability of these signals. Participants had to learn signals for meanings differing in size, shape, and brightness; their productions in the test phase were transmitted to the next participant. Across transmission chains of 10 generations each, Experiment 1 varied how much learning of auditory signals took place, and Experiment 2 varied temporal stability of visual signals. We found that combinatorial structure emerged only for auditory signals, and iconicity emerged when the amount of learning was reduced, as an opportunity for rote-memorization hampers the exploration of the iconic affordances of the signal space. In addition, compositionality followed an inverted u-shaped trajectory raising across several generations before declining again toward the end of the transmission chains. This suggests that detection of systematic form-meaning linkages requires stable combinatorial units that can guide learners toward the structural properties of signals, but these combinatorial units had not yet emerged in these unfamiliar systems. Our findings underscore the importance of systematically manipulating training conditions and signal characteristics in iterated language learning experiments to study the interactions between the emergence of iconicity, combinatorial and compositional structure in novel signaling systems.