Introduction to the Special Section: Suicide Risk Assessment and Intervention in School Counselor Training

This special section on school counselor preparation in assessing for crisis and suicide risk considers the impact of the perception of school counselor training and expertise related to suicide assessment and intervention. The collection of six articles focuses on considerations and best practices in assessing and intervening with PK-12 students experiencing suicidality, the unique considerations within a school setting, and corresponding implications for school counselor training

Impact of Dielectric Formation and Processing Techniques on the Operation of 4H-SiC MOSFETs

The mobility of carriers in the channel of silicon carbide is significantly lower than in equivalent silicon devices. This results in a significant increase in on-state resistance in comparison to theoretical predictions and is hindering the uptake of silicon carbide technology in commercial circuits. The density of interface traps at the interface between silicon carbide and the dielectric film is higher and this is often considered to be the primary reason for the low mobility. In this work, we show that the mobility is dominated by the surface roughness of the silicon carbide, especially when the transistor is operating in the strong inversion regime, by careful examination of the characteristics of lateral transistors designed to form complimentary MOS functions

Shear wave elastography of the cervical arteries: a novel approach to the assessment of cervical arterial wall stiffness. An investigation of psychometric properties and intra-rater reliability

Cervical arterial dissection, can occur spontaneously and is a rare but catastrophic adverse event associated with neck manipulation. Pathophysiology involves altered integrity of the arterial wall increasing its vulnerability to minor trauma. Those at risk are difficult to detect. Previous screening investigated blood flow but altered mechanical properties as stiffness of cervical arterial wall could provide a more valid indication of arterial integrity or even early dissection.To investigate suitability and intra-rater reliability of shear wave ultrasound elastography to measure mechanical properties of the cervical arterial wall. Suitability was assessed by ability to track arteries along their length and measurement accuracy.Observational and intra-rater reliability study.Internal carotid (ICA) and vertebral arteries (VA) of healthy participants were examined with shear wave elastography. Shear wave velocity (m/s) indicative of wall stiffness was measured with the head in the neutral position: proximally (C3-4) and distally (C1-2) where injuries have been more commonly reported. Proximal measures were repeated to assess intra-rater reliability.Thirty healthy participants (13 female), mean age of 29 (±12.8) years were imaged. Mean VA wall stiffness (3.4 m/s) was greater than ICA (2.3 m/s) (p

The control of malaria vectors in rice fields: a systematic review and meta-analysis.

The relatively stable aquatic conditions of irrigated lowland and rainfed rice, which is grown across 145 million hectares in more than 100 countries, are capable of generating large numbers of mosquito vectors of malaria, which causes more than 400,000 deaths per year worldwide. Many methods can control these vectors, but a systematic review has not previously been conducted. This study assesses whether larviciding, fish or intermittent irrigation can significantly reduce malaria vectors in rice fields whilst increasing rice yield. After a literature search for studies reporting the effect of larval control and rice cultivation practices on malaria vector densities in rice fields, 33 studies were eligible for meta-analysis. Larviciding was effective at reducing rice-field malaria vectors. Pooled analysis of five controlled time-series (CTS) studies with chemical insecticides showed an overall combined reduction of larval densities of 77% compared to no larviciding. Eight CTSs with biological larvicides showed a pooled reduction of 60% compared to no larviciding. Cultivating rice and fish together provided good control too: a pooled analysis of three CTSs showed an overall 82% reduction in anopheline larvae compared to no fish. Pooled analysis of four studies suggested that intermittent irrigation (using various timings and frequencies of drainage) is effective at reducing the abundance of late-stage anopheline larvae (pooled reduction = - 35%), but not overall immature abundance, compared to continuous flooding. We conclude that many interventions such as larvicides, fish and intermittent irrigation can provide riceland malaria vector control, but the critical obstacle to wider use is farmer acceptability. Future research should be led by the agricultural sector, with inputs from entomologists, to investigate malaria control co-benefits within high-yielding rice cultivation practices

High angular resolution N-band observation of the silicate carbon star IRAS08002-3803 with the VLTI/MIDI instrument

We present the results of N-band spectro-interferometric observations of the silicate carbon star IRAS08002-3803 with the MID-infrared Interferometric instrument (MIDI) at the Very Large Telescope Interferometer (VLTI) of the European Southern Observatory (ESO). The observations were carried out using two unit telescopes (UT2 and UT3) with projected baseline lengths ranging from 39 to 47 m. Our observations of IRAS08002-3803 have spatially resolved the dusty environment of a silicate carbon star for the first time and revealed an unexpected wavelength dependence of the angular size in the N band: the uniform-disk diameter is found to be constant and ~36 mas (72 Rstar) between 8 and 10 micron, while it steeply increases longward of 10 micron to reach ~53 mas (106 Rstar) at 13 micron. Model calculations with our Monte Carlo radiative transfer code show that neither spherical shell models nor axisymmetric disk models consisting of silicate grains alone can simultaneously explain the observed wavelength dependence of the visibility and the spectral energy distribution (SED). We propose that the circumstellar environment of IRAS08002-3803 may consist of two grain species coexisting in the disk: silicate and a second grain species, for which we consider amorphous carbon, large silicate grains, and metallic iron grains. Comparison of the observed visibilities and SED with our models shows that such disk models can fairly -- though not entirely satisfactorily -- reproduce the observed SED and N-band visibilities. Our MIDI observations and the radiative transfer calculations lend support to the picture where oxygen-rich material around IRAS08002-3803 is stored in a circumbinary disk surrounding the carbon-rich primary star and its putative low-luminosity companion.Comment: 15 pages, 8 figures, accepted for publication in A&

Malaria transmission and prevalence in rice-growing versus non-rice-growing villages in Africa: a systematic review and meta-analysis.

BACKGROUND: Rice fields in Africa are major breeding sites for malaria vectors. However, when reviewed in the 1990s, in settings where transmission was relatively intense, there was no tendency for malaria indices to be higher in villages with irrigated rice fields than in those without. Subsequently, intervention coverage in sub-Saharan Africa has been massively scaled up and malaria infection prevalence has halved. We re-examined this rice-malaria relationship to assess whether, with lower malaria transmission, malaria risk is greater in rice-growing than in non-rice-growing areas. METHODS: For this systematic review and meta-analysis, we searched EMBASE, Global Health, PubMed, Scopus, and Web of Science to identify observational studies published between Jan 1, 1900, and Sept 18, 2020. Studies were considered eligible if they were observational studies (cross-sectional, case-control, or cohort) comparing epidemiological or entomological outcomes of interest between people living in rice-growing and non-rice-growing rural communities in sub-Saharan Africa. Studies with pregnant women, displaced people, and military personnel as participants were excluded because they were considered not representative of a typical community. Data were extracted with use of a standardised data extraction form. The primary outcomes were parasite prevalence (P falciparum parasite rate age-standardised to 2-10-year-olds, calculated from total numbers of participants and number of infections [confirmed by microscopy or rapid diagnostic test] in each group) and clinical malaria incidence (number of diagnoses [fever with Plasmodium parasitaemia confirmed by microscopy or rapid diagnostic test] per 1000 person-days in each group). We did random-effects meta-analyses to estimate the pooled risk ratio (RR) for malaria parasite prevalence and incidence rate ratio (IRR) for clinical malaria in rice-growing versus non-rice-growing villages. RRs were compared in studies conducted before and after 2003 (chosen to mark the start of the mass scale-up of antimalaria interventions). This study is registered with PROSPERO (CRD42020204936). FINDINGS: Of the 2913 unique studies identified and screened, 53 studies (including 113 160 participants across 14 African countries) were eligible for inclusion. In studies done before 2003, malaria parasite prevalence was not significantly different in rice-growing versus non-rice-growing villages (pooled RR 0·82 [95% CI 0·63-1·06]; 16 studies, 99 574 participants); however, in post-2003 studies, prevalence was significantly higher in rice-growing versus non-rice growing villages (1·73 [1·01-2·96]; seven studies, 14 002 participants). Clinical malaria incidence was not associated with residence in rice-growing versus non-rice-growing areas (IRR 0·75 [95% CI 0·47-1·18], four studies, 77 890). Potential limitations of this study include its basis on observational studies (with evidence quality rated as very low according to the GRADE approach), as well as its omission for the effects of seasonality and type of rice being cultivated. Risk of bias and inconsistencies was relatively serious, with I2 greater than 90% indicating considerable heterogeneity. INTERPRETATION: Irrigated rice-growing communities in sub-Saharan Africa are exposed to greater malaria risk, as well as more mosquitoes. As increasing rice production and eliminating malaria are two major development goals in Africa, there is an urgent need to improve methods for growing rice without producing mosquitoes. FUNDING: Wellcome Trust Our Planet Our Health programme, CGIAR Agriculture for Nutrition and Health

Preliminary results of trial NPC-0501 evaluating the therapeutic gain by changing from concurrent-adjuvant to induction-concurrent chemoradiotherapy, changing from fluorouracil to capecitabine, and changing from conventional to accelerated radiotherapy fractionation in patients with locoregionally advanced nasopharyngeal carcinoma

© 2014 American Cancer Society. BACKGROUND A current recommendation for locoregionally advanced nasopharyngeal carcinoma (NPC) is conventional fractionated radiotherapy with concurrent cisplatin plus adjuvant cisplatin and fluorouracil (PF). In this randomized trial, the authors evaluated the potential therapeutic benefit from changing to an induction-concurrent chemotherapy sequence, replacing fluorouracil with oral capecitabine, and/or using accelerated rather than conventional radiotherapy fractionation. METHODS Patients with stage III through IVB, nonkeratinizing NPC were randomly allocated to 1 of 6 treatment arms. The protocol was amended in 2009 to permit confining randomization to the conventional fractionation arms. The primary endpoint was progression-free survival. Secondary endpoints included overall survival and safety. RESULTS In total, 803 patients were accrued, and 706 patients were randomly allocated to all 6 treatment arms. Comparisons of induction PF versus adjuvant PF did not indicate a significant improvement. Unadjusted comparisons of induction cisplatin and capecitabine (PX) versus adjuvant PF indicated a favorable trend in progression-free survival for the conventional fractionation arm (P = .045); analyses that were adjusted for other significant factors and fractionation reflected a significant reduction in the hazards of disease progression (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.36-0.80) and death (HR, 0.42; 95% CI, 0.25-0.70). Unadjusted comparisons of induction sequences versus adjuvant sequences did not reach statistical significance, but adjusted comparisons indicated favorable improvements by induction sequence. Comparisons of induction PX versus induction PF revealed fewer toxicities (neutropenia and electrolyte disturbance), unadjusted comparisons of efficacy were statistically insignificant, but adjusted analyses indicated that induction PX had a lower hazard of death (HR, 0.57; 95% CI, 0.34-0.97). Changing the fractionation from conventional to accelerated did not achieve any benefit but incurred higher toxicities (acute mucositis and dehydration). CONCLUSIONS Preliminary results indicate that the benefit of changing to an induction-concurrent sequence remains uncertain; replacing fluorouracil with oral capecitabine warrants further validation in view of its convenience, favorable toxicity profile, and favorable trends in efficacy; and accelerated fractionation is not recommended for patients with locoregionally advanced NPC who receive chemoradiotherapy.postprin

Outcome Assessment of a Dedicated HIV Positive Health Care Worker Clinic at a Central Hospital in Malawi: A Retrospective Observational Study

BACKGROUND: Malawi has one of the world's lowest densities of Health Care Workers (HCW) per capita. This study evaluates outcomes of a dedicated HCW HIV clinic in Malawi, created at Zomba Central Hospital in January 2007. METHODS AND FINDINGS: Retrospective cohort data was analyzed comparing HCW clinic patient baseline characteristics and treatment outcomes at 18 months after inception, against those attending the general HIV clinic. In-depth interviews and focus group discussions were conducted to explore perceptions of patients and caregivers regarding program value, level of awareness and barriers for uptake amongst HCW. 306 patients were enrolled on antiretroviral therapy (ART) in the HCW HIV clinic, 6784 in the general clinic. Significantly (p<0.01) more HCW clients were initiated on ART on the basis of CD4 as opposed to WHO Stage 3/4 (36% vs.23%). Significantly fewer HCW clients defaulted (6% vs.17%), and died (4% vs.12%). The dedicated HCW HIV clinic was perceived as important and convenient in terms of reduced waiting times, and prompt and high quality care. Improved confidentiality was an appreciated quality of the HCW clinic however barriers included fear of being recognized. CONCLUSIONS/SIGNIFICANCE: Outcomes at the HCW clinic appear better compared to the general HIV clinic. The strategy of dedicated clinics to care for health providers is a means of HIV impact mitigation within human resource constrained health systems in high prevalence settings