Manipulation of Photosensory and Circadian Signalling Restricts Phenotypic Plasticity in Response to Changing Environmental Conditions in Arabidopsis.

Plants exploit phenotypic plasticity to adapt their growth and development to prevailing environmental conditions. Interpretation of light and temperature signals are aided by the circadian system which provides a temporal context. Phenotypic plasticity provides a selective and competitive advantage in nature but is obstructive during large-scale, intensive agricultural practices since economically important traits (including vegetative growth and flowering time) can widely vary depending on local environmental conditions. This prevents accurate prediction of harvesting times and produces a variable crop. We sought to restrict phenotypic plasticity and circadian regulation by manipulating signalling systems that govern plants' responses to environmental signals. Mathematical modelling of plant growth and development predicted reduced plant responses to changing environments when circadian and light signaling pathways were manipulated. We tested this hypothesis by utilising a constitutively-active allele of the plant photoreceptor phytochromeB, along with disruption of the circadian system via mutation of EARLY FLOWERING3. We found that these manipulations produced plants that were less responsive to light and temperature cues and which failed to anticipate dawn. These engineered plants have uniform vegetative growth and flowering time, demonstrating how phenotypic plasticity can be limited whilst maintaining plant productivity. This has significant implications for future agriculture in both open fields and controlled environments.

Identifying factors and causal chains associated with optimal implementation of Lynch syndrome tumor screening: An application of coincidence analysis.

PURPOSE: This study compared Lynch syndrome universal tumor screening (UTS) across multiple health systems (some of which had two or more distinct UTS programs) to understand multi-level factors that may impact the successful implementation of complex programs. METHODS: Data from 66 stakeholder interviews were used to conduct multi-value coincidence analysis (mv-CNA) and identify key factors that consistently make a difference in whether UTS programs were implemented and optimized at the system level. RESULTS: The selected CNA model revealed combinations of conditions that distinguish 4 optimized UTS programs, 10 non-optimized programs, and 4 systems with no program. Fully optimized UTS programs had both a maintenance champion and a positive inner setting. Two independent paths were unique to non-optimized programs: 1) positive attitudes and a mixed inner setting, or 2) limited planning & engaging among stakeholders. Negative views about UTS evidence or lack of knowledge about UTS led to a lack of planning and engaging, which subsequently prevented program implementation. CONCLUSION: The model improved our understanding of program implementation in health care systems and informed the creation of a toolkit to guide UTS implementation, optimization, and changes. Our findings and toolkit may serve as a use case to increase the successful implementation of other complex precision health programs.

Design and characterization of a hybrid PET detector with DOI capability.

BACKGROUND: Monolithic or semi-monolithic detectors are attractive for positron emission tomography (PET) scanners with depth-of-interaction (DOI) capability. However, they often require complicated calibrations to determine the interaction positions of gamma photons. PURPOSE: We introduce a novel hybrid detector design that combines pixelated and semi-monolithic elements to achieve DOI capability while simplifying the calibrations for positioning. METHODS: A prototype detector with eight hybrid lutetium-yttrium oxyorthosilicate (LYSO) layers having dimensions of 25.8 × 12.9 × 15 mm3 was constructed. The energy-weighted and energy-squared weighted averages were used for estimating the x- (pixelated direction) and y-positions (non-pixelated direction). Pseudo-pixels were defined as discrete areas on the flood image based on the crystal look-up table (LUT). The intrinsic spatial resolutions in the pixelated and non-pixelated directions were measured. The ratio of the maximum to the sum of the multipixel photon counter (MPPC) signals was used to estimate the DOI positions. The coincidence timing resolution (CTR) was measured using the average and energy-weighted average of the earliest n time stamps. Two energy windows of 250-700 and 400-600 keV were applied for the measurements. RESULTS: The pattern of the flood images showed discrete event clusters, demonstrating that simple calibrations for determining the x- and y-positions of events could be achieved. Under 400-600 keV energy window, the average intrinsic spatial resolutions were 1.15 and 1.34 mm for the pixelated and non-pixelated directions; the average DOI resolution of the second row of pseudo-pixels was 5.1 mm in full width at half maximum (FWHM); when using the energy-weighted average of the earliest four-time stamps, the best CTR of 350 ps was achieved. Applying a broader energy window of 250-700 keV only slightly degrades the DOI resolution while maintaining the intrinsic resolution; the best CTR degrades to 410 ps. CONCLUSIONS: The proposed hybrid detector concept was verified, and a prototype detector showed high performance for 3D positioning and timing resolution. The novel detector concept shows promise for preclinical and clinical PET scanners with DOI capability.

Determination of the activity and nuclear decay data of 157Tb.

Terbium-157 was radiochemically extracted from an irradiated tantalum target. Since the resulting material contained a significant impurity of 158Tb, 157Tb was isotopically purified using laser resonance ionization at the RISIKO mass separator in Mainz and then implanted on an aluminum (Al) foil. The implanted 157Tb was measured by two different calibrated gamma-ray spectrometers to determine photon emission rates. After dissolving the Al foil, a high purity 157Tb solution was obtained. The corresponding activity concentration was determined with a low relative uncertainty of 0.52% through a combination of liquid scintillation counting using the TDCR method and 4π(X,e)(LS)-(X,γ)(CeBr3) coincidence counting. By combining the results from all measurement techniques, emission intensities for K X-rays and gamma-rays were derived and found to be 16.05(31)% and 0.0064(2)%, respectively. The probability for K electron capture of the first forbidden non-unique transition to the ground state was determined to be 17.16(35)%. The probabilities for the electron-capture branch to the excited level and the ground state were found to be 0.084(4)% and 99.916(4)%, respectively. A Q+ value of 60.23(18) keV was estimated based on simplified BetaShape calculations, assuming an allowed transition.

Children's representation of coincidence.

People relish thinking about coincidences-we puzzle over their meanings and delight in conveying our experiences of them to others. But whereas some research has begun to explore how coincidences are represented by adults, little is known about the early development of these representations. Here we explored factors influencing coincidence representations in both adults and children. Across two experiments, participants read stories describing co-occurring events and then judged whether these constituted coincidences. In Experiment 1 we found that adults' coincidence judgments were highly sensitive to the presence or absence of plausible explanations: as expected, adults were more likely to judge co-occurrences as a coincidence when no explanation was available. Importantly, their coincidence judgments were also modulated by the number of events that co-occurred. Adults tended to reject scenarios involving too many co-occurring events as coincidences regardless of whether an explanation was present, suggesting that observing suspiciously many co-occurrences triggered them to infer their own underlying explanation (and thus blocking the events' interpretation as a coincidence). In Experiment 2 we found that 4- to 10-year-old children also represent coincidences, and identify them via the absence of plausible explanations. Older children, like adults, rejected suspiciously large numbers of co-occurring events as coincidental, whereas younger children did not exhibit this sensitivity. Overall, these results suggest that representation of coincidence is available from early in life, but undergoes developmental change during the early school-age years.

A Computational Model of Auditory Chirp-Velocity Sensitivity and Amplitude-Modulation Tuning in Inferior Colliculus Neurons.

We demonstrate a model of chirp-velocity sensitivity in the inferior colliculus (IC) that retains the tuning to amplitude modulation (AM) that was established in earlier models. The mechanism of velocity sensitivity is sequence detection by octopus cells of the posteroventral cochlear nucleus, which have been proposed in physiological studies to respond preferentially to the order of arrival of cross-frequency inputs of different amplitudes. Model architecture is based on coincidence detection of a combination of excitatory and inhibitory inputs. Chirp-sensitivity of the IC output is largely controlled by the strength and timing of the chirp-sensitive octopus-cell inhibitory input. AM tuning is controlled by inhibition and excitation that are tuned to the same frequency. We present several example neurons that demonstrate the feasibility of the model in simulating realistic chirp-sensitivity and AM tuning for a wide range of characteristic frequencies. Additionally, we explore the systematic impact of varying parameters on model responses. The proposed model can be used to assess the contribution of IC chirp-velocity sensitivity to responses to complex sounds, such as speech.

How context links to best practice use in long-term care homes: a mixed methods study.

BACKGROUND: Context (work environment) plays a crucial role in implementing evidence-based best practices within health care settings. Context is multi-faceted and its complex relationship with best practice use by care aides in long-term care (LTC) homes are understudied. This study used an innovative approach to investigate how context elements interrelate and influence best practice use by LTC care aides. METHODS: In this secondary analysis study, we combined coincidence analysis (a configurational comparative method) and qualitative analysis to examine data collected through the Translating Research in Elder Care (TREC) program. Coincidence analysis of clinical microsystem (care unit)-level data aggregated from a survey of 1,506 care aides across 36 Canadian LTC homes identified configurations (paths) of context elements linked consistently to care aides' best practices use, measured with a scale of conceptual research use (CRU). Qualitative analysis of ethnographic case study data from 3 LTC homes (co-occurring with the survey) further informed interpretation of the configurations. RESULTS: Three paths led to very high CRU at the care unit level: very high leadership; frequent use of educational materials; or a combination of very high social capital (teamwork) and frequent communication between care aides and clinical educators or specialists. Conversely, 2 paths led to very low CRU, consisting of 3 context elements related to unfavorable conditions in relationships, resources, and formal learning opportunities. Our qualitative analysis provided insights into how specific context elements served as facilitators or barriers for best practices. This qualitative exploration was especially helpful in understanding 2 of the paths, illustrating the pivotal role of leadership and the function of teamwork in mitigating the negative impact of time constraints. CONCLUSIONS: Our study deepens understanding of the complex interrelationships between context elements and their impact on the implementation of best practices in LTC homes. The findings underscore that there is no singular, universal bundle of context-related elements that enhance or hinder best practice use in LTC homes.

Bright Innovations: Review of Next-Generation Advances in Scintillator Engineering.

This review focuses on modern scintillators, the heart of ionizing radiation detection with applications in medical diagnostics, homeland security, research, and other areas. The conventional method to improve their characteristics, such as light output and timing properties, consists of improving in material composition and doping, etc., which are intrinsic to the material. On the contrary, we review recent advancements in cutting-edge approaches to shape scintillator characteristics via photonic and metamaterial engineering, which are extrinsic and introduce controlled inhomogeneity in the scintillator's surface or volume. The methods to be discussed include improved light out-coupling using photonic crystal (PhC) coating, dielectric architecture modification producing the Purcell effect, and meta-materials engineering based on energy sharing. These approaches help to break traditional bulk scintillators' limitations, e.g., to deal with poor light extraction efficiency from the material due to a typically large refractive index mismatch or improve timing performance compared to bulk materials. In the Outlook section, modern physical phenomena are discussed and suggested as the basis for the next generations of scintillation-based detectors and technology, followed by a brief discussion on cost-effective fabrication techniques that could be scalable.

The Eruptive Fevers at Sixes and Sevens.

Sixth Disease (roseola infantum) and its primary causative agent, HHV-6, share names that numerically concur. This article examines and answers the question of whether that correspondence is by design or coincidental by briefly reviewing the history and nomenclature of the HHV viruses and the classic febrile rashes of childhood while highlighting some clinical and microbiologic features of HHV-6 infection.

Combination of metagenomic next-generation sequencing and conventional tests unraveled pathogen profiles in infected patients undergoing allogeneic hematopoietic stem cell transplantation in Jilin Province of China.

Background: Infection is the main cause of death for patients after allogeneic hematopoietic stem cell transplantation (HSCT). However, pathogen profiles still have not been reported in detail due to their heterogeneity caused by geographic region. Objective: To evaluate the performance of metagenomic next-generation sequencing (mNGS) and summarize regional pathogen profiles of infected patients after HSCT. Methods: From February 2021 to August 2022, 64 patients, admitted to the Department of Hematology of The First Hospital of Jilin University for HSCT and diagnosed as suspected infections, were retrospectively enrolled. Results: A total of 38 patients were diagnosed as having infections, including bloodstream (n =17), pulmonary (n =16), central nervous system (CNS) (n =4), and chest (n =1) infections. Human betaherpesvirus 5 (CMV) was the most common pathogen in both bloodstream (n =10) and pulmonary (n =8) infections, while CNS (n =2) and chest (n =1) infections were mainly caused by Human gammaherpesvirus 4 (EBV). For bloodstream infection, Mycobacterium tuberculosis complex (n =3), Staphylococcus epidermidis (n =1), and Candida tropicalis (n =1) were also diagnosed as causative pathogens. Furthermore, mNGS combined with conventional tests can identify more causative pathogens with high sensitivity of 82.9% (95% CI 70.4-95.3%), and the total coincidence rate can reach up to 76.7% (95% CI 64.1-89.4%). Conclusions: Our findings emphasized the importance of mNGS in diagnosing, managing, and ruling out infections, and an era of more rapid, independent, and impartial diagnosis of infections after HSCT can be expected.

Lateral distribution cosmic ray muon coincidences up to 36 m.

Primary cosmic ray particles comprise about 85 % protons, 12 % helium, 3 % iron, and heavier elements. These particles interact with the Earth's atmosphere, generating the Extensive Air Showers (EAS). Among the particles produced are pions and kaons, which decay into cosmic ray muons. In this research, the lateral distribution of cosmic ray muons was measured using two-fold coincidences. Four NaI (Tl) detectors and the associated electronics were used in the measurements of cosmic ray muons. The detectors were positioned from 0 to 36 m at regular intervals. The muon count rate was observed to decrease as the distance between the detectors increased. The measurements were fitted to the Nishimura-Kamata-Greisen (NKG) function to analyze the lateral distribution. Monte Carlo (MC) simulations of EAS were performed using the Cosmic Ray Simulations for the KAscade Grande (CORSIKA) program. The simulations made use of EPOS and GHEISHA models for high and lower energies respectively.•The measurements for the two-fold coincidence are consistent with the NKG function.•The simulated and measured data were found to be in agreement.•The knowledge gained from the lateral distribution of cosmic ray muons is essential for the understanding of the development of extensive air showers.

Dark Matter and Mirror World.

Overwhelming astronomical evidence for dark matter and absence of any laboratory evidence for it despite many dedicated searches have fueled speculation that dark matter may reside in a parallel universe interacting with the familiar universe only via gravitational interactions as well as possibly via some ultra-weak forces. In this scenario, we postulate that the visible universe co-exists with a mirror world consisting of an identical duplicate of forces and matter of our world, obeying a mirror symmetry. This picture, motivated by particle physics considerations, not only provides a natural candidate for dark matter but also has the potential to explain the matter dark matter coincidence problem, i.e., why the dark matter content of the universe is only a few times the visible matter content. One requirement for mirror models is that the mirror world must be colder than our world to maintain the success of big bang nucleosynthesis. After a review of the basic features of the model, we present several new results: first is that the consistency between the coldness of the mirror world and the explanation of the matter dark matter coincidence implies an upper bound on the inflation reheat temperature of the universe to be around 106.5 GeV. We also argue that the coldness implies the mirror world consists mainly of mirror Helium and very little mirror hydrogen, which is the exact opposite of what we see in the visible world.

Performance evaluation of the FastIC readout ASIC with emphasis on Cherenkov emission in TOF-PET.

Objective.The efficient usage of prompt photons like Cherenkov emission is of great interest for the design of the next generation, cost-effective, and ultra-high-sensitivity time-of-flight positron emission tomography (TOF-PET) scanners. With custom, high power consuming, readout electronics and fast digitization the prospect of sub-300 ps FWHM with PET-sized BGO crystals have been shown. However, these results are not scalable to a full system consisting of thousands of detector elements.Approach.To pave the way toward a full TOF-PET scanner, we examine the performance of the FastIC ASIC with Cherenkov-emitting scintillators (BGO), together with one of the most recent SiPM detector developments based on metal trenching from FBK. The FastIC is a highly configurable ASIC with 8 input channels, a power consumption of 12 mW ch-1and excellent linearity on the energy measurement. To put the timing performance of the FastIC into perspective, comparison measurements with high-power consuming readout electronics are performed.Main results.We achieve a best CTR FWHM of 330 ps for 2 × 2 × 3 mm3and 490 ps for 2 × 2 × 20 mm3BGO crystals with the FastIC. In addition, using 20 mm long LSO:Ce:Ca crystals, CTR values of 129 ps FWHM have been measured with the FastIC, only slightly worse to the state-of-the-art of 95 ps obtained with discrete HF electronics.Significance.For the first time, the timing capability of BGO with a scalable ASIC has been evaluated. The findings underscore the potential of the FastIC ASIC in the development of cost-effective TOF-PET scanners with excellent timing characteristics.

[Use of the ETV6/RUNX1 probe to verify the performance of the fluorescence in situ hybridization probe before clinical detection].

Objective: To explore the standardized performance of a FISH probe before clinical detection. Methods: The probe sensitivity and specificity of ETV6/RUNX1 were analyzed via interphase and metaphase FISH in 20 discarded healthy bone marrow samples. The threshold system of the probe was established using an inverse beta distribution, and an interpretation standard was established. Finally, a parallel-controlled polymerase chain reaction detection study was conducted on 286 bone marrow samples from patients at our hospital. The clinical sensitivity, specificity, and diagnostic coincidence rate of ETV6/RUNX1 FISH detection were analyzed, and the diagnostic consistency of the two methods was analyzed by the kappa test. Results: The probe sensitivity and specificity of the ETV6/RUNX1 probe were 98.47% and 100%, respectively. When 50, 100, and 200 cells were counted, the typical positive signal pattern cutoffs were 5.81%, 2.95%, and 1.49%, respectively, and the atypical positive signal pattern cutoffs were 13.98%, 9.75%, and 6.26%, respectively. The clinical sensitivity of FISH was 96.1%, clinical specificity was 99.6%, diagnostic coincidence rate was 99.00%, diagnostic consistency test kappa value was 0.964, and P value was <0.001. Conclusion: For FISH probes without a national medical device registration certificate, standardized performance verification and methodology performance verification can be performed using laboratory developed test verification standards to ensure a reliable and accurate reference basis for clinical diagnosis and treatment.

What a difference a chlorine makes: The remarkable unimolecular ion chemistry of phenyl formate and phenyl chloroformate.

Imaging photoelectron photoion coincidence (iPEPICO) spectroscopy and tandem mass spectrometry were employed to explore the ionisation and dissociative ionisation of phenyl formate (PF) and phenyl chloroformate (PCF). The threshold photoelectron spectra of both compounds are featureless and lack a definitive origin transition, owing to the internal rotation of the formate functional group relative to the benzene ring, active upon ionisation. CBS-QB3 calculations yield ionisation energies of 8.88 and 9.03 eV for PF and PCF, respectively. Ionised PF dissociates by the loss of CO via a transition state composed of a phenoxy cation and HCO moieties. The dissociation of PCF ions involves the competing losses of CO (m/z 128/130), Cl (m/z 121) and CO2 (m/z 112/114), with Cl loss also shown to occur from the second excited state in a non-statistical process. The primary CO- and Cl-loss fragment ions undergo sequential reactions leading to fragment ions at m/z 98 and 77. The mass-analysed ion kinetic energy (MIKE) spectrum of PCF+ showed that the loss of CO2 occurs with a large reverse energy barrier, which is consistent with the computationally derived minimum energy reaction pathway.

PtdIns4P is required for the autophagosomal recruitment of STX17 (syntaxin 17) to promote lysosomal fusion.

The autophagosomal SNARE STX17 (syntaxin 17) promotes lysosomal fusion and degradation, but its autophagosomal recruitment is incompletely understood. Notably, PtdIns4P is generated on autophagosomes and promotes fusion through an unknown mechanism. Here we show that soluble recombinant STX17 is spontaneously recruited to negatively charged liposomes and adding PtdIns4P to liposomes containing neutral lipids is sufficient for its recruitment. Consistently, STX17 colocalizes with PtdIns4P-positive autophagosomes in cells, and specific inhibition of PtdIns4P synthesis on autophagosomes prevents its loading. Molecular dynamics simulations indicate that C-terminal positively charged amino acids establish contact with membrane bilayers containing negatively charged PtdIns4P. Accordingly, Ala substitution of Lys and Arg residues in the C terminus of STX17 abolishes membrane binding and impairs its autophagosomal recruitment. Finally, only wild type but not Ala substituted STX17 expression rescues the autophagosome-lysosome fusion defect of STX17 loss-of-function cells. We thus identify a key step of autophagosome maturation that promotes lysosomal fusion.Abbreviations: Cardiolipin: 1',3'-bis[1-palmitoyl-2-oleoyl-sn-glycero-3-phospho]-glycerol; DMSO: dimethyl sulfoxide; GST: glutathione S-transferase; GUV: giant unilamellar vesicles; LAMP1: lysosomal associated membrane protein 1; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; PA: 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphate; PC/POPC: 1-palmitoyl-2-oleoyl-glycero-3-phosphocholine; PG: 1-palmitoyl-2-linoleoyl-sn-glycero-3-phospho-(1'-rac-glycerol); PI: L-α-phosphatidylinositol; PI4K2A: phosphatidylinositol 4-kinase type 2 alpha; PIK3C3/VPS34: phosphatidylinositol 3-kinase catalytic subunit type 3; POPE/PE: 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphoethanolamine; PS: 1-stearoyl-2-linoleoyl-sn-glycero-3-phospho-L-serine; PtdIns(3,5)P2: 1,2-dioleoyl-sn-glycero-3-phospho-(1"-myo-inositol-3',5'-bisphosphate); PtdIns3P: 1,2- dioleoyl-sn-glycero-3-phospho-(1'-myo-inositol-3'-phosphate); PtdIns4P: 1,2-dioleoyl-sn-glycero-3-phospho-(1"-myo-inositol-4'-phosphate); SDS-PAGE: sodium dodecyl sulfate-polyacrylamide gel electrophoresis; STX17: syntaxin 17.

Reducing sickness absence among public-sector healthcare employees: the difference-making roles of managerial and employee participation.

PURPOSE: Evaluations of organizational-level interventions to prevent work-related illness have identified enabling factors, but knowledge of necessary and sufficient conditions for intervention success is needed. The aim was to identify difference-making factors that distinguish intervention groups with and without a positive intervention effect on sickness absence. METHODS: An organizational-level intervention designed to decrease sickness absence by providing support from process facilitators was implemented at eight healthcare workplaces in Sweden between 2017 and 2018. We applied coincidence analysis (CNA) to analyze 34 factors and determine which factors were necessary and sufficient for a successful implementation of tailored interventional measures on an organizational level (dichotomous) and reduced sickness absence (trichotomous). RESULTS: Two factors perfectly explained both the presence and absence of a successful implementation: "a high sense of urgency" and "good anchoring and participation from the strategic management". The presence of either of these factors alone was sufficient for successful implementation, whereas the joint absence of both conditions was necessary and sufficient for the absence of successful implementation and an intervention effect. In addition, high employee participation was both necessary and sufficient for a high intervention effect. For organizations without high employee participation, successful implementation led to a medium-effect size. CONCLUSIONS: This study identified participation as a difference-maker in the implementation process. Participation from different stakeholders turned out to be important in different phases. When implementing organizational-level interventions, high participation from both strategic management and employees appears to be crucial in terms of the intervention's effect on sickness absence.

Identification of olfactory alarm substances in zebrafish.

Escaping from danger is one of the most fundamental survival behaviors for animals. Most freshwater fishes display olfactory alarm reactions in which an injured fish releases putative alarm substances from the skin to notify its shoaling company about the presence of danger. Here, we identified two small compounds in zebrafish skin extract, designated as ostariopterin and daniol sulfate. Ostariopterin is a pterin derivative commonly produced in many freshwater fishes belonging to the Ostariophysi superorder. Daniol sulfate is a novel sulfated bile alcohol specifically present in the Danio species, including zebrafish. Ostariopterin and daniol sulfate activate distinct glomeruli in the olfactory bulb. Zebrafish display robust alarm reactions, composed of darting, freezing, and bottom dwelling, only when they are concomitantly stimulated with ostariopterin and daniol sulfate. These results demonstrate that the fish alarm reaction is driven through a coincidence detection mechanism of the two compounds along the olfactory neural circuitry.

Theoretical design of a solid scintillation detector for tritium surface contamination measurement based on CaF2(Eu) sheet and self-coincidence technology of MCP-PMT.

Measurement of tritium surface contamination is important for tritium related facilities, especially for fusion devices. A novel detector has been designed for tritium surface contamination measurements based on CaF2(Eu) sheet and Microchannel plate photomultiplier tube (MCP-PMT). Self-coincidence technology has been introduced to obtain lower detection limit by diminishing the background noise caused by γ-rays and hot electrons. Performance of the detector was optimized by specifying the key parameters including the distance of the scintillator and sample, the thickness of light guide, the number of annular electrodes et al., using Monte Carlo method. Results indicate that detection efficiency of 49.4 % and the response deviations at different positions less than 0.5 % could be achieved. The detection limit of tritium under the simulation conditions is 0.09 Bq/cm2 and 0.03 Bq/cm2 when the counting time is 10 s and 60 s, respectively.

Uncovering determinants of perceived feasibility of TF-CBT through coincidence analysis.

Introduction: A mental health provider's perception of how well an intervention can be carried out in their context (i.e., feasibility) is an important implementation outcome. This article aims to identify determinants of feasibility of trauma-focused cognitive behavioral therapy (TF-CBT) through a case-based causal approach. Method: Data come from an implementation-effectiveness study in which lay counselors (teachers and community health volunteers) implemented a culturally adapted manualized mental health intervention, TF-CBT, delivered to teens who were previously orphaned and were experiencing posttraumatic stress symptoms and prolonged grief in Western Kenya. The intervention team identified combinations of determinants that led to feasibility among teacher- and community health volunteer-counselors through coincidence analysis. Results: Among teacher-counselors, organizational-level factors (implementation climate, implementation leadership) determined moderate and high levels of feasibility. Among community health volunteer-counselors, a strong relationship between a clinical supervisor and the supervisee was the most influential determinant of feasibility. Conclusion: Methodology and findings from this article can guide the assessment of determinants of feasibility and the development of implementation strategies for manualized mental health interventions in contexts like Western Kenya. Plain Language Summary: A mental health provider's perception of how easy a therapy is to use in their work setting (i.e., feasibility) can impact whether the provider uses the therapy in their setting. Implementation researchers have recommended finding practices and constructs that lead to important indicators that a therapy will be used. However, limited research to our knowledge has searched and found practices and constructs that might determine feasibility of a therapy. This article uses existing data from a large trial looking at the continued use of a trauma-focused therapy to find practices and constructs that lead to moderate and high levels of feasibility. We found that in settings with a strong organizational structure that organization and leadership support for the therapy led to teachers in Kenya to perceive the therapy as easy to use. On the other hand, in settings with a weaker organizational structure, outside support from a clinical supervisor led to community health volunteers in Kenya perceiving the therapy as easy to use. The findings from this article can guide context-specific recommendations for increasing perceived therapy feasibility at the provider-, organization-, and policy levels.