A systematic review and meta-analysis of the good-enough level (GEL) literature

The “good-enough level” (GEL) model proposes that people respond differentially to psychotherapy, and that the typical curvilinear “dose-response” shape of change may be an artifact of aggregation. We conducted a systematic review and meta-analysis of the GEL literature to examine (a) whether different subgroups of adults accessing psychotherapy respond to therapy at different rates and (b) whether the shape of change is linear or nonlinear. This review was preregistered on PROSPERO. Fifteen studies were synthesized (n = 114,123), with 10 included across two meta-analyses (n = 46,921; n = 41,515). Systematic searches took place using Medline, APA PsycInfo and Scopus databases. A key inclusion criterion was that cases must be stratified by treatment length to examine the GEL. In support of the GEL, there was no overall association between treatment duration and outcomes (r = −0.24, 95% confidence interval [CI: −0.70, 0.36], p = .27). Longer treatments were associated with higher baseline symptom scores (r = 0.15, 95% CI [0.08, 0.22], p < .001) and slower rates of change. Different shapes of change were also evidenced: Curvilinear responses were more often found in shorter treatments, while linear shapes were more often found in longer treatments. However, findings varied depending on methodological criteria used. Although rates of change varied in line with the GEL, most people nonetheless responded within defined boundaries as described in the dose-response literature. We therefore refer to the notion of “boundaried responsive regulation” to describe the relationship between treatment duration and outcomes

Highly precocious activation of reproductive function in autumn-born goats (Capra hircus) by exposure to sexually active bucks

Goats are seasonal breeders with the main cue controlling the timing of breeding season being photoperiod. Hence, the season of birth impacts puberty onset: spring-born goats reach puberty in autumn, at 7 mo of age, whereas autumn-born goats reach puberty at 1 yr during the next reproductive season. The aim of this study was to determine whether exposure of autumn-born young females to sexually active males could counteract the delay in puberty onset observed in autumn-born goats. Females exposed to sexually active males (n = 8) reached puberty earlier than isolated females (n = 8), with exposed females ovulating at a mean age of 3.5 mo. To our knowledge, such precocious puberty onset obtained through social stimulation has never been described in the literature. Moreover, those exposed females exhibited estrus behavior for most ovulations. Our results indicate that in goats born out of season, exposure to sexually active bucks is a really efficient approach to induce early puberty, suggesting that social interactions could have a crucial impact on the regulation of pubertal transition

The continuous presence of ewes in estrus in spring influences testicular volume, testicular echogenicity and testosterone concentration, but not LH pulsatility in rams

The continuous presence of active male small ruminants prevents seasonal anestrus in females, but evidence of the same mechanism operating from the females to the males is scarce. This study assessed the effects of the continuous presence of ewes in estrus in spring on ram sexual activity, testicular size and echogenicity, and LH and testosterone concentrations. On 1 March, 20 rams were assigned to two groups (n = 10 each): isolated (ISO) from other sheep, or stimulated (STI) by 12 ewes, which were separated from the rams by an openwork metal barrier, allowing contact between sexes. Each week, four ewes were induced into estrus by intravaginal sponges. Live weight, scrotal circumference, testicular width (TW) and length (TL) were recorded at the beginning and at the end of the experiment, and testicular volume (TV) was calculated; at the same time, testicular ultrasonography and color Doppler scanning were performed. Blood samples (March to May) were collected once per week for testosterone determinations, and at the end of the experiment, blood samples were collected for 6 h at 20-min intervals for LH analysis. Rams were exposed to four estrous ewes in a serving-capacity test. Scrotal circumference, TW and TL were higher in the STI than in the ISO rams (P < 0.05) in May, and TV was higher (P < 0.05) in the STI (391 ± 17 cm3) than in the ISO rams (354 ± 24 cm3). In ISO rams, the number of white pixels was higher (P < 0.01) in May (348 ± 74) than in March (94 ± 21) and differed significantly (P < 0.01) from that of the STI rams in May (160 ± 33). In ISO rams, the number of grey pixels was higher (P < 0.05) in May (107 ± 3) than it was in March (99 ± 1). Stimulated and ISO rams did not differ significantly in mean LH plasma concentrations (0.8 ± 0.5 v. 0.9 ± 0.4 ng/ml), LH pulses (2.1 ± 0.5 v. 2.2 ± 0.2) and amplitude (2.0 ± 0.4 v. 3.2 ± 0.7 ng/ml, respectively). Stimulated rams had significantly higher testosterone concentrations than ISO rams from April to the end of the experiment. Stimulated rams performed more (P < 0.05) mountings with intromission (3.0 ± 0.4) than did ISO rams (1.5 ± 0.5). In conclusion, after 3 months in the continuous presence of ewes in estrus in spring, rams had higher TV and some testicular echogenic parameters were modified than isolated rams. Although exposed rams also had higher levels of testosterone after 2 months in the presence of estrous ewes, their LH pulsatility at the end of the study was not modified

Matrix geometries and Matrix Models

We study a two parameter single trace 3-matrix model with SO(3) global symmetry. The model has two phases, a fuzzy sphere phase and a matrix phase. Configurations in the matrix phase are consistent with fluctuations around a background of commuting matrices whose eigenvalues are confined to the interior of a ball of radius R=2.0. We study the co-existence curve of the model and find evidence that it has two distinct portions one with a discontinuous internal energy yet critical fluctuations of the specific heat but only on the low temperature side of the transition and the other portion has a continuous internal energy with a discontinuous specific heat of finite jump. We study in detail the eigenvalue distributions of different observables.Comment: 20 page

Predictors of depression relapse and recurrence after cognitive behavioural therapy: a systematic review and meta-analysis

Background: Cognitive behavioural therapy (CBT) is an effective psychological treatment for major depressive disorder, although some patients experience a return of symptoms after finishing therapy. The ability to predict which individuals are more vulnerable to deterioration would allow for targeted interventions to prevent short-term relapse and longer-term recurrence. Aim: This systematic review and meta-analysis aimed to identify factors associated with an increased risk of relapse and/or recurrence (RR) after CBT for depression. Method: We reviewed 13 relevant papers, of which a small set of unique samples were eligible for meta-analysis (k = 5, N = 369). Twenty-six predictor variables were identified and grouped into seven categories: residual depressive symptoms; prior episodes of depression; cognitive reactivity; stressful life events; personality factors; clinical and diagnostic factors; demographics. Results: Meta-analyses indicated that residual depressive symptoms (r = 0.34 [0.10, 0.54], p = .01) and prior episodes (r = 0.19 [0.07, 0.30], p = .002) were statistically significant predictors of RR, but cognitive reactivity was not (r = 0.18 [−0.02, 0.36], p = .08). Other variables lacked replicated findings. On average, 33.4% of patients experienced RR after CBT. Conclusions: Patients with the above risk factors could be offered evidence-based continuation-phase interventions to enhance the longer-term effectiveness of CBT

Fibromatosis of the Plantar Fascia: Diagnosis and Indications For Surgical Treatment

Plantar fibromatosis is a rare, benign lesion involving the plantar aponeurosis. Eleven patients (13 feet) underwent 24 operations, including local excision, wide excision, or complete plantar fasciectomy. Clinical results were evaluated retrospectively. There were no differences among the subgroups in postoperative complications. Two primary fasciectomies did not recur. Three of six revised fasciectomies, seven of nine wide excisions, and six of seven local excisions recurred. Our results indicate that recurrence of plantar fibromatosis after surgical resection can be reduced by aggressive initial surgical resection

Reduciendo la incertidumbre en la ejecución de un piloto de combustión in situ en un campo de crudo extra pesado colombiano mediante la realización de una prueba de conectividad con nitrógeno

Prior to start any Enhanced Oil Recovery (EOR) process, it is desirable to characterize the flow pattern within the affected reservoir volume. This becomes of critical importance for in situ combustion in heavy oil reservoirs, where the mobility ratio is highly unfavorable, oftentimes resulting in channeling or early breakthrough. An inter-well connectivity test through immiscible gas injection aids improving the characterization of the flow distribution, in addition to: 1) calibrating estimates for sweep efficiency; 2) evidencing geological features that may lead to preferential flow towards a particular well or group of them, or lack of connection amongst them; 3) creating a gas path between the injector and producer wells to enable a safe progression of the combustion front; and 4) evaluating the performance of artificial lift and well control systems under high gas-liquid ratio conditions. A connectivity test using nitrogen was designed, implemented and evaluated at the Chichimene field, prior to the ignition of the in situ combustion pilot. This process is summarized and described in this paper. This will be the first in situ combustion trial in a deep (≈ 8000 ft.), extra-heavy oil reservoir, and will serve as a data source to evaluate the development of resources under similar conditions in the eastern plains basin of Colombia. This set of reservoirs bears a significant fraction of the hydrocarbon resources in the country and under Ecopetrol operation. The importance of this pilot makes this connectivity test of even larger relevance to reduce the subsurface and operational uncertainty, identifying potential risks, and increase the probability of success of the combustion process as an option to economically produce these resources.Antes de comenzar cualquier proceso de recuperación mejorada de petróleo (EOR), es deseable caracterizar el patrón de flujo dentro del volumen del yacimiento afectado. Esto se vuelve de importancia crítica para la combustión in situ en yacimientos de petróleo pesado, donde la relación de movilidad es altamente desfavorable, a menudo dando como resultado una canalización o un avance temprano del frente de inyección o combustión. Una prueba de conectividad entre pozos a través de inyecciones de gas inmiscible contribuye a mejorar la caracterización de la distribución de flujo de gas, además de: 1) Estimar eficiencias de barrido, 2) evidenciar características geológicas que pueden conducir a un flujo preferencial hacia un pozo o grupo particular de ellos, o falta de conexión entre ellos, 3) creación de una ruta de gas entre el inyector y los pozos productores para permitir una progresión segura del frente de combustión, y 4) evaluación del rendimiento de los sistemas de levantamiento artificial y sistemas de control de pozos en condiciones de alta relación gas-líquido. Se diseñó, implementó y evaluó una prueba de conectividad usando nitrógeno en el campo Chichimene, antes del inicio del piloto de combustión in situ. Este proceso se resume y describe en este documento. Esta será la primera prueba de combustión in situ en un yacimiento de petróleo extra-pesado profundo (≈ 8000 pies) a nivel mundial y servirá como una fuente de datos para evaluar el desarrollo de recursos en condiciones similares en la cuenca de los llanos orientales de Colombia. Este conjunto de yacimientos tiene una fracción significativa de los recursos de hidrocarburos en el país y están bajo la operación de Ecopetrol. La importancia de este piloto hace que esta prueba de conectividad tenga una relevancia aún mayor para reducir las incertidumbres de subsuelo y operativas, identificar riesgos y aumentar la probabilidad de éxito del proceso de combustión como una opción para producir estos recursos de manera económicamente rentable

The Role of Practice Research Networks (PRN) in the Development and Implementation of Evidence: The Northern Improving Access to Psychological Therapies PRN Case Study

Practice research networks (PRNs) can support the implementation of evidence based practice in routine services and generate practice based evidence. This paper describes the structure, processes and learning from a new PRN in the Improving Access to Psychological Therapies programme in England, in relation to an implementation framework and using one study as a case example. Challenges related to: ethics and governance processes; communications with multiple stakeholders; competing time pressures and linking outcome data. Enablers included: early tangible outputs and impact; a collaborative approach; engaging with local research leads; clarity of processes; effective dissemination; and committed leadership

A Bayesian network analysis of psychosocial risk and protective factors for suicidal ideation

Background: The aim of this study was to investigate and model the interactions between a range of risk and protective factors for suicidal ideation using general population data collected during the critical phase of the COVID-19 pandemic. Methods: Bayesian network analyses were applied to cross-sectional data collected 1 month after the COVID-19 lockdown measures were implemented in Austria and the United Kingdom. In nationally representative samples (n = 1,005 Austria; n = 1,006 UK), sociodemographic features and a multi-domain battery of health, wellbeing and quality of life (QOL) measures were completed. Predictive accuracy was examined using the area under the curve (AUC) within-sample (country) and out-of-sample. Results: The AUC of the Bayesian network models were ≥ 0.84 within-sample and ≥0.79 out-of-sample, explaining close to 50% of variability in suicidal ideation. In total, 15 interrelated risk and protective factors were identified. Seven of these factors were replicated in both countries: depressive symptoms, loneliness, anxiety symptoms, self-efficacy, resilience, QOL physical health, and QOL living environment. Conclusions: Bayesian network models had high predictive accuracy. Several psychosocial risk and protective factors have complex interrelationships that influence suicidal ideation. It is possible to predict suicidal risk with high accuracy using this information