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• A diagnosis through scanning and digital mounting allows the detection of premature contacts. • Upper palatal and lower buccal cusps are functional cusps crucial for determining the vertical dimension. • Upper buccal and lower lingual cusps are non-functional (shearing) cusps that play a role in chewing. • When performing occlusal adjustments, it's vital to consider the anatomy and function of these cusps to avoid unnecessary structural dental removal. • Occlusal adjustment is an important clinical tool before, during, and after orthodontic treatment. The closest possible coincidence between centric occlusion (CO) and centric relation (CR) is a meaningful goal of orthodontic treatment. Teeth should be related in a cusp-fossa interaction, with bilateral and symmetrical occlusal contacts and mandibular excursions without interferences. At a joint level, condyles should be well-seated in the glenoid fossae, without mandibular functional accommodations and muscular balance. To provide long-term stability of treatment results. Occlusal adjustment is one of the clinical procedures that help fine-tune this resulting occlusal relationship. Traditional analog diagnostic methods can be upgraded to digital static and dynamic current technologies. Occlusal adjustment today can be integrated with digital flow and mounting by analyzing premature contacts after scanning the patient. The clinical procedure of selective grinding may be simple and reproducible by acquiring adequate knowledge, following the ten guidelines presented in this paper, and implementing judicious clinical skills. Since tooth structure preservation while achieving functional occlusal goals is of utmost importance. Eight possible clinical scenarios where occlusal adjustment is indicated are presented. They can occur before, during, or after treatment, allowing for a better finish of the orthodontic case. The situations begin with diagnosis, followed by arch coordination, transverse, vertical, sagittal issues, rotations, upper and lower coupling, and relapse. [ABSTRACT FROM AUTHOR]

To determine the digital game addiction levels of secondary school students and to examine the parental awareness against digital game addiction levels of students. This is a descriptive and correlational study. The population of the study consisted of students in a secondary school and 392 students were included in the study. The data were collected using the "Digital Parenting Awareness Scale (DPAS)," and "Digital Game Addiction Scale for Children (DGAS-child form). In the study, Kurtosis and Skewness coefficients were used for normal distribution; mean, standard deviation, percentage, and frequency were used to evaluate quantitative data; and Pearson chi-square analysis was used to make correlational inferences. The DGAS mean score of the students was 47.31 ± 16.19. The results of the study showed that the parents had high level of digital awareness. It was found that the students' DGAS mean score had a weak positive correlation with RM subscale of DPAS and a moderate positive correlation with DN subscale of DPAS. DGAS mean score had a weak negative correlation with EU and PR subscales of DPAS. Parents-children's age did not affect the levels of DGAS and DPAS. Raising parents' digital awareness reduces digital game addiction in their children. One of the most important roles of nurses is education. Parent trainings for children to use digital devices correctly and efficiently contribute to improving digital awareness of parents and protecting/promoting child health. • The digital world is a popular and highly preferred medium for children today. • Parents assume important roles in protecting their children from the negative impacts of the digital world. • As parents' digital awareness levels elevate, their children' digital game addiction decreases. [ABSTRACT FROM AUTHOR]

Correct alignment of the image receptor (IR) in mammography for the mediolateral oblique (MLO) view of the breast is fundamental to enable the maximum inclusion of breast tissue. This study aims to assess Australian radiographers' knowledge and digital era practice in selecting the IR angle for female body habitus in the MLO view of the breast. An online survey was distributed to all members of the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) through their electronic newsletter and via direct email to radiographers holding the Certificate of Mammographic Practice (CMP). Descriptive analysis was undertaken, and a Pearson's chi-squared test of independence was used to compare associations between academic qualification and IR selection data. A value of p < 0.05 was deemed statistically significant. A total of 107 valid surveys were returned; 67.3 % reported using the posterior lateral margin to select the IR angle. For linear body habitus, 44.9 % reported using 50°; for all other body habitus, participants most commonly used 45° (59.1 %); 85.1 % used a range of angles between 40 and 55°; 16.8 % recognised the link between correct IR angle selection and breast tissue inclusion. The range of angles used in practice has reduced in the digital era; the frequency of the use of 45° across all body habitus may reflect tube angle movement automation. Few radiographers recognised the important link between correct selection of IR angle and breast tissue inclusion on the image. Understanding of the link between IR angle selection and image quality enhances current practice in the digital era to maximise the inclusion of breast tissue and minimise the potential of missed breast cancer. [ABSTRACT FROM AUTHOR]

Previous studies have shown that digital microscopy is an indispensable tool for teaching oral pathology laboratory course. Despite this, our institute relies solely on recommended/reference book images for oral pathology practicals, neglecting both light and digital microscopy methods. Gathering students' feedback on these methods is essential before considering digital microscopy as part of the oral pathology curriculum. Therefore, this study aimed to compare the usefulness of light and digital microscopy among second-year dental students. The study was conducted from December 6 to December 7, 2023, in the Department of Oral Pathology, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences. The study involved the selection of five cases from the oral pathology course, followed by feedback on students' diagnostic skills, learning impact and acceptance rate of light and digital microscopy using an online questionnaire. Mann–Whitney U test was used to compare students' responses and P -value < 0.05 was set as statistically significant. There was a statistically significant difference in diagnostic scores between light microscopy and digital microscopy (P < 0.05). Statistically significant differences favoring digital microscopy were observed in various aspects, including interpreting variations, diagnosis, time efficiency, and image clarity. Although diagnostic scores were lower, digital microscopy was perceived as a useful method for enhancing diagnostic skills among dental students. Both light microscopy and digital microscopy are viable options for oral pathology practicals, however, digital microscopy was preferred by students due to its time efficiency and clear image quality. [ABSTRACT FROM AUTHOR]

Hallucinations are a common feature of psychosis, yet access to effective psychological treatment is limited. The Managing Unusual Sensory Experiences for First-Episode-Psychosis (MUSE-FEP) trial aimed to establish the feasibility and acceptability of a brief, hallucination-specific, digitally provided treatment, delivered by a non-specialist workforce for people with psychosis. MUSE uses psychoeducation about the causal mechanisms of hallucinations and tailored interventions to help a person understand and manage their experiences. We undertook a two-site, single-blind (rater) Randomised Controlled Trial and recruited 82 participants who were allocated 1:1 to MUSE and treatment as usual (TAU) (n = 40) or TAU alone (n = 42). Participants completed assessments before and after treatment (2 months), and at follow up (3–4 months). Information on recruitment rates, adherence, and completion of outcome assessments was collected. Analyses focussed on feasibility outcomes and initial estimates of intervention effects to inform a future trial. The trial is registered with the ISRCTN registry 16793301. Criteria for the feasibility of trial methodology and intervention delivery were met. The trial exceeded the recruitment target, had high retention rates (87.8%) at end of treatment, and at follow up (86.6%), with good acceptability of treatment. There were 3 serious adverse events in the therapy group, and 5 in the TAU group. Improvements were evident in both groups at the end of treatment and follow up, with a particular benefit in perceived recovery in the MUSE group. We showed it was feasible to increase access to psychological intervention but a definitive trial requires further changes to the trial design or treatment. • This study trained a widely available workforce to deliver a new digital therapy fordistressing hallucinations. • The brief, targeted therapy was seen to be acceptable and well received by participants and staff delivering it. • Improvements were in perceived recovery rather than in hallucinations. • The trial demonstrated it was feasible to recruit and retain participants and a future definitive study would be possible. • Access to help can be increased by using shorter, targeted, digitally delivered treatments by a wider workforce. [ABSTRACT FROM AUTHOR]

The primary goal of esthetic treatment is to ensure patient satisfaction and meet their expectations of improving their facial esthetics and smile. However, some patients may have doubts regarding the irreversible nature of the treatment. In such cases, the Digital Smile Designing (DSD) technique can be employed to educate and motivate patients. DSD is a technical tool that allows digital designing and modification of a patient's smile, enabling them to visualize the potential outcomes before the actual treatment begins. This technique facilitates visual communication and patient involvement in the smile design process, leading to predictable treatment results and higher acceptance rates. This article provides an overview of DSD in esthetic dental practice and discusses its applications, advantages, limitations, and future possibilities. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic brought unprecedented challenges in radiology education. RadDiscord, a digital, open-access radiology educational platform now with over 4100 members internationally, emerged as a COVID-era innovation that has transformed radiology education, broken down institutional silos, and equalized access to high-quality education. This special report will discuss the origin of RadDiscord, overcoming early barriers, building an organization and community, innovation and impact, and the future of radiological education. This may offer helpful perspectives to trainees and educators who are interested in innovating in the realm of radiology education. [ABSTRACT FROM AUTHOR]

The objective of this systematic review is to assess the effectiveness of digital orthodontics in utilizing implants for maxillary protraction as a treatment for skeletal class III malocclusion in children. The study was registered with PROSPERO with the number CRD42023407406 on 23/03/2023. We conducted an extensive comprehensive literature search in nine electronic databases, including PubMed, PubMed Central, Scopus, Cochrane databases, Google Scholar, MEDLINE, EMBASE, LILACS, and the Web of Sciences databases. The studies were evaluated for their methodology, the intervention technology used, the outcomes, and their quality. Publication bias assessment was conducted using the Jadad scale and the ROBINS-I assessment tool. We included a total of 17 studies that comprised a total of 376 patients in this analysis. The number of patients and participants fluctuated between 1 and 71, with > 60 % being female. The patients were aged between 1.1 and 19.2 years. We included only nine studies in the meta -analysis, in which we observed a success rate between 71.4 % and 100 % with a 95 % CI of 17.4 ± 2.988 (±17.2 %) [14.412–20.388]. The failure rates, although minimal, ranged from 5.9 % to 28.6 %, with a 95 % CI of 2.3 ± 1.480 (±64.3 %) [0.820–3.780]. The evidence suggests that digital orthodontics is a promising approach for treating children with skeletal class III malocclusion using implants for maxillary protraction. However, further high-quality studies are required for validating our current observations and regulating the stability of treatment outcomes on a long-term basis. [ABSTRACT FROM AUTHOR]

• What is currently known about this topic. • Various instructional approaches and impact on learning. • What the paper adds to the existing knowledge. • Conceptual framework of online interactive instruction and its impact on learning. • How the information in your manuscript can be applied to practice. • Shows trends in instructional approaches for undergraduate and graduate curricula. This paper discusses the underlying conceptual theories that support the use of technology-based educational tools and their implications on student learning outcomes. The use of technology-based educational tools has expanded where virtual classrooms, digital simulations, real-time feedback, interactive quizzes, podcasts, and other multimedia tools are integrated into instruction, especially throughout higher education. These educational tools are hypothesized to augment both student learning and attitudes towards learning. The instructional components in technology-based learning are engrained in theory and supported by empirical research. The relationship between active learning and student success, how technology-based educational tools can be designed to facilitate active learning, and how they positively impact student self-efficacy and self-regulation, including metacognitive awareness will be explicated. The theoretical underpinnings of online, interactive learning will also be applied to trends in nursing curricula. [ABSTRACT FROM AUTHOR]

To evaluate the features of esthetic-specific Clinic Management Softwares (CMS) and scrutinize these against the General Medical Council (GMC) and Joint Commission (JC) guidance, an indicative CMS framework with GMC and JC compliant features is developed, to improve patient outcomes, service quality, and work toward a centralized database for complications to enable research analysis. A systematic search was performed to evaluate the CMS on the market tailored to esthetic clinics. An analysis was made of the GMC guidance for record keeping and the JC standards for Patient Safety Systems. The CMS features were each scrutinized against the GMC and JC guidance including complication capturing. Eighteen esthetic-specific CMS were identified and analyzed. None of the included CMSs were 100% compliant with both GMC and JC guidance. In 2022, the mean monthly cost of the basic packages for each of the CMS was £106.4, with a standard deviation of £83.3. The main users of the CMSs were doctors and nurses. CMS are a potentially powerful tool to form a centralized database that will allow for increased transparency on the number of procedures performed as well as complications. [Display omitted] [ABSTRACT FROM AUTHOR]

Considerable comorbidity exists between insomnia and anxiety, and evidence shows that the benefits of CBT for insomnia extend to anxiety. Using data from two large trials of digital CBT (dCBT) for insomnia, we evaluated whether improving sleep is an effective treatment target to reduce both insomnia and anxiety symptoms in individuals with insomnia and clinically significant anxiety. This was a controlled sub-analysis combining individual participant data from two previous randomised controlled trials of dCBT for insomnia (Sleepio). Participants (N = 2172) with insomnia disorder and clinically significant anxiety symptoms were included in this sub-analysis and received either dCBT or control (usual care or sleep hygiene education). Assessments were evaluated at baseline, post-intervention (week 8 or 10), and follow-up (week 22 or 24). Mediation was evaluated using structural equation models. dCBT for insomnia was superior to control at reducing both insomnia (Hedges' g range = 0.77–0.81; both p < 0.001) and anxiety symptoms (Hedges' g range = 0.39–0.44; both p < 0.001) at all time points. Baseline insomnia symptoms moderated the effects of dCBT on insomnia, however no variables moderated treatment effects on anxiety. Reductions in anxiety symptoms at follow-up were mediated by improvements in sleep at post-intervention (% mediated = 84 %), suggesting a causal pathway. Participants did not have a formal anxiety disorder diagnosis and so the effects of dCBT for insomnia on anxiety may differ by anxiety disorder. Addressing sleep using dCBT for insomnia may serve as a treatment target from which to improve anxiety in individuals with insomnia and clinically significant comorbid anxiety. Digital Insomnia therapy to Assist your Life as well as your Sleep (DIALS) - ISRCTN60530898 http://www.isrctn.com/ISRCTN60530898. Oxford Access for Students Improving Sleep (OASIS) - ISRCTN61272251 http://www.isrctn.com/ISRCTN61272251. • Digital CBT for insomnia led to benefits in both insomnia and anxiety. • Improvements in sleep significantly mediated benefits to anxiety symptoms. • Sleep may be a transdiagnostic treatment target in those with insomnia and anxiety. • No variables moderated the effects of digital CBT for insomnia on anxiety. [ABSTRACT FROM AUTHOR]

Various digital sleep interventions have been implemented to address sleep and psychological complications during the coronavirus disease 2019 (COVID-19) pandemic. However, the characteristics and effectiveness of digital sleep interventions on sleep and psychological outcomes for people with sleep problems during the COVID-19 pandemic are unknown. The protocol of this systematic review and meta-analysis was registered on PROSPERO (ID: CRD42022325662), seven databases were searched from December 2019 to June 2023. Reference lists from digital sleep reviews were also identified and selected. Two reviewers independently screened eligible articles and extracted data. Quality appraisal was undertaken by two independent reviewers using the Cochrane Risk-of-Bias Tools. Data synthesis was conducted using fixed- or random-effects model based on the results of the heterogeneity test. A total of 20 studies were identified, including nine randomised controlled trials (RCTs) and 11 non-RCTs, involving 3860 participants. Meta-analyses showed that digital sleep interventions significantly improve sleep quality, insomnia, and depression during the COVID-19 pandemic. Subgroup analysis showed that interventions of more than four weeks, healthcare workers as participants, and relaxation therapies may have the advantage of improving sleep quality. Most non-RCTs supported the efficacy of digital sleep interventions on sleep and psychological health. Digital sleep interventions during the COVID-19 pandemic had significant effectiveness in improving sleep and psychological outcomes for people with sleep problems. More structured and personalised digital sleep interventions should be designed, and other diverse digital technologies could be used to improve sleep and psychological disorders. • The COVID-19 pandemic has caused a higher risk of sleep disorders and increased psychological problems. • Digital sleep interventions significantly improve sleep quality, insomnia, and depression during the COVID-19 pandemic. • Longer intervention duration, healthcare providers as participants, and relaxation therapy may have more benefits on sleep. • Future research could further explore the role of digital technologies in sleep assessment, management, and resources sharing. [ABSTRACT FROM AUTHOR]

To evaluate the effectiveness of digital psychotherapies for depression and anxiety. We conducted a systematic review and network meta-analyses (NMA) to make comparisons of digital psychotherapies. A bayesian NMA was conducted in this study. The databases including PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials and CINAL were searched for all eligible randomized controlled trials (RCTs) published from Jan 1, 2012 to Oct 1, 2022. We used the Cochrane Collaboration's Risk of bias tool for quality assessment. The primary outcomes were set as a standardized mean difference model in efficacy to describe continuous outcomes. We used STATA and WinBUGS to conduct a bayesian network meta-analysis of all interventions based on a random-effects model. This study was registered with PROSPERO, number CRD42022374558. From the retrieved 16,750 publications, we included 72 RCTs (13,096 participants) with the overall medium quality and above. In terms of depression scale, cognitive behavioral therapy (CBT) was more effective than TAU (SMDs 0.53) and NT (SMDs 0.98). In terms of anxiety scale, CBT (SMDs 0.68; SMDs 0.72) and exercise therapy (ERT) (SMDs 1.01; SMDs 1.05) were more effective than TAU and NT. Uneven quality of literature, simple network, and subjective judgment. Based on NMA results, we suggest that CBT, which is the most commonly used digital technology, should be preferred among digital psychotherapy for relieving depression and anxiety symptoms. Digital exercise therapy is an effective strategy to relieve some anxiety problems in the context of COVID-19. • Evaluating the effectiveness of digital psychotherapies and providing insights for its future development. • Cognitive behavioral therapy is the most widely used digital technology for relieving depression and anxiety symptoms. • Digital exercise therapy is an effective strategy to relieve anxiety problems especially in the context of COVID-19. [ABSTRACT FROM AUTHOR]

The Remote Malnutrition Application (R-MAPP) was developed during the COVID-19 pandemic to provide support for health care professionals (HCPs) working in the community to complete remote nutritional assessments and provide practical guidance for nutritional care. R-MAPP was adapted into Pediatric Remote Malnutrition Application (Pedi-R-MAPP) using a modified Delphi consensus, with the goal of providing a structured approach to completing a nutrition focused assessment as part of a technology enabled care service (TECS) consultation. The aim of this study was to develop and validate a digital version of Pedi-R-MAPP using the IDEAS framework (Integrate, Design, Assess and Share). A ten-step process was completed using the IDEAS framework. This involved the four concept processes; Stage-1, Integrate (Step 1–3) identify the problem, specify the goal, and use an evidence-based approach. Stage-2, (Step 4–7) design iteratively and rapidly with user feedback. Stage 3, (Step 8–9) Assess rigorously, and Stage 4 (Step 9–10) publish and launch of the tool. Stage 1:Evidence-based development, Pedi-R-MAPP was developed using Delphi consensus methodology. Stage 2:Iteration & design, HCPs (n = 22) from UK, Europe, South Africa, and North America were involved four workshops to further develop a paper prototype of the tool and complete small-scale testing of a beta version of the tool which resulted in eight iterations. Stage 3:Assess rigorously, Small scale retrospective testing of the tool on children with congenital heart disease (n = 80) was completed by a single researcher, with iterative changes made to improve agreement with summary advice. Large scale testing amongst (n = 745) children in different settings was completed by specialist paediatric dietitians (n = 15) advice who recorded agreement with the summary advice compared with their own clinical assessment. Paediatric dietitians were in overall agreement with the summary advice in the tool 86% (n = 640), compared to their own clinical practice. The main reasons for disagreement were i) frequency of planned review 57.1% (n = 60/105), ii) need for ongoing dietetic review due to chronic condition 20.0% (n = 21/105), iii) disagreement with recommendation for discharge 16.2% (n = 17/105) and iv) concerns with faltering growth and/or need for condition specific growth charts 6.7% (7/105). Iterative changes were made to the algorithm, leading to an improvement in agreement of the summary advice on re-evaluation to 98% (p=<0.0001). A digital version of the Pedi-R-MAPP nutrition awareness tool was developed using the IDEAS framework. The summary advice provided by the tool achieved a high level of agreement when compared to paediatric dietetic assessment, by providing a structured approach to completing a remote nutrition focused assessment, along with identifying the frequency of follow-up or an in-person assessment. [ABSTRACT FROM AUTHOR]

• We developed a brief mindfulness-based digital intervention for anorexia nervosa. • The intervention had excellent acceptability and feasibility. • Use of mindfulness skills was high and associated with higher state mindfulness. • We found large, significant improvements in trait mindfulness and emotion regulation. • We found medium-to-large significant reductions in eating disorder symptoms. Anorexia nervosa (AN) is a chronic and debilitating psychiatric disorder. Unfortunately, current treatments are lacking, with only 30-50% of individuals with AN recovering after treatment. We developed a beta-version of a digital mindfulness-based intervention for AN called Mindful Courage-Beta , which includes: (a) one foundational multimedia module; (b) 10 daily meditation mini-modules; (c) emphasis on a core skill set called the BOAT (Breathe, Observe, Accept, Take a Moment); and (d) brief phone coaching for both technical and motivational support. In this open trial, we aimed to evaluate (1) acceptability and feasibility; (2) intervention skill use and its association with state mindfulness in daily life; and (3) pre-to-post changes in target mechanisms and outcomes. Eighteen individuals with past-year AN or past-year atypical AN completed Mindful Courage-Beta over 2 weeks. Participants completed measures of acceptability, trait mindfulness, emotion regulation, eating disorder symptoms, and body dissatisfaction. Participants also completed ecological momentary assessment of skill use and state mindfulness. Acceptability ratings were good (ease-of-use: 8.2/10, helpfulness: 7.6/10). Adherence was excellent (100% completion for foundational module and 96% for mini-modules). Use of the BOAT in daily life was high (1.8 times/day) and was significantly associated with higher state mindfulness at the within-person level. We also found significant, large improvements in the target mechanisms of trait mindfulness (d =.96) and emotion regulation (d =.76), as well as significant, small-medium to medium-large reductions in eating disorder symptoms (ds =.36–.67) and body dissatisfaction (d =.60). Changes in trait mindfulness and emotion regulation had medium-large size correlations with changes in global ED symptoms and body dissatisfaction (rs =.43 –.56). Mindful Courage-Beta appears to be promising and further research on a longer, refined version is warranted. [ABSTRACT FROM AUTHOR]

This study investigated whether a 360° virtual counselling environment (360°VCE) was more effective at decreasing patients' anxiety than routine standard of care counselling for patients undergoing coronary computed tomography angiography (CCTA), and if there was any difference in the process times for both of these groups. A total of 86 patients underwent CCTA in this randomised controlled trial. Patients were randomly assigned to intervention and control groups. The 360°VCE was developed using spherical panoramic images and non-immersive 360° technology. The primary outcome, anxiety, was measured using the State-Trait Anxiety Inventory (STAI). The secondary outcome, CCTA process time, was measured from the time of arrival in the department until end of examination. Pre-scan anxiety was lower among patients in the 360°VCE group immediately before CCTA in comparison to patients in the control group (p = 0.015). Women demonstrated higher levels of anxiety than men in both groups. No between-group differences were discerned in CCTA process time. Access to 360°VCE can reduce patients' pre-CCTA anxiety levels. The presented results can be used to improve patient counselling and care, reduce anxiety among patients undergoing CCTA, and optimise the CCTA examination procedure. [ABSTRACT FROM AUTHOR]

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Cet article cherche à explorer l'évolution des pratiques en termes d'usages de supports numériques dans le cadre du bilan psychologique. La méthode est une revue systématique de la littérature sur les pratiques numériques du bilan et une réflexion sur l'utilisation du dessin en réalité virtuelle comme complément d'un bilan psychologique complet. La revue de la littérature systématique révèle que l'essentiel des travaux porte sur l'utilisation de la version numérique des échelles de Wechsler dans une tentative de vérifier l'équivalence des différents modes de passation. La démarche consiste à chercher une équivalence de construction mais aussi le plus souvent une équivalence des scores bruts afin de bénéficier des qualités métriques des tests d'origine ainsi que de leur étalonnage. Dans notre réflexion sur le bilan psychologique numérique, la recherche d'équivalence n'est pas le seul but, nous cherchons aussi à tirer profit de la situation inédite de l'immersion dans le virtuel afin d'explorer des aspects nouveaux de la réalité psychique des sujets. Les résultats des recherches sur le bilan psychologique numérique montrent qu'il est possible d'utiliser ces nouvelles méthodes d'administration des tests sans prendre le risque de s'écarter de l'objectif de ce qui est mesuré avec les outils d'origine mais ouvre aussi à des aspects inédits intéressants. Le bilan psychologique numérique, sans prétendre vouloir remplacer les méthodes traditionnelles, mérite d'être étudié afin de mettre en lumière de manière plus précise ses limites mais aussi sa richesse potentielle selon les situations cliniques spécifiques où il est déployé. This article seeks to explore the evolution of practices in terms of the use of digital media in the context of psychological assessment. The method is a systematic review of the literature on the digital practices of assessment and a reflection on the use of drawing in virtual reality as a complement to a complete psychological assessment. The systematic literature review reveals that most of the work focuses on the use of the digital version of the Wechsler scales in an attempt to verify the equivalence of the different delivery methods. The approach consists in looking for an equivalence of construction but also an equivalence of the raw scores in order to benefit from the metric qualities of the original tests as well as their calibration. In our reflection, the search for equivalence is not the only goal; we also seek to take advantage of the unprecedented situation of immersion in virtual reality in order to explore new aspects of subjects' psychic reality. The results of research on the digital psychological assessment show that it is possible to use these new methods of test administration without deviating from the objective of what is measured with the tools of origin; furthermore, digital tools also open up interesting new aspects. While we do not call for the replacement of traditional methods with digital psychological assessment, the latter deserves to be studied in order to highlight more precisely its limits but also its potential richness according to the specific clinical situations where it is deployed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if the use of postoperative therapeutic dose intravenous heparin (POTDIVH) was indicated in digital replantation and revascularization by assessing digit survival and complications associated with heparin. All patients with amputation distal to the carpal tunnel treated at our center from 2004 to 2020 were included for chart review. Digit survival and complication rates were compared between patients who received POTDIVH (group A) and those who did not (group B). Logistic regression analysis and subgroup analysis were conducted. A total of 795 patients (1,155 digits) were included in this study (248 patients/374 digits in group A and 547 patients/781 digits in group B). The overall revascularization and replantation success rate was 79.9% in the POTDIVH group and 92.8% in the non-POTDIVH group. In our retrospective regression and subgroup analyses, group A demonstrated increased odds of failure compared with group B and was associated with increased bleeding-related complications. Subgroup analyses stratified by the mechanism of injury and vein grafting also showed a significantly decreased survival in the POTDIVH group. Our retrospective data seem to indicate that heparin in digit replantation and revascularization appears to have no benefit on digit survival across all subgroups, including crush and avulsion injuries, and is associated with a significantly increased rate of complications. Therapeutic IV. [ABSTRACT FROM AUTHOR]

Large-scale microbial fuel cells treat wastewater while generating electricity, saving electricity and preventing air pollution. Long term use is difficult and hardly realized what is done in this work for more than three years. To prolong the time of service significantly a novel electronic control device was developed. It blocked the notorious and growing voltage reversals over time and balanced the 1000 L microbial fuel cell. It prevented voltage reversals in 64 units in a serial/parallel microbial fuel cell stack setup. This electronic voltage regulator worked in conjunction with maximum power point tracking. Both electronic tools individually optimized 16 microbial fuel cell units simultaneously to achieve stack balance and heal defiant units. To understand the applicability of this computational voltage reversal prevention controller, blocking experiments were performed with variable thresholds set at: +50, +25, 0, −25, −50 mV. The two best blocking thresholds were 50 mV and zero volts. The electronic balancing tool even revived the end-of-life 1000-L microbial fuel cell stack by resolving voltage reversals in the third year of constant operation. The voltage reversal blocker allowed to generate 1.7 to 2.7 times more power than without electronic control. The voltage balancing technique developed is expected to be useful for larger multi-unit microbial fuel cell stacks. • Electronic regulator prevented voltage reversals in 64 MFCs in 1000-L stack. • Voltage controller balanced the stacked 64 MFCs and prolonged system life. • Maximum power tracking and regulator optimized 16 MFCs simultaneously. • Findings suggest scalability for larger, long-term MFC stack application. [ABSTRACT FROM AUTHOR]

• Subjective functional neurological symptoms (FNS) were monitored for 7-days. • Ecological momentary assessment tracked FNS and other subjective experiences. • Wearables assessed objective physiological signals, including autonomic markers. • Our novel remote monitoring protocol was feasible, acceptable and valid. • Daily events and negative affect were robust temporal predictors of FNS severity. Functional neurological symptom disorder (FNSD) is a neuropsychiatric diagnosis referring to symptoms resembling those of neurological disorders, occurring without causal neuropathology. FNSD has a complex biopsychosocial aetiology but its mechanisms are poorly understood. Remote monitoring technologies (RMT) could provide critical insights into functional neurological symptoms (FNS) in real-world contexts. We examined the feasibility and acceptability of a novel RMT protocol, to identify psychobiological correlates and antecedents of FNS in everyday life. Seventeen individuals with FNS (seizures/motor) and 17 healthy controls (HC) completed ecological momentary assessments (EMA) eight times daily for 1-week, reporting FNS severity, associated physical and psychological symptoms, and subjectively significant events. Sleep quality was reported daily. Physiological variables were measured using wearable Fitbit 5 devices. Multilevel modelling examined variables associated with FNS variability. Average EMA completion rates were good in both groups (≥80%). At week-level, the FNS group reported significantly greater subjective arousal, pain, fatigue, dissociation, negative affect, daily events, stressful events, and sleep duration, compared to HC. Objective sleep disturbance and duration, and resting heartrate, were also significantly greater in the FNS sample. FNS severity correlated significantly with daily events, affect, subjective arousal, pain, fatigue and sleep disturbance, at day- or within-day levels. Daily events and negative affect were the most prominent time-lagged predictors of within-day moment-to-moment FNS severity. RMTs are feasible and acceptable tools for investigation of FNS in real-world settings, revealing daily events and negative affect as possible triggers of FNS. Interventions targeting affective reactivity and regulation might be beneficial in this group. Larger-scale, longer-term RMT studies are needed in this population. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy and safety of interventions for treating eye strain related to computer use relative to placebo or no treatment. Computer use is pervasive and often associated with eye strain, referred to as computer vision syndrome (CVS). Currently, no clinical guidelines exist to help practitioners provide evidence-based advice about CVS treatments, many of which are marketed directly to patients. This systematic review and meta-analysis was designed to help inform best practice for eye care providers. Eligible randomized controlled trials (RCTs) were identified in Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and trial registries, searched from inception through November 23, 2021. Eligible studies were appraised for risk of bias and were synthesized. The certainty of the body of evidence was judged using the Grading of Recommendations, Assessment, Development, and Evaluation system. Standardized mean differences (SMDs) were used when differently scaled measures were combined. Forty-five RCTs, involving 4497 participants, were included. Multifocal lenses did not improve visual fatigue scores compared with single-vision lenses (3 RCTs; SMD, 0.11; 95% confidence interval [CI], –0.14 to 0.37; P = 0.38). Visual fatigue symptoms were not reduced by blue-blocking spectacles (3 RCTs), with evidence judged of low certainty. Relative to placebo, oral berry extract supplementation did not improve visual fatigue (7 RCTs; SMD, –0.27; 95% CI, –0.70 to 0.16; P = 0.22) or dry eye symptoms (4 RCTs; SMD, –0.10; 95% CI, –0.54 to 0.33; P = 0.65). Likewise, berry extract supplementation had no significant effects on critical flicker-fusion frequency (CFF) or accommodative amplitude. Oral omega-3 supplementation for 45 days to 3 months improved dry eye symptoms (2 RCTs; mean difference [MD], –3.36; 95% CI, –3.63 to –3.10 on an 18 unit scale; P < 0.00001) relative to placebo. Oral carotenoid supplementation improved CFF (2 RCTs; MD, 1.55 Hz; 95% CI, 0.42 to 2.67 Hz; P = 0.007) relative to placebo, although the clinical significance of this finding is unclear. We did not identify high-certainty evidence supporting the use of any of the therapies analyzed. Low-certainty evidence suggested that oral omega-3 supplementation reduces dry eye symptoms in symptomatic computer users. [ABSTRACT FROM AUTHOR]

Background: Negative symptoms are typically observed in people with schizophrenia and indicate a loss or reduction of normal function (e.g. reduced motivation and affect display). Despite obstructing people's recovery, intervention development has received limited attention. This study tests the feasibility and acceptability of a novel Virtual Reality Supported Therapy for the Negative Symptoms of Schizophrenia (V-NeST).Method: A single (rater) blind randomised study with two conditions; V-NeST plus treatment as-usual (TAU) vs. TAU alone, recruiting people with schizophrenia experiencing debilitating negative symptoms. Assessment was at baseline and 3-month post-randomisation. The pre-specified primary outcome was participants' goal attainment, secondary outcomes were negative symptoms and functioning. The study assessed feasibility and acceptability parameters including recruitment, eligibility, treatment adherence and retention. Acceptability was also evaluated qualitatively using a post-therapy feedback interview. Explorative therapy effect on outcomes was estimated.Results: The study recruited to its pre-specified target of 30 participants (15 randomised to V-Nest). Two participants in each trial arm disengaged and did not complete the study. Therapy engagement for those randomised to V-NeST was appropriate and research procedures were feasible. The experience with therapy and VR was described as positive and useful. Preliminary analysis suggested the therapy may have a large effect on participants goals and a possible effect on negative symptoms.Conclusion: V-NeST is a feasible and acceptable intervention. This therapy has the potential to support people with schizophrenia achieving their recovery goals and may reduce negative symptoms. The efficacy results need to be evaluated in an appropriately powered efficacy study. [ABSTRACT FROM AUTHOR]

This randomized clinical trial tested the efficacy of a 6-week text message program to reduce texting while driving (TWD) for young adults. Eligible individuals recruited from four emergency departments from December 2019 to June 2021 were aged 18–25 years who reported TWD in the past 2 weeks. Participants were randomly assigned 1:1 to intervention:assessment control. The intervention arm (n = 57) received an automated interactive text message program, including weekly queries about TWD for 6 weeks with feedback and goal support to promote cessation of TWD. The assessment control arm (n = 55) received identical weekly TWD queries but no additional feedback. Outcomes were collected via web-based self-assessments at 6- and 12 weeks and analyzed under intent-to-treat models, presented as adjusted odds ratios (ORs) with 95% confidence intervals (CIs). The mean (SD) age was 21.7 (2.1) years, 73 (65%) were female, and 40 (36%) were White. The 6-week follow-up rate was 77.7% (n = 87) and 12-week follow-up rate was 64.3% (n = 72). At 6 weeks, 52.6% (95% CI, 39.0%–66.0%) of intervention participants reported TWD versus 63.6% (95% CI, 49.6%–76.2%) of control participants (adjusted OR, 0.71; 95% CI, 0.32–1.59). At 12 weeks, 38.2% (95% CI, 22.8%–53.5%) of intervention participants reported TWD versus 69.3% (95% CI, 53.8%–84.7%) of control participants (adjusted OR, 0.29; 95% CI, 0.11–0.80). An interactive text message intervention was more effective at reducing self-reported TWD among young adults than assessment control at 12 weeks. [ABSTRACT FROM AUTHOR]

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The agri-food sector represents a boundless source for sustaining a growing global population, with food quality emerging as a paramount concern. However, the evolving landscape presents several challenges, necessitating a compelling need to harness the potential of recent advancements in computer-aided systems. Fortunately, advances in computer-aided digital transformation have ushered in the era of Industry 4.0, representing a dramatic leap forward. Within this framework, Quality 4.0 has emerged as a pivotal component, leveraging intelligent and innovative technologies to enhance quality monitoring systems. This review emphasizes within the broader context of digital transformation that defines today's food industry, facilitating the utilization of artificial intelligence (AI), big data analytics, food printing techniques, digital twins, smart sensors, and blockchain technology to revolutionize quality management in different food sector. [ABSTRACT FROM AUTHOR]

Young people in rural areas face challenges related to their living conditions, and unequal access to physical and mental healthcare. Despite the high prevalence of trauma exposure among young people, there is a significant lack of evidence-based treatment that is tailored to the needs of young people in rural parts of Northern Sweden. Barriers to accessing treatment include the need to travel long distances to access services, and a lack of educated, culturally competent therapists. Accordingly, this article aims to explore how young trauma patients in rural areas have experienced their trauma therapy, and their views on future trauma therapy (including digital forms). This knowledge will be used to develop trauma therapy that is adapted to the needs of young patients in rural areas in Sweden. The study included young trauma patients in rural areas in Northern Sweden between the ages of 15 and 21 (n = 14). Qualitative individual semi-structured interviews were performed and analyzed using reflexive thematic analysis. The analysis resulted in one overarching theme, "Longing to be cared about and cared for," and three themes: 1. "Rural circumstances matter," 2. "Feeling understood and empowered", and 3. "Ambivalence regarding digital trauma therapy". The results show that rural contexts present both possibilities and challenges: new creative care landscapes are needed where young people are cared about and cared for (and with), including a deeper understanding of the multidimensional relationship between people, places, and care. Young trauma patients in rural areas want effective therapy with more knowledge and cultural sensitivity. The findings indicate that digital trauma therapy offers many benefits and reduces barriers. However, young people want future therapy to be provided both digitally and in person, and –importantly – individually adapted. [ABSTRACT FROM AUTHOR]

Data converters such as analog-to-digital converters (ADCs), digital-to-analog converters (DACs), digital-to-time converters (DTCs), time-to-digital converters (TDCs), among others, are considered some of the most essential blocks in the field of integrated circuit design. In this work, we introduce a novel type of data converter known as the Digital-to-Pulse converter (DPC) and present its novel analog flow circuit implementation. The DPC system is a critical component in emerging artificial neural network accelerators and in-memory computing systems. The DPC system presented in this study offers two distinct operating modes. The first mode is the generation of a single pulse with a width that is modulated by the digital input. The second mode is an n-bit digital to discrete pulse converter, where the number of generated pulses is directly related to the value of the digital input. The proposed DPC system offers designers a high level of flexibility in shaping the characteristics of the output pulses, including the number of pulses, pulse width, and pulse amplitude. This empowers designers to accommodate different application requirements and scenarios effectively. The proposed circuit has been verified and tested using Virtuoso Cadence circuit tools in 180 nm CMOS technology with post-layout simulation and analysis. The results indicate a significant enhancement in average power consumption (∼ 12 ×), layout area (∼ 5 ×), and latency (∼ 1. 4 ×) with the proposed system compared to the digital Register Transfer Level (RTL) implementation under a power supply of 1.8V and a clock frequency of 1 GHz in the Application Specific Integrated Circuits (ASIC) flow. This demonstrates the suitability of the proposed system for low-power and high-speed applications. [ABSTRACT FROM AUTHOR]

This review aimed to scope the literature by examining preregistration nursing and midwifery students' perceptions regarding professional use of social media. Digital professionalism refers to the competence required when interacting online, such as social network platforms by maintaining the values and attitudes which align with professional codes of conduct. With increasing social media platforms being used by nursing and midwifery students, there are concerns about professional behaviour and the implications for those who may not be clear on its use in the professional context of their profession. Methodology included utilising best-practice guidelines for undertaking scoping reviews. The PCC framework (population, concept and context) was applied to this review; Population – preregistration nursing and/or midwifery students; Concept/s- professionalism when using social media platforms; and Context – preregistration (undergraduate) or entry level students studying either midwifery or nursing. The databases included in the review were MEDLINE, CINAHL, Embase (OVID) and Scopus due to their relevancy to health professional education, identifying 1087 articles up to May 2024, which were screened independently by two reviewers. Seventeen articles (17) met the inclusion criteria. Content analysis assisted with mapping of themes and subthemes. The year of publication of the 17 primary studies ranged from 2012 to 2023. Twelve studies were cross-sectional, one was a randomised controlled trial, one was a retrospective analysis and three were qualitative designs. A wide number of countries were represented. Social media platforms included Facebook, Instagram, Twitter, WhatsApp, Snapchat, YouTube, WeChat, Ozone, QQ, Sina Weibo, TikTok and LinkedIn. Two major themes represented nursing and/or midwifery student views and experiences with their professional engagement when using social media, with a focus on digital professionalism: Professional Boundaries and Responsibility and Accountability. There is a need to ensure nursing and midwifery students are aware of social media policies and procedures which must have a strong presence within preregistration curricula. Further research is required to co-design and facilitate clear guidelines and further education on digital professionalism. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic lockdown imposed drastic measures at hospitals internationally to rapidly pivot their approaches to patient care. Early on when the pandemic was declared, hospitals responded to local public health restrictions by limiting all non-essential visits for their patients. Digital devices allowed Canadians to remain connected with their friends and families during the imposed isolation restrictions. The aim of this clinical perspective is to share the experience with the immediate implementation of digital connections for patients by exploring the impact as well as to describe key learnings from the initiative. 150 iPads were distributed to clinical teams for use by patients, for either clinical care or for social connection. An iterative evaluation process, guided by quality improvement methodology, was followed which ensured that any changes to the iPad implementation process were responsive in real time. The evaluation measures included a clinician survey and collection of narratives from patients and clinicians. All clinician respondents (n=7) indicated that the iPads were a valuable tool to support patients and families. Narratives from patients indicated that virtual connections brought joy to them especially given that they were isolated from their support systems during the initial days of COVID-19. Key learnings for the Implementation Team were: the importance in maintaining cognitive stimulation as an enabler to recovery for patients; staff members provide support beyond direct clinical care; technology needs to be harnessed to facilitate clinical care; technology should be leveraged to support clinical care; and interprofesssional collaboration of the entire Implementation Team is a key enabler of success. Since implementation, iPads have been integrated as a supporting digital tool for both social connections as well as clinical care as a result of the benefits seen during this initiative. The iPads have also been recognized as a tool to complement patient connection and care and currently being expanded as part of services to patients, families and their clinicians. [ABSTRACT FROM AUTHOR]

We conducted a rapid evidence review to explore the benefits and harms of digital cognitive-behavioral therapy (dCBT) and the barriers to and facilitators of implementing dCBT for adolescents. We searched MEDLINE, PsycINFO, CENTRAL through December 6, 2021, for controlled trials conducted in settings highly applicable to the United States. Additionally, we searched relevant systematic reviews for eligible studies. Results were summarized qualitatively. We included 12 trials (n = 1,575) that examined the effects of nine dCBT programs. Overall, dCBT was slightly superior to comparators in improving depression symptoms immediately post-intervention, but not at a longer follow-up. The use of dCBT did not appear to result in an increased risk for suicidal attempts or ideation; however, the number of events was very small. Potential barriers to implementing/maintaining dCBT are challenges engaging/retaining patients, developing infrastructure, and training therapists to facilitate dCBT. Data on harms or unintended negative consequences were not reported in the included studies. A limited body of evidence suggests that dCBT programs might outperform control interventions for reducing depressive symptoms immediately post-intervention, but not at a longer follow-up. The safety of dCBT programs for adolescents with depression is understudied. [ABSTRACT FROM AUTHOR]

The aim of this study was to outline the characteristics of severe trauma-induced oro-maxillofacial defects and explore the application of microsurgical reconstruction of these defects by selecting appropriate free vascularised composite tissue flaps. A retrospective analysis was performed in 11 cases with severe trauma-induced oromaxillofacial defects from 2005 to 2018, All cases were reconstructed with free vascularised composite flaps using a supermicro-surgical/micro-surgical and digital technology. This study consisted of 11 patients (8 men, 3 women) with a median age (range) of 28 (6–64) years. Patients with long-standing trauma experienced severe scars and displacements. The trauma-induced oro-maxillofacial defects ranged in size from 4.0 × 5.0 cm2 to 7 × 15 cm2. Six radial forearm flaps, three fibular osteocutaneous flaps, a lateral thoracic flap, and an anterolateral thigh flap were harvested individually. All patients were treated effectively and followed up for over two years, with a 100% survival rate of these free vascularised composite tissue flaps. No uncontrollable complications occurred, and all patients were satisfied with the postoperative shape and function. The trauma-induced oro-maxillofacial defects display unique features, and microsurgical techniques play an important role in the reconstruction of shapes and function. In addition, some patients may need multi-stage surgeries to attain aesthetic refinement. [ABSTRACT FROM AUTHOR]

La crise sanitaire n'est pas encore tout à fait derrière nous, mais nous pouvons commencer à en entrevoir l'issue grâce aux vaccins et traitements anti-Covid qui sont fabriqués par les industriels du médicament et distribués à travers le monde. Une carrière au sein de l'industrie pharmaceutique offre la possibilité de participer aux innovations qui nous protégeront des futures pandémies, mais aussi d'améliorer la vie des patients, voire de les guérir d'une pathologie grave. The health crisis is not quite behind us yet, but we can begin to see a way out of it thanks to the vaccines and anti-Covid treatments that are being manufactured by the drug industry and distributed around the world. A career in the pharmaceutical industry offers the opportunity to be part of the innovations that will protect us from future pandemics, but also to improve the lives of patients and even cure them of a serious illness. [ABSTRACT FROM AUTHOR]

Driven by the fourth industrial revolution (Industry 4.0), Real Time Location Systems (RTLS) are gaining importance. Holistic information about the position and movement of persons, vehicles and goods is an essential prerequisite for being able to efficiently automate entire process chains in the future with increasing machine autonomy. RTLS technologies enable the spatial and temporal localisation of objects within an environment. The current technological standard in the field of RTLS is based on anchors and transponders (e.g. Ultra Wide Band (UWB) systems), which use radio frequency (RF) signals to determine positions. However, the need for additional technical equipment is also a major weakness of these systems. In this paper, a new technological approach for real-time localisation of objects for industrial applications is presented. The proposed optical RTLS (ORTLS) is based on a decentralised sensor network, which enables the positioning of persons, vehicles and objects in industrial environments by means of artificial intelligence (AI) based object detection. In order to be able to use the system for safety-relevant applications in the future, certification must be obtained with regard to applicable regulations. A prerequisite for this is the validation and monitoring of the system performance with regard to the requirements of functional safety. For the analysis and evaluation of the system performance, this paper presents a methodology for the analysis of the AI-based detection under consideration of the environmental factors. [ABSTRACT FROM AUTHOR]

Research about predictors of response to cognitive behaviour therapy for insomnia (CBT-I) is ongoing. We examined any whether pre-intervention expectations or post-intervention appraisals of difficulties in utilizing face to face (FtF) or digital (dCBT-I) versions of the therapy were associated with outcome. Self-rating data were extracted on 101 adult participants in a recent randomized controlled trial of FtF versus dCBT-I. Network intervention analyses were used to explore any associations between expectations of CBT-I at response at 9 weeks and between post-intervention ratings of difficulties, modality of therapy and response at 9-weeks and at 6-months. Anticipated and actual difficulties in employing sleep restriction techniques predicted response in all network models. Modality of therapy played a more overt role in the 9-week outcome network, with FtF therapy more robustly associated with response. However, the direct association between FtF therapy and response was not found in the 6-month outcome network. Notable predictors of poor outcome at 9-weeks and 6-month follow-up were difficulties in accommodating CBT-I into work and daily routines and applying the rules of CBT-I. This network intervention analysis highlights that self-confidence and ability in undertaking sleep restriction is a key active ingredient of CBT-I. Also, benefits and gains from access to the FtF version of this multi-component therapy were more apparent in the short than the longer term. However, it is important that findings from this proof of principle study are confirmed in further studies. • Dynamic analytic models may shed light on the active ingredients of multi-component therapies. • We employed network intervention analysis to examine self-rated expectations and difficulties with using cognitive behaviour therapy for insomnia (CBT-I). • We identified that expectations and difficulties in using sleep restriction techniques were related to response to CBT-I. • Individuals receiving face to face rather than digital CBT-I self-reported fewer difficulties in following therapy rules. [ABSTRACT FROM AUTHOR]

While robots have very well proven their flexibility and efficiency in mass production and are recognized as the production resource of the future, their adoption in lower volume, diverse environment is heavily constrained. The main reason for this is the high integration and deployment complexity that overshadows the performance benefits of this technology. This paper presents the vision of ODIN European funded project which is to strengthen the EU production companies' trust in utilizing advanced robotics, by demonstrating that novel robot-based production systems are not only technically feasible, but also efficient and sustainable for immediate introduction at the shopfloor. To achieve that, ODIN brings together, by means of hardware and software, the latest technological advancements in the fields of a) collaborating robots and human robot collaborative workplaces, b) autonomous robotics and AI based task planning, c) mobile robots and reconfigurable tooling, d) Digital Twins and Virtual Commissioning and e) Service Oriented Robotics Integration and Communication Architectures. ODIN will provide a systematic approach for integrating these technologies under modular and reconfigurable large-scale robotic pilots. The performance of these robotic pilots will be tested and validated in three case studies, from the automotive, the white goods and the aeronautics industry. [ABSTRACT FROM AUTHOR]

Prevention is better than cure. Early help for children is the total support that improves a family's resilience and outcomes, or reduces the chance of a problem getting worse. Early help has been likened to a fence at the top of the cliff, rather than the ambulance at the bottom. However, many healthcare systems have tended to under invest in services that reduce demand to acute services. In the UK it has been difficult to plan a whole system approach to early help across a local area. Austerity and the COVID-19 pandemic have brought further challenges to disadvantaged families, NHS, local authorities, police, schools and other local partners. However, a new model of early help is emerging, in collaboration with partners, with communities and with families. By pro-actively reaching out and compassionately supporting families before their needs escalate, through a new category of service delivery, we are able to reduce future demand as well as providing more human engagement and help. This paper includes an overview of early help design, emerging changes that paediatricians will contribute to in their localities, the national vision, and an example from Birmingham Children's Partnership that shows how an early help response supported families through the pandemic. [ABSTRACT FROM AUTHOR]

Vaccine discovery and vaccination against preventable diseases are one of most important achievements of the human race. While medical, scientific & technological advancements have kept in pace and found their way into treatment options for a vast majority of diseases, vaccines as a prevention tool in the public health realm are found languishing in the gap between such innovations and their easy availability/accessibility to vulnerable populations. This paradox has been best highlighted during the unprecedented crisis of the COVID-19 pandemic. As part of a two series publication on the vaccine industry's view on how to accelerate the availability of vaccines worldwide, this paper offers a deep dive into detailed proposals to enable this objective. These first-of-its-kind technical proposals gleaned from challenges and learnings from the COVID-19 pandemic are applicable to vaccines that are already on the market for routine pathogens as well as for production of new(er) vaccines for emerging pathogens with a public health threat potential. The technical proposals offer feasible and sustainable solutions in pivotal areas such as process validation, comparability, stability, post-approval changes, release testing, packaging, genetically modified organisms and variants, which are linked to manufacturing and quality control of vaccines. Ultimately these proposals aim to ease high regulatory complexity and heterogeneity surrounding the manufacturing & distribution of vaccines, by advocating the use of (1) Science and Risk based approaches, (2) global regulatory harmonization, (3) use of reliance, work-sharing, and recognition processes and (4) digitalization. Capitalizing & collaborating on such new-world advancements into the science of vaccines will eventually benefit the world by turning vaccines into vaccination, ensuring the health of everyone. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has shown itself to be an unprecedented challenge for vaccines which are widely recognized as the most important tool to exit this pandemic. We have witnessed vaccine scientists, developers, manufacturers, and stakeholders deliver several vaccines in just about a year. This is an unprecedented achievement in an environment that was not ready to manage such a global public health crisis. Indeed, the pandemic has highlighted some hurdles that need to be addressed in the system in order to streamline the regulatory processes and be in a situation where life-saving pharmaceutical solutions such as vaccines can be delivered quickly and equitably to people across the globe. More precisely, trade-offs had to be made between the need for regulatory flexibility in the requirements for manufacturing and controls to enable rapid availability of large volumes of vaccines vs the increased stringency and the lack of harmonization in the regulatory environment for vaccines globally. It is also characterized by a high heterogeneity in terms of review and approval processes, limiting equitable and timely access. We review and highlight the challenges relating to several topics, including process validation, comparability, stability, post-approval-changes, release testing, packaging, genetically modified organisms and variants. We see four areas for accelerating access to vaccines which provide solutions for the regulatory concerns, (1) science- and risk-based approaches, (2) global regulatory harmonization, (3) use of reliance, work-sharing, and recognition processes and (4) digitalization. These solutions are not new and have been previously highlighted. In recent months, we have seen some progress at the health authority level, but still much needs to be done. It is now time to reflect on the first lessons learnt from a devastating pandemic to ultimately ensure quick and wide access to medicines and vaccines for the citizens and patients. [ABSTRACT FROM AUTHOR]

• Digital Mental Health Services (DMHS) can greatly increase access to care. • Training is needed so providers can effectively integrate DMHS into their treatments. • More research on DMHS is needed, along with regulatory standards. • DMHS may help reduce health disparities but questions remain about cultural tailoring. The papers in this special series make a compelling case for the value of digital mental health services (DMHS; including technology-based interventions, assessments, and prevention programs) to help address some of the currently unmet needs in mental health care. At the same time, the papers highlight the work that needs to be accomplished for DMHS to fulfill their promise. We review the papers' contributions in terms of (a) the imperative to increase access to evidence-informed, high-quality care, especially for underserved populations, both in the United States and globally; (b) ways to use DMHS to improve the ways that clinical care is provided to make treatment provision more effective and efficient; and (c) the current state of the research on DMHS for emotional disorders. We then consider lessons learned and recommendations to move the field forward, such as increasing (and making transparent) the research base on DMHS, adopting regulatory standards for DMHS, attending carefully to training issues for DMHS and best practices for dissemination and implementation, designing specifically for digital platforms, and being intentional about efforts to reduce disparities regarding who benefits from DMHS. [ABSTRACT FROM AUTHOR]

• Digital mental health interventions are a promising way to disseminate evidence-supported therapy for depression. • Research supports the efficacy of digital cognitive-behavioral interventions for depression. • There is a need to make digital mental health interventions for depression more appealing. • Entertaining forms of digitally-based CBT hold promise as a method to increase treatment engagement. This paper provides an overview of the of digital mental health (DMHI) interventions for depression. The paper begins with a description of the clinical context and services needs for persons experiencing depressed mood. It is well-known that there is a large gap between the availability of evidence-supported psychotherapy for depression and the large number of people who would likely benefit from it. DHMIs based on a cognitive-behavioral (CBT) model have shown substantial promise as a method to deliver tested-effective treatment to large numbers of people experiencing depression. The article continues with a review of clinical research evaluating DMHIs for depression with a special emphasis on CBT. The article also reviews both the strengths and challenges associated with the clinical use of DHMI for depression. Next, the article continues with a description of a newly-developed DHMI for depression that uses an entertaining approach to deliver well-established CBT strategies. Finally, the paper concludes with a discussion of the need for further research and development of DHMIs for persons experiencing depression. [ABSTRACT FROM AUTHOR]