Systematic Review of the Key Factors Influencing the Indoor Airborne Spread of SARS-CoV-2.

The COVID-19 pandemic due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been plaguing the world since late 2019/early 2020 and has changed the way we function as a society, halting both economic and social activities worldwide. Classrooms, offices, restaurants, public transport, and other enclosed spaces that typically gather large groups of people indoors, and are considered focal points for the spread of the virus. For society to be able to go "back to normal", it is crucial to keep these places open and functioning. An understanding of the transmission modes occurring in these contexts is essential to set up effective infection control strategies. This understanding was made using a systematic review, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PRISMA) 2020 guidelines. We analyze the different parameters influencing airborne transmission indoors, the mathematical models proposed to understand it, and discuss how we can act on these parameters. Methods to judge infection risks through the analysis of the indoor air quality are described. Various mitigation measures are listed, and their efficiency, feasibility, and acceptability are ranked by a panel of experts in the field. Thus, effective ventilation procedures controlled by CO2-monitoring, continued mask wearing, and a strategic control of room occupancy, among other measures, are put forth to enable a safe return to these essential places.

Potential for the valorisation of brewer's spent grains: A case study for the sequential extraction of saccharides and lignin.

This study highlights the possibility of using brewers' grains (BSGs) for the successive extraction of the main lignocellulosic biopolymers, namely, cellulose, hemicelluloses and lignin. An exhaustive chemical characterisation revealed a variability of composition in distinct batches of BSGs, depending on their origin and the brewing process used. In particular, the protein content can vary from 13wt% to 23wt%, which is accompanied by a change in the hemicelluloses content from 9% to 23% (in the samples of our study). By applying a two-step aqueous treatment, involving an acid (1.25% v/v aq. H2SO4) and a base (3% w/v aq. NaOH) at a temperature of 120°C and fixed reaction time of a few tens of minutes (15-90 minutes), more than 80% of hemicelluloses could be recovered. Cellulose could be isolated at more than 68%, while a high purity lignin could be recovered from a lignin-rich fraction (70wt%). Our work also suggests that the variability of the chemical composition of these BSGs is a hindrance to achieving process standardisation and large-scale exploitation. The pooling of various materials is therefore not a recommended option, and the preliminary chemical analysis of the composition is therefore a prerequisite for an efficient extraction process.

Commitment, Forgiveness, and Relationship Self-Regulation: An Actor Partner Interdependence Model of Relationship Virtues and Relationship Effort in Couple Relationships.

Dyadic data from 679 committed couples were used to examine associations between commitment, forgiveness, and perceptions of partner's relationship self-regulation (RSR) behaviors-that is effort and strategies that partners exert to maintain the relationship. We found that for both partners, higher self-reports of commitment and forgiveness were associated with higher perceptions of their partner's RSR. For females, higher commitment and forgiveness were associated with higher male perceptions of her RSR, and higher male forgiveness was associated with higher female perceptions of his RSR. These findings demonstrate the importance of marital virtues and relationship work and give credence to the marital competence model of "other-centeredness" by Carroll et al. (2006, Journal of Family Issues, 27(7), 1001). Clinical implications are discussed.

Eating disorders treatment patterns by age.

This longitudinal, retrospective study examines patterns in eating disorder outpatient mental health treatment by age. Participants (n = 5,445) included patients treated for an eating disorder, with claims for treatment from Cigna, a leading health care insurance provider in the United States. Treatments for individuals 55 and older were less expensive and shorter than for any other age group. Treatments for individuals 44-55 were less expensive than for 15-24. Individual therapy is the most common treatment modality, but younger individuals are likely to receive family therapy. Younger individuals have lower dropout and higher return to care rates.

Central serotonergic neuron deficiency in a mouse model of Zellweger syndrome.

Zellweger syndrome (ZS) is a severe peroxisomal disorder caused by mutations in peroxisome biogenesis, or PEX, genes. A central hallmark of ZS is abnormal neuronal migration and neurodegeneration, which manifests as widespread neurological dysfunction. The molecular basis of ZS neuropathology is not well understood. Here we present findings using a mouse model of ZS neuropathology with conditional brain inactivation of the PEX13 gene. We demonstrate that PEX13 brain mutants display changes that reflect an abnormal serotonergic system - decreased levels of tryptophan hydroxylase-2, the rate-limiting enzyme of serotonin (5-hydroxytryptamine, 5-HT) synthesis, dysmorphic 5-HT-positive neurons, abnormal distribution of 5-HT neurons, and dystrophic serotonergic axons. The raphe nuclei region of PEX13 brain mutants also display increased levels of apoptotic cells and reactive, inflammatory gliosis. Given the role of the serotonergic system in brain development and motor control, dysfunction of this system would account in part for the observed neurological changes of PEX13 brain mutants.

Family intervention and health care costs for kansas medicaid patients with schizophrenia.

Despite a number of studies investigating the effect of pharmacotherapy on treatment costs for schizophrenia patients, there has been little attention given to the effect of family intervention. In this study, data from the Kansas Medicaid system were used to analyze healthcare costs for 164 schizophrenia patients who had participated in family intervention. Structural equation modeling was used to test two competing views of the role of family intervention in treatment. The results showed that a model including direct and indirect effects of family intervention provided a better fit to the data. Family intervention had a significant indirect effect on general medical costs (through other psychological treatment) that showed a savings of $586 for each unit increase in the provision of these services. In addition, the total indirect effects for family intervention showed a $580 savings for general medical costs and $796 for hospitalization costs (for each unit increase).

Assessing play-based activities, child talk, and single session outcome in family therapy with young children.

This exploratory, observational study was designed to reveal descriptive information regarding therapists' actual practices with preschool- and school-aged children in a single session of family therapy and to investigate change mechanisms in family play therapy that have been proposed to make this approach effective. A purposive sample of 30 families receiving family therapy was recruited and video-taped during a family session where at least one child between the ages of 4 and 12 was present. Following the session, the therapist and parent(s) completed questionnaires while one of the children (aged 4-12) was interviewed. Session recordings were coded, minute-by-minute, for participant talk time, visual aids or props used, and therapy technique type (e.g., play-based/activity vs. talk-only techniques). Hierarchical regression and canonical correlational analyses revealed evidence supporting the theory that play-based techniques promote young children's participation, enhance the quality of the child-therapist relationship, and build positive emotional experiences in family therapy.

The influence of profession and therapy type on the treatment of sexual dysfunctions.

Sexual dysfunctions are serious mental health issues that affect an estimated 1 in 3 Americans, yet many people with sexual dysfunctions do not seek treatment. Health services research on variables related to access, barriers, costs, and outcomes of treatment may help improve the quality of care. The current research is a retrospective analysis of administrative data from CIGNA that explores whether the type of profession (i.e., psychologist, social worker, marriage and family therapist, or professional counselor) or therapy modality (i.e., individual, conjoint, or mixed-mode, a combination of individual and conjoint therapy) influence the outcomes of mental health treatment. Participants included 230 men and 189 women between the ages of 18 to 101 years from all regions of the United States who received treatment for sexual disorders from 2001 to 2006. Results indicate that outcomes are similar across the different license types. Results also suggest that mixed-mode therapy has lower dropout rates and longer retention than individual or conjoint therapy. These results suggest that using a combination of relational and individual sessions may be beneficial for the treatment of sexual dysfunctions.

Costs of treating depression with individual versus family therapy.

Depression is one of the most common concerns that bring clients to treatment. Although marriage and family therapy has been shown to be an effective treatment, little research exists regarding the cost-effectiveness of related services. In this study, we examined claims data for 164,667 individuals diagnosed with depression to determine (a) differences in the cost of treating depression according to type of therapy and license type, (b) differences in recidivism rates by age, gender, type of therapy, and type of mental health professional, and (c) differences in cost-effectiveness by therapy modality and type of professional. The results showed that services provided by marriage and family therapists resulted in the lowest recidivism rate, and family therapy services were the least expensive.

Individual versus family psychotherapy in managed care: comparing the costs of treatment by the mental health professions.

In an effort to understand how psychotherapy is practiced in the "real world," outpatient claims data were examined to determine the cost of individual and family therapy provided by marital and family therapists, master's nurses, master's social workers, medical doctors, psychologists, or professional counselors. Claims for 490,000 unique persons over 4 years were obtained from CIGNA. Family therapy proved to be substantially more cost-effective than individual or "mixed" psychotherapy. Physicians provided care in the fewest sessions, marital and family therapists had the highest success (86.6%) and lowest recidivism rates (13.4%), and professional counselors were the least costly. Outcomes were overwhelmingly successful, with 85% of patients requiring only one episode of care.

Psychotherapy dropouts: differences by modality, license, and DSM-IV diagnosis.

Dropouts are frequent in mental health care. Several client factors have been identified as dropout predictors, including ethnic minority status, race, low SES, and more severe symptoms. Research on therapist and process variables is less common, and findings are inconsistent. This study used administrative data for 434,317 patients from CIGNA Behavioral Health (CIGNA) to examine dropout rates by profession of provider, therapy modality, and DSM-IV diagnosis. Results indicate that among the providers, MFTs have the lowest dropout rates in the CIGNA network. Of the therapy modalities, individual therapy is associated with lower dropout rates than family therapy. Mood and anxiety disorders have lower dropout rates than other diagnosis categories, while schizophrenia, psychotic, and substance use disorders have the highest dropout rates.

Cost-effectiveness of family-based substance abuse treatment.

In order to compete in a financially sensitive health care system, family systems-based treatments must demonstrate effective clinical results as well as cost-effectiveness. Cost-effectiveness research can demonstrate to health care insurers and policy makers which treatments are viable options for implementation. The present literature review identified eight cost-effectiveness family-based substance abuse treatment studies. The results suggest that certain family-based treatments are cost-effective and warrant consideration for inclusion in health care delivery systems.

Method validation of microcystins in water and tissue by enhanced liquid chromatography tandem mass spectrometry.

A liquid chromatography-electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS) method has been developed and validated to identify and quantify trace levels of cyanotoxins or microcystins (MC) in water, bivalves and fish tissue with enhanced sensitivity and specificity. The method enables confirmation and quantification of six MCs (MC-LA, LF, LR, LW, RR and YR) with a single chromatographic run. The applied chromatography also allows determination of certain MC metabolites (Desmethyl-LR and -RR). By using LC-ESI-MS/MS in multiple reaction monitoring (MRM) mode, the limit of detection and quantitation for the microcystins studied, were determined to be between 0.2 and 1 pg on column (5:1 S/N ratio). These values are below the 2 pg detection limits found in the available literature.

A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet-rich plasma.

OBJECTIVE: To appraise existing evidence for prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injection therapies for lateral epicondylosis (LE). DESIGN: Systematic review. DATA SOURCES: Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine. SEARCH STRATEGY: names and descriptors of the therapies and LE. STUDY SELECTION: All human studies assessing the four therapies for LE. MAIN RESULTS: Results of five prospective case series and four controlled trials (three prolotherapy, two polidocanol, three autologous whole blood and one platelet-rich plasma) suggest each of the four therapies is effective for LE. In follow-up periods ranging from 9 to 108 weeks, studies reported sustained, statistically significant (p<0.05) improvement in visual analogue scale primary outcome pain score measures and disease-specific questionnaires; relative effect sizes ranged from 51% to 94%; Cohen's d ranged from 0.68 to 6.68. Secondary outcomes also improved, including biomechanical elbow function assessment (polidocanol and prolotherapy), presence of abnormalities and increased vascularity on ultrasound (autologous whole blood and polidocanol). Subjects reported satisfaction with therapies on single-item assessments. All studies were limited by small sample size. CONCLUSIONS: There is strong pilot-level evidence supporting the use of prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injections in the treatment of LE. Rigorous studies of sufficient sample size, assessing these injection therapies using validated clinical, radiological and biomechanical measures, and tissue injury/healing-responsive biomarkers, are needed to determine long-term effectiveness and safety, and whether these techniques can play a definitive role in the management of LE and other tendinopathies.

Extraction and analysis methods for the determination of pyrethroid insecticides in surface water, sediments and biological tissues at environmentally relevant concentrations.

The aim of this study was to develop and validate chemical methods for measuring pyrethroid insecticides at environmentally relevant concentrations in different matrices. The analytes included six synthetic pyrethroids with the highest agricultural and commercial structural uses in California: bifenthrin, cyfluthrin, cypermethrin, esfenvalerate/fenvalerate, lambda-cyhalothrin, permethrin, and their corresponding stereoisomers, which includes enantiomers, diastereomers and racemic mixtures. Fortified water samples were extracted for analysis of synthetic pyrethroids using liquid-liquid extraction, while fortified sediment and fish tissue samples were extracted using pressurized fluid extraction followed by gel permeation chromatography (GPC) to remove matrix interferences. A florisil column was used for additional cleanup and fractionation of sediment and tissue extracts. Extracts were analyzed using dual column high resolution gas chromatography with electron capture detection (GC/ECD) and confirmation was obtained with gas chromatography mass spectrometry using a quadrupole ion trap detector in MS-MS mode. Method detection limits (MDLs) have been established for water (1-3 ng/L), sediment (0.5-4 ng/g dry weight) and tissue (1-3 ng/g fresh weight). Mean percent recoveries of fortified blanks and samples ranged from 75 to 115% with relative standard deviation (RSD) values less than 20% for all target compounds.

Mitigation assessment of vegetated drainage ditches for collecting irrigation runoff in California.

Widespread contamination of California water bodies by the organophosphate insecticides diazinon and chlorpyrifos is well documented. While their usage has decreased over the last few years, a concomitant increase in pyrethroid usage (e.g., permethrin) (replacement insecticides) has occurred. Vegetated agricultural drainage ditches (VADD) have been proposed as a potential economical and environmentally efficient management practice to mitigate the effects of pesticides in irrigation and storm runoff. Three ditches were constructed in Yolo County, California for a field trial. A U-shaped vegetated ditch, a V-shaped vegetated ditch, and a V-shaped unvegetated ditch were each amended for 8 h with a mixture of diazinon, permethrin, and suspended sediment simulating an irrigation runoff event. Water, sediment, and plant samples were collected spatially and temporally and analyzed for diazinon and permethrin concentrations. Pesticide half-lives were similar between ditches and pesticides, ranging from 2.4 to 6.4 h. Differences in half-distances (distance required to reduce initial pesticide concentration by 50%) among pesticides and ditches were present, indicating importance of vegetation in mitigation. Cis-permethrin half-distances in V ditches ranged from 22 m (V-vegetated) to 50 m (V-unvegetated). Half-distances for trans-permethrin were similar, ranging from 21 m (V-vegetated) to 55 m (V-unvegetated). Diazinon half-distances demonstrated the greatest differences (55 m for V-vegetated and 158 m for V-unvegetated). Such economical and environmentally successful management practices will offer farmers, ranchers, and landowners a viable alternative to more conventional (and sometimes expensive) practices.

The development of core competencies for the practice of marriage and family therapy.

In response to a series of national policy reports regarding what has been termed the "quality chasm" in health and mental health care in the United States, in January 2003, the American Association for Marriage and Family Therapy convened a task force to develop core competencies (CC) for the practice of marriage and family therapy (MFT). The task force also was responding to a call for outcome-based education and for the need to answer questions about what marriage and family therapists do. Development of the CC moves the field of MFT into a leading-edge position in mental health. This article describes the development of the CC, outcomes of the development process for the competencies, and recommendations for their continued development and implementation.

Research on the cost of providing family therapy: a summary and progress report.

This article provides a summary of effectiveness research on the costs of including family therapy in mental health services. Data was available from four different sources: (1) a large western Health Maintenance Organization with 180,000 subscribers in the local Utah region; (2) the Medicaid system of the entire State of Kansas in the United States; (3) a US health insurance company with several million subscribers; and (4) a Family Therapy training clinic. Results suggest that family therapy reduces the number of health care visits, especially for high utilizers. These results were also replicated in a graduate student training clinic. Also, studies of two different health care systems (and a cost projection study) suggest that including family therapy as a treatment option does not significantly increase health care costs.

A study of Physico-Chemical Interactions between Haemophilus Influenzae Type b and Meningococcus group C Conjugate Vaccines

Background: Haemophilus influenzae type b (Hib) and Meningococcal group C (MenC) conjugate vaccines; which protect against otitis media; bacteremia and invasive diseases; including pneumonia and meningitis; are attractive candidates for combination; since they are both administered to infants and children.A Hib-MenC combination booster at 12 mo has recently been introduced in the U.K. Objectives: To rule out the possibility for the individual vaccine components in a Hib-MenC combination to interact; rendering one or both of them less effective; this work assessed whether these two saccharide-protein conjugates; namely; Hib oligosaccharideCRM197 (Cross-Reacting Material 197) and MenC-CRM197; interact in solution. Furthermore an evaluation of the size and integrity of the vaccines was also performed. Methods: HPLC Size-exclusion chromatography (SEC) with UV-adsorption and refractive index detection was performed with a phosphate and non-phosphate saline buffer to characterize the size of Hib and MenC conjugates as individual components or when combined. Results: Hib-CRM197 eluted significantly earlier than MenC-CRM197 in both phosphate-saline and MOPS-saline buffers on a TSK5000 PWXL column.When combined; there was no significant change in their elution. Refractive index monitoring showed no evidence of significant free saccharide or free protein. Conclusions: By size-exclusion chromatography and refractive index detection methods; there was no indication of degradation; and no evidence of significant associative interactions between Hib-CRM197 and MenC-CRM197 in saline-based buffers; pH 7.2