Mathiesenhudson9889

Many veterans receive behavioral health care services from providers in their communities. The Community Provider Toolkit (the Toolkit) is a website developed by the National Center for PTSD and the Department of Veterans Affairs intended to provide community mental health care providers with key veteran-focused educational resources. This mixed-methods study examined the potential impact of the Toolkit on provider knowledge and behaviors. Sixty-four clinicians in the community who currently or plan to provide services to veterans were surveyed. The majority of providers found the website useful and easy to navigate. After visiting the site, many providers found additional online and educational resources that they would add to a hypothetical treatment plan. Forty-five providers completed a 1-month follow-up survey focused on use of the Toolkit. Results indicate that the Toolkit may be a valuable tool for increasing provider knowledge about veteran-specific resources.

Oncoplastic breast surgery (OBS) is gaining popularity among surgeons for breast-conserving surgery treatments. OBS relies on complex relocation and deformation of breast tissue involving the tumor bed (TB). In this study, we investigate the validity of using surgical clips with OBS for accurate TB delineation in adjuvant, targeted breastradiotherapy.

Different OBS techniques were simulated on realistic breast phantoms. Surgical clips were used to demarcate the TB. Following tumor resection and closure, the true TB (TB

) was extracted. Each phantom was CT imaged at several phases of surgery in order to record pre- and post-OBS closure surgical clip displacements. Two senior radiation oncologists (ROs) were asked to delineate TBs on CTs by relying on surgical clips placedas per standard protocol, and by referring to operative notes. Their original contours, as well as those expanded using 5-15 mm margins, were compared with the accurate TB

using the dice similarity coefficient (DSC), Hausdorff Distance (HD), and over- and under-contoured volumes. Inter- and intra-RO contour agreements were also evaluated.

Post-OBS surgical clips were significantly displaced outside the original breast quadrant. Inter- and Intra-RO TB contours were consistent, yet systematically differed from TB

(DSC values range = 0.38 to 0.69, and maximum HD range = 17.8 mm to 38.0mm). Using expansion margins did not improve contour congruence and caused significant over-contoured volumes.

Following OBS, surgical clips alone are not reliable radiographic surrogates of TB locations and accurate TB delineation is challenging. For complex OBS cases, indication of any type of partial breast irradiation is very questionable.

Following OBS, surgical clips alone are not reliable radiographic surrogates of TB locations and accurate TB delineation is challenging. For complex OBS cases, indication of any type of partial breast irradiation is very questionable.

This study compares the sensitivity of dedicated breast positron emission tomography (DbPET) and whole body positron emission tomography (WBPET) in detecting invasive breast cancer based on tumor size and biology. Further, we explored the relationship between maximum standardized uptake value (SUVmax) of DbPET and biological features of the tumor.

A total of 639 invasive breast cancer lesions subjected to both DbPET and WBPET before surgery, between January 2016 and May 2019, were included in the study. The sensitivity of DbPET and WBPET in detection and the biology of the tumor according to the clinicopathological features were retrospectively evaluated.

The overall sensitivity of DbPET was higher than that of WBPET (91.4% vs. 80.3%, p < 0.001). Subcentimetric tumors were significant (80.9% vs. 54.3%, p < 0.001). Regardless of the nuclear grade, DbPET could detect more lesions than WBPET. The SUVmax was positively correlated with tumor size (R = 0.395, p < 0.001) and the nuclear grade (p < 0.001). Luminal A-like breast cancer had significantly lower SUVmax values than the other subtypes (p < 0.001).

DbPET is superior to WBPET in the detection of subcentimetric, low-grade breast cancers. Further, by using SUVmax, DbPET can distinguish luminal A-like breast cancer from the other subtypes.

DbPET is superior to WBPET in the detection of subcentimetric, low-grade breast cancers. Further, by using SUVmax, DbPET can distinguish luminal A-like breast cancer from the other subtypes.In 1904 Paul Morawitz postulated that an enzyme, which he named thrombokinase, would be the primary activator of prothrombin. Fifty years passed before J Haskell Milstone isolated, purified and functionally characterized the enzyme we now call Factor Xa. This essay summarizes Milstone's work on thrombokinase, and finds context for why his efforts succeeded while others struggled.Regeneration of plants through seed is governed by the ability and rate to germinate, which largely depends on the climatic variables prevailing during pre-harvest (mother plant growth) and post-harvest (processing and storage) stages. Atmospheric carbon dioxide concentration [CO2] is increasing rapidly and is expected to surpass 550 ppm within this century. Elevated CO2 (e[CO2]) is reported to influence the mother plant at morphological, phenological, physiological and biochemical levels across the species. Such changes are expected to alter the quality components of the progeny seeds, which has received very little research attention. This review discusses about the possible implications of e[CO2] on quality attributes of seed affecting its planting value with much emphasis on seed weight, germination, vigour and its biochemical constituents. Research indicates that the effect of e[CO2] on seed weight is variable and influenced by the availability of nutrients particularly nitrogen. Likewise, seed germination shows a divergent effect, whereas seed vigour that indicates the strength of a seed usually is compromised under e[CO2]. It generally alters the balance between tissue carbon and nitrogen content, thus impairs the normal CN ratio in progeny seed, which eventually impacts the next generation crop. For mitigation, while global breeding efforts focused on elite but narrow gene pool across the crop species shredded some of the ecologically important seed traits, such as thick and dark seed coat in legumes, such traits must be considered in designing breeding programs as they provide resilience to various stresses. We have suggested additional potential mitigation strategies and areas for future research.Naturalistic developmental behavioral interventions (NDBIs) are evidence-based interventions for young children with autism spectrum disorder. There has been growing interest in implementing manualized NDBIs within the early intervention (EI) system without a clear understanding of how these programs and the broader strategies encompassed within them are already used by EI providers. This study examined the use of manualized NDBI programs and broader NDBI strategies within an EI system and factors that impacted their use. Eighty-eight EI providers completed a measure of NDBI program and strategy use. Thirty-three providers participated in a supplemental focus group or interview. Overall, providers described using broader NDBI strategies and the need to adapt manualized NDBI programs. Provider-, intervention-, and organization-level factors impacted their use of NDBI programs and strategies.This study investigated the feasibility and preliminary effectiveness of a concurrent mindfulness program (MYmind) on Chinese adolescents with autism spectrum disorder and their parents in Hong Kong, China using a randomized controlled trial with a waitlist control group. Results showed the study had 80% compliance rate, 0% dropout rate, and 89% response rate. Between-group comparisons showed mindfulness had trend effects on parent's rumination (g = 1.16), mindful parenting (d = 0.6), parenting style (d = 0.59), and parenting stress (d = 0.5). The study demonstrated the feasibility of the MYmind program in the Chinese context. A larger trial with longer follow-up period is suggested to better examine the effect of mindfulness on adolescents with ASD and their parents.Over the past two decades, therapeutic alliance research has increasingly focused on understanding the process by which the alliance is ruptured and repaired. This paper is the first to explore how alliance rupture segments from psychotherapy sessions differ from non-rupture segments on key dimensions of the referential process. A sample of 27 psychotherapy sessions were scored using a measure designed to identify rupture from non-rupture segments. These segments were then scored for key linguistic dimensions of the referential process. During ruptures patients manifested a referential process marked by a decrease in emotional engagement, an increase in a measure of distancing, and an increase in negation as compared to non-rupture segments. Therapists show similar patterns but, in addition, manifest a language pattern that suggests that during ruptures, therapists are attempting to make sense of, and self-disclose, aspects of their inner experience. Implications for research and clinical work are explored.The photo-thermal lens technique is based on the measurement of the gradient temperature that is produced in an illuminated sample by laser beam as a result of non-radiative relaxation. The sensitivity of photo-thermal lens is higher than conventional absorption techniques, due to the direct measurement of absorbed energy. However, the main drawback of the photo-thermal lens technique is the inability to measure molecules that release their excess energy of absorption in the form of radiation relaxation. In fluorescence molecules, because their excess energy is released by radiation, the photo-thermal lens is insignificant. In this research, we aim to increase the photo-thermal lens sensitivity of the fluorescence molecules by selecting the appropriate acceptor for the fluorescence molecules as the donor. We investigated the effect of the presence of AuNPs on the photo-thermal lens of di-triazene (DTA) as fluorescence molecules. We observed that AuNPs enhanced the photo-thermal lens of DTA. TMP269 The quantum yield of DTA was calculated to be 90.45%. The energy transfer from DTA to AuNPs occurs by fluorescence resonance energy transfer (FRET) mechanism. The FRET efficiency was 83.43%. In the presence of AuNPs, the photo-thermal lens of the DTA was amplified by four times more. The calibration curve of DTA is linear in the range of 0.1 to 110 ng/mL. The limited of detection (LOD) value of 0.08 ng/mL is calculated.

We investigate the possibility to exploit high-field MRI to acquire 3D images of Purkinje network which plays a crucial role in cardiac function. Since Purkinje fibers (PF) have a distinct cellular structure and are surrounded by connective tissue, we investigated conventional contrast mechanisms along with the magnetization transfer (MT) imaging technique to improve image contrast between ventricular structures of differing macromolecular content.

Three fixed porcine ventricular samples were used with free-running PFs on the endocardium. T1, T2*, T2, and M0 were evaluated on 2D slices for each sample at 9.4T. MT parameters were optimized using hard pulses with different amplitudes, offset frequencies and durations. The cardiac structure was assessed through 2D and 3D T1w images with isotropic resolutions of 150µm. Histology, immunofluorescence, and qPCR were performed to analyze collagen contents of cardiac tissue and PF.

An MT preparation module of 350ms duration inserted into the sequence with a B1 = 10 µT and frequency offset = 3000Hz showed the best contrast, approximately 0.