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Background: Lateral Epicondylitis is the tendinosis of the extensor musculature of the forearm that has their common origin from the lateral epicondyle of the humerus due to angioblastic degeneration. The study aimed to determine and compare the effectiveness of MET and MaRhyThe in individuals with chronic lateral epicondylitis concerning pain, grip strength, and function. Methods: The study was a randomized clinical trial with 30 subjects divided into two equal groups, with 15 subjects in each group. Group A received MET for seven sessions, and Group B received MaRhyThe for one session. Both the groups received hot moist pack and conventional exercises for seven sessions. Visual Analogue Scale (VAS), Patient Rated Tennis Elbow Evaluation (PRTEE) Questionnaire, and Pain-Free Grip Strength (PFGS) were taken as the outcome measures. Results: Within-group paired sample t-test showed statistical significance in VAS at rest, VAS on activity, PRTEE, and PFGS with a p-value of 0.001 for all. However, between-group analysis using independent sample t-test showed statistical significance in VAS on activity and PRTEE with a p-value of 0.049 and 0.029, respectively, and clinical significance for VAS at rest and PFGS for Group B. Conclusion: The study concludes that both MET and MaRhyThe are effective in treating chronic LE concerning pain, improving function, and strength. However, MaRhyThe is more effective in pain reduction and improving functional activities.

Metastasis is an intricate and formidable pathophysiological process encompassing the dissemination of cancer cells from the primary tumour body to distant organs. It stands as a profound and devastating phenomenon that constitutes the primary driver of cancer-related mortality. Despite great strides of advancements in cancer research and treatment, tailored anti-metastasis therapies are either lacking or have shown limited success, necessitating a deeper understanding of the intrinsic elements driving cancer invasiveness. This comprehensive review presents a contemporary elucidation of pivotal facets within the realm of cancer metastasis, commencing with the intricate processes of homing and invasion. The process of angiogenesis, which supports tumour growth and metastasis, is addressed, along with the pre-metastatic niche, wherein the primary tumour prepares for a favorable microenvironment at distant sites for subsequent metastatic colonization. The landscape of metastasis-related genetic and epigenetic mechanisms, involvement of metastasis genes and metastasis suppressor genes, and microRNAs (miRNA) are also discussed. Furthermore, immune modulators' impact on metastasis and their potential as therapeutic targets are addressed. The interplay between cancer cells and the immune system, including immune evasion mechanisms employed by metastatic cells, is discussed, highlighting the importance of targeting immune modulation in arresting metastatic progression. Finally, this review presents promising treatment opportunities derived from the insights gained into the mechanisms of metastasis. Identifying novel therapeutic targets and developing innovative strategies to disrupt the metastatic cascade holds excellent potential for improving patient outcomes and ultimately reducing cancer-related mortality.

A product of microorganisms, crop plants, and animal-based oil, biodiesel holds excellent promise as a sustainable energy resource and a solution to the world's rising energy issues. Biofuel resembles the qualities of fossil diesel, while it is also proven to be a greener fuel and viable alternative. To enhance the properties of biodiesel, the additives, mainly antioxidants, were added to the 20 % blend of safflower biodiesel (B20) at various injection pressures (190, 200, and 210 bar). At a concentration of 1000 ppm, the antioxidants, namely BHA (butylated hydroxy anisole) and BHT (butylated hydroxytoluene), were added to the B20 blend of higher IP. Investigation on the effects of antioxidants with biodiesel on the performance and emission characteristics were tested in CI diesel engines at different injection pressures (IP). The findings from this study indicate that antioxidants added to biodiesel significantly improved the engine's performance. Higher IP resulted in higher BTE (1.6 %) with lesser emissions of CO (33.33 %), HC (10 %) and smoke (19.5 %) than diesel. But it emits higher NOx emissions (2.5 %). The addition of the antioxidant BHA showed a decrease in NOx emissions by 5 % to higher IP. Thus, the safflower biodiesel B20 added with antioxidant BHA will likely be a tremendous alternate fuel for the CI engine.

Artificial intelligence (AI) is a technological breakthrough that is rapidly progressing all over the world. AI has a variety of uses in medicine and dentistry, ranging from data analysis to using neural networks for diagnosis. AI has received enormous attention and has gone through a transition stage from being a pure statistical tool to being one of the main drivers of modern medicine. We are at the dawn of a new era, and AI is undoubtedly the future of dental practice management. This aim article is to review the various applications of AI in all the specialties of dentistry.

Abstract The Vietnamese indica landrace ‘Tetep’ is known worldwide for its durable and broad spectrum-resistance to blast. We performed genetic and molecular analyses of leaf blast resistance in a Tetep derived recombinant inbred line ‘RIL4’ which is resistant to both leaf and neck blast. Phenotypic analysis of segregating F2 progenies suggested that leaf blast resistance in RIL4 was controlled by a dominant gene tentatively designated as Pi-l(t). The gene was mapped to a 2.4 cm region close to the centromere of chromosome 12. The search for the gene content in the equivalent genomic region of reference cv. Nipponbare revealed the presence of five NBS-LRR genes, two of which corresponded to the alleles of Pita and Pi67 genes previously identified from Tetep. The two other genes, LOC_Os12g17090, and LOC_Os12g17490 represented the homologs of stripe rust resistance gene Yr10. The allelic tests with Pita2 and Pi67 lines suggested that the leaf blast resistance gene in RIL4 is either allelic or tightly linked to these genes. The genomic position of the leaf blast resistance gene in RIL4 perfectly coincided with the genomic position of a neck blast resistance gene Pb2 previously identified from this line suggesting that the same gene confers resistance to leaf and neck blast. The present results were discussed in juxtaposition with past studies on the genes of Pita/Pita 2 resistance gene complex.

Stingless bee honey, also known as pot honey, is a unique product that differs from other honey (Apis) in terms of flavor, chemical composition, biological characteristics, and sourness. Raw and by-products made from this honey have substantial use for its diverse health benefits and human dietary requirements. The physiochemical properties of honey from stingless bee mainly rely on nectar sources, geographic locations, climate, bee species, and handling and storage conditions. The honey contains reducing sugars, water, minerals, and ash content, and its characteristic features include color, acidity, pH, electrical conductivity, and viscosity. Further, it contains several biological and therapeutic constituents such as flavonoids, antioxidants, antibacterial, wound-healing, antidiabetic, and anticancer properties, and the Maillard reaction product hydroxymethylfurfural. This review summarizes the literature on the physical and biological properties and therapeutic constituents' use of stingless bee honey. It also highlights the quality standards available worldwide and required modifications in establishing universal standards for promoting this honey.

Objectives To describe the feeding profile of low birthweight (LBW) infants in the first half of infancy; and to examine growth patterns and early risk factors of poor 6-month growth outcomes.Design Prospective observational cohort study.Setting and participants Stable, moderately LBW (1.50 to

Globally, increasing rates of facility-based childbirth enable early intervention for small vulnerable newborns. We describe health system-level inputs, current feeding, and discharge practices for moderately low birthweight (MLBW) infants (1500-10% less than their birthweight; 18.8% of infants were discharged with weights below facility-specific policy [1800g in India, 1500g in Malawi, and 2000g in Tanzania]. Based on descriptive analysis, we found constraints in health system inputs which have the potential to hinder high quality care for MLBW infants. Targeted LBW-specific lactation support, discharge at appropriate weight, and access to feeding alternatives would position MLBW for successful feeding and growth post-discharge.

Although Nepal has made remarkable progress in the drinking water only sector from past few decades, the status of drinking water, in terms of climate change, is poorly documented and thus less known. This review aims to sum up drinking water status in climate change perspectives by reviewing available secondary data from published and gray literature. Climate change, and its impact on the drinking water sector, is undeniable. Though many policies and laws are enforced to address climate change issues, very few policies and laws have incorporated climate change-resilient WASH as a priority. It is of current need to carry out action-based research followed by eco-region wise interventions for adaptation and mitigation of impacts on WASH sector due to climate change. HIGHLIGHTS This review provides the water, sanitation, and hygiene (WASH) status in Nepal.; Clear evidence on the climate change impact on drinking water and adaptation is provided via review.;

The present study focuses on the nutritional, phytochemical composition, and antioxidant activities of the fruits of Rourea minor (Gaertn.) Alston., an underutilized plant species. The ripened seeds contained 0.28%, 12.39%, 25.70%, 1.4%, and 3.4% of fat, protein, carbohydrate, ash, and fiber, respectively, whereas ripened pulp possessed 0.19%, 0.34%, 0.90%, 0.35%, and 0.98% of fat, protein, carbohydrates, ash, and fiber, respectively. The ripened seed and pulp were also rich in mineral elements and especially microelements. The pulp, when ripe, had high levels of microelements such as boron, iron, zinc, copper, and manganese with values of 25.98, 2523.56, 499.12, 33.62, and 40.30 µg/g DW, respectively. Phytate and oxalate content were comparatively higher in ripened seeds (6.91 and 31.88 mg/g FW) than in the pulp. Acetone, absolute methanol, water, and 70% methanol were used for the extraction of phytochemicals, and 70% methanol extract contained the highest phytochemicals. The total phenolic, flavonoid, and alkaloid content of unripe seeds was 180.47 mg gallic acid equivalent (GAE)/DW, 68.95 quercetin equivalent (QE)/g DW, and 0.35 atropine equivalent (AE)/g DW, respectively, and that of unripe pulp was 8.21 mg GAE/g DW, 2.97 mg QE/g DW and 1.20 mg AE/g DW, respectively. All the extracts showed remarkable antioxidant activity, proved by 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity, total antioxidant activity, and ferric-reducing antioxidant power (FRAP) assay, following a similar trend to the phytochemical composition. The study concludes that Rourea minor fruits, both seeds, and pulp, could be an excellent source of nutrients, microelements, and antioxidants.

Background: The term “congenital” is used for cases of nephrotic syndrome (NS) that manifests in the first 3 months of life. They are rare diseases mainly due to genetic causes but sometimes attributed to congenital infections. The prognosis depends on the type of mutation in the former and whether remission occurs with specific therapy in the latter. Clinical Description: We describe an 11-week-old baby who presented with generalized edema and features of septic shock that responded to antibiotics. The presence of hypoalbuminemia, proteinuria, and hypercholesterolemia completed the clinical phenotype of NS. Mesangioproliferative glomerulonephritis was confirmed on histopathology. The presence of persistent hepatosplenomegaly, neurological findings, decreased head circumference, and poor nutritional status prompted us to investigate for congenital infections. Positive antibody levels for Cytomegalovirus (CMV) and positive polymerase chain reaction confirmed CMV infection, though we were unable to establish whether it was congenital or acquired postnatally. A novel genetic mutation (c. 712+1G>C) was identified in the NPHS 1 gene. Management: The baby was initiated on specific antiviral therapy and attained partial remission of renal symptoms after 4 weeks. The patient was lost to follow-up after 6 months. Conclusion: The coexistence of the Finnish variety and CMV infection might have caused the severity of phenotype. The authors emphasize the importance of performing a genetic test in cases of congenital NS and also working up for acquired causes on an individualized basis.

Vertebral hemangiomas are incidental finding and most of the time do not necessitate immediate attention unless symptomatic. Vertebral hemangiomas can be very aggressive to the extent that they can produce cord compression and paraplegia/paraparesis. Such cases need evaluation with magnetic resonance imaging to assess the cause, extent, and mass effect on the spinal cord. Transcatheter embolization and decompression surgery are well established modes of treatment as single or combined approach. Pulmonary arteriovenous malformation (AVM) is caused by the direct communication of main pulmonary artery with pulmonary vein, leading to a high-flow right-to-left shunt. This usually presents clinically as hypoxia, cyanosis, and dyspnea. The clinical signs and symptoms vary depending on the size, number, and flow of fistula as well as the associated vascular malformations. Transcatheter embolization is a treatment of choice for pulmonary AVM. However, this method may result in incomplete resolution if the malformation is large in size or supplied by multiple feeding arteries. Surgical resection may be considered in those kinds of cases. As AVM can lead to hemodynamical instability, these lesions need to be addressed first. In this case, pulmonary AVM came to notice post surgical decompression. Here, we report a case of aggressive vertebral body hemangioma and a large pulmonary AVM in the same patient, which were treated by embolization in two different settings.

This study aimed to develop a physical profile of international cricketers, and investigate if positional differences exist between bowlers and batters. Nineteen, international male cricketers, eleven bowlers (age 24.1 ± 5.2 years; height 179.73 ± 5.27 cm; weight 73.64 ± 6.65 kg), and eight batters (age 22.9 ± 3.8 years; height 180.25 ± 5.57 cm; weight 77.01 ± 8.99 kg) participated in this study. The physical test battery included; power, speed, strength and aerobic fitness tests. Batters demonstrated significantly higher scores for the countermovement jump (p < 0.03; ES = -1.55) and squat jump (p < 0.03; ES = -0.98). Furthermore, batters showed non-significant but small ES for faster 0–5 m (ES = 0.40) and 0–10 m (ES = 0.35) sprint times, superior hand grip strength (ES = -0.20), and higher Yo-Yo intermittent recovery test scores (ES = -0.46). Bowlers showed non-significant but small ES for faster 5 km time trials (ES = -0.51), lower bodyweight (ES = -0.42) and lower body fat percentage (ES = -0.30). However, intra-positional (i.e., seam and spin bowlers) and individual differences amongst players were observed. The physical profiles presented in this study can be used by coaches responsible for the physical development of cricket players to compare their existing data with. Furthermore, it is recommended that practitioners account for individual physical fitness profiles in addition to team profiles, to effectively design and evaluate tailored programs, with the aim of improving both physical and cricket performance.

Satish T Pote,1,2 Mahesh S Sonawane,1 Praveen Rahi,1 Sunil R Shah,3 Yogesh S Shouche,1 Milind S Patole,1 Madhuri R Thakar,2 Rohit Sharma1 1National Centre for Microbial Resource (NCMR), National Centre for Cell Science, NCCS Complex, S.P. Pune University, Pune 411 007, Maharashtra, India; 2National AIDS Research Institute, Pune 411026, Maharashtra, India; 3Bharati Vidyapeeth Deemed University Medical College, Bharati Vidyapeeth, Pune 411043, Maharashtra, IndiaCorrespondence: Rohit SharmaNational Centre for Microbial Resource (NCMR), National Centre for Cell Science, NCCS Complex, S.P. Pune University, Ganeshkhind, Pune 411 007, Maharashtra, IndiaTel +91-20-25329035Fax +91-20-25692259Email rohit@nccs.res.inIntroduction: Species of genus Candida are part of the common microbiota of humans; however, some of the Candida species are known opportunistic pathogens. Formation of biofilms, resistance to antifungal drugs, and increase in asymptomatic infections demands more studies on isolation, identification and characterization of Candida from clinical samples.Methods: The present manuscript deals with assessment of authentic yeast identification by three methods viz., DNA sequencing of 28S rRNA gene, protein profiles using MALDI-TOF MS, and colony coloration on chromogenic media. Antifungal susceptibility and in vitro cell invasion assays were performed to further characterize these isolates.Results: Comparison of three methods showed that DNA sequence analysis correctly identified more than 99.4% of the isolates up to species level as compared to 89% by MALDI-TOF MS. In this study, we isolated a total of 176 yeasts from clinical samples and preliminary morphological characters indicated that these yeast isolates belong to the genus Candida. The species distribution of isolates was as follows: 75 isolates of Candida albicans (42.61%), 50 of C. tropicalis (28.40%), 22 of C. glabrata (12.5%), 14 of C. parapsilosis (7.95%) and 4 of Clavispora lusitaniae (2.27%). Other species like Cyberlindnera fabianii, Issatchenkia orientalis, Kluyveromyces marxianus, Kodamaea ohmeri, Lodderomyces sp., and Trichosporon asahii were less than 2%. Antifungal susceptibility assay performed with 157 isolates showed that most of the isolates were resistant to the four azoles viz., clotrimazole, fluconazole, itraconazole, and ketoconazole, and the frequency of resistance was more in non-albicans Candida isolates. The susceptibility to azole drugs ranged from 7% to 48%, while 75% of the tested yeasts were susceptible to nystatin. Moreover, 88 isolates were also tested for their capacity to invade human cells using HeLa cells. In vitro invasion assay showed that most of the C. albicans isolates showed epithelial cell invasion as compared to isolates belonging to C. glabrata, C. parapsilosis and C. tropicalis.Discussion: The identification of yeasts of clinical origin by sequencing of 28S rRNA gene performed better than MALDI-TOF MS. The present study reiterates the world scenario wherein there is a shift from Candida strains to emerging opportunistic pathogens which were earlier regarded as environmental strains. The present study enlightens the current understanding of identification methods for clinical yeast isolates, increased antifungal drug resistance, epithelial cell invasion as a virulence factor, and diversity of yeasts in Indian clinical samples.Keywords: yeast clinical isolates, chromogenic media, DNA sequencing, MALDI-TOF MS, antifungal drug resistance

This scoping review provides the available evidence on support interventions and networks for youths aging out of child and youth care centres (CYCCs), and makes recommendations for best practice to alleviate the plight of youths leaving CYCCs. Thirteen databases were searched, resulting in the retrieval of 80 articles, 26 of which met the review criteria: English, full-text, peer-reviewed, open-access studies conducted between 2015 and 2020 on social networks and transitional services to youths aging out of residential care. Recommendations are made for policy changes, extending the age of eligibility and strengthening social support networks for youths transitioning into independent living.

Worldwide, there is increasing awareness that the use of alternative energy technology is one of the best means to accomplish development of sustainable energy. One of the method is to convert the compounds which are full of organic biodegradable material into useful material. This involves a basic but complex conversion process known as anaerobic digestion. The production of Biogas can be done by organic waste material like forest dry leaves, flowers, fruits, materials from animals such as cowdung, poultry waste, materials which are bi products of dairy and food industries. The vegetable waste in finely shredded form from our kitchen can also be used for biogas. Initially the process was very much time consuming as the technical parameters related to biogas production were not known. It has been observed that the generation of biogas can be controlled by monitoring various parameters related to design of biogas plant, internal parameters related to digestion process and also use of different feedstock’s. This paper highlights the use of different feedstock materials for biogas generation.

Water is a major component in the living ecosystem. As water quality is degrading due to human intervention, continuous monitoring is necessary. One of the indicators is Chlorophyll-a (Chl-a) which indicates algal blooms which are often driven by eutrophication phenomena in freshwater. Lakes should be monitored for Chl-a because Chla-a is related to eutrophication phenomena which are an enrichment of water by nutrients salt. When the environment becomes enriched with nutrients the excessive growth can lead to the death of fish. In this study, the Remote Sensing (RS) and Geographic Information System (GIS) techniques were utilized to determine Chl-a concentration of Phewa Lake of Kaski district. We used Landsat 8 satellite imagery for estimation and mapping of the Chl-a concentration. In-situ measurements from different sample points were taken and used to form a regression model for Chl-a and its concentration over the water body was calculated. The preceding year’s (2016) in situ measurement data of Chl-a concentration at a specific location were assessed with the one evaluated from the regression model thus produced for the succeeding year (2017) using Root Mean Square Error (RMSE) technique. As a result, we concluded that the estimation and mapping of Chl-a of a lake in Nepal can be done with the help of RS and GIS techniques.

Penelitian ini bertujuan memahami Yohanes 14: 1-14 dengan menggunakan metode eksegetis sosial-saintifik. Penelitian mengutamakan tinjauan historis dan eksegese terhadap karya penulisan-penulisan sejarah mengenai Jalan dan Kebenaran dan Hidup sejak zaman Perjanjian Lama (PL) hingga zaman Perjanjian Baru (PB). Yesus sebagai jalan, kebenaran, dan hidup dalam rangka menghadapi relativisme postmodern zaman ini. Hasil penelitian menyimpulkan bahwa “Yesus adalah hidup (kekal)“, dan “Yesus adalah kebenaran” di mana gereja dan umat Yesus (Gereja) mampu berdialog dan menerapkan kebenaran relatif di dalam kasih, keadilan dan pembebasan sosial.

Well-differentiated hepatocellular carcinoma in non-cirrhotic liver can show morphological features similar to hepatocellular adenoma. In rare instances, hepatocellular carcinoma can arise in the setting of hepatocellular adenoma. This study compares the immunohistochemical and cytogenetic features of the hepatocellular adenoma-like and hepatocellular carcinoma portions of these tumors. Immunohistochemistry for β-catenin, glutamine synthetase, serum amyloid A protein, glypican-3, and heat-shock protein 70 was done in 11 cases of hepatocellular carcinoma arising in hepatocellular adenoma in non-cirrhotic liver. Tumors with nuclear β-catenin and/or diffuse glutamine synthetase were considered β-catenin activated. Fluorescence in situ hybridization (FISH) was done in nine cases for gains of chromosomes 1, 8 and MYC. There were seven men (33-75 years) and four women (29-65 years). Focal atypical morphological features were seen in hepatocellular adenoma-like areas in 7 (64%) cases. Hepatocellular adenoma-like areas showed features of inflammatory hepatocellular adenoma in 7 (64%) cases; 4 of these were also serum amyloid A-positive in the hepatocellular carcinoma portion. β-Catenin activation, heat-shock protein 70 positivity, and chromosomal gains on FISH were seen in the hepatocellular adenoma portion in 55%, 40%, and 56% of cases, and 73%, 60%, and 78% of cases in the hepatocellular carcinoma portion, respectively. In conclusion, the hepatocellular adenoma-like portion of most cases of hepatocellular carcinoma arising in hepatocellular adenoma shows features typically seen in hepatocellular carcinoma such as focal morphological abnormalities, β-catenin activation, heat-shock protein 70 expression, and chromosomal gains. Hepatocellular adenoma-like areas in these tumors, especially in men and older women, may represent an extremely well-differentiated variant of hepatocellular carcinoma, whereas the morphologically recognizable hepatocellular carcinoma portion represents a relatively higher grade component of the tumor.

The natural dye extracted from Amaranthus dye and Carica Papaya dye which has been prepared in ethanol solution as a sensitizer on DSSC. The Spin coating method is used so that the deposition on TiO2 gets a homogeneous thin layer on the active area of the FTO substrate. The dye solution was tested for characterization using the Elkahfi I-V Meter and UV-Vis 1601 while the FTO structure substrate that had been prepared as a sandwich was tested using Keithley I-V type 2602A. The result of absorbance of dye is at a wavelength of 400 nm - 800 nm and there is also a shift in wavelength and peak absorption of the dye. The greatest efficiency was obtained from chlorophyll amaranthus which is 0.730% while chlorophyll Carica papaya obtained an efficiency of 0.432%. In the combination of Amaranthus dye and Carica papaya dye, the efficiency was 0.526%. High efficiency on TiO2 electrodes shows good performance on Dye-sensitized solar cells.

Background: Children with chronic physical health conditions are up to six times more likely to develop a mental health condition than their physically well peers. Frontline pediatric hospital staff are in a good position to identify mental health problems and facilitate appropriate support for patients. To date, no evaluation of mental health literacy training has taken place with this professional group to enable early identification of difficulties. It is also not known whether face-to-face or digital training is more effective or preferable in this setting. To improve the skills of frontline hospital staff, a face-to-face and digital mental health literacy training course was delivered using MindEd content and evaluated in a randomized controlled trial.Method: Two-hundred and three frontline staff across different professions from a tertiary pediatric hospital were randomized to a face-to-face (n = 64), digital (n = 71), or waitlist control group (n = 68). Face-to-face training was two and a half hours and digital training took ~1 h. The effects of training were evaluated pre- and post-training and at two-week follow-up. Questionnaires assessed mental health knowledge, stigma, confidence in recognizing concerns and knowing what to do, actual helping behavior, as well as training delivery preference, completion rate, and satisfaction.Results: Both face-to-face and digital training increased mental health knowledge, confidence in recognizing mental health problems and knowing what to do compared to waitlist controls. Digital training increased actual helping behavior relative to the waitlist controls and stigma decreased across all groups. Staff were satisfied with both delivery methods but preferred face-to-face training.Conclusions: The results provide promising findings that digital content is an effective way of improving mental health literacy in frontline pediatric hospital staff. Providing digital training could be a time-efficient way of upskilling non-mental health professionals to identify mental health needs in a pediatric population and facilitate access to appropriate care.

Objectives Digital practice in psychological services is a rapidly expanding and innovative area which is supporting continuation of clinical provision during the COVID-19 pandemic. Training the workforce to deliver safe and effective online psychological provision is key to service success and relies on accurate mapping of competences and current training needs. This paper discusses the initial stage for developing the first digital mental health competence framework for applied psychology in the UK. It reports on the digital training currently provided nationally and barriers/facilitators to acquiring these competencies. Methods Eighteen of the thirty UK Clinical Psychology Doctoral training programmes completed a 16-item survey. This mapped current digital health teaching and skills acquisition for trainee Clinical Psychologists throughout their 3-year pre-registration training. Furthermore, potential barriers and facilitators to developing these digital skills for both trainee and qualified Clinical Psychologists were investigated. Results The quantitative analysis highlighted the majority of respondents viewed developing digital mental health competencies with importance, but were not integrating this into teaching or clinical placements activity. The qualitative, inductive content analysis revealed seven key themes influencing the development of digital mental health skills, with the majority of respondents identifying with two themes; the need for practice guidelines (50% of respondents) and opportunities for digital mental health experience. Conclusions The findings suggest the need for a greater focus on developing the digital health knowledge, skills, and confidence across trainee and qualified Clinical Psychologists. Strategic analysis indicated the need to develop a framework for digital mental health competences across the curriculum and placement experience. Easily accessible learning packages may support the implementation of training nationally.

Producers in Northwest Arkansas and globally need alternative management practices to ensure long-term sustainable and economical use of poultry litter, which is an abundant source of valuable carbon (C), nitrogen (N) and phosphorus (P). Project objectives were to measure the efficacy of conservation management practices (i.e., pasture aeration and subsurface litter incorporation) to reduce nutrient runoff compared to poultry litter surface applications from small watersheds under rainfed and grazed conditions. Watersheds (0.23 ha each) were assigned a treatment [pasture aeration, subsurface litter incorporation, or surface application of litter (positive control)] on a Leadvale (fine-silty, siliceous, thermic Typic Fragiudult) silt loam. Poultry litter was applied annually to each watershed from 2007-2012. Over the 4-yr study period, runoff loads of NO3–N, total nitrogen (TN), soluble reactive phosphorus (SRP), and total phosphorus (TP) varied per conservation practice (P ≤ 0.05). Specifically, average annual loads of NO3–N, TN, SRP, and TP loads were reduced 49, 42, 28, and 35% following pasture aeration and by 78, 72, 55, and 59% from subsurface applying poultry litter, relative to surface applications, respectively. Greatest annual N loads and runoff corresponded with surface poultry litter applications, followed by pasture aeration, with subsurface incorporation of poultry litter resulting in lowest (P ≤ 0.05) TN and NO3–N loads. Overall, subsurface incorporation of poultry litter and pasture aeration are two promising conservation practices for reducing non-point source pollution in watersheds with nutrient imbalances. Further work needs to be done on factors influencing the efficacy of these conservation practices under rainfed conditions, as well as the economic feasibility of these conservation agricultural practices.

We present a passive (unpowered) exoskeleton that assists the back during lifting. Our exoskeleton uses carbon fiber beams as the sole means to store energy and return it to the wearer. To motivate the design, we present general requirements for the design of a lifting exoskeleton, including calculating the required torque to support the torso for people of different weights and heights. We compare a number of methods of energy storage for exoskeletons in terms of mass, volume, hysteresis, and cycle life. We then discuss the design of our exoskeleton, and show how the torso assembly leads to balanced forces. We characterize the energy storage in the exoskeleton and the torque it provides during testing with human subjects. Ten participants performed freestyle, stoop, and squat lifts. Custom image processing software was used to extract the curvature of the carbon fiber beams in the exoskeleton to determine the stored energy. During freestyle lifting, it stores an average of 59.3 J and provides a peak torque of 71.7 Nm.