bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating eviction prevalence across the United States
Authors: Gromis Ashley , Fellows Ian , Hendrickson James R. , Edmonds Lavar , Leung Lillian , Porton Adam , Desmond Matthew
Published: May 2022

Significance

Several negative effects of forced displacement have been well documented, yet we lack reliable measurement of eviction risk in the national perspective. This prevents accurate estimations of the scope and geography of the problem as well as evaluations of policies to reduce housing loss. We construct a nationwide database of eviction filings in the United States. Doing so reveals that 2.7 million households, on average, are threatened with eviction each year; that the highest eviction filing rates are not concentrated solely in high-cost urban areas; and that state-level housing policies are strongly associated with county-level eviction filing risk. These data facilitate an expanded research agenda on the causes and consequences of eviction lawsuits in the United States.
Farm vehicles approaching weights of sauropods exceed safe mechanical limits for soil functioning
Authors: Keller Thomas , Or Dani
Published: May 2022

Significance

Mechanization has transformed agriculture over the past century, greatly improving crop production efficiency. However, the higher capacity has resulted in increased farm vehicle weights. We show that while machinery design maintains constant surface contact stresses, an insidious and largely overlooked threat of subsoil compaction has developed. We demonstrate that modern vehicles induce high soil stresses that now exceed critical mechanical thresholds for many arable soils, inducing chronic soil compaction in root zones below tillage depths and adversely affecting soil functioning. We draw parallels between modern farm vehicles and the heaviest animals that walked Earth: sauropods. We hypothesize that these prehistoric giants may have induced subsoil compaction, thus presenting a paradox for productivity of the land that supported them.
Theget-passive in Tyneside English
Authors: Fehringer Carol
Published: May 2022

This paper provides a quantitative variationist analysis of the distribution ofget- versusbe-passives in spoken Tyneside English. Taking data from theDiachronic Electronic Corpus of Tyneside English(1960s to 2010), the paper uses mixed-effects modelling to examine a wide range of possible constraints on the distribution ofgetversusbe, some of which have been discussed at length in the literature on theget-passive (e.g. subject animacy, adversative semantics) and some of which have received less attention (e.g. grammatical person, tense, aspectuality). It demonstrates that the use of theget-passive is determined by a complex combination of semantic and syntactic factors (subject animacy, telicity, non-neutral semantics, tense and grammatical person). Moreover, it argues that, despite the dramatic rise in frequency ofget-passives over time (with younger speakers using them even more frequently thanbe-passives), most of the constraints remain in place and the variant is pragmatically marked. This stands in sharp contrast to the findings of recent investigations into the grammaticalization ofget-passives in standard British and American English, which found that increased frequency in those varieties was also accompanied by semantic bleaching and generalization.
Creating alignment echoes using a phase-shaped femtosecond laser pulse
Authors: Xu Shuwu , Liu Guizhen , Huang Yunxia
Published: May 2022

In recent years, molecular alignment echoes induced by a pair of time-delayed femtosecond laser pulses have been proposed and have aroused wide research interest. However, we demonstrate that an alignment echo can be alternatively produced by a shaped femtosecond laser pulse with a V-style spectral phase modulation. The full, fractional, and imaginary alignment echoes are formed by the excitation of the tailored two time-delayed sub-pulses. Both the delay time and the ratio of intensity between the two sub-pulses can be easily manipulated by designing the modulation parameters to induce various types of echoes. We further show that the optimal ratio of intensity between the two sub-pulses, which results in the maximal alignment degrees of the full echo, closely correlates with the energy of the sub-pulse. When the pulse energy is relatively low, the maximal alignment degree of the full echo is obtained when the two sub-pulses have equal intensity. The optimal ratio of intensity increases with the excitation energy of the first pump pulse.
Density functional theory study on Ti/h-BN interface in resistance random access memory device
Authors: Ding Cheng , Dai Yuehua , Yang Bin , Li Xing , Wang Feifei , Yang Fei , Lu Wenjuan , Ke Qing , Feng Zhe
Published: May 2022

By applying density functional theory calculations, we analyzed the intrinsic propensity of the Ti/h-BN interface in a resistive random access memory (RRAM) device upon the existence of a Stone–Wales (SW) defect and boron vacancy (VB). Following the construction of the Ti(001) surface and h-BN(SW) stack, Ti/h-BN interface models with different configurations and terminated sites were proposed, among which h-BN(SW)I/Ti(001)_TN was identified as the most stable interface system according to the binding energy. The charge transfer from Ti(001) toward the h-BN layers, resulting in heavy doping, formed an Ohmic contact in the interface. Moreover, through analysis of structure optimization, an intrinsic tendency of Ti ion migration to pass through the interface was revealed in the presence of SW defects and VB in the h-BN interface layer. The result of the migration barrier suggested that SW defects, especially B–B bond heptagons, provide preferential pathways for the vertical penetration of Ti ions through the interface, whereas VB in defects contribute most to the facilitation of Ti ion migration. Finally, I–V curves of RRAM device models with different interface configurations showed that SW defects and VB in the interface are critical to resistive switching behavior and can improve performance parameters, such as set voltage and current on/off ratios.
Application of machine learning and artificial intelligence to extend EFIT equilibrium reconstruction
Authors: Lao L L , Kruger S , Akcay C , Balaprakash P , Bechtel T A , Howell E , Koo J , Leddy J , Leinhauser M , Liu Y Q , Madireddy S , McClenaghan J , Orozco D , Pankin A , Schissel D , Smith S , Sun X , Williams S
Published: May 2022

Recent progress in the application of machine learning (ML)/artificial intelligence (AI) algorithms to improve the Equilibrium Fitting (EFIT) code equilibrium reconstruction for fusion data analysis applications is presented. A device-independent portable core equilibrium solver capable of computing or reconstructing equilibrium for different tokamaks has been created to facilitate adaptation of ML/AI algorithms. A large EFIT database comprising of DIII-D magnetic, motional Stark effect, and kinetic reconstruction data has been generated for developments of EFIT model-order-reduction (MOR) surrogate models to reconstruct approximate equilibrium solutions. A neural-network MOR surrogate model has been successfully trained and tested using the magnetically reconstructed datasets with encouraging results. Other progress includes developments of a Gaussian process Bayesian framework that can adapt its many hyperparameters to improve processing of experimental input data and a 3D perturbed equilibrium database from toroidal full magnetohydrodynamic linear response modeling using the Magnetohydrodynamic Resistive Spectrum - Feedback (MARS-F) code for developments of 3D-MOR surrogate models.
Phase portrait and fractal analyses in nanobiophotonics: carbon nanoparticle aided intra-pigment energy transfer in leaves
Authors: S Sankararaman
Published: May 2022

The paper delineates the potential application of nonlinear time series analysis (TSA) in Nanobiophotonics to explore the soot-assisted intra-pigment energy transport mechanism in leaves. The soot nanofluid, containing nano carbon allotropes, prepared in different concentrations, is sprayed over Lablab purpureus (L.) sweet leaves. The chlorophyll extracted from the leaves after ten days is subjected to UV-Visible absorption and single beam thermal lens (TL) studies. The variation of the absorbance of signature peaks of chlorophyll pigments with the soot concentration reveals the role of soot in the intra-pigment energy transport, divulged through the time series TL signal. The TSA of the TL signals, the plotting of phase portraits, and the computation of sample entropy (S), fractal dimension (FD), and Hurst exponent for the pigment-soot systems unwrap the particle/molecular dynamics and the flow of energy within the system. The analysis by segmenting the variations of the TSA measures with soot concentration reveals that the values of S and FD of the system are high in the low and high concentration ranges, in agreement with the randomness reflected in the phase portrait. The middle region, where S and FD decrease, seems more energy-efficient for the photosystem through heat trap and energy exchange between the pigment-soot system. The study gives information about the critical concentration range suitable for increased photosynthesis in leaves and yield enhancement.
Exploring black holes as particle accelerators: hoop-radius, target particles and escaping conditions
Authors: Liberati Stefano , Pfeifer Christian , Relancio Javier
Published: May 2022

The possibility that rotating black holes could be natural particle accelerators has been subject of intense debate. While it appears that for extremal Kerr black holes arbitrarily high center of mass energies could be achieved, several works pointed out that both theoretical as well as astrophysical arguments would severely dampen the attainable energies. In this work we study particle collisions near Kerr black holes, by reviewing and extending the so far proposed scenarios. Most noticeably, we shall focus on the recently advanced target particle scenarios which were claimed to reach arbitrarily high energies even for Schwarzschild black holes.
By implementing the hoop conjecture we show that these scenarios involving near-horizon target particles are in principle able to attain, sub-Planckian, but still ultra-high center of mass energies of the order of 1023–1025 eV even for non-extremal Kerr black holes. Furthermore, analysing the properties of particles produced in such collisions, we find that photons can escape to infinity. However, their energy is only of the order of the energy of the colliding particles and hence relatively low, which is the same conclusion previously reached in the literature about the original Bañados-Silk-West process. This finding points towards a general limitation of collisional Penrose processes, at least for what concerns their primary products.
Premature black hole death of Population III stars by dark matter
Authors: Ellis Sebastian A.R.
Published: May 2022

Population III stars were the first generation of stars, formed in minihalos of roughly primordial element abundances, and therefore metal-free. They are thought to have formed at the cores of dense dark matter clouds. Interactions between baryons and dark matter can therefore have had an important impact on their evolution. In this paper we consider the capture of non- or weakly-annihilating dark matter by these early massive stars. In a wide region of parameter space, interactions of dark matter with baryons lead to premature death of the star as a black hole. We sketch how this modification of the standard evolutionary history of Population III stars might impact the epoch of reionisation, by modifying the amount of UV emission, the transition to Population II star formation, and the X-ray and radio emission from accretion onto the black hole remnants. Signals of massive black holes originating from Population III stars could be observed through gravitational waves from their mergers. Finally, the observation of pair-instability supernovae could effectively preclude premature black hole death across a wide range of parameter space, ranging in mass from m
DM ∼ 0.1 GeV to m
DM ∼ m
Pl.
Dissociation of J/ψ in hot medium and magnetic field *
Authors: Teng Da , Guo Xingyu
Published: May 2022

Charmonium dissociation is an important probe of the quark–gluon plasma medium in heavy-ion collisions. The magnetic field produced in non-central collisions can affect the charmonia and their dissociation. We study the

bound state in magnetic field and at finite temperature using the Schrödinger equation. We find that below the dissociation temperature, both the magnetic field and momentum of the charmonia affect the formation or dissociation of the bound state, forming a non-trivial structure.
Real-time wall conditioning and recycling modification utilizing boron and boron nitride powder injections into the Large Helical Device
Authors: Lunsford R. , Masuzaki S. , Nespoli F. , Ashikawa N. , Gilson E.P. , Gates D.A. , Ida K. , Kawamura G. , Morisaki T. , Nagy A. , Oishi T. , Shoji M. , Suzuki C. , Yoshinuma M.
Published: May 2022

Controlled particulate injections from the PPPL impurity powder dropper (IPD) into the Large Helical Device have demonstrated positive effects on the wall conditions on both an intra and inter-shot basis. Injections over a range of densities, input powers, pulse lengths, heating schemes, injection quantities and main ion species show conclusive evidence of improvement to plasma wall conditions. Successful injections are confirmed by both spectroscopic measurements as well as real-time visible camera signals. In 7 s long plasmas the responses include a reduction in wall recycling as well as a reduction in native impurity content as observed over the course of several discharges. For plasmas longer than 40 s, improvements to the recycling rate and increased impurity control are observed in real time as a consequence of the extended particulate injections. These experiments demonstrate the extended applicability of this solid particulate conditioning technique to the control and maintenance of the plasma wall conditions. In addition they are an important initial step in the development of the real-time boronization technique as a supplement to standard conditioning scenarios.
Effects of intermetallic phases on electrochemical properties of powder metallurgy Mg-6%Al-5%Pb anode alloy used for seawater activated battery
Authors: Huang Jiefeng , Liu Hui , Fang Hongjie , Zhang Jiaxi , Zhang Qian , He Xuehua , Song Juemin , Li Zheng , Yan Yang , Yu Kun
Published: May 2022

The changes in intermetallic phases of Mg-6%Al-5%Pb (Mg-Al-Pb) alloy prepared by powder metallurgy and their effects on electrochemical properties were studied. Experimental results showed that coarse Mg17Al12 phases (with size ranges from 20 μm to 70 μm) and fine Mg2Pb phases (with the size of 100 nm scale) formed in the mixed Al, Pb and Mg powder during the hot press sintering procedure. Fine Mg2Pb phases exhibit strong diffusional ability to diffuse into Mg17Al12 phases. Extruding further promotes the diffusion of Mg2Pb phases into Mg17Al12 phases. Solution treatment produced a mixed microstructure which is Mg17Al12 phase containing Mg2Pb phases inside and made other Mg2Pb phases homogeneously distributed in Mg matrix. Mg17Al12 phases and the gathered Mg2Pb phases will accumulate the Mg(OH)2 corrosion products, which impedes the subsequent discharge behavior. Homogeneously distributed Mg2Pb phases will fall off during discharge, which makes the discharge curve more stable. The mixed microstructure has positive effect on corrosion resistance and discharge potential. Therefore, solution-treated alloy shows the highest negative potential and the smoothest curve during the galvanostatic discharge test. Compared with the commercial AZ61 sheet, solution-treated alloy exhibit much higher anode properties in Mg/PbCl2 battery test. Thus, the solution-treated alloy could serve as an excellent anode in seawater-activated batteries.
Trends in nanomaterial-based biosensors for viral detection
Authors: Harito Christian , Khalil Munawar , Septiani Ni Luh Wulan , Dewi Kariana Kusuma , Hardiansyah Andri , Yuliarto Brian , Walsh Frank C
Published: May 2022

Pandemics such as COVID-19 have highlighted the importance of point-of-care sensors for testing, tracing, and treatment to minimize and manage infection. Biosensors have been widely deployed in portable devices such as glucose sensors and pregnancy tests. Their development for point-of-exposure virus detection or point-of-care devices is anticipated but their reliability for the accurate detection of viruses is critical. Nanomaterials, such as metal nanoparticles (NPs), magnetic NPs, quantum dots, carbon-based nanomaterials, and molecularly imprinted polymer (MIP) NPs, have been utilized in biosensors to enhance sensitivity. Molecular imprinting is a cost-effective method to synthesize polymers for selective binding, which have excellent properties as biosensors. More research on MIP NPs can be expected in the near future. The utilization of nanomaterials in several types of transducers for biosensor devices is also illustrated to give an overview of their use. Finally, a summary is given together with a future perspective on how biosensors can be further developed as reliable, portable viral biosensors.
Expanding northern skies
Authors: Pye Dan
Published: May 2022

Kielder Observatory is established as a science communication hub under the award-winning skies of England's north-east. Now, says Dan Pye, it's making strides in the world of research.
Stay in love with your PhD
Authors: Bowman Dominic M , Richards Fred , Maunder Megan , O'Brien Áine , Boubert Douglas
Published: May 2022

Get this: PhDs are hard. But PhDs can be hard for the wrong reasons. A recent event held by the RAS's Early Career Network Committee identified a host of unnecessary energy-drains that should be avoided for a more profitable PhD experience. By Dominic M. Bowman, Fred Richards, Megan Maunder, Áine O'Brien and Douglas Boubert.
Five-year clinical outcomes in patients with frailty aged ≥75 years with non-ST elevation acute coronary syndrome undergoing invasive management
Authors: Ratcovich Hanna , Beska Benjamin , Mills Greg , Holmvang Lene , Adams-Hall Jennifer , Stevenson Hannah , Veerasamy Murugapathy , Wilkinson Chris , Kunadian Vijay
Published: May 2022

Aim

Frailty is associated with adverse outcomes in older patients with acute coronary syndrome (ACS). The impact of frailty on long-term clinical outcomes following invasive management of non-ST elevation ACS (NSTEACS) is unknown.

Methods and results

The multi-centre Improve Clinical Outcomes in high-risk patieNts with ACS 1 (ICON-1) prospective cohort study consisted of patients aged >75 years undergoing coronary angiography following NSTEACS. Patients were categorized by frailty assessed by Canadian Study of Health and Ageing Clinical Frailty Scale (CFS) and Fried criteria. The primary composite endpoint was all-cause mortality, unplanned revascularization, myocardial infarction, stroke, and bleeding. Of 263 patients, 33 (12.5%) were frail, 152 (57.8%) were pre-frail, and 78 (29.7%) were robust according to CFS. By Fried criteria, 70 patients (26.6%, mean age 82.1 years) were frail, 147 (55.9%, mean age 81.3 years) were pre-frail, and 46 (17.5%, mean age 79.9 years) were robust. The composite endpoint was more common at 5 years among patients with frailty according to CFS (frail: 22, 66.7%; pre-frail: 81, 53.3%; robust: 27, 34.6%, P = 0.003), with a similar trend when using Fried criteria (frail: 39, 55.7%; pre-frail: 72, 49.0%; robust: 16, 34.8%, P = 0.085). Frailty measured with both CFS and Fried criteria was associated with the primary endpoint [age and sex-adjusted hazard ratio (HR) compared with robust groups. CFS: 2.22, 95% confidence interval (CI) 1.23–4.02, P = 0.008; Fried: HR 1.81, 95% CI 1.00–3.27, P = 0.048].

Conclusion

In older patients who underwent angiography following NSTEACS, frailty is associated with an increased risk of the primary composite endpoint at 5 years.

Registration:

Clinicaltrials.gov NCT01933581
BSAC Vanguard Series: Behavioural science and antimicrobial resistance
Authors: Brazier Alix , Merriam Sarah , Halpern David
Published: May 2022

Antimicrobial resistance could cause 10 million deaths per year by 2050 if no action is taken. While we depend on researchers to find new antimicrobials, reducing the demand for existing ones requires human behaviour change. This article by The Behavioural Insights Team discusses some of the areas with the greatest potential for behavioural interventions to reduce the development of antimicrobial resistance. Three areas are discussed: (i) ‘nudging’ antimicrobial stewardship (e.g. highlighting comparative over-prescribing was seen to reduce GP antibiotics prescriptions by 3.3%); (ii) promoting good hygiene practices (e.g. placement and salience of hand sanitizer increased hospital visitor compliance from 0.4% to 19.7%); and (iii) leveraging market forces (e.g. front-of-package labelling could increase demand for meat produced with minimal antibiotics, encouraging food production behaviour change).
Assessing Population Structure and Genetic Diversity in US Suffolk Sheep to Define a Framework for Genomic Selection
Authors: Wilson Carrie S , Petersen Jessica L , Blackburn Harvey D , Lewis Ronald M
Published: May 2022

Long-term sustainability of breeds depends on having sufficient genetic diversity for adaptability to change, whether driven by climatic conditions or by priorities in breeding programs. Genetic diversity in Suffolk sheep in the United States was evaluated in four ways: 1) using genetic relationships from pedigree data [(n = 64 310 animals recorded in the US National Sheep Improvement Program (NSIP)]; 2) using molecular data (n = 304 Suffolk genotyped with the OvineHD BeadChip); 3) comparing Australian (n = 109) and Irish (n = 55) Suffolk sheep to those in the United States using molecular data; and 4) assessing genetic relationships (connectedness) among active Suffolk flocks (n = 18) in NSIP. By characterizing genetic diversity, a goal was to define the structure of a reference population for use for genomic selection strategies in this breed. Pedigree-based mean inbreeding level for the most recent year of available data was 5.5%. Ten animals defined 22.8% of the current gene pool. The effective population size (Ne) ranged from 27.5 to 244.2 based on pedigree and was 79.5 based on molecular data. Expected (HE) and observed (HO) heterozygosity were 0.317 and 0.306, respectively. Model-based population structure included 7 subpopulations. From Principal Component Analysis, countries separated into distinct populations. Within the US population, flocks formed genetically disconnected clusters. A decline in genetic diversity over time was observed from both pedigree and genomic-based derived measures with evidence of population substructure as measured by FST. Using these measures of genetic diversity, a framework for establishing a genomic reference population in US Suffolk sheep engaged in NSIP was proposed.
Mastery of Your Anxiety and Panic
Authors: Craske Michelle G. , Barlow David H.
Published: May 2022

This edition of the Mastery of Your Anxiety and Panic: Therapist Guide provides therapists with all the tools necessary to deliver effective treatment for panic disorder and agoraphobia. It provides step-by-step instructions for teaching clients the skills to overcome their fear of panic and panic attacks. The book also presents case vignettes as well as techniques for addressing atypical and problematic responses. The program, organized by skill, makes treatment able to be tailored to the individual. It also includes a chapter for adapting the treatment for effective delivery in six sessions within primary care or related settings. Although written for the client, the program is recommended to be carried out under the supervision of a mental health professional.
The Nature of Panic Disorder and Agoraphobia
Authors: Craske Michelle G. , Barlow David H.
Published: May 2022

This chapter discusses the nature of panic disorder (PD) and agoraphobia. The hallmark symptom of PD is a history of unexpected panic attacks that are experienced by the patient as occurring from out of the blue, without any obvious trigger or cue. However, some patients may be quite adept at predicting their panic attacks, and upon initial screening may even deny having unexpected panic attacks. Therapists should inquire carefully into the patient’s experiences of initial panic attacks to determine whether there is an early history of unexpected panic attacks. Meanwhile, according to DSM-5, and in a change from DSM-IV, agoraphobia is diagnosed separately from PD, though it can co-occur with PD if criteria are met for both. Agoraphobia is characterized by intense fear or anxiety about going into certain places or situations in which individuals might have panic-like or other embarrassing symptoms, especially in contexts where escape might be difficult or help unavailable. In severe cases, individuals with agoraphobia will not leave their homes, may avoid work, and (very rarely) may confine themselves to a single room in their home due to an intense fear of experiencing panic attacks or other symptoms. The chapter then looks at the psychobiological conceptualization of PD, before considering the development of agoraphobia. It also assesses nocturnal panic.
Introduction to the Program
Authors: Craske Michelle G. , Barlow David H.
Published: May 2022

This chapter examines the introduction to the treatment program. The information presented in this initial stage of treatment is intended to clarify the purposes of the workbook and provide corrective information that assures clients that they are neither insane nor atypical and that there is a good chance of successful treatment. By describing the phenomenology of panic disorder and the particular clustering of symptoms that characterizes panic disorder, the therapist informs clients that they are not alone in their experiences. Similarly, the psychobiological conceptualization of panic is presented to demystify the experience of panic and provide a conceptual framework within which the treatment makes sense. At the same time, the psychobiological model introduces the notion that panic attacks themselves are not the main issue; more important is the anticipation of and behavioral avoidance of panic attacks. Given the physical sensations experienced during panic and anxiety, however, a medical or chemical explanation of panic attacks is often more credible to clients than is an explanation that takes into account psychological variables. In addition, a medical or chemical account may be perceived as less stigmatizing than a psychological account.
Panic Attacks Are Not Harmful
Authors: Craske Michelle G. , Barlow David H.
Published: May 2022

This chapter highlights the importance of providing the client with information about panic attacks. Overall, the informational model of panic attacks builds on the previous chapters in providing an alternative conceptual framework that is nonthreatening and contributes to a personal scientist perspective, whereby clients can gain an objective understanding of their panic and anxiety. The program presents a panic attack as a learned fear of internal sensations. Crucial to the model of panic attacks is the role of anxiety about the recurrence of panic. Because the panic attack itself is feared as a dangerous event, it makes sense to anticipate the next time it will occur and to be very vigilant for signals of its next occurrence, which is the process of anxiety. Understanding the connections between different sensations experienced, their physiological basis, and their survival value engenders a greater sense of safety. It reassures clients that their sensations are not all imagined.
Establishing a Hierarchy of Agoraphobia Situations
Authors: Craske Michelle G. , Barlow David H.
Published: May 2022

This chapter assesses the process of establishing an individualized hierarchy of agoraphobia situations for the client, in preparation for in vivo exposure. A hierarchy composed of situations that range in anxiety level from mild to moderate, and all the way up to extremely anxious, will form the basis of a graduated approach to in vivo exposure. Although exposure exercises are not scheduled to take place for the next couple of weeks, it is important to introduce the hierarchy now. It is important to take into account the various conditions that moderate levels of anxiety, such as distance, being accompanied or being alone, the time of day, proximity to an exit, and so forth. Clients’ reliance on safety signals, safety behaviors, and distractions are also restated as other forms of avoidance that will interfere with corrective learning and contribute to anxiety in the long term. Thus, the goal of treatment is to learn to face agoraphobia situations without these forms of avoidance.
Breathing Skills
Authors: Craske Michelle G. , Barlow David H.
Published: May 2022

This chapter addresses breathing skills. The main goals are to introduce the physiology of overbreathing as something that may contribute to the physiological sensations during panic attacks and to recognize that hyperventilatory sensations are not harmful. It is important that the client not misconstrue the discussion of overbreathing as an indication that panic and fear are a direct result of primarily physiological irregularities. That is, the therapist should place the role of hyperventilation within the context of the interactions that occur among the three response components (i.e., behavioral, physiological, and subjective). The experience of overbreathing in isolation from catastrophic misinterpretations of bodily sensations or from learned fear of bodily sensations is unlikely to result in a panic attack. In this treatment, breathing skills training is intended to regulate breathing, but more importantly, it is also intended to interrupt the panic cycle and provide a tool to help clients face their fear, anxiety, and anxiety-producing situations.
Accomplishments, Maintenance, and Relapse Prevention
Authors: Craske Michelle G. , Barlow David H.
Published: May 2022

This chapter evaluates the importance of reviewing the client’s progress, encouraging the client to continue to face fear and anxiety, and discussing ways of maintaining progress and relapse prevention. Instead of focusing on feelings in general, an assessment that is likely to be biased, progress is best evaluated by examining objective data. Progress is indexed by improvement—not by reaching an absolute end goal of no panic, anxiety, or agoraphobia—and by skill development. The temporary resurgence of old habits is not a sign that treatment did not work. If necessary, the therapist may work with the client to identify areas for further practice. Clients frequently express concerns about ending the program. It is therefore important to emphasize again that the treatment was designed to provide clients with the necessary skills for managing anxiety and that they now can use these skills to continue their progress.
Therapist Guide for Brief Six-Session Version for Primary Care and Related Settings
Authors: Craske Michelle G. , Barlow David H.
Published: May 2022

This chapter presents a therapist guide to the Mastery of Your Anxiety and Panic: Workbook for Brief Six-Session Version for Primary Care and Related Settings. It begins by tracing the evolution of this brief treatment program. This treatment entails the same components as the full version of panic control treatment, including psychoeducation and cognitive restructuring, breathing retraining, interoceptive exposure, and in vivo exposure. In addition, the brief six-session version of MAP includes more discussion of medications, since this treatment was initially evaluated in a study in which MAP was combined with medications. The in-clinic visits end with the development of a relapse prevention plan that covers medication adherence, implementation of cognitive behavioral strategies, and the coordination of continued care with the primary care physician and/or other community resources.
Mastery of Your Anxiety and Panic
Authors: Barlow David H. , Craske Michelle G.
Published: May 2022

This edition of the Mastery of Your Anxiety and Panic Workbook has been updated to include strategies and techniques for dealing with both panic disorder and agoraphobia. The program outlined is based on the principles of cognitive behavioral therapy (CBT) and is organized by skill, with each chapter building on the one before it. It covers the importance of recordkeeping and monitoring progress, as well as breathing techniques and thinking skills. The main focus of the treatment involves learning how to face agoraphobia situations and the often frightening physical symptoms of panic from an entirely new perspective. Self-assessment quizzes, homework exercises, and interactive forms allow patients to become active participants in treatment and to learn to manage panic attacks, anxiety about panic, and avoidance of panic and agoraphobic situations.
Panic Attacks Are Not Harmful
Authors: Barlow David H. , Craske Michelle G.
Published: May 2022

This chapter examines the importance of learning about the causes of the physical symptoms of panic. The physical changes that underlie the physical symptoms of panic and anxiety are protective in that they are designed to help us escape from or fight off danger. The symptoms are real, but they are not harmful. Interestingly, physical symptoms are sometimes felt in the absence of actual physical changes. This occurs because an intense and anxious focus on physical feelings can create the perception of a physical disturbance even when none really exists. However, intense panic attacks are almost always based on real physical changes. The chapter then assesses how physical symptoms influence what we think and do. When the sympathetic nervous system is activated into an emergency flight or fight response, there are certain natural effects on our behaviors and our thoughts. The chapter also looks at typical mistaken beliefs about panic symptoms.
Thinking Skills
Authors: Barlow David H. , Craske Michelle G.
Published: May 2022

This chapter assesses the process of building thinking skills for changing one’s mistaken beliefs and negative thoughts. Years of research have shown that when we become anxious or panicky, we make two mistakes in our thinking. The mistakes are (1) to jump to conclusions about negative events and (2) to blow things out of proportion. These mistakes lead us to believe that events are more dangerous than they really are and to make us more anxious. It is thus important to learn how to correct those mistakes. The first step toward change is to treat thoughts as guesses rather than as facts. The goal is to develop more evidence-based ways of thinking.
Facing Physical Symptoms
Authors: Barlow David H. , Craske Michelle G.
Published: May 2022

This chapter addresses the value of facing physical symptoms of panic and anxiety. Fear of physical symptoms is central to panic disorder. Indeed, being afraid of physical symptoms leads to more physical symptoms, since the symptoms are the natural result of anxiety and fear. This is part of the panic cycle. It is thus important to face the physical symptoms directly so that one can learn that the symptoms are not harmful; that one can handle the symptoms and the anxiety; and that, eventually, the anxiety about the physical symptoms will decrease. The reasons why fears of physical symptoms persist include avoidance behavior, mistaken beliefs, and interoceptive conditioning. The chapter then looks at symptom exercises and outlines the rules for the repeated practice with physical symptoms.
Medications
Authors: Barlow David H. , Craske Michelle G.
Published: May 2022

This chapter covers medications that are prescribed for anxiety and panic. Many people with anxiety and panic attacks have had their doctors prescribe medications. Many of these medications, however, are not effective in the long term unless one continues to take them. Even then, they may lose some of their effectiveness unless one learns some new, more helpful methods of coping with anxiety and panic while taking the medication. The chapter then reviews the ways in which medications work and the different types of medications prescribed for anxiety and panic, including antidepressants, benzodiazepines, and beta-blockers. It also looks at ways in which medications can be used in combination with the methods outlined in this program, as well as ways of weaning off of medications.
Selection Balancing at Innate Immune Genes: Adaptive Polymorphism Maintenance in Toll-Like Receptors
Authors: Minias Piotr , Vinkler Michal
Published: May 2022

Balancing selection is a classic mechanism for maintaining variability in immune genes involved in host–pathogen interactions. However, it remains unclear how widespread the mechanism is across immune genes other than the major histocompatibility complex (MHC). Although occasional reports suggest that balancing selection (heterozygote advantage, negative frequency-dependent selection, and fluctuating selection) may act on other immune genes, the current understanding of the phenomenon in non-MHC immune genes is far from solid. In this review, we focus on Toll-like receptors (TLRs), innate immune genes directly involved in pathogen recognition and immune response activation, as there is a growing body of research testing the assumptions of balancing selection in these genes. After reviewing infection- and fitness-based evidence, along with evidence based on population allelic frequencies and heterozygosity levels, we conclude that balancing selection maintains variation in TLRs, though it tends to occur under specific conditions in certain evolutionary lineages rather than being universal and ubiquitous. Our review also identifies key gaps in current knowledge and proposes promising areas for future research. Improving our understanding of host–pathogen interactions and balancing selection in innate immune genes are increasingly important, particularly regarding threats from emerging zoonotic diseases.
Increased feeding frequency prior to farrowing: effects on sow performance
Authors: Tucker Bryony S , Petrovski Kiro R , Craig Jessica R , Morrison Rebecca S , Smits Robert J , Kirkwood Roy N
Published: May 2022

Reducing the interval between the consumption of the last meal and the start of farrowing is suggested to increase the energy available to sows during farrowing, potentially reducing the farrowing duration and easing piglet births. The present study aimed to examine whether increasing feeding frequency from one to two feeds within standard production hours (0700 to 1500 hours) would produce a difference in farrowing duration and/or stillborn numbers. From entry to farrowing crates (110 ± 1 d gestation) to farrowing (116 ± 1 d gestation), multiparous sows (n = 118) were fed a daily fixed amount of feed either once at 0800 hours or in two meals at 0800 and 1300 hours. Sow weights and backfat depths were recorded on entry and exit from the farrowing crate. Litter size and weight were recorded 24 h after farrowing and on day 21 of lactation. Sows fed twice had a shorter farrowing duration and fewer stillborn piglets than those fed once (2.21 ± 0.56 h vs. 3.25 ± 0.52 h; P = 0.001). The interaction between treatment and farrowing duration showed that sows fed twice have a reduced farrowing duration and had significantly lower stillborn rates than those fed once or those fed twice with longer farrowing durations (P < 0.001). These findings suggest that increasing feeding frequency prior to farrow can reduce the farrowing duration and stillborn numbers in some sows, however, some sows remain with a high stillborn rate regardless of feeding frequency. Piglet average daily gain was greater in once-fed sows, but fewer of these sows remained in the herd at subsequent farrowing. Further, subsequent total born and born alive were higher in twice-fed sows. Feeding sows at a higher frequency can improve farrowing performance in some sows and could increase the longevity of the sow in the herd.
Association of an Obstetric Surgical Closing Protocol With Infection After Cesarean Delivery
Authors: Wyatt Michelle A. , Weaver Amy L. , Jensen Claire , Yelsa Isabel , Rangel Latuche Laureano J. , Sharpe Emily E. , Rivera-Chiauzzi Enid Y.
Published: May 2022

OBJECTIVE:

To examine surgical site infection rates before and after the addition of a closing protocol to an existing surgical site infection risk-reduction bundle used during cesarean delivery.

METHODS:

We conducted a single-center retrospective cohort study to review the association of a closing protocol with rates of surgical site infection after cesarean delivery. The closing protocol included fresh surgical instruments and physician and scrub nurse glove change before fascia closure. Surgical site infections were defined using Centers for Disease Control and Prevention criteria. Eligible patients underwent cesarean delivery at our institution from July 1, 2013, through December 31, 2015 (n=1,708; preimplementation group), or from June 1, 2016, through April 30, 2018 (n=1,228; postimplementation group).

RESULTS:

The surgical site infection rate was 2.3% preimplementation and 2.7% postimplementation (difference 0.4%, 95% CI −1.6 to 0.7%]. The mean [SD] duration of the surgical procedure was longer postimplementation (59.6 [23.7] vs 55.6 [21.5] minutes; P<.001).

CONCLUSION:

Addition of a closing tray and glove change to our existing surgical site infection risk-reduction bundle was not associated with a reduction in the frequency of postcesarean surgical site infection but was associated with longer operating times.
Pregnancy and the Risk of In-Hospital Coronavirus Disease 2019 (COVID-19) Mortality
Authors: Pineles Beth L. , Goodman Katherine E. , Pineles Lisa , O'Hara Lyndsay M. , Nadimpalli Gita , Magder Laurence S. , Baghdadi Jonathan D. , Parchem Jacqueline G. , Harris Anthony D.
Published: May 2022

OBJECTIVE:

To evaluate whether pregnancy is an independent risk factor for in-hospital mortality among patients of reproductive age hospitalized with coronavirus disease 2019 (COVID-19) viral pneumonia.

METHODS:

We conducted a retrospective cohort study (April 2020–May 2021) of 23,574 female inpatients aged 15–45 years with an International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code for COVID-19 discharged from 749 U.S. hospitals in the Premier Healthcare Database. We used a viral pneumonia diagnosis to select for patients with symptomatic COVID-19. The associations between pregnancy and in-hospital mortality, intensive care unit (ICU) admission, and mechanical ventilation were analyzed using propensity score–matched conditional logistic regression. Models were matched for age, marital status, race and ethnicity, Elixhauser comorbidity score, payer, hospital number of beds, season of discharge, hospital region, obesity, hypertension, diabetes mellitus, chronic pulmonary disease, deficiency anemias, depression, hypothyroidism, and liver disease.

RESULTS:

In-hospital mortality occurred in 1.1% of pregnant patients and 3.5% of nonpregnant patients hospitalized with COVID-19 and viral pneumonia (propensity score–matched odds ratio [OR] 0.39, 95% CI 0.25–0.63). The frequency of ICU admission for pregnant and nonpregnant patients was 22.0% and 17.7%, respectively (OR 1.34, 95% CI 1.15–1.55). Mechanical ventilation was used in 8.7% of both pregnant and nonpregnant patients (OR 1.05, 95% CI 0.86–1.29). Among patients who were admitted to an ICU, mortality was lower for pregnant compared with nonpregnant patients (OR 0.33, 95% CI 0.20–0.57), though mechanical ventilation rates were similar (35.7% vs 38.3%, OR 0.90, 95% CI 0.70–1.16). Among patients with mechanical ventilation, pregnant patients had a reduced risk of in-hospital mortality compared with nonpregnant patients (0.26, 95% CI 0.15–0.46).

CONCLUSION:

Despite a higher frequency of ICU admission, in-hospital mortality was lower among pregnant patients compared with nonpregnant patients with COVID-19 viral pneumonia, and these findings persisted after propensity score matching.
Depot Medroxyprogesterone Acetate Use and the Development and Progression of Uterine Leiomyoma
Authors: Harmon Quaker E. , Patchel Stacy A. , Zhao Shanshan , Umbach David M. , Cooper Tracy E. , Baird Donna D.
Published: May 2022

OBJECTIVE:

Investigate the association between use of depot medroxyprogesterone acetate (DMPA) (an injectable progestin-only contraceptive) and leiomyoma development.

METHODS:

We conducted a cohort study in the Detroit, Michigan, area that involved four clinic visits at 20-month intervals over 5 years (2010–2018) and used a standardized ultrasonography protocol to prospectively measure leiomyomas 0.5 cm or more in diameter. Participants were 1,693 self-identified Black women aged 23–35 years with no prior leiomyoma diagnosis and no hysterectomy. For this substudy, years since last use of DMPA was ascertained from questionnaire data at every visit. Leiomyoma incidence was defined as the first visit with an observed leiomyoma among women who were leiomyoma-free at enrollment. Depot medroxyprogesterone acetate associations were examined with Cox models. Leiomyoma growth was calculated as the change in log-volume for leiomyomas matched at successive visits and was modeled using linear mixed models accounting for clustered data. Leiomyoma loss, defined as a reduction in leiomyoma number in successive visits, was modeled using Poisson regression. All models used time-varying exposure and covariates.

RESULTS:

Of participants with at least one follow-up visit (N=1,610), 42.9% had ever used DMPA. Participants exposed to DMPA within the previous 2 years experienced reduced leiomyoma development during the subsequent observation interval compared with never users, including lower leiomyoma incidence (5.2% vs 10.7%), adjusted hazard ratio 0.6 (95% CI 0.4–1.0), 42.0% lower leiomyoma growth (95% CI −51.4 to −30.7) and 60% greater leiomyoma loss (adjusted risk ratio 1.6, 95% CI 1.1–2.2). Excess leiomyoma loss was also seen for those who used DMPA 2–4 years before the visit compared with never users, 2.1-fold increase (95% CI 1.4–3.1).

CONCLUSION:

Recent use of DMPA was associated with reduced leiomyoma development and increased leiomyoma loss. Such changes in early leiomyoma development in young women could delay symptom onset and reduce the need for invasive treatment.