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Target-based approaches have traditionally been used in the search for new anti-infective molecules. Target selection process, a critical step in Drug Discovery, identifies targets that are essential to establish or maintain the infection, tractable to be susceptible for inhibition, selective towards their human ortholog and amenable for large scale purification and high throughput screening. The work presented herein validates the Plasmodium falciparum mRNA 5’ triphosphatase (PfPRT1), the first enzymatic step to cap parasite nuclear mRNAs, as a candidate target for the development of new antimalarial compounds. mRNA capping is essential to maintain the integrity and stability of the messengers, allowing their translation. PfPRT1 has been identified as a member of the tunnel, metal dependent mRNA 5′ triphosphatase family which differs structurally and mechanistically from human metal independent mRNA 5′ triphosphatase. In the present study the essentiality of PfPRT1 was confirmed and molecular biology tools and methods for target purification, enzymatic assessment and target engagement were developed, with the goal of running a future high throughput screening to discover PfPRT1 inhibitors.

This study aims to impact the responsible management practices of factories in the Ready-Made Garment (RMG) sector in Bangladesh. Collaborative research with our main partner - the BGMEA University for Fashion and Technology (BUFT) - on responsible management has contributed to the embedding of ethical practices in the RMG sector. More specifically, in a first stage of this program, the collaborative knowledge development is ingrained in the degree and executive education programs of BUFT - impacting about a quarter of the professionals entering the RMG sector in Bangladesh - and has informed the practices and policies of professional bodies, such as BGMEA in Bangladesh, MODINT in the Netherlands and the International Apparel Federation (IAF). Furthermore, in a second stage of this program, research on sustainability hot spots in the RMG value chain has influenced decision-making of the European Committee in relation to their sustainability policies. It substantially advanced the understanding of how European non-development policies and regulations aimed at private and public market actors contribute to or undermine sustainable development policies. The project delivered practical tools and innovative regulatory reform proposals with substantial potential for greater policy-coherence for development, thereby contributing to an integral approach focusing on a shift towards responsibility.

The impact case enhances the understanding of socio-legal research that contemplates the development of novel legal company forms which serve the well-being of humans and nature equally. Introducing novel company law forms for social change regards research in the field of social entrepreneurship and law, such as the development of tailor-made legislation for social enterprises in the Netherlands. Current legal forms for companies in the Netherlands do not support types of social entrepreneurial activity. Our research influenced directly the regulatory-making process of the novel forthcoming company law entity named the Besloten Vennootschap maatschappelijk (BVm), i.e., the private limited company with societal purpose which is about to be introduced in the Dutch company legislation. Particularly, our research team: (i) formulated key indicators for the BVm, which were accepted by the government in 2020 and will form the basis for new legislation which is currently being drafted; (ii) generated multiple academic studies, publications, seminars and conferences, as well as a PhD dissertation about the topic; (iii) supported many social enterprises in finding suitable legal forms (through educational programs, network sessions and collaboration with company and tax law experts).

The selection of the optimal methodology for the 3D geometric documentation of cultural heritage is a subject of high concern in contemporary scientific research. As a matter of fact, it requires a multi-source data acquisition process and the fusion of datasets from different sensors. This paper aims to demonstrate the workflow for the proper implementation and integration of geodetic, photogrammetric and laser scanning techniques so that high-quality photorealistic 3D models and other documentation products can be generated for a complicated, large-dimensional architectural monument and its surroundings. As a case study, we present the monitoring of the Mehmet Bey Mosque, which is a landmark in the city of Serres and a significant remaining sample of the Ottoman architecture in Greece. The surveying campaign was conducted in the context of the 2022–2023 annual workshop of the Interdepartmental Program of Postgraduate Studies “Protection Conservation and Restoration of Cultural Monuments” of the Aristotle University of Thessaloniki, and it served as a geometric background for interdisciplinary cooperation and decision-making on the monument restoration process. The results of our study encourage the fusion of terrestrial laser scanning and photogrammetric datasets for the 3D modeling of the mosque, as they supplement each other as regards geometry and texture.

Abstract Background Genetic mutations in beta-glucocerebrosidase (GBA) represent the major genetic risk factor for Parkinson’s disease (PD). GBA participates in both the endo-lysosomal pathway and the immune response, two important mechanisms involved in the pathogenesis of PD. However, modifiers of GBA penetrance have not yet been fully elucidated. Methods We characterized the transcriptomic profiles of circulating monocytes in a population of patients with PD and healthy controls (CTRL) with and without GBA variants (n = 23 PD/GBA, 13 CTRL/GBA, 56 PD, 66 CTRL) and whole blood (n = 616 PD, 362 CTRL, 127 PD/GBA, 165 CTRL/GBA). Differential expression analysis, pathway enrichment analysis, and outlier detection were performed. Ultrastructural characterization of isolated CD14+ monocytes in the four groups was also performed through electron microscopy. Results We observed hundreds of differentially expressed genes and dysregulated pathways when comparing manifesting and non-manifesting GBA mutation carriers. Specifically, when compared to idiopathic PD, PD/GBA showed dysregulation in genes involved in alpha-synuclein degradation, aging and amyloid processing. Gene-based outlier analysis confirmed the involvement of lysosomal, membrane trafficking, and mitochondrial processing in manifesting compared to non-manifesting GBA-carriers, as also observed at the ultrastructural levels. Transcriptomic results were only partially replicated in an independent cohort of whole blood samples, suggesting cell-type specific changes. Conclusions Overall, our transcriptomic analysis of primary monocytes identified gene targets and biological processes that can help in understanding the pathogenic mechanisms associated with GBA mutations in the context of PD.

Highly-sensitive and stable ozone and hydrogen sensing elements were fabricated based on well-crystalline rounded cube-shaped CsPbBr3 microcrystals, synthesized by a facile solution process performed under ambient conditions. It is shown that such elements demonstrate enhanced room temperature gas sensing ability compared to the previously reported metal halide and oxide-based ones. Electrical measurements performed on these sensing components revealed high sensitivity to ultra-low ozone and hydrogen concentrations, namely 4 ppb and 1 ppm respectively, as well as a remarkable repeatability, even after a few months of storage in ambient conditions. Both ozone and hydrogen sensors were self-activated, as they did not require the use of UV or heating external stimuli to operate, and exhibited fast detection and short restoration times. All such attractive properties along with the simple fabrication process could provide an easy, efficient and low-cost technology for the realization of future gas sensing devices.

Aims: There is evidence that morbidly obese patients have more intra- and postoperative complications and poorer outcomes when undergoing total hip arthroplasty (THA) with the direct anterior approach (DAA). The aim of this study was to determine the efficacy of DAA for THA, and compare the complications and outcomes of morbidly obese patients with nonobese patients. Methods: Morbidly obese patients (n = 86), with BMI ≥ 40 kg/m2 who underwent DAA THA at our institution between September 2010 and December 2017, were matched to 172 patients with BMI < 30 kg/m2. Data regarding demographics, set-up and operating time, blood loss, radiological assessment, Harris Hip Score (HHS), International Hip Outcome Tool (12-items), reoperation rate, and complications at two years postoperatively were retrospectively analyzed. Results: No significant differences in blood loss, intra- and postoperative complications, or implant position were observed between the two groups. Superficial wound infection rate was higher in the obese group (8.1%) compared to the nonobese group (1.2%) (p = 0.007) and relative risk of reoperation was 2.59 (95% confidence interval 0.68 to 9.91). One periprosthetic joint infection was reported in the obese group. Set-up time in the operating table and mean operating time were higher in morbidly obese patients. Functional outcomes and patient-related outcome measurements were superior in the obese group (mean increase of HHS was 52.19 (SD 5.95) vs 45.1 (SD 4.42); p < 0.001), and mean increase of International Hip Outcome Tool (12-items) was 56.8 (SD 8.88) versus 55.2 (SD 5.85); p = 0.041). Conclusion: Our results suggest that THA in morbidly obese patients can be safely and effectively performed via the DAA by experienced surgeons. Cite this article: Bone Jt Open 2022;3(1):4–11.

The increased penetration of renewables and the variable behavior of solar irradiation makes the energy storage important for overcoming several stability issues that arise in the power network. The current paper examines the design and stability analysis of a grid-connected residential photovoltaic (PV) system with battery–supercapacitor hybrid energy storage. The battery and supercapacitor packs are connected to the common 400 V DC-bus in a fully active parallel configuration through two bidirectional DC–DC converters, hence they have different voltage levels and their power flow is controlled separately. A detailed small-signal stability analysis is considered for the design of the current controllers for the bidirectional converters of the battery and supercapacitor. An important contribution here is that a detailed stability analysis is performed for both the boost and the buck mode of operation for the battery and supercapacitor converters, resulting in more accurate tuning of the controllers. Moreover, the small-signal stability analysis of the voltage source inverter (VSI) is considered in order to design the DC-bus voltage controller, where a reference output current is obtained using a phase-locked loop (PLL) for grid synchronization. The proposed model is developed and simulated in the MATLAB/Simulink software environment, based on mathematical analysis and average modeling. The simulation results verify the dynamic performance of the proposed model, through several rapid changes in PV generation and in load demand. Also, the model works properly and responds extremely fast during different mode transitions, exhibiting a very fast DC-bus voltage regulation with a very small ripple voltage (a maximum of ± 0.625%). Finally, the supercapacitor handles the rapid changes occurring within 0.2 s, hence this can relieve the battery stress and extend the battery lifetime.

IntroductionOrganizational culture determines the ability of companies to adapt, transform, and innovate, thereby directly affecting their profitability and competitiveness. However, the same applies to the public sector since, now more than ever, it has to be agile in order to shield its society and economy against modern challenges (such as COVID-19, climate change, and digitalization). This article uses the case of Greece as an example to present the need for change in organizational culture to unlock its development and growth potential through transformation, adaptation, and innovation. To support our argument, we combine the findings of the international literature regarding the relationship between organizational culture and the aforementioned elements, as well as empirical evidence from Greece.MethodsIn particular, we assess organizational culture pertaining to the major sector reforms that took place in Greece, as a result of the recent economic and financial crisis, by presenting and evaluating comparative empirical findings on the characteristics of the prevailing and desired future organizational culture.Results and discussionExamining and comparing the results of previous studies in Greece that used the Organizational Culture Assessment Instrument (OCAI) questionnaire survey in both private (such as banking and telecoms) and public sectors (such as social security, public revenues authority, and hospitals), two interesting results arise: (i) there is a clear distinction between the public sector and the private sector, with the former being mainly characterized by “hierarchy culture,” while the latter by “market culture” and (ii) in both sectors and all industries/services, the desire to prevail in future organizational culture is the “clan culture.” These findings are of immense importance as organizational culture issues play a key role in formulating future strategic plans, enabling the development of key sectors of the Greek economy and enhancing effective governance and social services. Concisely, our results draw useful conclusions for policy implications and academics, implying that there is an emergent need for organizational transformation in both private and public sectors in Greece, which can be achieved through new innovative methods of organization and operation, creating a new more agile, adaptive, and innovative culture.

Recent improvements in low-altitude remote sensors and image processing analysis can be utilised to support archaeological research. Over the last decade, the increased use of remote sensing sensors and their products for archaeological science and cultural heritage studies has been reported in the literature. Therefore, different spatial and spectral analysis datasets have been applied to recognise archaeological remains or map environmental changes over time. Recently, more thorough object detection approaches have been adopted by researchers for the automated detection of surface ceramics. In this study, we applied several supervised machine learning classifiers using red-green-blue (RGB) and multispectral high-resolution drone imageries over a simulated archaeological area to evaluate their performance towards semi-automatic surface ceramic detection. The overall results indicated that low-altitude remote sensing sensors and advanced image processing techniques can be innovative in archaeological research. Nevertheless, the study results also pointed out existing research limitations in the detection of surface ceramics, which affect the detection accuracy. The development of a novel, robust methodology aimed to address the “accuracy paradox” of imbalanced data samples for optimising archaeological surface ceramic detection. At the same time, this study attempted to fill a gap in the literature by blending AI methodologies for non-uniformly distributed classes. Indeed, detecting surface ceramics using RGB or multi-spectral drone imageries should be reconsidered as an ‘imbalanced data distribution’ problem. To address this paradox, novel approaches need to be developed.

Purpose: This study is part of the first systematic program in the Republic of Cyprus examining the prevalence of traumatic brain injury (TBI) in children, teenagers, and university students. The study incorporated the Greek Version of the Brain Injury Screening Questionnaire (BISQ-G) as the primary tool to identify students with TBI. Methods: The BISQ-G was sent out to 2,800 families of children (aged 6-18 years) attending rural and urban elementary and secondary schools from varied socioeconomic backgrounds. Nine hundred forty-four questionnaires (33.8%) were returned. In addition to school-aged children, 322 university students (aged 17-25 years) were recruited from 3 universities and completed the BISQ-G. Results: Analyses indicated that 5.8% elementary, 9.7% secondary, and 22.7% university students had symptoms consistent with TBI. Several participants reported more than 1 TBI. Etiology of TBI was similar in all 3 groups and included sports, biking, and falls. Factor analyses yielded a 7-factor structure for the BISQ-G. Discussion/Conclusions: The BISQ-G is a valid tool for the identification of individuals with a prior history of TBI. Causes and symptoms of TBI were similar to those reported in the international literature. The article concludes with suggestions for TBI management in the schools.

Objective: Fresh frozen plasma (FFP) transfusion is widely used in modern clinical settings. Practices regarding its use vary due to lack of guidelines from randomized trials. The aim of this study was to assess both the current practices regarding FFP production, use, and wastage and the implementation of quality control (QC), female donor plasma production policies, and use of pharmaceutical hemostatic agents in Greece. Materials and Methods: The study was conducted during February-April 2018. For the first part of the study, data including FFP transfusion indication, hospital department, diagnosis, FFP units/transfusion episode, ABO compatibility, blood donor's sex, and reasons for discarding were collected. For the second part, questionnaire data were analyzed. Results: According to data from 20 Greek hospitals, 12655 FFP units were transfused to 2700 patients during 5069 transfusion episodes in the studied period of time. Most patients were hospitalized in internal medicine, general surgery, and intensive care unit departments. Each patient received on average 4.69 units (2.5 units/episode). Transfusion requests were in accordance with international guidelines in 63.44% of cases and 99.04% of the units were given to ABO-identical patients. Main reasons for discarding included failure to meet quality requirements (30.06%), female donors (22.17%), and other causes (27.26%). Among 96.9% of all transfusion services across the country, 28.26% perform QC according to the directions of the European Directorate for the Quality of Medicines & Health Care and 68.83% discard plasma from female donors. Pharmaceutic hemostatic agents are used in 37.23% of the hospitals. Conclusion: This is the first national survey regarding FFP production and transfusion in Greece. Staff of internal medicine, general surgery, and ICU departments, where most FFP-transfused patients are hospitalized, should be regularly involved in training on contemporary transfusion guidelines. Upcoming centralization of FFP production and inventory management could help in homogenizing practices regarding FFP use and improve product quality. Strengthening the use of pharmaceutic hemostatic agents could improve patients' management.

Background: Platelet transfusion is among the most useful therapeutic tools in modern clinical settings which mean that ensuring an adequate supply is of paramount importance. Aim: The aim of our study was to record the use and wastage of platelet concentrates (PCs) in Greece, so as to come up with evidence-based interventions. Methods: The study was conducted during May and June 2015. We evaluated the use of random-donor platelets (RDPs) and single-donor apheresis platelets (SDPs). We analyzed such parameters as hospital department and diagnosis, indication for transfusion, PCs' age at the time of transfusion, and wastage rate. Results: We used data from 21 hospitals across the country. A total of 12,061 RDPs and 1189 SDPs were transfused, with an average of 4.84 (±2.72) and 1.12 (±2.73) units per episode, respectively. Most patients had been admitted to the internal medicine and hematology departments. The transfusions were mostly given prophylactically, usually in cases of acute leukemia, and mostly on the day before expiration. Wastage rate was 16.75% for RPDs and 2.70% for SDPs, primarily because of the expiration of the use-by date. Conclusions: This is the first national survey regarding platelet transfusion in Greece. Since most patients were admitted in internal medicine and hematology departments, we recommend that the staff of the abovementioned departments should undergo training on contemporary transfusion guidelines. Platelet discard rate could further be lowered through the centralization of inventory management along with the extension of the lifetime of PCs by means of emerging technologies.

Monitoring the levels of IgG antibodies against the SARS-CoV-2 is important during the coronavirus disease 2019 (COVID-19) pandemic, to plan an adequate and evidence-based public health response. After this study we report that the plasma levels of IgG antibodies against SARS-CoV-2 spike protein were higher in individuals with evidence of prior infection who received at least one dose of either an mRNA-based vaccine (Comirnaty BNT162b2/Pfizer-BioNTech or Spikevax mRNA-1273/Moderna) or an adenoviral-based vaccine (Vaxzervia ChAdOx1 nCoV-19 /Oxford-Astra Zeneca) (n = 39) compared to i) unvaccinated individuals with evidence of prior infection with SARS-CoV-2 (n = 109) and ii) individuals without evidence of prior infection with SARS-CoV-2 who received one or two doses of one of the aforementioned vaccines (n = 342). Our analysis also revealed that regardless of the vaccine technology (mRNA-based and adenoviral vector-based) two doses achieved high anti- SARS-CoV-2 IgG responses. Our results indicate that vaccine-induced responses lead to higher levels of IgG antibodies compared to those produced following infection with the virus. Additionally, in agreement with previous studies, our results suggest that among individuals previously infected with SARS-CoV-2, even a single dose of a vaccine is adequate to elicit high levels of antibody response.

The documentation and protection of archaeological and cultural heritage (ACH) using remote sensing, a non-destructive tool, is increasingly popular for experts around the world, as it allows rapid searching and mapping at multiple scales, rapid analysis of multi-source data sets, and dynamic monitoring of ACH sites and their environments. The exploitation of remote sensing data and their products have seen an increased use in recent years in the fields of archaeological science and cultural heritage. Different spatial and spectral analysis datasets have been applied to distinguish archaeological remains and detect changes in the landscape over time, and, in the last decade, archaeologists have adopted more thoroughly automated object detection approaches for potential sites. These approaches included, among others, object detection methods, such as those of machine learning (ML) and deep learning (DL) algorithms, as well as convolutional neural networks (CNN) and deep learning (DL) models using aerial and satellite images, airborne and spaceborne remote sensing (ASRS), multispectral, hyperspectral images, and active methods (synthetic aperture radar (SAR) and light detection and ranging radar (LiDAR)). Researchers also refer to the potential for archaeologists to explore such artificial intelligence (AI) approaches in various ways, such as identifying archaeological features and classifying them. Here, we present a review study related to the contributions of remote sensing (RS) and artificial intelligence in archaeology. However, a main question remains open in the field of research: the rate of positive contribution of remote sensing and artificial intelligence techniques in archaeological research. The scope of this study is to summarize the state of the art related to AI and RS for archaeological research and provide some further insights into the existing literature.

The selection of the optimal methodology for the 3D geometric documentation of cultural heritage is a subject of high concern in contemporary scientific research. As a matter of fact, it requires a multi-source data acquisition process and the fusion of datasets from different sensors. This paper aims to demonstrate the workflow for the proper implementation and integration of geodetic, photogrammetric and laser scanning techniques so that high-quality photorealistic 3D models and other documentation products can be generated for a complicated, large-dimensional architectural monument and its surroundings. As a case study, we present the monitoring of the Mehmet Bey Mosque, which is a landmark in the city of Serres and a significant remaining sample of the Ottoman architecture in Greece. The surveying campaign was conducted in the context of the 2022–2023 annual workshop of the Interdepartmental Program of Postgraduate Studies "Protection Conservation and Restoration of Cultural Monuments" of the Aristotle University of Thessaloniki, and it served as a geometric background for interdisciplinary cooperation and decision-making on the monument restoration process. The results of our study encourage the fusion of terrestrial laser scanning and photogrammetric datasets for the 3D modeling of the mosque, as they supplement each other as regards geometry and texture. [ABSTRACT FROM AUTHOR]

Background: Multimodal analgesia for total hip arthroplasty (THA) is increasingly employed to reduce early postoperative pain and promote fast patient discharge. The aim of this study was to compare the efficacy and tolerability of tramadol/dexketoprofen (TRAM/DKP, Group A) versus paracetamol + tramadol (PARA+TRAM, Group B) in patients undergoing THA using minimally invasive direct anterior approach (DAA). Methods: A single-centre, randomised, single-blind, parallel, interventional study conducted in 323 patients undergoing primary THA with DAA was performed. Group A consisted of 188 patients and Group B of 135. The primary endpoints were the change from baseline (measured 2 hours postoperatively) in pain intensity (PI) during the treatment period (48 hours), assessed by visual analogue scale (VAS) at pre-specified postoperative time-points (2, 8, 24, 48 hours) and the total rescue medication (RM) use during the first 24 hours postoperatively. Results: As early as 2 hours after baseline, Group A showed a greater PI reduction from baseline compared to Group B (−26.24% vs. −6.87%; p < 0.001). A lower mean PI (VAS) score was consistently found over the entire observation period following treatment with TRAM/DKP than with PARA+TRAM as well as more than 2-fold higher proportion of responders at the end of treatment period. More patients in Group B required RM in comparison to those in Group A (15.6% vs. 3.7%, p < 0.001). Both treatments were well tolerated. Conclusions: After THA, oral TRAM/DKP provides faster and greater pain relief when compared to intravenous PARA+TRAM with limited consumption of RM and favourable tolerability profile. Our study expands the use of TRAM/DKP in the setting of major orthopaedic surgeries. Clinical trial registration: clinicaltrials.gov (NCT04178109) [ABSTRACT FROM AUTHOR]

Simple Summary: Hepatocellular carcinoma represents the majority of all liver cancers and the fourth cause of cancer-related deaths worldwide. Despite the progress in diagnostic and therapeutic evaluation, its prognosis remains dismal, with mortality rates increasing per year. As the investigation of the human genome project advances, so does the deeper understanding of tumor biology, with numerous molecular biomarkers proved to play a promising role in clinical practice, in terms of diagnosis, surveillance, and the prediction of treatment efficacy. One important aspect is evaluating the potential role of new ancillary biomarkers associated with tumor invasiveness and response to available therapeutic options, which is useful in treatment monitoring and may reduce the health costs faced by standard methods. Connexins, a family of tetraspan membrane proteins forming intercellular channels localized in gap junctions, play a pivotal role at the different stages of tumor progression presenting both pro- and anti-tumorigenic effects. Considering the potential role of connexins as tumor suppressors through multiple channel-independent mechanisms, their loss of expression may be associated with tumorigenic activity, while it is hypothesized that connexins favor the clonal expansion of tumor cells and promote cell migration, invasion, and proliferation, affecting metastasis and chemoresistance in some cases. Hepatocellular carcinoma (HCC), characterized by unfavorable prognosis and limited responsiveness to current therapeutic strategies, has been linked to gap junction proteins as tumorigenic factors with prognostic value. Notably, several members of connexins have emerged as promising markers for assessing the progression and aggressiveness of HCC, as well as the chemosensitivity and radiosensitivity of hepatocellular tumor cells. Our review sheds light on the multifaceted role of connexins in HCC pathogenesis, offering valuable insights on recent advances in determining their prognostic and therapeutic potential. [ABSTRACT FROM AUTHOR]

Objectives: Binge spectrum disorders are prevalent worldwide. Psychiatric and medical comorbidities are common, and societal costs are significant. Evidence-based treatment remains underutilized. Cognitive behavioral therapy is the recommended first-line treatment, but pharmacotherapy may be easier to access. Interventions: Meta-analytic evidence directly comparing cognitive behavioral therapy with pharmacotherapy is lacking. We aimed to compare the effects of cognitive behavioral therapy interventions with any pharmacological treatment for binge spectrum disorders. We searched PubMed, Embase, CENTRAL, ClinicalTrials.gov and reference lists for randomized controlled trials comparing cognitive behavioral therapy with any pharmacotherapy for bulimia nervosa/binge eating disorder and performed pairwise meta-analytic evaluations. Primary Outcomes: Primary outcomes are remission and frequency of binges. Secondary outcomes are frequency of purges, response, eating disorder psychopathology, weight/body mass index, depression, anxiety, quality of life and dropouts. Results: Eleven randomized controlled trials comparing cognitive behavioral therapy with fluoxetine/imipramine/desipramine/methylphenidate/sibutramine were identified (N = 531). Cognitive behavioral therapy was superior to antidepressants in terms of remission, frequency of binges and eating disorder psychopathology. There were no statistically significant differences for any of the individual cognitive behavioral therapy vs drug comparisons in terms of response/depression/anxiety/weight/quality of life/dropouts. Cognitive behavioral therapy was not superior to sibutramine/methylphenidate for the primary outcomes. Conclusions: Data are scarce, comparisons underpowered and, considering the inherent methodological limitations of psychotherapy trials, questions arise regarding the presumed superiority of cognitive behavioral therapy. Further research is needed. [ABSTRACT FROM AUTHOR]