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BackgroundThe considerable rise of mental health challenges during the COVID-19 pandemic has had detrimental effects on the public health sector and economy. To meet the overwhelming and growing demand for mental health care, innovative approaches must be employed to significantly expand mental health care delivery capacity. Although it is not feasible to increase the number of mental health care providers or hours they work in the short term, improving their time efficiency may be a viable solution. Virtually and digitally delivering psychotherapy, which has been shown to be efficient and clinically effective, might be a good method for addressing this growing demand. ObjectiveThis research protocol aims to evaluate the feasibility and efficacy of using an online, digital, asynchronous care model to treat mental health issues that are started or aggravated by stressors associated with the COVID-19 pandemic. MethodsThis nonrandomized controlled trial intervention will be delivered through the Online Psychotherapy Tool, a secure, cloud-based, digital mental health platform. Participants will be offered a 9-week electronically delivered cognitive behavioral therapy program that is tailored to address mental health problems in the context of the COVID-19 pandemic. This program will involve weekly self-guided educational material that provides an overview of behavioral skills and weekly homework. Participants (N=80) will receive personalized feedback from and weekly interaction with a therapist throughout the course of the program. The efficacy of the program will be evaluated using clinically validated symptomology questionnaires, which are to be completed by participants at baseline, week 5, and posttreatment. Inclusion criteria includes the capacity to consent; a primary diagnosis of generalized anxiety disorder or major depressive disorder, with symptoms that started or worsened during the COVID-19 pandemic; the ability to speak and read English; and consistent and reliable access to the internet. Exclusion criteria includes active psychosis, acute mania, severe alcohol or substance use disorder, and active suicidal or homicidal ideation. ResultsThis study received funding in May 2020. Ethics approval was received in June 2020. The recruitment of participants began in June 2020. Participant recruitment is being conducted via social media, web-based communities, and physician referrals. To date, 58 participants have been recruited (intervention group: n=35; control group: n=23). Data collection is expected to conclude by the end of 2020. Analyses (ie, linear regression analysis for continuous outcomes and binomial regression analysis for categorical outcomes) are expected to be completed by February 2021. ConclusionsIf proven feasible, this care delivery method could increase care capacity by up to fourfold. The findings from this study can potentially influence clinical practices and policies and increase accessibility to care during the COVID-19 pandemic, without sacrificing the quality of care. Trial RegistrationClinicalTrials.gov NCT04476667; https://clinicaltrials.gov/ct2/show/NCT04476667 International Registered Report Identifier (IRRID)DERR1-10.2196/24913

This paper analyzes the first two years of operation of Marc Ferrez & Filhos (Marc Ferrez & Sons), a pioneer of film distribution in Brazil. As exclusive representative of French Pathe Freres in the country, the company oversaw the expansion of permanent movie theaters in Rio deJaneiro starting in 1907, created a national distribution network, and shaped the buddingfilm market in Brazil. The paper shows that the increase in domestic film production after 1908, the so-called belle epoque of Brazilian cinema, resulted from Marc Ferrez & Filhos' dom inance in program ming at the best movie theaters in the capital of Brazil using their own original and exclusive representation model. KEYWORDS: Brazilian cinema, Pathe Freres, distribution, exhibition, movie theaters, In their first years, films in Brazil were mostly screened in rented theaters or halls by itinerant exhibitors who traveled from city to city carrying equipment and film prints acquired [...]

Background/Objectives: Post-traumatic stress disorder (PTSD) is a challenging psychiatric condition to treat, with suboptimal recovery and difficulty tolerating exposure-based psychotherapies often noted in outcomes research. The aim of this study was to examine patterns of symptom reduction in veterans with PTSD treated with a Capnometry-Guided Respiratory Intervention (CGRI), a 28-day treatment teaching about the normalization of respiratory rate and exhaled carbon dioxide levels via biofeedback. We hypothesized reductions in total PCL-5 scores and all symptom clusters immediately post-treatment but with relative resistance to changes in hyperarousal symptoms, as reported in the outcomes of research using other evidence-based psychotherapies. Methods: In this report of real-world outcomes, we included 164 veterans treated with CGRI. Pre- and post-treatment PTSD Checklists for DSM-5 (PCL-5) scales were recorded and analyzed based on the total, cluster, and item scores. Subjects were additionally classified into Recovered, Improved, or Suboptimal subgroups based on their response to treatment. Data were compiled during routine clinical care and are available for retrospective analysis. Results: Treatment response was reported in 53% of participants, with a mean total PCL-5 score reduction of 12 points post-treatment (effect size, Glass's Δ = 0.99, large) and individual PCL-5 clusters showing medium to large effect sizes (effect size = 0.71 to 0.98). Contrary to our hypothesis, a large effect size was found in the hyperarousal cluster, with post-treatment scores being significantly improved compared to pre-treatment scores (effect size = 0.98). In the Recovered group, all 20 PCL-5 items showed significant declines, while significant reductions were reported in some items in the Improved group and no item improvements were noted in the Suboptimal group. Conclusions: Consistently with prior published trials reporting overall improvements in PTSD symptoms, in this report, the CGRI produced clinically meaningful reductions in PCL-5 cluster scores in addition to total scores. Unlike reports from several trials of cognitive therapies, this study found hyperarousal symptoms to be responsive to treatment. The CGRI shows evidence of improvement across the range of PTSD symptoms in the immediate post-treatment interval. The absence of an extended post-treatment follow up introduces uncertainty concerning the durability of benefits experienced, although previous CGRI research on both panic disorder and PTSD has shown the maintenance of symptom reduction in six- to twelve-month intervals. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the antimicrobial potential of glass ionomer cement (GIC) incorporated with silver and copper nanoparticles (CuAgNP) in three different concentrations (GIC 0.01% CuAgNP, GIC 0.05% CuAgNP, and GIC 0.1% CuAgNP) on the inhibition of in vitro formation of duospecies biofilm of Streptococcus mutans and Candida albicans, surface roughness, color variation, and curing time. A control group was also included, consisting of GIC without nanoparticles. Duoespecie biofilms were grown on specimens of GIC in Tryptic Soy Broth placed in 24-well plates for 72 h. The biofilms were then collected and plated on Mitis-Salivarius-Bacitracin (MSB) agar and Sabouraud dextrose agar for Streptococcus mutans and Candida albicans, respectively. Colony-forming unit (CFU) counts and dry weight were measured to assess the biofilm growth. Physical properties were evaluated through tests on surface roughness, color variation, and curing time. The normality of the distribution was evaluated using the Kolmogorov–Smirnov test. Data were analyzed using ANOVA followed by Tukey's test. The results showed that the addition of CuAgNP did not increase antimicrobial activity compared to the control (p > 0.05). Furthermore, longer curing time resulted in negative effects on physical properties, such as color variation and greater surface roughness (p < 0.05). The addition of CuAgNP did not improve the properties of GIC in this study. [ABSTRACT FROM AUTHOR]