The Experiences of People From Arab Countries in Coping with Trauma Resulting From War and Conflict in the Middle East: A Systematic Review and Meta-synthesis of Qualitative Studies

The Middle East region has been an area of war and political conflict for several decades. There is currently limited research on the experiences of war and conflict among the individuals from Arab countries in the Middle East. The aim of this review was to systematically review and meta-synthesize qualitative literature on the experiences of individuals from Arab countries in the Middle East of going through and coping with war and political conflict. We systematically searched for relevant literature through MEDLINE, PsycINFO, CINAHL, Google Scholar, EThOS, OpenGrey, and The Arab Journal of Psychiatry. Studies selected needed to have a qualitative design reporting on the war and conflict experiences of participants aged 18 years or older from Arab countries in the Middle East. The review protocol was preregistered with PROSPERO (Ref: CRD42022314108). We identified 27 studies to be included in the final review. Four overarching themes were included in the meta-synthesis: War and conflict as life-defining experiences, experiences of hardship, coping with war and conflict, and positives out of a painful experience. Participants in the included studies reported significant distress and losing their sense of self, as well as resilience and positive growth. This review and meta-synthesis revealed the particular culturally informed experiences of individuals from Arab countries in the Middle East in processing their conflict experiences. These experiences highlight the need for culturally sensitive interventions for a population that has been under significant war-related stressors

Adaptive Noise Cancellation for a Class of Non-Linear IIR Filters

A new filter structure known as the NARMAX model (Nonlinear AutoRegressive Moving Average model with eXogenous inputs)is introduced as a basis for the design of a class of nonlinear filters which can be used for noise cancellation. The new design is an extension of the classical IIR filter and it is shown that the filter parameters can be estimated using a suboptimal least squares algorithm originally developed for system identification. Conditions for the convergence of the algorithm are briefly discussed and simulation results are presented which show the effectiveness of the new structure

Intensive cognitive therapy for post-traumatic stress disorder in routine clinical practice: A matched comparison audit

OBJECTIVES: Intensive cognitive therapy for post‐traumatic stress disorder (PTSD) has been shown to be as effective as weekly treatment in controlled trials. In this study, outcome data comparing standard and intensive treatments delivered in routine clinical practice were analysed. METHODS: A consecutive case series of intensive treatment cases were compared to matched control cases who had completed weekly treatment. RESULTS: Both groups showed significant improvements on PTSD and depression measures. The intensive group showed larger PTSD symptomatic improvement. There were differences between the groups in age and time since trauma, suggesting selection biases in who is offered, and/or who chooses intensive treatment. CONCLUSIONS: For some individuals, an intensive format may be more effective than weekly treatment

MODIFI: protocol for randomised feasibility study of eye-movement desensitisation and reprocessing therapy (EMDR) for functional neurological disorder (FND)

INTRODUCTION: Functional neurological disorder (FND) refers to an involuntary loss of control over and/or aberrant perception of the body. Common presenting symptoms are functional (non-epileptic) seizures, and functional motor disorder, for example, walking difficulties, weakness or tremor. Greater access to effective treatments would lead to reduced distress and disability; and reduce unnecessary healthcare costs.This study will examine eye-movement desensitisation and reprocessing therapy (EMDR) as a treatment for FND. EMDR is an evidence-based treatment for post-traumatic stress disorder (PTSD), but its use for other conditions is growing. An FND-specific EMDR protocol will be tested, and if the intervention proves feasible with promising clinical outcomes, progression to a substantive study could take place. METHODS AND ANALYSIS: Fifty adult patients diagnosed with FND will be recruited. It will be a single-blind randomised controlled trial with two arms: EMDR (plus standard neuropsychiatric care; NPC) and standard NPC. The two groups will be compared at baseline (T0), 3 months (T1), 6 months (T2) and 9 months (T3). Measures of feasibility include safety, recruitment, retention, treatment adherence and acceptability. Clinical outcome measures will assess health-related functioning/quality of life, ratings of FND symptoms and severity, depression, anxiety, PTSD, dissociation, service utilisation and other costs. Improvement and satisfaction ratings will also be assessed. Feasibility outcomes will be summarised using descriptive statistics. Exploratory analyses using (linear/logistic) mixed-effect models will examine the rate of change in the groups' clinical outcome measures across the four time-points.After the intervention period, a sample of participants, and clinicians, will be invited to attend semistructured interviews. The interviews will be analysed using reflexive thematic analysis. ETHICS AND DISSEMINATION: This study has been approved by the NHS West Midlands-Edgbaston Research Ethics Committee. Study findings will be published in open access peer-reviewed journals, presented at conferences, and communicated to participants and other relevant stakeholders. TRIAL REGISTRATION: NCT05455450 (www.gov)

We didn\u27t have courage : Internalizing Racism and the Limits of Participatory Action Research

This article follows a group of Latino/a English language learners conducting Participatory Action Research in a segregated school. I examine how students’ perspectives on civic engagement shifted after they joined an after‐school initiative that brought them together with students from a private Jewish day school located directly across the street. Even as students formed new perspectives on civic engagement throughout the year, internalized racism framed how they understood their capacity for civic action

Dynamic modeling of DC-DC converters with peak current control in double-stage photovoltaic grid-connected inverters

In photovoltaic (PV) double-stage grid-connected inverters a high-frequency DC-DC isolation and voltage step-up stage is commonly used between the panel and the grid-connected inverter. This paper is focused on the modeling and control design of DC-DC converters with Peak Current mode Control (PCC) and an external control loop of the PV panel voltage, which works following a voltage reference provided by a maximum power point tracking (MPPT) algorithm. In the proposed overall control structure the output voltage of the DC-DC converter is regulated by the grid-connected inverter. Therefore, the inverter may be considered as a constant voltage load for the development of the small-signal model of the DC-DC converter, whereas the PV panel is considered as a negative resistance. The sensitivity of the control loops to variations of the power extracted from the PV panel and of its voltage is studied. The theoretical analysis is corroborated by frequency response measurements on a 230 W experimental inverter working from a single PV panel. The inverter is based on a Flyback DC-DC converter operating in discontinuous conduction mode (DCM) followed by a PWM full-bridge single-phase inverter. The time response of the whole system (DC-DC + inverter) is also shown to validate the concept. Copyright © 2011 John Wiley & Sons, Ltd. In photovoltaic (PV) double-stage gridconnected inverters a high-frequency DC-DC isolation and voltage step-up stage is commonly used between the panel and the grid-connected inverter. This paper is focused on the modeling and control design of DC-DC converters with Peak Current mode Control (PCC) and an external control loop of the PV panel voltage, which works following a voltage reference provided by a maximum power point tracking (MPPT) algorithm. The sensitivity of the control loops to variations of the power extracted from the PV panel and of its voltage is studied. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.This work was supported by the Spanish Ministry of Science and Innovation (MICINN) under grant ENE2009-13998-C02-02. The company AUSTRIAMICROSYSTEMS co-financed this project.Garcerá Sanfeliú, G.; González Medina, R.; Figueres Amorós, E.; Sandía Paredes, J. (2012). Dynamic modeling of DC-DC converters with peak current control in double-stage photovoltaic grid-connected inverters. International Journal of Circuit Theory and Applications. 40(8):793-813. https://doi.org/10.1002/cta.756S793813408Carrasco, J. M., Franquelo, L. G., Bialasiewicz, J. T., Galvan, E., PortilloGuisado, R. C., Prats, M. A. M., … Moreno-Alfonso, N. (2006). Power-Electronic Systems for the Grid Integration of Renewable Energy Sources: A Survey. IEEE Transactions on Industrial Electronics, 53(4), 1002-1016. doi:10.1109/tie.2006.878356Kjaer, S. B., Pedersen, J. K., & Blaabjerg, F. (2005). A Review of Single-Phase Grid-Connected Inverters for Photovoltaic Modules. IEEE Transactions on Industry Applications, 41(5), 1292-1306. doi:10.1109/tia.2005.853371Ridley, R. B. (1991). A new, continuous-time model for current-mode control (power convertors). IEEE Transactions on Power Electronics, 6(2), 271-280. doi:10.1109/63.76813Femia, N., Petrone, G., Spagnuolo, G., & Vitelli, M. (2005). Optimization of Perturb and Observe Maximum Power Point Tracking Method. IEEE Transactions on Power Electronics, 20(4), 963-973. doi:10.1109/tpel.2005.850975Hua, C., & Lin, J. (2004). A modified tracking algorithm for maximum power tracking of solar array. Energy Conversion and Management, 45(6), 911-925. doi:10.1016/s0196-8904(03)00193-6Tan, Y. T., Kirschen, D. S., & Jenkins, N. (2004). A Model of PV Generation Suitable for Stability Analysis. IEEE Transactions on Energy Conversion, 19(4), 748-755. doi:10.1109/tec.2004.827707Femia, N., Petrone, G., Spagnuolo, G., & Vitelli, M. (2009). A Technique for Improving P&O MPPT Performances of Double-Stage Grid-Connected Photovoltaic Systems. IEEE Transactions on Industrial Electronics, 56(11), 4473-4482. doi:10.1109/tie.2009.2029589Chiu, H.-J., Huang, H.-M., Yang, H.-T., & Cheng, S.-J. (2008). An improved single-stage Flyback PFC converter for high-luminance lighting LED lamps. International Journal of Circuit Theory and Applications, 36(2), 205-210. doi:10.1002/cta.404Chiu, H.-J., Yao, C.-J., & Lo, Y.-K. (2009). A DC/DC converter topology for renewable energy systems. International Journal of Circuit Theory and Applications, 37(3), 485-495. doi:10.1002/cta.475Martins DC Demonti R Photovoltaic Energy Processing for Utility Connected System 1292 1296 10.1109/IECON.2001.975968www.focus.ti.com/lit/ml/slup127/slup127.pdf2003 http://www.fairchildsemi.comEsram, T., & Chapman, P. L. (2007). Comparison of Photovoltaic Array Maximum Power Point Tracking Techniques. IEEE Transactions on Energy Conversion, 22(2), 439-449. doi:10.1109/tec.2006.874230Liserre, M., Blaabjerg, F., & Hansen, S. (2005). Design and Control of an LCL-Filter-Based Three-Phase Active Rectifier. IEEE Transactions on Industry Applications, 41(5), 1281-1291. doi:10.1109/tia.2005.853373Liserre, M., Teodorescu, R., & Blaabjerg, F. (2006). Stability of photovoltaic and wind turbine grid-connected inverters for a large set of grid impedance values. IEEE Transactions on Power Electronics, 21(1), 263-272. doi:10.1109/tpel.2005.861185Figueres, E., Garcera, G., Sandia, J., Gonzalez-Espin, F., & Rubio, J. C. (2009). Sensitivity Study of the Dynamics of Three-Phase Photovoltaic Inverters With an LCL Grid Filter. IEEE Transactions on Industrial Electronics, 56(3), 706-717. doi:10.1109/tie.2008.2010175Ciobotaru M Teodorescu R Blaabjerg F Control of single-stage single-phase PV inverter P.1 P.10 10.1109/EPE.2005.219501Zmood, D. N., & Holmes, D. G. (2003). Stationary frame current regulation of PWM inverters with zero steady-state error. IEEE Transactions on Power Electronics, 18(3), 814-822. doi:10.1109/tpel.2003.810852Castilla, M., Miret, J., Matas, J., Garcia de Vicuna, L., & Guerrero, J. M. (2009). Control Design Guidelines for Single-Phase Grid-Connected Photovoltaic Inverters With Damped Resonant Harmonic Compensators. IEEE Transactions on Industrial Electronics, 56(11), 4492-4501. doi:10.1109/tie.2009.2017820Timbus A Teodorescu R Blaabjerg F Liserre M Synchronization methods for three phase distributed power generation systems 2474 2481 10.1109/PESC.2005.1581980Vorperian, V. (1990). Simplified analysis of PWM converters using model of PWM switch. II. Discontinuous conduction mode. IEEE Transactions on Aerospace and Electronic Systems, 26(3), 497-505. doi:10.1109/7.106127Reatti A Balzani M PWM switch model of a buck-boost converter operated under discontinuous conduction mode 667 670 10.1109/MWSCAS.2005.1594189Reatti, A., & Kazimierczuk, M. K. (2003). Small-signal model of PWM converters for discontinuous conduction mode and its application for boost converter. IEEE Transactions on Circuits and Systems I: Fundamental Theory and Applications, 50(1), 65-73. doi:10.1109/tcsi.2002.805709Lin, B.-R., Huang, C.-L., & Li, M.-Y. (2009). Novel interleaved ZVS converter with ripple current cancellation. International Journal of Circuit Theory and Applications, 37(3), 413-431. doi:10.1002/cta.480MIDDLEBROOK, R. D. (1975). Measurement of loop gain in feedback systems†. International Journal of Electronics, 38(4), 485-512. doi:10.1080/0020721750892042

A decision support tool for predicting patients at risk of readmission : a comparison of classification trees, logistic regression, generalized additive models, and multivariate adaptive regression splines

This is the peer reviewed version of the following article: Eren Demir, “Classification Trees, Logistic Regression, Generalized Additive Models, and Multivariate Adaptive Regression Splines” Decision Sciences, Vol 45(5): 849-880, October 2014, which has been published in final form at doi: 10.1111/deci.12094. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. © 2014 Decision Sciences InstituteThe number of emergency (or unplanned) readmissions in the United Kingdom National Health Service (NHS) has been rising for many years. This trend, which is possibly related to poor patient care, places financial pressures on hospitals and on national healthcare budgets. As a result, clinicians and key decision makers (e.g. managers and commissioners) are interested in predicting patients at high risk of readmission. Logistic regression is the most popular method of predicting patient-specific probabilities. However, these studies have produced conflicting results with poor prediction accuracies. We compared the predictive accuracy of logistic regression with that of regression trees for predicting emergency readmissions within forty five days after been discharged from hospital. We also examined the predictive ability of two other types of data-driven models: generalized additive models (GAMs) and multivariate adaptive regression splines (MARS). We used data on 963 patients readmitted to hospitals with chronic obstructive pulmonary disease and asthma. We used repeated split-sample validation: the data were divided into derivation and validation samples. Predictive models were estimated using the derivation sample and the predictive accuracy of the resultant model was assessed using a number of performance measures, such as area under the receiver operating characteristic (ROC) curve in the validation sample. This process was repeated 1000 times—the initial data set was divided into derivation and validation samples 1000 times, and the predictive accuracy of each method was assessed each time. The mean ROC curve area for the regression tree models in the 1000 derivation samples was 0.928, while the mean ROC curve area of a logistic regression model was 0.924. Our study shows that logistic regression model and regression trees had performance comparable to that of more flexible, data-driven models such as GAMs and MARS. Given that the models have produced excellent predictive accuracies, this could be a valuable decision support tool for clinicians (health care managers, policy makers, etc.) for informed decision making in the management of diseases, which ultimately contributes to improved measures for hospital performance management.Peer reviewedFinal Accepted Versio

MODIFI: protocol for randomised feasibility study of eye-movement desensitisation and reprocessing therapy (EMDR) for functional neurological disorder (FND).

INTRODUCTION: Functional neurological disorder (FND) refers to an involuntary loss of control over and/or aberrant perception of the body. Common presenting symptoms are functional (non-epileptic) seizures, and functional motor disorder, for example, walking difficulties, weakness or tremor. Greater access to effective treatments would lead to reduced distress and disability; and reduce unnecessary healthcare costs.This study will examine eye-movement desensitisation and reprocessing therapy (EMDR) as a treatment for FND. EMDR is an evidence-based treatment for post-traumatic stress disorder (PTSD), but its use for other conditions is growing. An FND-specific EMDR protocol will be tested, and if the intervention proves feasible with promising clinical outcomes, progression to a substantive study could take place. METHODS AND ANALYSIS: Fifty adult patients diagnosed with FND will be recruited. It will be a single-blind randomised controlled trial with two arms: EMDR (plus standard neuropsychiatric care; NPC) and standard NPC. The two groups will be compared at baseline (T0), 3 months (T1), 6 months (T2) and 9 months (T3). Measures of feasibility include safety, recruitment, retention, treatment adherence and acceptability. Clinical outcome measures will assess health-related functioning/quality of life, ratings of FND symptoms and severity, depression, anxiety, PTSD, dissociation, service utilisation and other costs. Improvement and satisfaction ratings will also be assessed. Feasibility outcomes will be summarised using descriptive statistics. Exploratory analyses using (linear/logistic) mixed-effect models will examine the rate of change in the groups' clinical outcome measures across the four time-points.After the intervention period, a sample of participants, and clinicians, will be invited to attend semistructured interviews. The interviews will be analysed using reflexive thematic analysis. ETHICS AND DISSEMINATION: This study has been approved by the NHS West Midlands-Edgbaston Research Ethics Committee. Study findings will be published in open access peer-reviewed journals, presented at conferences, and communicated to participants and other relevant stakeholders. TRIAL REGISTRATION: NCT05455450 (www. CLINICALTRIALS: gov)

Allele Summation of Diabetes Risk Genes Predicts Impaired Glucose Tolerance in Female and Obese Individuals

INTRODUCTION: Single nucleotide polymorphisms (SNPs) in approximately 40 genes have been associated with an increased risk for type 2 diabetes (T2D) in genome-wide association studies. It is not known whether a similar genetic impact on the risk of prediabetes (impaired glucose tolerance [IGT] or impaired fasting glycemia [IFG]) exists. METHODS: In our cohort of 1442 non-diabetic subjects of European origin (normal glucose tolerance [NGT] n = 1046, isolated IFG n = 142, isolated IGT n = 140, IFG+IGT n = 114), an impact on glucose homeostasis has been shown for 9 SNPs in previous studies in this specific cohort. We analyzed these SNPs (within or in the vicinity of the genes TCF7L2, KCNJ11, HHEX, SLC30A8, WFS1, KCNQ1, MTNR1B, FTO, PPARG) for association with prediabetes. RESULTS: The genetic risk load was significantly associated with the risk for IGT (p = 0.0006) in a model including gender, age, BMI and insulin sensitivity. To further evaluate potential confounding effects, we stratified the population on gender, BMI and insulin sensitivity. The association of the risk score with IGT was present in female participants (p = 0.008), but not in male participants. The risk score was significantly associated with IGT (p = 0.008) in subjects with a body mass index higher than 30 kg/m(2) but not in non-obese individuals. Furthermore, only in insulin resistant subjects a significant association between the genetic load and the risk for IGT (p = 0.01) was found. DISCUSSION: We found that T2D genetic risk alleles cause an increased risk for IGT. This effect was not present in male, lean and insulin sensitive subjects, suggesting a protective role of beneficial environmental factors on the genetic risk