Psychotherapy session frequency: A naturalistic examination in a university counseling center.

With increasing demand for psychotherapy services, clinicians are carrying increasingly large caseloads (Bailey et al., 2020). As the number of new intakes exceeds the number of clinical hours available each week in some settings, psychotherapy is delivered on an attenuated schedule for returning clients (rather than the traditional weekly frequency); there is, however, little support for the efficacy of this practice.

Adapting stepped care: Changes to service delivery format in the context of high demand.

Given the ongoing dilemma for college counseling centers to meet steady increases in demand for services, this study outlines the implementation of an adapted stepped care model in a university counseling center. Our adapted model focused, as do other stepped care models, on treatment planning and lower-intensity interventions, with the addition of the intensive therapy option being provided on a weekly basis. We adopted our stepped care model across a large center and hypothesized that after implementation we would be able to serve a similar number of clients as our previous model and that treatment outcomes for these clients would improve.

Nano- and Microfiber PVB Patches as Natural Oil Carriers for Atopic Skin Treatment.

Atopic dermatitis (eczema) is a widespread disorder, with researchers constantly looking for more efficacious treatments. Natural oils are reported to be an effective therapy for dry skin, and medical textiles can be used as an alternative or supporting therapy. In this study, fibrous membranes from poly(vinyl butyral-co-vinyl alcohol-co-vinyl acetate) (PVB) with low and high molecular weights were manufactured to obtain nano- and micrometer fibers electrospinning for the designed patches used as oil carriers for atopic skin treatment.

Busy therapists: Examining caseload as a potential factor in outcome.

As demand increased for mental health services, especially in university counseling centers, providers have seen increasing numbers of clients. The effect of this increase on therapist caseloads is explored, with a recognition that past research on therapist caseloads lacks direct and fluctuating measures of caseload that reflect practice in naturalistic settings. Using a large dataset from a counseling center ( = 18,322), therapist caseload was conceptualized dynamically over rolling 30-day periods, using within-therapist counts of therapy sessions, unique clients seen, and the proportion of unique clients to sessions.

Solid lipid nanoparticles self-assembled from spray dried microparticles.

We report the self-assembly of drug-loaded solid lipid nanoparticles (SLNs) from spray dried microparticles comprising poly(vinylpyrrolidone) (PVP) loaded with glyceryl tristearate (GTS) and either indomethacin (IMC) or 5-fluorouracil (5-FU). When the spray dried microparticles are added to water, the PVP matrix dissolves and the GTS and drug self-assemble into SLNs. The SLNs provide a non-toxic delivery platform for both hydrophobic (IMC) and hydrophilic (5-FU) drugs.

Using EHRs to advance epilepsy care.

The improved use of Electronic Health Record (EHR) Systems provides an opportunity to improve the overall efficiency and quality of care of patients with epilepsy. Tools and strategies that may be incorporated into the use of EHRs include utilizing patient generated data, clinical decision support systems and natural language processing systems. Standardization of data from EHR systems may lead to improvement in clinical research through the creation of data collections and multi-center collaborations.

Microbial-tubeworm associations in a 440 million year old hydrothermal vent community.

Microorganisms are the chief primary producers within present-day deep-sea hydrothermal vent ecosystems, and play a fundamental role in shaping the ecology of these environments. However, very little is known about the microbes that occurred within, and structured, ancient vent communities. The evolutionary history, diversity and the nature of interactions between ancient vent microorganisms and hydrothermal vent animals are largely undetermined.

Trends in intracranial monitoring for pediatric medically intractable epilepsy: 2000-2012.

Objective: To retrospectively examine nationwide trends in intracranial monitoring (ICM) for pediatric medically intractable epilepsy (MIE) from 2000 to 2012.

Methods: The Healthcare Cost and Utilization Project Kids' Inpatient Database was analyzed to identify admissions with ICD-9-CM codes corresponding to MIE and ICM from 2000 to 2012, inclusive. Associations between independent variables and outcomes were tested using χ test or Fisher exact test.

A Case of KCNQ2-Associated Movement Disorder Triggered by Fever.

The differential diagnosis of fever-induced movement disorders in childhood is broad. Whole exome sequencing has yielded new insights into those cases with a suspected genetic basis. We report the case of an 8-year-old boy with a history of neonatal seizures who presented with near-continuous hyperkinetic movements of his limbs during a febrile illness.

A longitudinal investigation of the impact of psychotherapist training: Does training improve client outcomes?

This study is a longitudinal examination of the impact of therapist stage of training on client outcomes in psychotherapy. The study included 22 PhD-level psychologists who work in a university counseling center (8 female, 14 male) who had completed at least 2 training periods in the center where data were gathered. Therapists worked with 4,047 clients, and 40,271 sessions were included in our analyses.

Prognostic Significance of Cavitary Lung Nodules in Granulomatosis With Polyangiitis (Wegener's): A Clinical Imaging Study of 225 Patients.

Objective: Granulomatosis with polyangiitis (Wegener's) (GPA) is a systemic necrotizing vasculitis in which pulmonary nodules are a common manifestation. Our study examined whether pulmonary nodules, and nodule type (solid versus cavitary), are associated with different disease manifestations and outcomes.

Methods: Demographic, clinical, biologic, and radiologic data at diagnosis and during followup and treatments of GPA patients followed at the Mount Sinai Hospital (Canada) Vasculitis Clinic were analyzed.

Sunshine on my shoulders: Weather, pollution, and emotional distress.

Background: Researchers have examined the relationship between mental health and weather/pollution with mixed results. The current study aimed to examine a range of weather and atmospheric phenomena and their association with time-bound mental health data.

Methods: Nineteen different weather/pollution variables were examined in connection with an archive of self-reported mental health data for university students participating in mental health treatment (n=16,452) using the Outcome Questionnaire 45.

Wetting Hierarchy in Oleophobic 3D Electrospun Nanofiber Networks.

Wetting behavior between electrospun nanofibrous networks and liquids is of critical importance in many applications including filtration and liquid-repellent textiles. The relationship between intrinsic nanofiber properties, including surface characteristics, and extrinsic nanofibrous network organization on resultant wetting characteristics of the nanofiber network is shown in this work. Novel 3D imaging exploiting focused ion beam (FIB) microscopy and cryo-scanning electron microscopy (cryo-SEM) highlights a wetting hierarchy that defines liquid interactions with the network.

Using the Assessment for Signal Clients as a feedback tool for reducing treatment failure.

Objective: The Clinical Support Tools (CSTs) were developed to help therapists organize and target potential problems that might account for negative outcomes in psychotherapy. The core of CST feedback is the Assessment for Signal Clients. The purpose of this study was to describe and identify patterns of problems that typically characterize off-track cases.

Disturbed cartilage and joint homeostasis resulting from a loss of mitogen-inducible gene 6 in a mouse model of joint dysfunction.

Objective: Mitogen-inducible gene 6 (MIG-6) regulates epidermal growth factor receptor (EGFR) signaling in synovial joint tissues. Whole-body knockout of the Mig6 gene in mice has been shown to induce osteoarthritis and joint degeneration. To evaluate the role of chondrocytes in this process, Mig6 was conditionally deleted from Col2a1-expressing cell types in the cartilage of mice.

Loss of ATRX does not confer susceptibility to osteoarthritis.

The chromatin remodelling protein ATRX is associated with the rare genetic disorder ATR-X syndrome. This syndrome includes developmental delay, cognitive impairment, and a variety of skeletal deformities. ATRX plays a role in several basic chromatin-mediated cellular events including DNA replication, telomere stability, gene transcription, and chromosome congression and cohesion during cell division.

Nanoscale-targeted patch-clamp recordings of functional presynaptic ion channels.

Direct electrical access to presynaptic ion channels has hitherto been limited to large specialized terminals such as the calyx of Held or hippocampal mossy fiber bouton. The electrophysiology and ion-channel complement of far more abundant small synaptic terminals (≤ 1 μm) remain poorly understood. Here we report a method based on superresolution scanning ion conductance imaging of small synapses in culture at approximately 100-150 nm 3D resolution, which allows presynaptic patch-clamp recordings in all four configurations (cell-attached, inside-out, outside-out, and whole-cell).

Targeted loss of the ATR-X syndrome protein in the limb mesenchyme of mice causes brachydactyly.

ATR-X syndrome is a rare genetic disorder caused by mutations in the ATRX gene. Affected individuals are cognitively impaired and display a variety of developmental abnormalities, including skeletal deformities. To investigate the function of ATRX during skeletal development, we selectively deleted the gene in the developing forelimb mesenchyme of mice.

Evaluating focused ion beam induced damage in soft materials.

Focused ion beam (FIB) microscopy uses Ga(+) ions to remove material from a sample for a variety of imaging and preparation techniques. While considerable work has examined the effects of FIB exposure on a number of materials, optimized FIB conditions for use with softer polymeric materials are yet to be determined. In this report we use phase contrast AFM to measure local changes in the elastic modulus of polycarbonate surfaces parallel to a sectioning FIB at varying beam energies.

Automated vulnerability testing identifies patients with inadequate defibrillation safety margin.

Background: Implantable cardioverter-defibrillator system efficacy is tested at implant by induction of ventricular fibrillation (VF). Defibrillation safety margin can be assessed without VF induction using upper limit of vulnerability methods, but these methods have required manual determination of T-wave timing.

Methods And Results: To test the feasibility of an inductionless system of implant testing, a multicenter prospective study of an automated vulnerability safety margin system was conducted, which measured T-wave timing using an intracardiac electrogram during a ventricular pacing train.

Manufacture of void-free electrospun polymer nanofiber composites with optimized mechanical properties.

Engineered fiber reinforced polymer composites require effective impregnation of polymer matrix within the fibers to form coherent interfaces. In this work, we investigated solution interactions with electrospun fiber mats for the manufacture of nanocomposites with optimized mechanical properties. Void free composites of electrospun nonwoven PA6 nanofibers were manufactured using a PVA matrix that is introduced into the nonwoven mat using a solution-based processing method.

In situ tensile testing of nanofibers by combining atomic force microscopy and scanning electron microscopy.

A nanomechanical testing set-up is developed by integrating an atomic force microscope (AFM) for force measurements with a scanning electron microscope (SEM) to provide imaging capabilities. Electrospun nanofibers of polyvinyl alcohol (PVA), nylon-6 and biological mineralized collagen fibrils (MCFs) from antler bone were manipulated and tensile-tested using the AFM-SEM set-up. The complete stress-strain behavior to failure of individual nanofibers was recorded and a diversity of mechanical properties observed, highlighting how this technique is able to elucidate mechanical behavior due to structural composition at nanometer length scales.

Acute evaluation of programmer-guided AV/PV and VV delay optimization comparing an IEGM method and echocardiogram for cardiac resynchronization therapy in heart failure patients and dual-chamber ICD implants.

Introduction: Intracardiac delay optimization of biventricular and dual-chamber pacing devices currently relies on time-consuming echocardiographic measurements. A novel intracardiac electrogram (IEGM) method for atrioventricular (AV/PV) and interventricular (VV) delay optimization was developed, which can be performed during routine device follow-up.

Methods And Results: In this prospective, nonrandomized, multi-center trial, patients previously implanted with St.