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Implementation of video call-based cognitive behavioural therapy (CBT) has increased significantly since the COVID-19 pandemic, enabling more flexible delivery, but less is known about user experience and effectiveness. This systematic review and meta-analysis investigated feasibility, acceptability, and effectiveness of individual video call-based CBT for adults with mild to moderate mental health conditions (Prospero CRD42021291055). Medline, Embase, PsycINFO and Web of Science were searched until 4 September 2023. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) assessed methodological quality of studies. Meta-analysis was conducted in R. Thirty studies (n=3275), published 2000 to 2022, mainly in the USA (n=22/30, 73%), were included. There were 15 randomised control trials, one controlled clinical trial, and 14 uncontrolled studies. Findings indicated feasibility, acceptability and effectiveness (effect size range 0.02–8.30), especially in post-traumatic stress disorder (PTSD) for military populations. Other studies investigated depression, obsessive-compulsive disorder, panic with agoraphobia, insomnia, and anxiety. Studies indicated that initial challenges with video call-based CBT subsided as therapy progressed and technical difficulties were managed with limited impact on care. EPHPP ratings were strong (n=12/30, 40%), moderate (n=12/30, 40%), and weak (n=6/30, 20%). Meta-analysis on 12 studies indicated that the difference in effectiveness of video call-based CBT and in-person CBT in reducing symptoms was not significant (SMD=0.044; CI=–0.086; 0.174). Video calls could increase access to CBT without diminishing effectiveness. Limitations include high prevalence of PTSD studies, lack of standardised definitions, and limited studies, especially those since the COVID-19 pandemic escalated use of video calls.
Key learning aims
This review assesses feasibility, acceptability, and effectiveness of individual video call-based CBT for adults with mild to moderate common mental health conditions, as defined by the ICD-11.
Secondary aims were to assess if the therapeutic relationship is affected and identify any potential training needs in delivering video call-based CBT.
The adjunct meta-analysis quantitatively explored whether video call-based CBT is as effective as in-person interventions in symptom reduction on primary outcome measures by pooling estimates for studies that compare these treatment conditions.
The stratified inclined duct (SID) sustains an exchange flow in a long, gently sloping duct as a model for continuously forced density-stratified flows such as those found in estuaries. Experiments have shown that the emergence of interfacial waves and their transition to turbulence as the tilt angle is increased appears to be linked to a threshold in the exchange flow rate given by inviscid two-layer hydraulics. We uncover these hydraulic mechanisms by (i) using recent direct numerical simulations (DNS) providing full flow data in the key flow regimes (Zhu et al., J. Fluid Mech., vol. 969, 2023, A20), (ii) averaging these DNS into two layers, and (iii) using an inviscid two-layer shallow-water and instability theory to diagnose interfacial wave behaviour and provide physical insight. The laminar flow is subcritical and stable throughout the duct and hydraulically controlled at the ends of the duct. As the tilt is increased, the flow becomes supercritical everywhere and unstable to long waves. An internal jump featuring stationary waves first appears near the centre of the duct, then leads to larger-amplitude travelling waves, and to stronger jumps, wave breaking and intermittent turbulence at the largest tilt angle. Long waves described by the (nonlinear) shallow-water equation are interpreted locally as linear waves on a two-layer parallel base flow described by the Taylor–Goldstein equation. This link helps us to interpret long-wave instability and contrast it with short-wave (e.g. Kelvin–Helmholtz) instability. Our results suggest a transition to turbulence in SID through long-wave instability relying on vertical confinement by the top and bottom walls.
The stratified inclined duct (SID) experiment consists of a zero-net-volume exchange flow in a long tilted rectangular duct, which allows the study of realistic stratified shear flows with sustained internal forcing. We present the first three-dimensional direct numerical simulations (DNS) of SID to explore the transitions between increasingly turbulent flow regimes first described by Meyer & Linden (J. Fluid Mech., vol. 753, 2014, pp. 242–253). We develop a numerical set-up that faithfully reproduces the experiments and sustains the flow for arbitrarily long times at minimal computational cost. We recover the four qualitative flow regimes found experimentally in the same regions of parameter space: laminar flow, waves, intermittent turbulence and fully developed turbulence. We find good qualitative and quantitative agreement between DNS and experiments and highlight the added value of DNS to complement experimental diagnostics and increase our understanding of the transition to turbulence, both temporally (laminar/turbulent cycles) and parametrically (as the tilt angle of the duct and the Reynolds number are increased). These results demonstrate that numerical studies of SID – and deeper integration between simulations and experiments – have the potential to lead to a better understanding of stratified turbulence.
OBJECTIVES/GOALS: Glioblastomas (GBMs) are heterogeneous, treatment-resistant tumors that are driven by populations of cancer stem cells (CSCs). In this study, we perform an epigenetic-focused functional genomics screen in GBM organoids and identify WDR5 as an essential epigenetic regulator in the SOX2-enriched, therapy resistant cancer stem cell niche. METHODS/STUDY POPULATION: Despite their importance for tumor growth, few molecular mechanisms critical for CSC population maintenance have been exploited for therapeutic development. We developed a spatially resolved loss-of-function screen in GBM patient-derived organoids to identify essential epigenetic regulators in the SOX2-enriched, therapy resistant niche. Our niche-specific screens identified WDR5, an H3K4 histone methyltransferase responsible for activating specific gene expression, as indispensable for GBM CSC growth and survival. RESULTS/ANTICIPATED RESULTS: In GBM CSC models, WDR5 inhibitors blocked WRAD complex assembly and reduced H3K4 trimethylation and expression of genes involved in CSC-relevant oncogenic pathways. H3K4me3 peaks lost with WDR5 inhibitor treatment occurred disproportionally on POU transcription factor motifs, required for stem cell maintenance and including the POU5F1(OCT4)::SOX2 motif. We incorporated a SOX2/OCT4 motif driven GFP reporter system into our CSC cell models and found that WDR5 inhibitor treatment resulted in dose-dependent silencing of stem cell reporter activity. Further, WDR5 inhibitor treatment altered the stem cell state, disrupting CSC in vitro growth and self-renewal as well as in vivo tumor growth. DISCUSSION/SIGNIFICANCE: Our results unveiled the role of WDR5 in maintaining the CSC state in GBM and provide a rationale for therapeutic development of WDR5 inhibitors for GBM and other advanced cancers. This conceptual and experimental framework can be applied to many cancers, and can unmask unique microenvironmental biology and rationally designed combination therapies.
Severe acute respiratory syndrome (SARS) is a highly contagious viral respiratory illness associated with hypoxia and dyspnea. Many of those who contracted and recovered from SARS during the 2002–2003 outbreak reported persistent physical, psychological, and cognitive difficulties. Here, we investigated the residual influences of SARS on cognition for a subset of healthcare professionals who recovered and were referred for neuropsychological evaluation through their workplace insurance.
Method:
Twenty-eight healthcare professionals were evaluated on neuropsychological and mood functioning approximately 1.5 years post-recovery from a severe respiratory illness. Test scores were compared with age-matched normative data, and correlations were examined between mood, self-report memory scales, subjective complaints (e.g., poor concentration, pain, fatigue), illness severity (i.e., length of hospitalization, oxygen use during hospital stay), and cognitive performance.
Results:
Participants performed within age expectations on the majority of cognitive measures including overall memory ability. Although processing speed was generally within normal limits, 43% showed significant speed–accuracy trade-offs favoring accuracy over maintaining speed. Deficits were observed on measures of complex attention, such as working memory and the ability to sustain attention under conditions of distraction. Participants endorsed poorer memory ability than same-age peers on a meta-memory measure and mild to moderate depression and anxiety symptoms. Objective test performance was largely uncorrelated with self-reports, mood, or illness severity, except for moderate correlations between complex attention and participants’ subjective ratings of Everyday Task-Oriented Memory.
Conclusions:
These findings demonstrate specific long-term cognitive deficits associated with SARS and provide further evidence of the cognitive effects of hypoxic illnesses.
Republican Rome saw a range of laws designed to moderate the acquisition of wealth, and this chapter focuses on two such measures, the Lex Licinia de modo agrorum (367 BCE) and Tiberius Gracchus’ agrarian law of 133 BCE. In our later sources these two historical moments tend to be conflated, and the chapter begins by confronting the ensuing methodological problems. A critical review of the previous scholarship establishes that whereas the pre-Gracchan limit applied to all landholding not just public land, Gracchus, who was interested in reclaiming public land for distribution rather than putting a limit on elite wealth, revived the earlier limit, but applied it only to public land. These findings serve as basis for a discussion of the law carried by the tribune C. Licinius Stolo in 367 BCE, including the identification of an ‘ethos of frugality’ in mid-republican Rome which was meant to prevent individuals from accumulating excessive material resources. The final part of the chapter traces the history of the tension between the pursuit of personal enrichment and the interest of the wider community to keep such pursuits in check – an endeavour rendered increasingly difficult given Rome’s foreign conquests.
Field experiments were conducted at four locations in the Central Pacific region of Costa Rica between 1994 and 1996 to determine suitable tactics for integrated control of propanil-resistant junglerice in rain-fed rice. Stubble incorporation within 3 mo after rice harvest did not affect the density of junglerice that emerged with the crop at the beginning of the rainy season at any location. However, the elimination with glyphosate of the first junglerice seedling population emerging before rice planting consistently reduced the in-crop infestation of junglerice and resulted in increased grain yields. The positive effect of eliminating the first junglerice flush remained even after the in-crop treatments were applied and lasted after rice harvest. Substitution of the two customary applications of propanil (3.8 kg ha−1 each) with a single application of pendimethalin (0.75 to 1.5 kg ha−1), preemergence or early postemergence, also reduced junglerice infestation and improved grain yield. Both propanil, in mixture with the synergist piperophos, and quinclorac controlled propanil-resistant junglerice and increased grain yields. Control of the initial junglerice population and improved in-crop weed management can serve as the basis for integrated management of herbicide-resistant junglerice in rain-fed rice.
Rapid detection methods were developed for discriminating between resistant (R) and susceptible (S) biotypes of Echinochloa colona to either propanil or fenoxaprop-P at all growth stages. In the pregerminated seed assay for fenoxaprop-P, seeds were placed on 1.0% agar containing a range of concentrations of herbicides and kept under humid conditions. For propanil, pregerminated seeds were placed on moist filter paper in the lid of a petri dish and, when one leaf had developed, the lid was inverted for 1 min into propanil solutions at a range of concentrations. For the fenoxaprop-P and propanil test, seedling length and fresh weight were measured after 1 wk. For juvenile plants with four-leaf to one-tiller, shoots and roots were trimmed and placed in 20-ml glass tubes containing 0.2% (wt/v) agar and a range of concentrations of herbicides. Shoot extension and weight were recorded after 7 d. Larger plants with several small tillers were also assayed by this method. Tillers were removed from larger plants and were evaluated as described for juvenile plants. At later growth stages from ear emergence to flowering, excised stem node segments (8 cm) were soaked in water to stimulate rooting. Rooted nodes were placed in 30-ml glass bottles containing 0.2% agar with a range of concentrations of herbicides, and the test was conducted as described for juvenile plants but with the final assessment of new shoot extension and weight being recorded after 10 d. Discrimination between R and S biotypes was possible on the basis of GR50 values for shoot length and fresh weight in all testing methods. With few exceptions, GR50 values for the length of new shoot were very similar to those for the new shoot fresh weight. We concluded that all testing methods in our study provided reliable and quick discrimination between biotypes for both propanil and fenoxaprop-P susceptibility, covering various growth stages from seed to flowering stage. Trimming plants before herbicide treatment gives a rapid method of discrimination by measuring not only newly grown shoot fresh weight but also shoot length.
We use the underlying data of the IMPLAN Pro 3.0 regional economic simulation model to estimate the current economic contribution of Michigan's local food system and explore the chain of transactions giving rise to consumption of locally sourced goods from producer to processor to consumption. The proposed methodology includes both unprocessed and processed foods in the estimation of the local food system's economic value. The model also provides a replicable and consistent approach to estimating the value of local food systems within regional and state economies.
This volume examines the Bible's role in the modern world - beginning with a treatment of its production and distribution that discusses publishers, printers, text critics, and translators and continuing with a presentation of new methods of studying the text that have emerged, including historical, literary, social-scientific, feminist, postcolonial, liberal, and fundamentalist readings. There is a full discussion of the changes in understandings of and approaches to the Bible in various faith communities. The dissemination of the Bible throughout the globe has also produced a host of new interpretations, and this volume provides a comprehensive geographical survey of its reception. In the final chapters, the authors offer a thematic overview of the Bible in relation to literature, art, film, science, and other disciplines. They demonstrate that, in spite of challenges to the Bible's authority in western Europe, it remains highly relevant and influential, not least in the Americas, Africa, and Asia.
The Reformation's emphasis on the Bible as the major authority and the appearance of German criticism inspired many writers of the Enlightenment and the age of Romanticism to present biblical characters and stories in a new humanistic light. Writers presented new interpretations of negative or suffering biblical characters who seem to have been unfairly cursed by God including Adam and Eve, Cain, Hagar, Ishmael, and, later in the nineteenth century, Judas and feminine characters like Mary Magdalene. Inspired by the Christian revelation of God as a God of love, literature often rewrites the Bible in a sympathetic and forgiving Spirit. The 'quest for the historical Jesus' in the nineteenth and twentieth centuries produced several academic and fictional concepts and images. Most fictional Jesus narratives belong to second-rate literature. Pontius Pilate traditionally plays an important role in literature about Jesus, presenting the conflict between earthly and divine power and wisdom.