PAX Scientific (United States)

This individual participant data meta-analysis aimed to investigate the effectiveness of cognitive behavioral therapy with a trauma focus (CBT-TF) for posttraumatic stress disorder (PTSD). Furthermore, we examined the effect of moderators on PTSD symptom severity. This study included randomized controlled trials comparing CBT-TF to an inactive or active comparison group for adults with PTSD. The primary and secondary outcomes were PTSD symptom severity and remission, respectively. Moderators included sociodemographic and clinical variables. Twelve studies compared CBT-TF with inactive (n = 625) and 11 with active comparison conditions (n = 706). The one-stage individual participant data meta-analysis found that CBT-TF was more effective than inactive comparison conditions (β = -0.78; OR = 2.34) and not significantly different from active comparison conditions (β = 0.02; OR = 0.53) in reducing PTSD symptom severity and achieving PTSD remission, respectively. When comparing CBT-TF with inactive treatments, moderator analysis found that divorced participants had greater PTSD symptoms postintervention following CBT-TF than participants who were single, cohabitating, or married receiving CBT-TF, both in the completer (β = 0.93) and full-sample (β = 0.59) analyses. For the active treatment comparison, moderator analysis found that participants taking psychotropic medication had lower PTSD symptoms following CBT-TF than those not taking psychotropic medication in the completer analysis (β = -0.39). Based on our moderator analyses, further research is needed to understand the effect of psychotropic medication on the CBT-TF intervention process. Moreover, divorced participants with PTSD receiving CBT-TF might benefit from enhanced support. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Most earthquake energy release arises during fault slip many kilometers below the Earth’s surface. Understanding earthquakes and their hazard requires mapping the geometry and distribution of this slip. Such finite-fault maps are typically derived from surface phenomena, such as seismic and geodetic ground motions. Here we introduce an imaging procedure for mapping finite-fault slip directly from seismicity and aftershocks—phenomena occurring at depth around an earthquake rupture. For specified source and receiver faults, we map source-fault slip in 3D by correlation of point-source Coulomb failure stress change (ΔCFS) kernels across the distribution of seismicity around the source. These seismicity-stress maps show relative, static fault slip compatible with the surrounding seismicity given the physics of ΔCFS; they can aid other slip inversions, aftershock forecasting, and study of early instrumental earthquakes and volcanic intrusions. We verify this procedure recovers synthetic fault slip which matches independent estimates of slip for the 2004 Mw 6.0 Parkfield and 2021 Mw 6.0 Antelope Valley California earthquakes. For the 2018 Mw 7.1 Anchorage Alaska intra-slab earthquake, seismicity-stress maps, combined with multi-scale precise hypocenter relocation, resolve the enigma of which mainshock faulting plane ruptured (the gently east-dipping plane), and clarify slab structures activated in the energetic aftershock sequence.

In the evolving landscape of modern healthcare, real-time data integration has emerged as a critical component for delivering optimal patient care while maintaining robust security and regulatory compliance. This comprehensive article explores the implementation strategies, challenges, and outcomes of healthcare data integration systems across diverse clinical settings. The article examines the impact of integrated systems on clinical workflows, patient outcomes, and operational efficiency while addressing the complex requirements of data security and regulatory compliance. Through detailed case studies of large hospital networks and rural healthcare providers, this article demonstrates how strategic implementation of integrated healthcare systems can transform care delivery, enhance patient outcomes, and optimize resource utilization. The findings provide valuable insights for healthcare organizations at various stages of their digital transformation journey, offering evidence-based strategies for successful system implementation and optimization.