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The supply / demand issue in behavioral health care is a well-established fact, and the mental health toll of the COVID-19 pandemic continues to add challenges to an already taxed system. Existing healthcare models are not set up to adequately address the increasing mental health related needs. As such, innovative models are needed to provide patients with access to appropriate, evidence-based behavioral health care within routine clinical care. This paper introduces Precision Behavioral Health (PBH) as an example of such a model. PBH is an innovative, digital first care delivery model that provides an ecosystem of evidence-based digital mental health interventions to patients as a frontline behavioral health treatment within routine care in a large multispecialty group medical center in the United States. This paper describes the implementation of PBH within a practice research network set-up as part of an integrated behavioral health department. We will present how our team leveraged the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance; "What is RE-AIM?," n.d.) implementation science framework, which emphasizes the design, dissemination, and implementation processes at the individual, staff, and organizational levels, to prioritize key implementation constructs to enhance the successful integration of PBH within routine care. We describe how each of these constructs were operationalized to aid data gathering for rapid evaluation and lessons learned. We discuss the benefits of these types of initiatives across multiple stakeholders including patients, providers, organizations, payers, and digital intervention vendors. [ABSTRACT FROM AUTHOR]

When an oxidized metal is cooled from a high temperature, stresses are produced at the metal-scale interface, owing to the difference in thermal expansion rates of the oxide and metal. Such stresses become time- and temperature-dependent if the scale or underlying metal creeps as cooling occurs. A model is presented which describes thermally induced stresses in the scale and accounts for partial stress relaxation by creep of the metal substrate and/ or the scale. The expected stresses are a function of the material parameters: thermal expansion coefficients, elastic modulii, and creep rates of both metal and scale. To illustrate a range of behaviors, we have presented example calculations for three CrO forming metals, Ni-30Cr, pure Cr, and MA-754. The effect of stress relaxation during thermal cycling was also examined briefly. In these examples, creep of the CrO scale was not expected to be important. [ABSTRACT FROM AUTHOR]

A high-speed synchrotron X-ray imaging technique was used to investigate the binder jetting additive manufacturing (AM) process. A commercial binder jetting printer with droplet-on-demand ink-jet print-head was used to print single lines on powder beds. The printing process was recorded in real time using high-speed X-ray imaging. The ink-jet droplets showed distinct elongated shape with spherical head, long tail, and three to five trailing satellite droplets. Significant drift was observed between the impact points of main droplet and satellite droplets. The impact of the droplet on the powder bed caused movement and ejection of the powder particles. The depth of disturbance in the powder bed from movement and ejection was defined as interaction depth, which is found to be dependent on the size, shape, and material of the powder particles. For smaller powder particles (diameter less than 10 μm), three consecutive binder droplets were observed to coalesce to form large agglomerates. The observations reported here will facilitate the understanding of underlying physics that govern the binder jetting processes, which will then help in improving the quality of parts manufactured using this AM process. [ABSTRACT FROM AUTHOR]

Influenza viruses undergo rapid evolutionary changes, which requires continuous surveillance to monitor for genetic and potential antigenic changes in circulating viruses that can guide control and prevention decision making. We sequenced and phylogenetically analyzed A(H1N1)pdm09 virus genome sequences obtained from specimens collected from hospitalized patients of all ages with or without pneumonia between 2009 and 2018 from seven sentinel surveillance sites across Kenya. We compared these sequences with recommended vaccine strains during the study period to infer genetic and potential antigenic changes in circulating viruses and associations of clinical outcome. We generated and analyzed a total of 383 A(H1N1)pdm09 virus genome sequences. Phylogenetic analyses of HA protein revealed that multiple genetic groups (clades, subclades, and subgroups) of A(H1N1)pdm09 virus circulated in Kenya over the study period; these evolved away from their vaccine strain, forming clades 7 and 6, subclades 6C, 6B, and 6B.1, and subgroups 6B.1A and 6B.1A1 through acquisition of additional substitutions. Several amino acid substitutions among circulating viruses were associated with continued evolution of the viruses, especially in antigenic epitopes and receptor binding sites (RBS) of circulating viruses. Disease severity declined with an increase in age among children aged < 5 years. Our study highlights the necessity of timely genomic surveillance to monitor the evolutionary changes of influenza viruses. Routine influenza surveillance with broad geographic representation and whole genome sequencing capacity to inform on prioritization of antigenic analysis and the severity of circulating strains are critical to improved selection of influenza strains for inclusion in vaccines. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented recommending how to design, optimize and implement informatics pipelines in light of the guidelines developed by the Next-Generation Sequencing: Standardization of Clinical Testing II (Nex-StoCT II) informatics workgroup.