A significant number of veterans of the conflicts in Iraq and Afghanistan have posttraumatic stress disorder (PTSD), yet underutilization of mental health treatment remains a significant problem. The ...purpose of this review was to summarize rates of dropout from outpatient, psychosocial PTSD interventions provided to U.S. Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and Operation New Dawn (OND) veterans with combat‐related PTSD. There were 788 articles that were identified which yielded 20 studies involving 1,191 individuals eligible for the review. The dropout rates in individual studies ranged from 5.0% to 78.2%, and the overall pooled dropout rate was 36%, 95% CI 26.20, 43.90. The dropout rate differed marginally by study type (routine clinical care settings had higher dropout rates than clinical trials) and treatment format (group treatment had higher dropout rates than individual treatment), but not by whether comorbid substance dependence was excluded, by treatment modality (telemedicine vs. in‐person treatment), or treatment type (exposure therapy vs. nonexposure therapy). Dropout is a critical aspect of the problem of underutilization of care among OEF/OIF/OND veterans with combat‐related PTSD. Innovative strategies to enhance treatment retention are needed.
Resumen
Un número significativo de veteranos de los conflictos en Irak y Afganistán tienen trastorno por estrés postraumático (TEPT), sin embargo, la subutilización de tratamiento de salud mental sigue siendo un problema significativo. El propósito de esta revisión fue resumir las tasas de deserción de pacientes ambulatorios, en intervenciones psicosociales para TEPT realizadas a los veteranos con TEPT relacionado a combate de las Operaciones Libertad Iraquí (OIF), Libertad Duradera (OEF) y Nuevo Amanecer (OND). Se identificó un total de 788 artículos y se obtuvo 20 estudios que involucran a 1.191 personas, elegibles para la revisión. Las tasas de deserción en estudios individuales variaron del 5,0% al 78,2%, y la tasa global de deserción agrupada fue de 36%, IC 95% 26,20, 43,90. Las tasas de deserción difirieron según el tipo de estudio (contextos de cuidado clínico de rutina tuvieron mayores tasas de abandono que los ensayos clínicos) y según el formato de tratamiento (tratamiento grupal tuvo mayores tasas de abandono que el tratamiento individual), pero no difería ya fuera que se excluyera o no la comorbilidad con dependencia a sustancias, por modalidad de tratamiento (telemedicina vs.tratamiento en persona), o el tipo de tratamiento (terapia de exposición vs. terapia sin exposición). El abandono es un aspecto crítico del problema de la subutilización de la atención entre losveteranos con TEPT relacionado con el combate de las OEF, OIF y OND. Se necesitan estrategias innovadoras para mejorar la retención en el tratamiento.
抽象
Traditional and Simplified Chinese s by AsianSTSS
標題 : 伊拉克和阿富汗戰爭退役軍人接受創傷後壓力症治療的放棄率༚一項系統性的審核
撮要: 患創傷後壓力症(PTSD)的伊拉克和阿富汗戰爭退役軍人數目顯著༌但他們接受心理治療的比率持續偏低。有為「持久自由行動」(OEF)和伊拉克戰爭(OIF、OND) 中患戰鬥相關PTSD的退役軍人提供的PTSD心理社會干預門診治療༌本研究旨在概述這項治療服務裡的放棄率。研究共找出788份過往研究紀錄༌當中20項研究包含1,191名符合審核條件的人士。個別研究的放棄治療率為5.0% 至 78.2%༌整體的放棄治療率為36%༌95% CI 26.20, 43.90。放棄治療率因以下因素生異༚研究樣式 ༈例行的治療設定比臨床試驗的放棄率更高༉和治療樣式༈團體治療比個人治療的放棄率更高༉。不論治療有沒有考慮到濫用藥物共病༌還是治療方式༈遠距或親身醫療༉、治療種類༈暴露或非暴露療法༉༌也沒影響放棄治療率。放棄治療是患戰鬥相關PTSD的OEF/OIF/OND退役軍人接受心理治療率偏低的關鍵問題༌需有創新的策略使他們保持接受治療。
标题 : 伊拉克和阿富汗战争退役军人接受创伤后压力症治疗的放弃率༚一项系统性的审核
撮要: 患创伤后压力症(PTSD)的伊拉克和阿富汗战争退役军人数目显著༌但他们接受心理治疗的比率持续偏低。有为「持久自由行动」(OEF)和伊拉克战争(OIF、OND) 中患战斗相关PTSD的退役军人提供的PTSD心理社会干预门诊治疗༌本研究旨在概述这项治疗服务里的放弃率。研究共找出788份过往研究纪录༌当中20项研究包含1,191名符合审核条件的人士。个别研究的放弃治疗率为5.0% 至 78.2%༌整体的放弃治疗率为36%༌95% CI 26.20, 43.90。放弃治疗率因以下因素生异༚研究样式 ༈例行的治疗设定比临床试验的放弃率更高༉和治疗样式༈团体治疗比个人治疗的放弃率更高༉。不论治疗有没有考虑到滥用药物共病༌还是治疗方式༈远距或亲身医疗༉、治疗种类༈暴露或非暴露疗法༉༌也没影响放弃治疗率。放弃治疗是患战斗相关PTSD的OEF/OIF/OND退役军人接受心理治疗率偏低的关键问题༌需有创新的策略使他们保持接受治疗。
By applying an interdigitated back contacted solar cell concept with poly-Si on oxide passivating contacts an efficiency of 26.1% was achieved recently. In this paper the impact of the implemented ...initially intrinsic poly-Si region between p-type poly-Si and n-type poly-Si regions is investigated. Two recombination paths are identified: The recombination at the interface between the initially intrinsic poly-Si and the wafer as well as the recombination across the resulting p(i)n diode on the rear side which is aimed to be reduced by introducing an initially intrinsic region. By using test structures, it is demonstrated that the width of the initially intrinsic region ((i) poly-Si region) has a strong influence on the recombination current through the p(i)n diode and that this initially intrinsic region needs to be about 30 μm wide to sufficiently reduce the recombination across the p(i)n diode. Lateral and depth-resolved time of flight secondary ion mass spectrometry analysis shows that the high-temperature annealing step causes a strong lateral inter-diffusion of donor and acceptor atoms into the initially intrinsic region. This diffusion has a positive impact on the passivation quality at the c-Si/SiO
/i poly-Si interface and is thus essential for achieving an independently confirmed efficiency of 26.1% with 30 μm-wide initially intrinsic poly-Si regions.
Alien plants experience novel abiotic conditions and interactions with native communities in the introduced area. Intra‐ and interspecific selection on functional traits in the new environment may ...lead to increased population growth with time since introduction (residence time). However, selection regimes might differ depending on the invaded habitat. Additionally, in high‐competition habitats, a build‐up of biotic resistance of native species due to accumulation of eco‐evolutionary experience to aliens over time may limit invasion success. We tested if the effect of functional traits and the population dynamics of aliens depends on interspecific competition with native plant communities. We conducted a multi‐species experiment with 40 annual Asteraceae that differ in residence time in Germany. We followed their population growth in monocultures and in interspecific competition with an experienced native community (varying co‐existence times between focals and community). To more robustly test our findings, we used a naïve community that never co‐existed with the focals. We found that high seed mass decreased population growth in monocultures but tended to increase population growth under high interspecific competition. We found no evidence for a build‐up of competition‐mediated biotic resistance by the experienced community over time. Instead, population growth of the focal species was similarly inhibited by the experienced and naïve community. By comparing the effect of experienced and naïve communities on population dynamics over 2 years across a large set of species with a high variation in functional traits and residence time, this study advances the understanding of the long‐term dynamics of plant invasions. In our study system, population growth of alien species was not limited by an increase of competitive effects by native communities (one aspect of biotic resistance) over time. Instead, invasion success of alien plants may be limited because initial spread in low‐competition habitats requires different traits than establishment in high‐competition habitats.
The fitness of alien plants in their new area should be determined by functional traits that are related to invasiveness and effects of competition by native plant communities that may depend on their eco‐evolutionary experience and thus interact with residence time of the invader. In this context, the role of traits for fitness is likely to change depending on the habitat that is being invaded and may thus be determined by competition.
► The intention of the present review is to update the consensus knowledge on gm. ► Gaps in knowledge and research priorities are indicated for the near future. ► In particular, how has gm evolved ...among phylogenetically distant groups? ► Can gm be uncoupled from the water path regulation? ► Mechanistic models of gm incorpored in photosynthesis models are needed.
Mesophyll diffusion conductance to CO2 is a key photosynthetic trait that has been studied intensively in the past years. The intention of the present review is to update knowledge of gm, and highlight the important unknown and controversial aspects that require future work. The photosynthetic limitation imposed by mesophyll conductance is large, and under certain conditions can be the most significant photosynthetic limitation. New evidence shows that anatomical traits, such as cell wall thickness and chloroplast distribution are amongst the stronger determinants of mesophyll conductance, although rapid variations in response to environmental changes might be regulated by other factors such as aquaporin conductance.
Gaps in knowledge that should be research priorities for the near future include: how different is mesophyll conductance among phylogenetically distant groups and how has it evolved? Can mesophyll conductance be uncoupled from regulation of the water path? What are the main drivers of mesophyll conductance? The need for mechanistic and phenomenological models of mesophyll conductance and its incorporation in process-based photosynthesis models is also highlighted.
Polycrystalline silicon (poly-Si) layers on thin silicon oxide films have received strong research interest as they form excellent carrier selective junctions on crystalline silicon substrates after ...appropriate thermal processing. Recently, we presented a new method to determine the pinhole density in interfacial oxide films of poly-Si on oxide (POLO)-junctions with excellent electrical properties. The concept of magnification of nanometer-size pinholes in the interfacial oxide by selective etching of the underlying crystalline silicon is used to investigate the influence of annealing temperature on pinhole densities. Eventually, the pinholes are detected by optical microscopy and scanning electron microscopy. We present results on the pinhole density in POLO-junctions with J0 values as low as 1.4 fA/cm2. The stability of this method is demonstrated by proving that no new holes are introduced to the oxide during the etching procedure for a wide range of etching times. Finally, we show the applicability to multiple oxide types and thickness values, differently doped poly-Si layers as well as several types of wafer surface morphologies. For wet chemically grown oxides, we verified the existence of pinholes with an areal density of 2×107cm−2 even already after annealing at a temperature of 750°C (lower than the optimum annealing temperature for these junctions).
•Pinhole densities are determined after selective etching with TMAH.•We prove the stability and versatility of the etching procedure.•Pinholes are found in all analyzed samples with varying parameters.•The relation between J0 and pinhole density matches with the pinhole model.
Carrier selective junctions using a poly-silicon/ silicon oxide stack on crystalline silicon feature low recombination currents J0 whilst allowing for low contact resistivity ρC. We describe the ...limiting current transport mechanism as a combination of homogeneous tunneling through the interfacial silicon oxide layer and transport through pinholes where the interfacial silicon oxide layer is locally disrupted. We present an experimental method and its theoretical basis to discriminate between homogenous tunneling and local pinhole transport mechanisms on n + /n or p + /p junctions by measuring the temperature-dependent contact resistance. Theory predicts opposing trends for the temperature dependencies of tunneling and pinhole transport. This allows identifying the dominant transport path. For the contact resistance of two differently prepared poly-Si/ silicon oxide/ c-Si junctions we either find clear pinhole-type or clear tunneling-type temperature dependence. Pinhole transport contributes more than 94% to the total current for the sample with a 2.1 nm-thick interfacial silicon oxide that we anneal at a temperature of 1050 °C to achieve highest selectivity. In contrast pinhole transport contributes less than 35 % to the total current for the sample with a 1.7 nm-thick silicon oxide that we annealed at only 700 °C in order to avoid pinholes.
•Contact resistance measurements of a pinhole dominated sample can be modelled with drift currents.•Contact resistance measurements of a tunneling dominated sample can be modelled like a metal-insulator semiconductor.•The maximum contribution of the non-dominant current is deduced from temperature-dependent contact resistance measurements
Heavy rainfall is the main driver of soil erosion by water, which is a threat to soil and water resources across the globe. As a consequence of climate change, precipitation – especially extreme ...precipitation – is increasing in a warmer world, leading to an increase in rainfall erosivity. However, conventional global climate models struggle to represent extreme rain events and cannot provide precipitation data at the high spatiotemporal resolution that is needed for an accurate estimation of future rainfall erosivity. Convection-permitting simulations (CPSs), on the other hand, provide high-resolution precipitation data and a better representation of extreme rain events, but they are mostly limited to relatively small spatial extents and short time periods. Here, we present, for the first time, rainfall erosivity in a large modeling domain such as central Europe based on high-resolution CPS climate data generated with the regional climate model COSMO-CLM using the Representative Concentration Pathway 8.5 (RCP8.5) emission scenario. We calculated rainfall erosivity for the past (1971–2000), present (2001–2019), near future (2031–2060) and far future (2071–2100). Our results showed that future increases in rainfall erosivity in central Europe can be up to 84 % in the region's river basins. These increases are much higher than previously estimated based on regression with mean annual precipitation. We conclude that despite remaining limitations, CPSs have an enormous and currently unexploited potential for climate impact studies on soil erosion. Thus, the soil erosion modeling community should closely follow the recent and future advances in climate modeling to take advantage of new CPSs for climate impact studies.
An 815 bp region of the promoter of the Saccharomyces cerevisiae gene CTR/HNM1, encoding choline permease was sequenced and its regulatory function analysed by deletion studies in an in-frame ...promoter-lacZ construct. In addition to the TATA box, a 10 bp motif (consensus 5'-CATGTGAAAT-3') was found to be mandatory for CTR/HNM1 expression. This 'decamer' motif is located between nucleotides -262 and -271 and is identical in 9 of 10 bp with the regulatory motif found in the S. cerevisiae INO1 and CHO1 genes. Constructs with the 10 bp sequence show high constitutive expression, while elimination or alterations at three nucleotide positions, of the decamer motif in the context of an otherwise unchanged promoter leads to total loss of beta-galactosidase production. Expression of the CTR/HNM1 gene in wild-type cells is regulated by the phospholipid precursors inositol and choline; no such influence is seen in cells bearing mutations in the phospholipid regulatory genes IN02, IN04, and OPI1. There is no regulation by IN02 and OPI1 in the absence of the decamer motif. However constructs not containing this sequcnce (promoter intact to positions -213 or -152) are still controlled by IN04. Other substrates of the choline permease, i.e. ethanolamine, nitrogen mustard and nitrogen half mustard do not regulate expression of CTR/HNM1.
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