The State of Sexuality Counseling Training in Counselor Education

Sexuality counseling training remains underdeveloped and lacks standardization across counselor education programs in the United States. We examined the integration of sexuality counseling in Clinical Mental Health Counseling (CMHC) programs. Out of 191 CMHC programs, 45% offered a standalone course and only 15.2% required one. We also performed summative and latent content analyses on the course descriptions to review the primary content of sexuality counseling courses. Content analysIs revealed course content largely focusing on sex positivity and inclusivity, though invalidating and potentially stigmatizing language persists. We conclude with implications for counselor education and future directions for research

Urgent need to clarify the definition of chronic critical limb ischemia - a position paper from the European Society for Vascular Medicine

Chronic critical lower limb ischemia (CLI) has been defined as ischemia that endangers the leg. An attempt was made to give a precise definition of CLI, based on clinical and hemodynamic data (Second European Consensus). CLI may be easily defined from a clinical point of view as rest pain of the distal foot or gangrene or ulceration. It is probably useful to add leg ulcers of other origin which do not heal because of severe ischemia, and to consider the impact of frailty on adverse outcome. From a hemodynamic viewpoint there is no consensus and most of the existing classifications are not based upon evidence. We should thus propose a definition and then validate it in a prospective cohort in order to define the patients at major risk of amputation, and also to define the categories of patients whose prognosis is improved by revascularisation. From today\u27s available data, it seems clear that the patients with a systolic toe pressure (STP) below 30 mmHg must be revascularised whenever possible. However other patients with clinically suspected CLI and STP above 30 mmHg must be evaluated and treated in specialised vascular units and revascularisation has to be discussed on a case by case basis, taking into account other data such as the WiFi classification for ulcers.In conclusion, many useful but at times contradictory definitions of CLI have been suggested. Only a few have taken into account evidence, and none have been validated prospectively. This paper aims to address this and to give notice that a CLI registry within Europe will be set up to prospectively validate, or not, the previous and suggested definitions of CLI

High "Normal" blood glucose is associated with decreased brain volume and cognitive performance in the 60s: the PATH through Life Study

Context:Type 2 diabetes is associated with cerebral atrophy, cognitive impairment and dementia. We recently showed higher glucose levels in the normal range not to be free of adverse effects and to be associated with greater hippocampal and amygdalar atrophy in older community-dwelling individuals free of diabetes.Objective:This study aimed to determine whether blood glucose levels in the normal range

Kaemika app, Integrating protocols and chemical simulation

Kaemika is an app available on the four major app stores. It provides deterministic and stochastic simulation, supporting natural chemical notation enhanced with recursive and conditional generation of chemical reaction networks. It has a liquid-handling protocol sublanguage compiled to a virtual digital microfluidic device. Chemical and microfluidic simulations can be interleaved for full experimental-cycle modeling. A novel and unambiguous representation of directed multigraphs is used to lay out chemical reaction networks in graphical form

Seismic response assessment and protection of statues and busts

Recent post-earthquake surveys carried out in Europe have shown that earthquake actions pose an immense threat to museums and their contents. For example, during the earthquake on 21 July 2017 in the island of Kos (Greece), severe and widespread damage on the city’s archaeological museum was reported (Figure 1). The earthquake extensively damaged the sculpture exhibition, where many pieces were dislocated, leaned against the walls, or overturned. Fortunately, the earthquake occurred when human visitors were not in the museum, since the damage to the exhibits varied from very light (minor fracturing) to severe (complete overturning and fracture of artefacts). In the case of heavy and slender sculptures, the overturning mechanism, apart from damaging the sculptures themselves, is a serious threat to other standing exhibits in the gallery and the visitors. It is, therefore, of paramount importance to have at our disposal methods and tools for characterising the seismic risk of museum artefacts and, where necessary, proposing cost-efficient protective measures. The study of the seismic vulnerability of museum artefacts, especially of slender, human-formed statues, is related to the research on the dynamic response of rocking rigid blocks. The dynamic characteristics of the hosting structures are also important. This is evident from the fact that, on many occasions, damage to the structure was reported leaving the exhibits intact and vice-versa. Although the problem is coupled, it can be studied looking separately at the structure and its contents, provided that the contents are not attached to the building. The seismic response of building contents is a topic of growing interest, since it is directly related to seismic loss assessment and earthquake community resilience. Building contents can be either attached to the structure, or may consist of objects that are simply standing. Museum exhibits belong to the latter category, while free-standing components are often studied as rocking objects and hence their response is sensitive to acceleration and velocity-based quantities and also to their geometry. Today, there is lack of standards, while the existing approaches are general in concept and do not sufficiently address the variety of rocking objects. The problem becomes more complicated when it comes to priceless objects such as museum artefacts where more refined and targeted studies are required for understanding their seismic response and also for proposing rapid tools for assessing their seismic risk. The paper presents an extensive experimental campaign on the seismic response of artefacts, with emphasis on statues and busts. The tests took place in the framework of SEREME project (Seismic Resilience of Museum Contents) at the AZALEE seismic simulator of CEA in Saclay, Paris under the auspices of the SERA project. The aim is to understand the seismic response of statues and busts and then develop novel and cost-effective risk mitigation schemes for improving the seismic resilience of museum valuable contents. The study is focused on the investigation of the seismic response of two real-scale marble roman statues and three busts of three roman emperors standing on pedestals of different types and size. Both isolated and non-isolated artefacts are considered, while two new and highly efficient base isolation systems, tailored to art objects, will be tested. The first isolator is a pendulum-based system, while the second utilizes Shape Memory Alloy wires. Furthermore, the paper examines the importance of the hosting building, i.e. building type and story. Specifically tailored, numerical models of varying complexity, for single and two-block rocking systems, were developed for the needs of this study and are also assessed against the experimental results

A Study of the Learnability of Relational Properties: Model Counting Meets Machine Learning (MCML)

This paper introduces the MCML approach for empirically studying the learnability of relational properties that can be expressed in the well-known software design language Alloy. A key novelty of MCML is quantification of the performance of and semantic differences among trained machine learning (ML) models, specifically decision trees, with respect to entire (bounded) input spaces, and not just for given training and test datasets (as is the common practice). MCML reduces the quantification problems to the classic complexity theory problem of model counting, and employs state-of-the-art model counters. The results show that relatively simple ML models can achieve surprisingly high performance (accuracy and F1-score) when evaluated in the common setting of using training and test datasets - even when the training dataset is much smaller than the test dataset - indicating the seeming simplicity of learning relational properties. However, MCML metrics based on model counting show that the performance can degrade substantially when tested against the entire (bounded) input space, indicating the high complexity of precisely learning these properties, and the usefulness of model counting in quantifying the true performance

Enhancing Perceived Safety in Human–Robot Collaborative Construction Using Immersive Virtual Environments

Advances in robotics now permit humans to work collaboratively with robots. However, humans often feel unsafe working alongside robots. Our knowledge of how to help humans overcome this issue is limited by two challenges. One, it is difficult, expensive and time-consuming to prototype robots and set up various work situations needed to conduct studies in this area. Two, we lack strong theoretical models to predict and explain perceived safety and its influence on human–robot work collaboration (HRWC). To address these issues, we introduce the Robot Acceptance Safety Model (RASM) and employ immersive virtual environments (IVEs) to examine perceived safety of working on tasks alongside a robot. Results from a between-subjects experiment done in an IVE show that separation of work areas between robots and humans increases perceived safety by promoting team identification and trust in the robot. In addition, the more participants felt it was safe to work with the robot, the more willing they were to work alongside the robot in the future.University of Michigan Mcubed Grant: Virtual Prototyping of Human-Robot Collaboration in Unstructured Construction EnvironmentsPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145620/1/You et al. forthcoming in AutCon.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145620/4/You et al. 2018.pdfDescription of You et al. 2018.pdf : Published Versio

The burden of breast, cervical, and colon and rectum cancer in the Balkan countries, 1990–2019 and forecast to 2030.

Background Despite effective prevention and control strategies, in countries of the Balkan region, cancers are the second leading cause of mortality, closely following circulatory system diseases. Objective To describe trends in the burden of breast, cervical, and colon and rectum cancer in the Balkan region and per country between 1990 and 2019, including a forecast to 2030. Methods We described the 2019 Global Burden of Disease (GBD) estimates for breast, cervical, and colon and rectum cancers in eleven Balkan countries over the period 1990–2019, including incidence, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALYs) rates per 100,000 population and accompanied 95% uncertainty interval. With the Autoregressive Integrated Moving Average, we forecasted these rates per country up to 2030. Results In the Balkan region, the highest incidence and DALYs rates in the study period were for colon and rectum, and breast cancers. Over the study period, the DALYs rates for breast cancer per 100,000 population were the highest in Serbia (reaching 670.84 in 2019) but the lowest in Albania (reaching 271.24 in 2019). In 2019, the highest incidence of breast cancer (85 /100,000) and highest YLD rate (64 /100,000) were observed in Greece. Romania had the highest incidence rates, YLD rates, DALY rates, and YLL rates of cervical cancer, with respective 20.59%, 23.39% 4.00%, and 3.47% increases for the 1990/2019 period, and the highest forecasted burden for cervical cancer in 2030. The highest incidence rates, YLD rates and DALY rates of colon and rectum cancers were continuously recorded in Croatia (an increase of 130.75%, 48.23%, and 63.28%, respectively), while the highest YLL rates were in Bulgaria (an increase of 63.85%). The YLL rates due to colon and rectum cancers are forecasted to progress by 2030 in all Balkan countries. Conclusion As most of the DALYs burden for breast, cervical, and colon and rectum cancer is due to premature mortality, the numerous country-specific barriers to cancer early detection and quality and care continuum should be a public priority of multi-stakeholder collaboration in the Balkan region

Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine .

COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including noncontrolled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine draws attention to patients with vascular disease (VD) and presents an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19. VAS recommends (1) a COVID-19-oriented primary health care network for patients with VD-CVR for identification of patients with VD-CVR in the community and patients' education for disease symptoms, use of eHealth technology, adherence to the antithrombotic and vascular regulating treatments, and (2) close medical follow-up for efficacious control of VD progression and prompt application of physical and social distancing measures in case of new epidemic waves. For patients with VD-CVR who receive home treatment for COVID-19, VAS recommends assessment for (1) disease worsening risk and prioritized hospitalization of those at high risk and (2) VTE risk assessment and thromboprophylaxis with rivaroxaban, betrixaban, or low-molecular-weight heparin (LMWH) for those at high risk. For hospitalized patients with VD-CVR and COVID-19, VAS recommends (1) routine thromboprophylaxis with weight-adjusted intermediate doses of LMWH (unless contraindication); (2) LMWH as the drug of choice over unfractionated heparin or direct oral anticoagulants for the treatment of VTE or hypercoagulability; (3) careful evaluation of the risk for disease worsening and prompt application of targeted antiviral or convalescence treatments; (4) monitoring of D-dimer for optimization of the antithrombotic treatment; and (5) evaluation of the risk of VTE before hospital discharge using the IMPROVE-D-dimer score and prolonged post-discharge thromboprophylaxis with rivaroxaban, betrixaban, or LMWH